局部类固醇治疗能否改善伴浆液性迷路炎的急性中耳炎结局？一项回顾性分析。
Does local steroid therapy improve outcomes in acute otitis media with serous labyrinthitis? A retrospective analysis.
文献信息
| PMID | 42900206 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | H T Fischer |
| 作者单位 | Universitätsklinik Für Hals, Nasen- Und Ohrenheilkunde, Medizinische Universität Innsbruck, Anichstraße 35, A-6020, Innsbruck, Österreich. |
| 期刊 | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 感音神经性听力损失是急性中耳炎（AOM）一种罕见但具有临床意义的并发症。尽管鼓室内糖皮质激素（GC）治疗已在其他耳蜗前庭疾病中确立，但其在此背景下的疗效仍研究不足。本研究旨在回顾性评估局部鼓室内糖皮质激素应用是否与急性中耳炎相关感音神经性听力损失患者临床结局改善相关。
方法： 对2014年1月至2024年11月期间诊断为AOM相关内耳受累的患者进行回顾性分析。患者按GC治疗方案分层：（1）鼓室内应用糖皮质激素（IC），（2）未鼓室内应用糖皮质激素（NIC）。根据手术引流方式和内耳受累严重程度进行亚组分析。主要终点为骨导纯音平均听阈（BCPTA4）改善。
结果： 共纳入137例患者（IC：44例，NIC：93例）。两组在性别、患侧和主观改善方面无显著差异（均p > 0.08）。两组治疗后均显示显著听力改善（p < 0.001）。尽管在不同严重程度水平上数值趋势有利于NIC组，但两种治疗方式之间BCPTA4改善无统计学显著差异（p = 0.8）；然而，非随机设计和基线组间差异限制了结果解读。在探索性分析中，通气管置入（VT）和CO₂激光鼓膜切开术（LP）与显著听力恢复相关（p < 0.001）。
结论： 两种治疗方案（IC、NIC）均使AOM相关内耳受累患者获得显著听力改善。在此非随机比较中，组间BCPTA4改善未检测到统计学显著差异；然而，选择偏倚、基线不平衡和残余混杂可能掩盖了小的治疗效应。这些发现不构成等效性证据。
英文摘要
PURPOSE: Sensorineural hearing loss represents a rare but clinically relevant complication of acute otitis media (AOM). Although intratympanic glucocorticoid (GC) therapy is established in other cochleovestibular disorders, its efficacy in this context remains insufficiently investigated. The aim of this study was to retrospectively assess whether local intratympanic glucocorticoid application is associated with improved clinical outcomes in patients with acute otitis media-related sensorineural hearing loss.
METHODS: A retrospective analysis was performed on patients diagnosed with AOM-associated inner ear involvement between January 2014 and November 2024. Patients were stratified according to GC treatment regimen: (1) intratympanic application of glucocorticoids (IC), (2) no intratympanic application of glucocorticoids (NIC). Subgroup analyses were performed according to the surgical drainage method and severity of inner ear involvement. Primary endpoint was improvement in bone-conduction pure-tone average (BCPTA4).
RESULTS: A total of 137 patients were included (IC: 44, NIC: 93). Sex, affected side and subjective improvement did not differ significantly between both groups (all p > 0.08). Both groups demonstrated significant hearing improvement following treatment (p < 0.001). Although numerical trends favored the NIC group across different severity levels, no statistically significant differences in BCPTA4 improvement were observed between treatment modalities (p = 0.8); however, the non-randomized design and baseline group differences limit interpretation. In exploratory analyses, Ventilation Tube Insertion (VT) and CO₂-laser myringotomy (LP) were associated with significant hearing recovery (p < 0.001).
CONCLUSIONS: Both treatment regimens (IC, NIC) led to significant hearing improvement in AOM-associated inner ear involvement. In this non-randomized comparison, no statistically significant difference in BCPTA4 improvement was detected between groups; however, selection bias, baseline imbalances and residual confounding may have obscured small treatment effects. These findings do not constitute evidence of equivalence.