Article record

经圆窗膜内镜单次给药皮质类固醇治疗重度至全聋型突发性聋挽救治疗的疗效：一项前瞻性队列研究

Efficacy of endoscopic single-session corticosteroid delivery via round window membrane for severe to complete sudden deafness salvage: a prospective cohort study.

临床研究耳科IF 1.3Q3

文献信息

PMID	42985769
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Siyu Li 查看其他 10 位作者 Dingding Liu；Yuqin Xu；Hao Wu；Guangjie Zhu；Han Zhou；Junru Yan；Maoli Duan；Xiaoyun Qian；Ao Li；Xia Gao
作者单位	Department of Otolaryngology Head and Neck Surgery, Jiangsu Provincial Key Medical Discipline (Laboratory), Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China. 查看其他 5 条单位信息 Department of Otolaryngology Head and Neck Surgery, Nanjing Drum Tower Hospital, Drum Tower Clinical College of Nanjing University of Chinese Medicine, Nanjing, China.；Department of Otolaryngology Head and Neck Surgery, Nanjing Drum Tower Hospital, Drum Tower Clinical College of Nanjing Medical University, Nanjing, China.；Department of Anesthesiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.；Department of Otolaryngology Head and Neck Surgery and Audiology and Neurotology, Karolinska University Hospital, Stockholm, Sweden.；Department of Clinical Science Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
期刊	Acta oto-laryngologica
SCI 分区	Q3
IF	1.3
研究类型	临床研究 · 临床
所属专科	耳科

中文摘要

背景： 突发性感音神经性听力损失（SSNHL）对全身性皮质类固醇治疗无反应时，常需挽救治疗。
目的： 我们介绍一种新的内镜辅助手术方法，通过圆窗膜实现精准的单次内耳给药，以治疗难治性SSNHL。
材料与方法： 患者接受手术，经圆窗膜局部给予甲泼尼龙。随访期间评估听力检查、CT扫描以及耳鸣和眩晕的严重程度。
结果： 共纳入56例重度至全聋型SSNHL患者，总体有效率达55.4%。平均纯音平均（PTA）阈值在3个月后从91.61±11.37 dB改善至76.79±19.52 dB（p<0.0001）。其中，极重度及全聋患者表现出显著恢复，平均PTA分别降低18.13±18.51 dB（p=0.0001）和13.87±10.20（p<0.0001）。及时干预也至关重要，ROC分析得出的13天截断值代表了挽救治疗的关键治疗窗口。治疗后耳鸣和眩晕症状显著改善（p<0.0001）。未观察到治疗相关不良事件。
结论与意义： 该方法为难治性重度至全聋型SSNHL的挽救治疗提供了一种新的、有前景的范式。

英文摘要

BACKGROUND: Sudden sensorineural hearing loss (SSNHL) often necessitates salvage therapy when unresponsive to systemic corticosteroids.
AIMS/OBJECTIVES: We introduce a novel endoscopic-assisted surgical approach for precise, single-session inner ear drug delivery via the round window membrane to treat refractory SSNHL.
MATERIAL AND METHODS: Patients underwent surgery for local administration of methylprednisolone through the round window membrane. And audiometry, CT scans and the severity of tinnitus and dizziness were evaluated during the follow-up period.
RESULTS: 56 patients with severe-to-complete SSNHL were recruited, and the overall efficacy reached 55.4%. Mean Pure-Tone Average (PTA) threshold improved from 91.61 ± 11.37 dB to 76.79 ± 19.52 dB after 3 months (p < 0.0001). Among which, patients with profound and complete hearing loss exhibited substantial recovery, with average PTA reduction of 18.13 ± 18.51 dB (p = 0.0001) and 13.87 ± 10.20 (p < 0.0001), separatively. Timely intervention was also critical, the 13-day cutoff derived from ROC analysis represents a critical therapeutic window for salvage. Tinnitus and vertigo symptoms significantly improved after treatment (p < 0.0001). No treatment-related adverse events were observed.
CONCLUSIONS AND SIGNIFICANCE: This approach provides a new, promising paradigm for the salvage treatment of refractory severe-to-complete SSNHL.