Медицинский совет (May 2020)
Alternative methods of delivering steroids to the middle ear in treatment of sudden sensorineural hearing loss
Abstract
Introduction. Sudden sensorineural hearing loss is the most common pathology of polyethological sound perception. Systemic glucocorticosteroid therapy has long been considered the main treatment method. In recent years, topical therapy has been of great interest. However, intratympanic injections cause considerable discomfort to the patient and require about 1 hour per day to perform the procedure.Materials. In order to modernize and reduce the time spent on delivering steroids into tympanic cavity, this article considers the experience of managing 41 patients with sudden unilateral sensorineural hearing loss. Patients of the first group received dexamethasone 4 mg / ml in a volume of 1 ml by catheterization of the auditory tube, followed by introduction into the tympanic cavity. Patients of the second group were divided into 2 subgroups: in the first subgroup, dexamethasone 4 mg / ml in a volume of 0.5 ml was administered into tympanic cavity through a pre-imposed hole in the eardrum using a radio-wave device, and patients of the second subgroup received a classic intratympanic injection of dexamethasone 4mg / ml 0.5 ml after application anesthesia of the eardrum. The audiometry was performed before treatment, after 1, 2 weeks, 1 and 6 months.Results. The average time spent in the clinic of patients of the first group was 30 minutes, while patients of the first subgroup of the second group had 20 minutes a day. The longest time in the clinic was 2 subgroup of patients from 2 groups-about 1 hour.Conclusions. Radio-wave myringotomy is the safest and most convenient method. The smallest amount of time spent on the patient was observed in the subgroup of intratympanic injections that performed radio-wave miringotomy. It has been proved that the methods of topical treatment are not inferior in efficiency to each other.
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