突発性難聴に対する鼓室内注入併用

We examined the effect of combined therapy（CT）with intratympanic and systemic steroids for idiopathic sudden sensorineural hearing loss（SSNHL）as compared to systemic steroid therapy alone（SST）. The hearing outcome was assessed according to the criteria used in the Ministry of Health, Labour and Welfare of Japan Study. A total of 31 patients received CT and 48 patients received SST. There were no statistically significant differences in the background characteristics between the two groups. The rates of complete recovery, significant improvement, slight improvement, and no change in the CT group were 55%, 23%, 6%, and 16%, respectively, while the corresponding rates in the SST group were 42%, 10%, 21%, and 27%. The recovery rate, which was defined as the sum of the rate of complete recovery and rate of significant improvement, was significantly higher in the CT group（p＝0.024）than in the SST group. Multivariate logistic analysis identified CT as the only significant factor influencing the recovery rate（p＝0.044）. The mean hearing improvement was significantly better in the CT group（27.7 dB）than in the SST group（18.3 dB）（p＝0.017）. When comparing the hearing improvement for different frequencies, hearing improvement in the CT group was significantly better at 250 Hz, 500 Hz, and 4,000 Hz. In regard to adverse events, delayed perforation of the tympanic membrane occurred in 1 case in the CT group. In conclusion, our results indicated that CT is more effective than SST for the treatment of SSNHL.