[Intratympanic dexamethasone vesus post-auricular subperiosteal injection of methylprednisolone treatment for sudden hearing loss].

Objective: To compare the efficacy and side effect between intratympanic dexamethasone and subperiosteal injection of methylprednisolone treatment for sudden hearing loss. Method: One hundred and eight unilateral sudden hearing loss patients were enrolled in this study, randomly divided into A group, which was accepted intratympanic dexamethasone (10 mg/ml) , and B group, which was accepted post-auricular subperiosteal injection of methylprednisolone (40 mg/ml) by every 3 days intotal 5 times. After 3 months follow-up, analysis of the differences of pure tone threshold, tinnitus handicap inventory (THI), dizziness handicap inventory (DHI), blood glucose between pretreatment and postreatment was made. Side effect such as perforation of tympanic membrane, infection of post-auricular skin was also observed. Result: ①Both in A and B group, there was no statistical changes in total efficiency and pure tone threshold decrease ( P > 0.05), whereas the pure tone threshold statistical change was observed in the low frequency sudden deafness between A and B group ( P < 0.05). ②Both in A and B group, there was no statistical changes in THI ( P > 0.05), whereas the THI statistical decrease was observed in the high frequency sudden deafness between A and B group ( P < 0.05). ③There was no statistical change in THI both in A and B group ( P > 0.05). ④Both in A and B group, there was no statistical changes in fasting plasma glucose between pretreatment and postreatment ( P > 0.05). ⑤There was no patient who had gotten tympanitis or postauricular infection, although in A group, there were 2 patients had gotten perforation of tympanic membrane, but they all healed after the follow-up. Conclusion: Both topical injection of glucocorticoid can improve pure tone threshold and reduce the score of THI and DHI for sudden hearing loss patients. Intratympanic dexamethasone can reduce more score of THI for high frequency sudden deafness patients whereas subperiosteal injection of methylprednisolone can improve pure tone threshold more for low frequency sudden deafness patients. None of the two administrations elevate blood glucose, but intratympanic dexamethasone have the risk of perforation of tympanic membrane.