Objective: To explore and realize the curative effect and untoward reaction for treating endolymphatic hydrops patients induced by autoimmune inner ear disorders with methylprednisolone or gentamicin locally injected into tympanic cavity.Methods: 62 cases of autoimmune endolymphatic hydrops were diagnosed. They were randomly divided into two groups, 29 cases as methylprednisolone (MP) group and 33 cases as gentamicin (GM) group. One week before and after therapy, the hearing function and vestibular function tests were performed respectively. The silica gel tube was occasionally put into tympanic cavity and fixed at round window niche. MP was injected into tympanic cavity through tubes on alternate days for two weeks. GM was injected on alternate days for 4 times. Next day following injection, the pure tone test was performed, and the injection was stopped immediately if hearing loss aggravating was found. Results: According to criteria for evaluating vertigo-control and hearing function improving, the response rate was respectively 69% in MP group and 64% in GM group. Hydrolabyrinth tests were changed into negative in 52 cases, and the incidence rate of directional preponderance were reduced in two groups and the incidence rate of channel-paralysis was reduced in MP group following therapy.Conclusion: Therapeutic effects of intratympanic methylprednisolone was similar to that of intratympanic gentamicin. Targeting at autoimmune inner ear disorder, not only could methylprednisolone control clinical symptoms, but also restore inner ear physiological function. |
[1] 龚帆,谭长强,BROOKES G B.交感性迷路炎?——临床迟发性膜迷路积水的免疫因素研究[J].东南大学学报:医学版,2002,21:65-68.
[2] 龚帆,谭长强.梅尼埃病的相关免疫因素[J].东南大学学报:医学版,2003,22(3):141-143.
[3] 杨彩虹,徐开旭,周子宁,等.甲强龙鼓室内注射治疗难治性中重度突发性耳聋疗效观察[J].山东医药,2010,50(10):421-422.
[4] 中华医学会耳鼻咽喉科学会,中华耳鼻咽喉科杂志编辑委员会.梅尼埃病诊断依据和疗效分级[J].中华耳鼻咽喉科杂志,1997,32:71.
[5] 中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉科学分会.梅尼埃病的诊断依据和疗效评估(2006年,贵阳)[J].中华耳鼻咽喉头颈外科杂志,2007,42(3):163-163.
[6] 谭长强,BROOKES G B.迟发性膜迷路积水的内耳自身免疫因素研究[J].临床耳鼻咽喉科杂志,2003,17(7):416-418.
[7] 冯红云,孙建军.梅尼埃病的局部治疗方法[J].中华耳鼻咽喉头颈外科杂志,2007,42(3):234-236.
[8] NEDZELSKI J M,SCHESSEL S A,BRYCE G E,et al.Chemical labyrinthecotmy:local application of gentamicin for the treatment of unilateral Meniere’s disease[J].Am J Otol,1992,13:18-22.
[9] 谭长强,BROOKES G B.乙状窦后径路内镜下选择性前庭神经切断术[J].中华耳鼻咽喉科杂志,2003,38(2):111-114.
[10] ROBERTO B,ANDREA C,ALESSANDRO M.Vertigo and autoimmunity[J].Eur Arch Otorhinolaryngol,2010,267:13-19.
[11] 李穗,龚树生.自身免疫性内耳病的药物治疗[J].国外医学:耳鼻咽喉科学分册,2004,28(6):374-276.
[12] LANGE G.The intratympanic greatment of Meniere’s disease with ototoxic antibiotics[J].Laryngol Rhinol Otol(Stuttg),1977,56(5):409-414.
[13] PARNES L S,SUN A H,FREEMAN D J.Corticosteroid pharmacokinetics in the inner ear fluids:an animal study followed by clinical application[J].Laryngoscope,1999,109:1-17.
[14] HERRAIZ C,PLAZA G,APARICIO J M,et al.Tyanstympanic steroids for Meniere’s disease[J].Otol Neurotol,2010,31(1):162-167.
[15] KYRODIMOS E,AIDONIS I,SISMSNIS A,et al.Hearing results following intratympanic gentamicin perfusion for Meniere’s disease[J].Laryngol Otol,2009,123(4):379-382. |