【摘要】 [背景]观察经颞颌关节径路注射甲泼尼龙琥珀酸钠治疗突发性耳聋的疗效.[病例报告]选择2017年11月—2020年1月间接受住院治疗的突发性耳聋患者264例分为对照组和观察组，其中对照组155例(低频下降型33例、高频下降型42例、平坦下降型46例、全聋型34例),观察组109例(低频下降型28例、高频下降型27例、平坦下降型25例、全聋型29例),根据突发性耳聋诊断和治疗指南(2015)给所有患者行规范化治疗，观察组和对照组分别行经颞颌关节径路及经耳后骨膜下注射给予2%(体积分数)利多卡因2 mL加甲泼尼龙琥珀酸钠40 mg治疗，每2 d注射1次，比较每个分型两组疗效.结果显示，低频下降型观察组与对照组治疗有效率分别为92.86%、87.88%,相比较差异无统计学意义(P>0.05);高频下降型观察组与对照组治疗有效率分别为88.89%、69.05%,两组间差异有统计学意义(P<0.01);平坦下降型观察组与对照组治疗有效率分别为88.00%、65.22%,两组间差异有统计学意义(P<0.01);全聋型观察组与对照组治疗有效率分别为89.66%、67.65%,两组间差异有统计学意义(P<0.01).[讨论]经颞颌关节径路注射甲泼尼龙琥珀酸钠治疗突发性耳聋疗效较好，除低频下降型外其他分型疗效均明显优于经耳后骨膜下径路注射给药.更多还原

【Abstract】 BACKGROUND To observe the therapeutic effect of methylprednisolone sodium succinate injection through temporomandibular joint pathway on sudden deafness. CASE REPORTS A total of 264 patients with sudden deafness who were hospitalized from November 2017 to January 2020 were selected and divided into control group and observation group. There were 155 cases in the control group(33 cases of low-frequency descending type, 42 cases of high-frequency descending type, 46 cases of flat descending type, 34 cases of total deafness type) and 109 cases in the observation group(28 cases of low-frequency descending type, 27 cases of high-frequency descending type, 25 cases of flat descending type, 29 cases of total deafness type). All patients were given standardized treatment according to the guidelines for diagnosis and treatment of sudden deafness(2015). The observation group and the control group were treated with 2 mL of 2%(volume fraction) lidocaine plus 40 mg of methylprednisolone sodium succinate via the temporomandibular joint pathway and retroauricular subperiosteal injection, respectively, once every 2 days. The efficacy of each subtype was compared between the two groups. The results showed that the efficacy of low-frequency descending type in the observation group and the control group was 92.86% and 87.88%, respectively, and the difference was not statistically significant(P>0.05). The efficacy of high-frequency descending type in the observation group and the control group was 88.89% and 69.05%, respectively, and the difference was statistically significant(P<0.01). The efficacy of flat decending type in the observation group and the control group was 88.00% and 65.22%, respectively, and the difference was statistically significant(P<0.01). The efficacy of total deafness in the observation group and the control group was 89.66% and 67.65%, respectively, and the difference was statistically significant(P<0.01). DISCUSSION Injection of methylprednisolone sodium succinate through temporomandibular joint pathway has better efficacy in the treatment of sudden deafness, except for the low-frequency descending type, the efficacy of other types was significantly better than that of retroauricular subperiosteal injection.更多还原