Comparison of the efficacy and safety of postauricular and intratympanic dexamethasone injection in the treatment of sudden sensorineural hearing loss with all frequency loss

PAN Huidi; BAO Qingfu; WANG Changyang

doi:10.6039/j.issn.1001-0408.2026.05.15

您当前的位置：

首页 >

文章列表页 >

Comparison of the efficacy and safety of postauricular and intratympanic dexamethasone injection in the treatment of sudden sensorineural hearing loss with all frequency loss

更新时间：2026-03-10

- Comparison of the efficacy and safety of postauricular and intratympanic dexamethasone injection in the treatment of sudden sensorineural hearing loss with all frequency loss
- ZHONGGUO YAOFANG Vol. 37, Issue 5, Pages: 639-644(2026)
- 作者机构：
  
  浙江中医药大学附属中西医结合医院（杭州市红十字会医院）耳鼻咽喉科，杭州　310005
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2026.05.15
  CLC： R969.4;R764.43
- Received：13 October 2025，
  
  Revised：2026-02-24，
  
  Accepted：24 February 2026，
  
  Published：15 March 2026
- 稿件说明：
移动端阅览
潘惠娣,宝庆付,王昌阳.耳后与鼓室内注射地塞米松治疗全频下降型突发性聋的疗效与安全性比较 ^Δ[J].中国药房,2026,37(05):639-644.

PAN Huidi,BAO Qingfu,WANG Changyang.Comparison of the efficacy and safety of postauricular and intratympanic dexamethasone injection in the treatment of sudden sensorineural hearing loss with all frequency loss[J].ZHONGGUO YAOFANG,2026,37(05):639-644.
潘惠娣,宝庆付,王昌阳.耳后与鼓室内注射地塞米松治疗全频下降型突发性聋的疗效与安全性比较 ^Δ[J].中国药房,2026,37(05):639-644. DOI： 10.6039/j.issn.1001-0408.2026.05.15.

PAN Huidi,BAO Qingfu,WANG Changyang.Comparison of the efficacy and safety of postauricular and intratympanic dexamethasone injection in the treatment of sudden sensorineural hearing loss with all frequency loss[J].ZHONGGUO YAOFANG,2026,37(05):639-644. DOI： 10.6039/j.issn.1001-0408.2026.05.15.

摘要

目的

对比分析耳后与鼓室内注射地塞米松联合常规治疗方案治疗全频下降型突发性聋的临床疗效与安全性。

方法

回顾性选取2020年6月1日至2025年5月31日于浙江中医药大学附属中西医结合医院就诊的全频下降型突发性聋患者150例为研究对象，按照其地塞米松的不同注射方式分为鼓室组（鼓室内注射，

＝78）与耳后组（耳后注射，

＝72）。对比两组患者治疗前后听阈指标及听力疗效、耳鸣/眩晕指标、治疗前后凝血功能指标，以及治疗期间不良反应的差异。

结果

治疗后，两组患者的平均言语听阈及平均听阈均较治疗前显著下降（

＜0.05），但组间比较差异无统计学意义（

＞0.05）。两组中不同听力损失程度患者的疗效均存在差异（鼓室组

＝0.005，耳后组

＜0.001），且听力损失程度与疗效等级均呈显著线性趋势关系（

＜0.001），表现为听力损失越重，疗效越差；其中鼓室组在重度和极重度听力损失患者中的疗效优于耳后组（

＜0.05）。在治疗前合并眩晕患者中，耳后组的有效率显著高于鼓室组（

＜0.05），而合并耳鸣患者中的两组差异无统计学意义（

＞0.05）。两组患者的纤维蛋白原（FIB）、活化部分凝血活酶时间均较治疗前显著降低或缩短（

＜0.05），凝血酶时间（TT）、凝血酶原时间均较治疗前显著延长（

＜0.05），且耳后组患者的FIB显著低于鼓室组、TT显著长于鼓室组（

＜0.05）。两组患者的消化道反应、出血征象、肝肾功能异常、过敏反应等不良反应发生率比较，差异均无统计学意义（

＞0.05），但鼓室组患者的前庭症状发生率显著高于耳后组（

＜0.05）。

结论

与鼓室内注射比较，耳后注射地塞米松联合常规治疗方案治疗全频下降型突发性聋在总体听力改善方面疗效相当，但后者在改善眩晕症状、提升不同听力损失程度患者应答、调节凝血功能和减少前庭不良反应方面存在一定优势，而前者可能更适合听力损失程度较重的患者。

Abstract

OBJECTIVE

To compare and analyze the clinical efficacy and safety of postauricular versus intratympanic dexamethasone injection in the treatment of sudden sensorineural hearing loss （SSNHL） with all frequency loss.

METHODS

A retrospective study was conducted on 150 patients with SSNHL with all frequency loss who were treated at the Hospital of Integrated Traditional Chinese

and Western Medicine Affiliated to Zhejiang University of Chinese Medicine between June 1， 2020， and May 31， 2025. According to different injection routes， the patients were divided into the intratympanic group （intratympanic injection，

＝78） and the postauricular group （postauricular injection，

＝72）. The differences in hearing threshold indicators and auditory outcomes before and after treatment， tinnitus/vertigo indicators， coagulation function indicators before and after treatment， as well as adverse reactions during treatment were compared between the two groups.

RESULTS

After treatment， both groups demonstrated significant reductions in the mean speech-frequency threshold and the mean hearing threshold compared with baseline （

＜0.05）， whereas no statistically significant differences were observed between the two groups （

＞0.05）. Therapeutic outcomes varied significantly across different degrees of hearing loss in each group （intratympanic group：

＝0.005； postauricular group：

＜0.001）. Moreover， a significant linear trend relationship was observed between the degree of hearing loss and treatment efficacy grades （

＜0.001）， indicating that the more severe the hearing loss， the poorer the treatment outcome （

＜0.05）. Notably， the intratympanic group demonstrated superior efficacy compared with the postauricular group in patients with severe and profound hearing loss （

＜0.05）. Among patients presenting with vertigo prior to treatment， the postauricular group exhibited a significantly higher response rate than the intratympanic group （

＜0.05）， while no statistically significant difference was observed between the two groups in patients with tinnitus （

＞0.05）. Regarding coagulation parameters， fibrinogen （FIB） levels and activated partial thromboplastin time decreased or shortened significantly follo

wing therapy （

＜0.05）， whereas thrombin time （TT） and prothrombin time were significantly prolonged （

＜0.05）. Moreover， the postauricular group showed lower FIB levels and longer TT values compared with the intratympanic group （

＜0.05）. No significant differences were identified between the two groups in the incidence of gastrointestinal reactions， bleeding manifestations， hepatic or renal dysfunction， or allergic reactions （

＞0.05）； however， vestibular adverse reactions occurred more frequently in the intratympanic group （

＜0.05）.

CONCLUSIONS

Compared with intratympanic injection， postauricular dexamethasone injection combined with conventional treatment regimens achieved comparable efficacy in overall hearing improvement in SSNHL patients with all frequency loss. However， the postauricular injection shows potential advantages in vertigo relief， enhancing treatment response in patients with varying degrees of hearing loss， regulating of coagulation function， and declucing of vestibular adverse reactions， while the intratympanic injection may be more suitable for patients with severe hearing loss.

关键词

Keywords

references

PRINCE A D P ， STUCKEN E Z . Sudden sensorineural hearing loss：a diagnostic and therapeutic emergency [J ] . J Am Board Fam Med ， 2021 ， 34 （ 1 ）： 216 - 223 .

马肃威，王大勇，王秋菊 . 突发性聋程度分级与疗效研究进展 [J ] . 中华耳科学杂志， 2025 ， 23 （ 5 ）： 677 - 682 .

YOUNG Y H . Contemporary review of the causes and differential diagnosis of sudden sensorineural hearing loss [J ] . Int J Audiol ， 2020 ， 59 （ 4 ）： 243 - 253 .

LIN C Y ， CHANG C H ， CHANG C J ， et al . Salvage therapy for refractory sudden sensorineural hearing loss （RSSNHL）：a systematic review and network meta-analysis [J ] . Int J Audiol ， 2025 ， 64 （ 1 ）： 1 - 10 .

MIRSALEHI M ， GHAJARZADEH M ， FARHADI M ， et al . Intratympanic corticosteroid injection as a first-line treatment of the patients with idiopathic sudden sensorineural hearing loss compared to systemic steroid：a systematic review and meta-analysis [J ] . Am J Otolaryngol ， 2022 ， 43 （ 5 ）： 103505 .

JOSHUA T G ， AYUB A ， WIJESINGHE P ， et al . Hyperbaric oxygen therapy for patients with sudden sensorineural hearing loss：a systematic review and meta-analysis [J ] . JAMA Otolaryngol Head Neck Surg ， 2022 ， 148 （ 1 ）： 5 - 11 .

ZHANG D ， LI D B ， CHEN T ， et al . Intratympanic lidocaine as a potent remedy for tinnitus in sudden sensorineural hearing loss：a double-blind，randomized clinical trial [J ] . Otol Neurotol ， 2024 ， 45 （ 8 ）： 849 - 854 .

TSUZUKI N ， WASANO K . Idiopathic sudden sensorineural hearing loss：a review focused on the contribution of vascular pathologies [J ] . Auris Nasus Larynx ， 2024 ， 51 （ 4 ）： 747 - 754 .

KITOH R ， NISHIO S Y ， SATO H ， et al . Clinical practice guidelines for the diagnosis and management of acute sensorineural hearing loss [J ] . Auris Nasus Larynx ， 2024 ， 51 （ 4 ）： 811 - 821 .

CHEW S C ， MD DAUD M K . The efficacy of intratympanic steroid injection for the treatment of idiopathic sudden sensorineural hearing loss [J ] . Med J Malaysia ， 2020 ， 75 （ 1 ）： 74 - 77 .

CHRYSOULI K ， KOLLIA P ， PAPANIKOLAOU V ， et al . The effectiveness of intratympanic steroid injection in addition to systemic corticosteroids in the treatment of idiopathic sudden sensorineural hearing loss [J ] . Am J Otolaryngol ， 2023 ， 44 （ 4 ）： 103872 .

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头颈外科学分会 . 突发性聋诊断和治疗指南：2015 [J ] . 中华耳鼻咽喉头颈外科杂志， 2015 ， 50 （ 6 ）： 443 - 447 .

CHADHA S ， KAMENOV K ， CIEZA A . The world report on hearing，2021 [J ] . Bull World Health Organ ， 2021 ， 99 （ 4 ）： 242-242A .

王倩滢，雷艳，潘小燕，等 . 突发性耳聋耳鸣与特发性耳鸣的临床特征比较 [J ] . 中华耳科学杂志， 2024 ， 22 （ 3 ）： 367 - 371 .

王崇，王建明，杨威，等 . 眩晕残障程度评定量表在良性阵发性位置性眩晕患者中的应用 [J ] . 中华全科医师杂志， 2016 ， 15 （ 7 ）： 550 - 552 .

LEE H A ， CHUNG J H . Contemporary review of idiopathic sudden sensorineural hearing loss：management and prognosis [J ] . J Audiol Otol ， 2024 ， 28 （ 1 ）： 10 - 17 .

PAPADOPOULOU A M ， PAPOULIAKOS S ， KARKOS P ， et al . The impact of cardiovascular risk factors on the incidence，severity，and prognosis of sudden sensorineural hearing loss （SSHL）：a systematic review [J ] . Cureus ， 2024 ， 16 （ 4 ）： e58377 .

LAN D ， JIAO B L ， SONG S Y ， et al . Effects of batroxobin on the antithrombotic system in patients with cerebral venous thrombosis：clues to mechanisms [J ] . CNS Neurosci Ther ， 2024 ， 30 （ 8 ）： e14861 .

CHEN A P ， LIU W W ， XU L ， et al . Comparison of the pathway to the inner ear between postauricular and intramuscular injection of dexamethasone in guinea pigs [J ] . Front Neurol ， 2022 ， 13 ： 811626 .

CHEN J ， FRASER-KIRK K . Management of sudden sensorineural hearing loss：a time-critical diagnosis [J ] . Aust J Gen Pract ， 2024 ， 53 （ Suppl.11 ）： S14 - S18 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Comparison of clinical efficacy of evolocumab and probucol after PCI in patients with ultra-high-risk atherosclerotic cardiovascular disease

Meta-analysis of efficacy and safety of intranasal corticosteroids combined with oral H₁-antihistamine in the treatment of allergic rhinitis

The effects of evolocumab combined with atorvastatin on post-PCI efficacy and coronary microcirculation in patients with acute ST-segment elevation myocardial infarction

Clinical observation of Shouhui tongbian capsule combined with linaclotide in the treatment of constipation-predominant irritable bowel syndrome

Efficacy and safety comparison of dupilumab versus thalidomide in the treatment of refractory prurigo nodularis in adults

Related Author

YUAN Yi

LI Na

SUN Haiying

SUN Jing

MA Yongqiang

WU Yan

YANG Guohong

LIU Junxiang

Related Institution

Dept. of Cardiology and Critical Care Medicine， Special Medical Center of the Chinese People’s Armed Police Force

Institute for Cardiovascular Disease Prevention and Control in High-Altitude and Cold Environments，Special Medical Center of the Chinese People’s Armed Police Force

Dept. of Otorhinolaryngology-Head and Neck Surgery， Chongqing University Fuling Hospital

Special Needs Ward， the First Affiliated Hospital of Nanyang Medical College

Cardiovascular Medicine Ward 2， Nanyang Central Hospital

⁰