CAJ | 학술논문

　　目的了解鼓室内注射地塞米松对难治性自身免疫性感音神经性聋的疗效。方法对已经确诊为自身免疫性感音神经性聋的病例32例，在全身应用大剂量糖皮质激素后，听力无明显改善的病例15例，药物减量后听力再次出现反复的病例17例，予鼓室内注射地塞米松约3mg，每日一次，注射7天后，复查听力，听力无好转，再注射7天，随诊6个月，并监测听力变化，比较注射前与注射后14天、3个月、6个月（500、1K、2K、4KHz）气导纯音听阈的平均阈值和听性脑干电反应的波V反应阈。结果32例自身免疫性感音神经性聋患者，鼓室注射治疗前平均听阈为64.92±25.36dBHL，听性脑干电反应波V平均反应阈为69.88±18.27dBnHL。治疗结束后平均听阈为46.58±29.32dBHL，波V平均反应阈为51.36±20.12dBnHL，经配对t检验，差异有统计学意义（P＜0.05）。结论鼓室内注射地塞米松治疗自身免疫性感音神经性聋安全、有效，可用于对自身免疫性感音神经性聋的辅助治疗。
　　목적료해고실내주사지새미송대난치성자신면역성감음신경성롱적료효。방법대이경학진위자신면역성감음신경성롱적병례32례，재전신응용대제량당피질격소후，은력무명현개선적병례15례，약물감량후은력재차출현반복적병례17례，여고실내주사지새미송약3mg，매일일차，주사7천후，복사은력，은력무호전，재주사7천，수진6개월，병감측은력변화，비교주사전여주사후14천、3개월、6개월（500、1K、2K、4KHz）기도순음은역적평균역치화은성뇌간전반응적파V반응역。결과32례자신면역성감음신경성롱환자，고실주사치료전평균은역위64.92±25.36dBHL，은성뇌간전반응파V평균반응역위69.88±18.27dBnHL。치료결속후평균은역위46.58±29.32dBHL，파V평균반응역위51.36±20.12dBnHL，경배대t검험，차이유통계학의의（P＜0.05）。결론고실내주사지새미송치료자신면역성감음신경성롱안전、유효，가용우대자신면역성감음신경성롱적보조치료。
Objective To investigate the effect of intratympanic dexamethasone injection on autotimmune sensorineu-ral hearing loss which is difficult to treat. Method Intratympanic injection of dexamethasone (3 mg qd for 7 days) was admin-istered in 32 cases of autotimmune sensorineural hearing loss, of which 15 showed no significant hearing improvement after systemic glucocorticoid treatment and 17 showed hearing declination after glucocorticoid taper. If no hearing improvement af-ter 7 days, the treatment was repeated for another 7 days. At 6 months follow-up, hearing and ABR results were recorded and compared to before the injection. Results Average hearing threshold and mean wave V threshold were 64.92±25.36 dB HL and 69.88±18.27 dB nHL, respectively, before intratympanic in the 32 patients, and 46.58±29.32 dB HL and 51.36±20.12 dB nHL respectively after intratympanic injection (P<0.05). Conclusion Intratympanic injection of dexamethasone is a safe and effective adjuvant treatment in the management of autotimmune sensorineural hearing loss.