Comparison of the efficacy and safety of postauricular and intratympanic dexamethasone injection in the treatment of sudden sensorineural hearing loss with all frequency loss
- VernacularTitle: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
- Author:
Huidi PAN
1
;
Qingfu BAO
1
;
Changyang WANG
1
Author Information
1. Dept. of Otolaryngology，Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Zhejiang University of Chinese Medicine （Hangzhou Red Cross Hospital），Hangzhou 310005，China
- Publication Type:Journal Article
- Keywords:
sudden sensorineural hearing loss with all frequency loss;
dexamethasone;
postauricular injection;
intratympanic
- From:
China Pharmacy
2026;37(5):639-644
- CountryChina
- Language:Chinese
-
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， n ＝78） and the postauricular group （postauricular injection， n ＝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 （ P ＜0.05）， whereas no statistically significant differences were observed between the two groups （ P ＞0.05）. Therapeutic outcomes varied significantly across different degrees of hearing loss in each group （intratympanic group： P ＝0.005； postauricular group： P ＜0.001）. Moreover， a significant linear trend relationship was observed between the degree of hearing loss and treatment efficacy grades （ P ＜0.001）， indicating that the more severe the hearing loss， the poorer the treatment outcome （ P ＜0.05）. Notably， the intratympanic group demonstrated superior efficacy compared with the postauricular group in patients with severe and profound hearing loss （ P ＜0.05）. Among patients presenting with vertigo prior to treatment， the postauricular group exhibited a significantly higher response rate than the intratympanic group （ P ＜0.05）， while no statistically significant difference was observed between the two groups in patients with tinnitus （ P ＞0.05）. Regarding coagulation parameters， fibrinogen （FIB） levels and activated partial thromboplastin time decreased or shortened significantly follo wing therapy （ P ＜0.05）， whereas thrombin time （TT） and prothrombin time were significantly prolonged （ P ＜0.05）. Moreover， the postauricular group showed lower FIB levels and longer TT values compared with the intratympanic group （ P ＜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 （ P ＞0.05）； however， vestibular adverse reactions occurred more frequently in the intratympanic group （ P ＜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.
