Effect of intratympanic injection of dexamethasone in the treatment of middle-aged and elderly patients with sudden deafness

Objective To compare the efficacy and safety of intravenous infusion and intratympanic injection of dexamethasone in the treatment of sudden deafness (SD) in middle-aged and elderly patients.

Methods A total of 115 middle-aged and elderly SD patients in the hospital from July 2018 to November 2023 were randomly divided into group A (n=57) and group B (n=58). Group A received intravenous infusion of dexamethasone, while group B received intratympanic injection of dexamethasone. The symptom improvement time (tinnitus disappearance time, vomiting disappearance time, vertigo disappearance time, and hearing recovery time), hearing thresholds (high and low frequencies), sleep qualitythe Pittsburgh Sleep Quality Index (PSQI), vascular endothelial function nitric oxide (NO), lipid peroxide (LPO) and superoxide dismutase (SOD), clinical efficacy, and adverse reactions (transient vertigo, mild ear pain, rash) were compared between the two groups.

Results The tinnitus disappearance time, vomiting disappearance time, vertigo disappearance time, and hearing recovery time in group B were significantly shorter than those in group A (P < 0.05). The hearing thresholds at high and low frequencies after treatment in both groups were significantly lower than those before treatment, and the hearing thresholds in group B were significantly lower than those in group A after treatment (P < 0.05). The PSQI scores after treatment in both groups were significantly lower than those before treatment, and the PSQI score in group B was significantly lower than that in group A after treatment (P < 0.05). After treatment, NO and SOD in group B were significantly higher than those in group A, while LPO was significantly lower than that in group A (P < 0.05). The total effective rate in the group B was 93.10%, which was significantly higher than 78.95% in the group A (P < 0.05). The incidence of adverse reactions was 12.07% in group B and 10.53% in group A, with no significant between-group difference (P>0.05).

Conclusion Intratympanic injection of dexamethasone is more effective than intravenous infusion in the treatment of SD in middle-aged and elderly patients, with faster symptom relief, improved hearing thresholds, better sleep quality, and endothelial function, without increasing adverse reactions, demonstrating high efficacy and safety.