Comparison between postauricular steroid injection and intratympanic steroid perfusion for refractory severe and profound sudden sensorineural hearing loss.

BACKGROUND: To analyze the clinical efficacy of intratympanic steroid perfusion (ISP) and postauricular steroid injection (PSI) for refractory severe and profound sudden sensorineural hearing loss (SSNHL). METHODS: SSNHL patients who failed a conventional treatment with severe to profound hearing loss [pure tone average (PTA, 0.25-8 kHz) > 60 dB] were treated with ISP or PSI plus antioxidant and neurotrophin for 10 consecutive days. Antioxidant and neurotrophin were administrated either intravenously and/or orally. All patients were assigned into the ISP group or the PSI group and followed up for more than three months. The changes in PTA, effective rate and side effects were analyzed in the two groups. RESULTS: Similar hearing improvements and effective rates were observed in the two groups. However, a slightly better efficacy was observed in the PSI group compared to the ISP group. Patients with shorter intervals from onset to treatment had significantly more hearing improvements. The route of antioxidant and neurotrophin administration had no impact on treatment effects. CONCLUSION: Both ISP and PSI could be used as salvage treatments for refractory SSNHL. These salvage treatments should be started as soon as possible once SSNHL patients fail a conventional treatment.

[Clinal analysis of 202 nasal bone fractures cases].

OBJECTIVE: To evaluate the age, sex, etiology, diagnosis and treatment time of nasal bone fractures. METHOD: Clinical data of 202 cases with nasal bone fractures treated in the hospital were retrospectively analysed. RESULT: A total of 202 cases,163 men (80. 7%) and 39 women (19. 3%). Fifty-two patients had a relationship with alcohol consumption, and all of them were males. The most frequent reasons of the injury were fight 46. 5% (94 cases) followed by falling-down 21. 3% (43 cases), traffic accidents 19. 3% (39 cases), works related 6. 5% (13 cases), sport injuries 5. 9% (12 cases) and others 0. 5% (1 cases). Patients distribution in seasons were: spring 54 cases (26.7%), summer 42 cases (20.8%), autumn 58 cases (28.7%), winter 48 cases (23. 8%). Diagnosis of nasal bone fractures were made positively by x-ray films in 79. 7% of cases, but 100% by CT. Positive predictive value of CT was superior to that of X-ray films in the diagnosis of nasal bone fracture. CONCLUSION: High morbidity of nasal bone fracture was seen in the age group of 20-29 years, and predominantly in male. Fight was found to be the main etiologic factor. We think that CT is necessary for diagnosing nasal bone fracture.