Postauricular Injection Research Articles

Uptake of gadolinium and dexamethasone in rat inner ear and facial nerve using different administrations

Background The pathway by which drugs are injected subcutaneously behind the ear to act on the inner ear has not been fully elucidated. Objectives To compare the uptake of gadopentetate dimeglumine (Gd-DTPA) and dexamethasone (Dex) in the cochlea and facial nerve of rats following different administrations. Materials and methods Magnetic resonance imaging was applied to observe the distribution of Gd-DTPA in the facial nerve and inner ear. We observed the uptake of Dex after it was injected with different methods. Results Images of the intravenous (IV) and intramuscular (IM) groups showed that the bilateral cochlea of the rat was visualized almost simultaneously. While in the left post-auricular (PA) injection group, it was asynchronous. The maximum accumulation (C max) of the Gd in the left facial nerve of the PA group (35.406 ± 5.32) was substantially higher than that of the IV group (16.765 ± 3.7542) (p < .01). Conclusions Compared with systemic administration, PA has the advantages of long Gd and Dex action time and high accumulation concentration to treat facial nerve diseases. Significance The distribution of Gd and Dex in the inner ear and facial nerve of rats following PA injection might be unique.

The auditory function in migraine model rats induced by postauricular nitroglycerin injection.

The mechanism by which migraines produce inner ear-related symptoms is not well understood. Previous studies have found that the latency of auditory brainstem response (ABR) in animal models of migraine has changed, but the threshold has not changed significantly. Therefore, it is necessary to establish a better animal model with both migraine and hearing loss to explore the relationship between migraine and auditory function deeply. In this study, the rat model of migraine was induced by postauricular injection of nitroglycerin (NTG), and the effect on the auditory function of the inner ear was explored by comparing with intraperitoneal injection of nitroglycerin. The rats were given the drug repeatedly on alternate days, a total of 5 dosing, with the body weight monitored during the drug administration. The tactile threshold of the rats' forepaw was measured using von-Frey filaments and auditory function was assessed by ABR. The results showed that the baseline tactile threshold of rats gradually decreased during the modeling process, and hyperalgesia appeared. Postauricular injection of NTG did not affect the weight gain of rats, while intraperitoneal injection of NTG showed slow or even negative weight gain. The ABR threshold of Click, 4 and 8 kHz of postauricular NTG injection rats increased, the latency was prolonged, and the ABR threshold in the right ear was higher than that in the left ear. We demonstrated that postauricular injection of nitroglycerin may be safer and more effective than intraperitoneal injection of nitroglycerin in the process of creating rat migraine model without affecting the weight gain. Postauricular injection of nitroglycerin has more damage to the auditory function of rats. Therefore, the migraine model rat induced by postauricular injection of nitroglycerin may be a new model of cochlear migraine.

Postauricular versus systemic use of steroids for sudden hearing loss: A systematic review and meta-analysis of randomized controlled trials.

Sudden sensorineural hearing loss (SSNHL) can be debilitating and is one of the most common otological diseases. Steroids play an important role in its treatment. There are many ways to administer steroids, and the efficacy and safety of different administration routes remain unclear. This meta-analysis aimed to investigate the effect and safety of different types of steroid delivery administration for the treatment of SSNHL. We searched the Weipu, Wanfang, Chinese Biomedical Literature, National Knowledge Infrastructure, Web of Science, Embase and PubMed databases for randomized controlled trials (RCTs) on glucocorticoid treatments for SSNHL to compare the efficacy of postauricular injection and systemic steroid administration. Review Manager 5.4 software was used for data synthesis, which included the recovery rate (RR) of reported hearing improvement and change level in pure-tone audiometry (PTA). Subgroup analyses were performed based on different drugs, basic treatment, initial PTA, drug administration methods, onset time, and treatment course. Stata 15.1 software was used for analyses of publication bias and sensitivity. Our meta-analysis included 38 studies involving 3609 patients with SSNHL. In all included studies, the risk difference (RD) using reported improvement as an outcome measure was 0.12 for postauricular injection administration compared with systemic therapy (95% confidence interval [CI] = 0.008, 0.16, P < .00001, I2 = 59%). When examining PTA changes as an outcome measure (19 studies), the mean difference was 6.06 (95% CI = 3.96, 8.16, P < .00001, I2 = 70%). The RD for hearing improvement was compared among different factors, and the results showed that postauricular injection is superior to systemic steroid administration. Postauricular injection may be safer and more effective treatment than systemic therapy as a treatment for SSNHL.

Efficacy of intratympanic or postauricular subperiosteal corticosteroid injection combined with systemic corticosteroid in the treatment of sudden sensorineural hearing loss: A prospective randomized study.

This study aimed to investigate the efficacy and safety of intratympanic or postauricular subperiosteal glucocorticoid injection combined with systemic glucocorticoid in the treatment of sudden sensorineural hearing loss (SSNHL). This study is a prospective randomized controlled study. This study included unilateral SSNHL patients who were hospitalized in our department between January 2020 and June 2021. Patients were randomly divided into three groups (groups A, B, and C). Patients in group A were treated with an intratympanic corticosteroid injection combined with systemic corticosteroid treatment, and patients in group B received a postauricular corticosteroid injection combined with systemic corticosteroid treatment. Patients in group C (control group) were treated with systemic corticosteroid alone. The case number of groups A, B, and C was 311, 375, and 369, respectively. There was no significant difference in gender distribution, the proportion of left and right affected ears, and the average interval from onset to treatment among the three groups (P > 0.05). However, there were significant differences in their average age, distribution of audiogram type, and hearing loss levels among them (P < 0.01). Our study shows that there was no significant difference in average hearing threshold improvement before and after treatment in the three groups (P > 0.05). Regarding the complications, in group A, 33 patients (10.6%) had a transient vertigo attack during tympanic injection, which lasted for ~1-3 min. In group B, 20 patients (6.43%) complained of pain at the injection site, which disappeared after 1-3 days. No other complications occurred in all the other patients. The addition of intratympanic or postauricular corticosteroid to systemic steroids did not result in a significant effect on hearing recovery in SSNHL. No obvious complications occur in SSNHL patients treated with intratympanic injection or postauricular injection of corticosteroid. [chictr.org.cn], registration number: ChiCTR2100048762.

Protective effect of anakinra on audiovestibular function in a murine model of endolymphatic hydrops.

Ménière's disease (MD), a common disease in the inner ear, is characterized by an increase in endolymph in the cochlear duct and vestibular labyrinth. The pathophysiology of the condition appears to be the immune response. Studies have shown that basal levels of the IL-1β increased in some MD patients. Here, we used a murine model of endolymphatic hydrops (EH) to study the effect of anakinra on auditory and vestibular function. Mice were intraperitoneal injected with anakinra or saline before LPS by postauricular injection. Weight and disease severity were measured, histologic changes in auditory were assessed, and inflammation state was evaluated. We found that anakinra therapy reduced LPS-induced EH, alleviated LPS-induced hearing loss and vestibular dysfunction, and inhibited the expression of the inflammatory cytokines and macrophage infiltration in the cochlea of mice. We further demonstrated that anakinra ameliorated the disorganization and degeneration of myelin sheath, and reduced the neuron damage in cochlea of EH mice. Consequently, anakinra contributes to a promising therapeutic approach to MD, by restricting EH, alleviating auditory and vestibular function, inhibiting inflammation of the inner ear and protecting the cochlear nerve. Further investigations are needed to assess the potential therapeutic benefits of anakinra in patients with MD.

Clinical Efficacy of Retroauricular Injection of Methylprednisolone Sodium Succinate in the Treatment of Sudden Deafness with Type 2 Diabetes.

Background The etiology of sudden deafness is still unclear. In recent years, people's life rhythm is getting faster and faster. Fatigue, environment, diet, psychology, and other factors have increased the morbidity rate of sudden deafness and improved the quality of life of patients. And work efficiency is greatly affected. Aims A study to investigate the clinical efficacy of postauricular injection of methylprednisolone sodium succinate in the treatment of sudden deafness with type 2 diabetes. Materials and Methods Sixty patients with sudden deafness who were treated in our hospital from January 2018 to October 2020 were selected as the subjects of this prospective study and divided into 30 cases each in the comparison group and the observation group according to the random number remainder grouping method. The comparison group was treated conventionally, and the observation group was treated with postauricular injection of methylprednisolone sodium succinate on the basis of the comparison group. Patients in the two groups were observed and compared on the 3rd, 6th, and 9th days after treatment with pure-tone hearing threshold checks and regular monitoring of blood glucose, blood rheology, and other indexes. Results On the 7th, 14th, and 30th days after treatment, the pure-tone audiometric thresholds of the two groups were gradually decreased, and the changes in the pure-tone audiometric thresholds in the observation group were greater than those in the control group. After lunch on the 6th day and after lunch on the 9th day, it was lower than that in the control group, and the difference was statistically significant (P < 0.05). 30 days after treatment, the blood viscosity, fibrin, and platelet aggregation rate of the observation group were significantly lower than those of the control group. After treatment, the clinical efficacy rate of the observation group was 96%, which was significantly higher than that of the control group, 80%, and the above differences were statistically significant (P < 0.05). Conclusion Treatment with postauricular injection of methylprednisolone sodium succinate has shown better therapeutic recovery in patients with sudden deafness, improved pure-tone hearing threshold, reduced risk of blood glucose elevation, and improved clinical outcomes for patients with sudden deafness, providing some reference for the treatment of patients with sudden deafness.

Is postauricular injection a systemic or a topical route for inner ear drug delivery?

The challenges associated with the blood-labyrinth barrier and unwanted systemic adverse effects severely impede the development of systemic drug administration for inner ear therapy. Previous studies have demonstrated that postauricular injection might be an alternative route for the systemic administration for inner ear therapy because it is minimally invasive and can achieve a high drug concentration in the inner ear. However, the in vivo effects remain unclear. This study aimed to compare differences in cisplatin-induced ototoxicity and systemic adverse effects between postauricular and systemic administration. Here, we compared the differences in hair cell loss, body weight change, and renal dysfunction (indicated by serum levels of blood urea nitrogen and creatinine) between these two routes of administration. The results showed that although postauricular injection of cisplatin might induce greater hair cell damage in the ipsilateral cochleae than that after intraperitoneal injection, significant hair cell damage in the contralateral cochleae as well as systemic adverse effects were also observed. Our results indicated that: (1) topical administration effects might occur in the ipsilateral inner ear following postauricular injection, and (2) systemic circulation might also be an underestimated route of drug delivery to the inner ear following postauricular injection. Overall, postauricular injection is a hybrid administration route, which simultaneously shares the features of topical and systemic administration for inner ear drug delivery.

Efficacy and safety of post-auricular injection of methylprednisolone sodium succinate and lidocaine in the treatment of acute tinnitus, and its effect on sleep quality

Purpose: To study the efficacy and safety of post-auricular injection of methylprednisolone sodium succinate plus lidocaine in the treatment of acute tinnitus, and its effect on sleep quality.Methods: Eighty acute tinnitus patients admitted to Nanfang Hospital, Southern Medical University, Guangzhou, China from January 2020 to June 2021, served as subjects for this retrospective analysis. The patients were equally assigned to a reference group given postauricular injection of lidocaine, and a research group treated with post-auricular injection of methylprednisolone sodium succinate in combination with lidocaine. Treatment efficacy values in the two groups of patients were determined and compared.Results: Total treatment effectiveness values in patients in the research group after one course of treatment, and at three months post-treatment, were significantly higher than the corresponding values in the reference group (p &lt; 0.05). After treatment, the two groups had markedly improved Tinnitus Handicap Inventory (THI) scores, although patients in the research group had lower scores than those in reference group (p &lt; 0.05). There were significant decreases in post-treatment pure tone threshold and Pittsburgh sleep quality index (PSQI) in the two groups of patients, with lower values in the research group than in the reference group (p &lt; 0.05). There were no obvious adverse drug reactions during treatment and during 3-month follow-up period.Conclusion: Post-auricular injection of methylprednisolone sodium succinate and lidocaine effectively improved the clinical efficacy and the sleep quality of acute tinnitus patients. It is a simple and highly safe operation which merits clinical application.

Comparison of the Pathway to the Inner Ear Between Postauricular and Intramuscular Injection of Dexamethasone in Guinea Pigs

BackgroundPostauricular injection as a local therapy has been confirmed to be effective for inner ear diseases. However, the mechanism for the drugs entering the inner ears remains unknown. This study aims to compare the distribution of dexamethasone by intramuscular injection with that by postauricular injection, and explore the pathway of the drugs entering the inner ears.MethodsAn in vivo optical imaging system was used to conduct a time course observation to compare the distribution of dexamethasone by intramuscular injection with that by postauricular injection in male guinea pigs. The drug availability in the tympanic mucosa, tympanum, endolymphatic sac, and cochlea was observed by a confocal laser scanning microscope.ResultsThe local fluorescent intensity by postauricular injection was significantly higher in the inner ears, and lower in partial peripheral organs, than that by the intramuscular injection. The drug metabolism by postauricular injection exhibited an obviously sustained release effect in the inner ears. Drugs by postauricular injection might enter the endolymphatic sac through the posterior auricular artery and occipital artery, as well as the connections of the mastoid emissary vein, sigmoid sinus and endolymphatic sac.ConclusionMore drugs concentrated in the inner ear for longer therapeutic time and less systemic delivery implied more effective and less risk of side effects through postauricular injection than intramuscular injection safer for the treatment of inner ear diseases.

Postauricular injection of methylprednisolone sodium succinate as a salvage treatment for refractory sudden sensorineural hearing loss.

Postauricular steroid administration has been popular for treating sudden sensorineural hearing loss. However, there are few reports on its use in patients with refractory sudden sensorineural hearing loss (RSSNHL). The objective of this study was to investigate the therapeutic efficacy of postauricular steroid injection as a salvage treatment for RSSNHL patients. This retrospective study enrolled 63 RSSNHL patients between January 2016 and January 2019. Thirty-three patients of them who have been divided into the treatment group received postauricular methylprednisolone sodium succinate injection. The remaining 30 patients who formed the control group did not receive any steroid as a salvage therapy. Improvements in hearing were evaluated between pre-salvage therapy and 3months follow-up after salvage therapy. The median hearing gain in PTA was 9.88dB HL (quartile range 7.58, 18.65) in the treatment group and 0.90dB HL (quartile range 0.00, 4.90) in the control group (P<0.01). According to the criteria of Furuhashi, the total percentage for effective prognosis was 48.48% (16/33) in the treatment group and 10.00% (3/30) in the control group (P<0.01). The time interval from onset to study entry was significantly and independently associated with the prognosis for RSSNHL patients (P< 0.01). The present findings suggest that postauricular corticosteroid administration as a salvage treatment demonstrated better results than no treatment for RSSNHL patients. The time interval from onset to study entry was mainly the prognostic factor for RSSNHL patients. It is therefore considered that postauricular corticosteroid administration may be used as a salvage therapy for RSSNHL patients.

Postauricular injection in the treatment of all-frequency and high frequency descending sudden hearing loss: A protocol for systematic review and meta-analysis.

Background:Sudden hearing loss (SHL) is a disease, at the same time a symptom, which needs to be treated in a timely manner and counts as an emergency health problem in the Department of Otolaryngology. There are many types of sudden hearing loss and among them, the occurrence of all-frequency descending sudden hearing loss and high frequency sudden hearing loss are high. The conventional treatment for these 2 types of sudden hearing loss sometimes is not as effective as expected. Postauricular injection of glucocorticoids could be the most effective treatment method. However, the effectiveness and safety of postauricular injection of glucocorticoid needs to be assessed systematically.Methods:The protocol for the meta-analysis was conducted under the guidance of Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The aim is to undertake a systematic review and meta-analysis on the effectiveness and safety of postauricular injection of glucocorticoid to treat patient diagnosed with all-frequency and high frequency descending sudden hearing loss. We searched through the following databases: English databases (PubMed, EMBASE, Web of Science) and Chinese databases (CNKI, Wanfang databases, CBM, VIP). The final selected articles will be evaluated using Cochrane RCT evaluation criteria. Revman 5.0 will be used for data analysis. Subgroup analysis, sensitivity analysis, and meta regression will detect sources of heterogeneity. Ethics approval was not required for this protocol. The findings will be disseminated through journal articles or conference presentations.OSF registration number:DOI 10.17605/OSF.IO/5Q9NAResults:Objectively, evaluate the efficacy and safety of postauricular injection of glucocorticoid in treating all-frequency descending sudden hearing loss and high frequency sudden hearing loss.Conclusion:To provide evidence-based medicine for glucocorticoid treatment methods in patients with all-frequency descending sudden hearing loss and high frequency descending hearing loss.

Postauricular injection glucocorticoid in the treatment of sudden hearing loss: A protocol for systematic review and meta-analysis.

Background:Sudden hearing loss is an emergency health problem in the Department of Otolaryngology that must be treated in a timely manner, or may cause lifelong regrets. The application of postauricular injection of glucocorticoid is a popular treatment to recover patients hearing level in recent years. However, the effectiveness and safety of postauricular injection of glucocorticoid needs to be assessed systematically.Methods and analysis:The purpose of the study is to undertake a systematic review and meta-analysis on the effectiveness and safety of postauricular injection of glucocorticoid to treat patient diagnosed with sudden hearing loss. We will search the following databases from the date of publication to July 1, 2020: PubMed, EMBASE, Web of Science, the Cochrane Library, CNKI, Wanfang databases, the Chinese Biomedical Literature Database (CBM), the Chinese Science and Technology Periodical Database (VIP) and the Chinese Cochrane Centre's Clinical Trial Registry Platform. Observational studies regarding the association between postauricular injection of glucocorticoid and sudden hearing loss were written in English and Chinese were included. RevManV.5.3 software will be used for meta-analysis. According to the heterogeneity of the research results, fixed effects model, random effects model, subgroup analysis, sensitivity analysis, and others will be used. Ethics approval was not required for this protocol. The findings will be disseminated through journal articles and conference presentations.Results:Objectively, evaluate the efficacy and safety of postauricular injection of glucocorticoid for sudden hearing loss.Conclusion:To provide evidence-based medicine for glucocorticoid treatment methods in patients with sudden hearing loss.OSF registration number:DOI 10.17605/OSF.IO/N5RV3.

Analysis of the treatment effects of refractory sudden total frequency deafness with steroid from different topical administration routes

Objective:To compare the efficacy between intratympanic dexamethasone and postauricular injection of methylprednisolone treatment for refractory sudden total frequency deafness. Method:Forty-eight cases of refractory sudden total frequency deafness were randomly divided into A group and B group (n=24 in each group). A group received intratympanic injection of dexamethasone 0.5 ml, and B group received postauricular injection of methylprednisolone 40 mg. Both treatments were performed once every other day for 2 weeks. The hearing was reviewed 2 weeks after the treatment. Result:In A group, 1 case was cured, 2 cases were markedly effective, 6 cases were effective, 15 cases were ineffective, the total effective rate was 37.5%; in B group, 0 cases were cured, 1 case was markedly effective, 4 cases were effective, 19 cases were ineffective, the total effective rate was 20.8%. There was no significant difference between the two groups in the total effective rate (P>0.05). The average PTA of patient in the A group and B group were respectively increased by (15.13±11.77) dB and (8.71±9.72) dB, and the difference was statistically significant (t=2.059, P<0.05). Conclusion:Both topical injection treatments of glucocorticoids can be recommended for patients with refractory sudden total frequency deafness, while intratympanic dexamethasone may be more advantageous in improving hearing threshold.

Treatment of sudden deafness with type 2 diabetesmellitus by post-auricular subperiosteal injection of methylprednisolone

Objective:To investigate the therapeutic effect of post-auricular subperiosteal injection of methylprednisolone combined with ginkgo biloba injection and mouse nerve growth factor in sudden deafness with type 2 diabetesmellitus. To understand the effect of post-auricular subperiosteal injection of methylprednisolone on type 2 diabetesmellitus complicated with sudden deafness and its effect on blood-glucose level, and to explore a more effective and safe method for treating this special group of sudden deafness. Method: Total 84 patients suffered from type 2 diabetesmellitus with sudden deafness and treated in Shaanxi Provincial People's Hospital from March 2017 to June 2018 were randomly divided into experimental group(post-auricular subperiosteal injection of methylprednisolone+ginkgo biloba injection, mouse nerve growth factor)(n=48) and a control group(ginkgo biloba injection, mouse nerve growth factor)(n=36). Each group was divided into high frequency, low frequency and flat and total deafness group. Then to compare the clinical efficacy of the two groups and the difference of the fluctuation of blood glucose and HbA1c before treatment and 2 hours after treatment. Result:①The effective rate of treatment in the experimental group was 79.17%, higher than that in the control group(58.33%), P<0.05. The results indicated that the effect of post-auricular subperiosteal injection of methylprednisolone combined with ginkgo biloba injection and mouse nerve growth factor was effective in sudden deafness with type 2 diabetesmellitus. ②There was no significant difference in the fluctuation of blood glucose and HbA1c before treatment and 2 hours after treatment in the experimental group, and it indicated that this treatment can effectively avoid systemic side effects of steroid and ensure the safety of the treatment. Conclusion:Post-auricular subperiosteal injection of methylprednisolone combined with ginkgo biloba injection and mouse nerve growth factor is effective in patients with sudden deafness with type 2 diabetesmellitus, furthermore, blood glucose will not be affected by the using of steroid, and it will aviod systemic hormonal side effects.

Therapeutic effects of postauricularinjection of lidocaine in tinnitus

Eighty patients with tinnitus as their first complaint were included in our study. They were randomly divided into four groups, each with 20 cases.They were treated with oral ginaton and mecobalamin tablets,and at the same time with postauricular injection of lidocaine at different doses (Group A, 2% lidocaine 3 ml; Group B, 2% lidocaine 2 ml+physiological saline 1 ml;Group C, 2% lidocaine 1 ml+physiological saline 2 ml; Group D, physiological saline 3 ml). TEQ scores were evaluated and compared before treatment, at the end of treatment, and one month after treatment.Result:At the end of treatment, the clinical effiCIency rates of four groups were 80%,70%,65% and 25% respectively. One month after treatment, the clinical effiCIency rates of four groups were 80%, 55%, 45% and 0% respectively. There were significant differences among four groups by chi square test (P<0.05).Patients' TEQ scores of the four groups after treatment were analyzed and compared by one-way ANOVA. TEQ scores of Group A,B and C were lower than Group D(P<0.05). TEQ scores of Group A were lower than Group C(P<0.05).TEQ scores at the end of treatment and one month after treatment were analyzed by paired t-test. Group B and C had higher TEQ scores one month after treatment(P<0.05).The total effective rate at the end of treatment for acute, subacute and chronic tinnitus patients was 79.31%, 70.83% and 42.86% respectively. The total effective rate of one month after treatment was 75.86%, 45.83% and 42.86%, respectively. The results of chi square test showed that the total effective rate of acute tinnitus patients was significantly higher than that of subacute and chronic tinnitus in one month after treatment (P<0.05). Postauricular injection of lidocaine is effective for simple subjective tinnitus, and the dose and concentration of lidocaine affect the efficacy and durability. Postauricular injection of lidocaine for the treatment of subjective tinnitus is a therapeutic method worthy of further research and popularization.

The effects of postauricular injection of methylprednisolone on medium-high frequency sudden hearing loss

Objective:To study the effects of postauricular injection of methylprednisolone on medium-high frequency sudden hearing loss.Method:The data of 45 patients with invalid treatment who were diagnosed as medium-high frequency sudden hearing loss were retrospectively studied. They were divided into postauricular injection group and non-postauricular injection group. The treatment efficiency and hearing improvement at each frequency were compared between the two groups.Result:The improvements of hearing threshold in the non-postauricular injection group were(6.30±5.00)dB HL,(3.80±5.52)dB HL,(5.35±5.50)dB HL,(15.60±11.84)dB HL,(19.60±13.46)dB HL,(15.40±12.90)dB HL at 250, 500, 1000, 2000, 4000 and 8000Hz, respectively. The hearing improvements of the postauricular injection group were (5.35±6.22)dB HL,(2.50±3.00)dB HL,(4.65±6.60)dB HL,(23.75±10.75)dB HL,(25.75±11.73)dB HL,(30.50±14.50)dB HL at 250, 500,1000,2000,4000 and 8000Hz, respectively. There were significant differences between the two groups in hearing improvements at 2000-8000Hz. The treatment effective rates were 44% and 80% for the non-postauricular injection group and postauricular injection group respectively, which showed a significant difference(χ²=8.385P<0.05).Conclusion:Postauricular injection of methylprednisolone as a remedy treatment is safe and effective for sudden hearing loss in middle and high frequency.

Clinical curative effect analysis of postauricular topical injection combining with oral hormone in the treatment of the flat type of sudden hearing loss

Objective:To analyze the clinical curative effect of postauricular topical injection combining with oral hormone in the treatment of the flat type of sudden hearing loss.Method:Data of 128 patients with the Sudden hearing lossfrom year 2015 till now were collected, and randomly divided into two groups: postauricular topical injection group (methylprednisolone sodium succinatefor injection 40 mg+linocaine 2.5 ml, retroauricular groove topical injection, qod, combining with taking methylprednisolone tablets 24 mg in the morning for 3 days) and non-postauricular injection group (take methylprednisolone tablets 24 mg in the morning for 3 days). Use SPSS 17.0 software to analyze the hearing curativeeffect of these two groups statistically.Result:The cure rate of postauricular injection group: 23.4%(15 cases), effect appear: 14.1%(9 cases), valid: 37.5%(24 cases), invalid:25.0%(16 cases), total effective rate:75%(48/64).The difference compare of these two group has a statistically significant (P< 0.05).②The cure rate of the flat type patients with the postauricular injection treatment among the total 64 cases is 23.4%, which is higher than the patients without the postauricular injection treatment.The difference compare of these two group has a statistically significant (P< 0.05).③The incrementsof the postauricular injection group in 250-8 000 Hz, which is divided into7different frequencies, from low to high, are (26.48±6.23)dBHL, (23.24±4.21)dBHL, (21.89±7.34)dBHL, (26.07±7.01)dBHL, (25.75±5.14)dBHL.The mean value compare of frequency 250-500 Hz and 250-4 000 Hz of these two group has a statistically significant (P< 0.05).Conclusion:The curative effect of postauricular topical injection combining with oral hormone in the treatment of the flat type of sudden hearing loss is better than only oral hormone.

The progress of glucocorticoids via postauricular injection in treatment of sudden hearing loss

Corticosteroids are commonly accepted and recommended for treating sudden hearing loss.In recent years，postauricular delivery attracts attention due to the advantage of high drug concentration in cochlear and minimal side effects.This article reviews the published literature related the application of glucocorticoids via postauricular injection in treatment of sudden hearing loss and its animal experiments, speculates the possible pathway that drugs enter inner ear, and put forward the idea of treating facial nerve diseases via postauricular injection.

The curative effect analysis between postauricular injection and systemic application of glucocorticoids in the treatment of sudden hearing loss

Objective To investigate the therapeutic effect of topical corticosteroids injection and systemic application in the treatment of sudden hearing loss. Methods Total of 58 patients with sudden hearing loss were randomly divided into two groups.The systemic application group:dexamethasone(DEX) was applied by intravenous injection in dose of 10mg×3d,followed by 5mg×4d.And the postauricular injection group: methylprednisolone sodium succinate of 40mg was injected into cortical bone of mastoid region every three days, until hearing back to normal,or 15 days.SPSS 13.0 software was used to analyze the data. Results The total effective rate of systemic application group was 67.7%,the total effective rate of postauricular injection group was 64.7%.There was no statistical difference between the two groups(χ2= 2.58,P= 0.316).The recovery rate in cases with postauricular injection group was significantly increased in comparison with the systemic application group,but no statistical difference between the two groups(t= 2.71,P= 0.062).Patients with hearing loss in low frequencies(250Hz,500 Hz),the recovery rate in cases with postauricular injection group was significantly increased in comparison with the systemic application group(t= 3.82,P= 0.031;t= 3.26,P= 0.042). Conclusion Postauricular topical injection and systemic application of glucocorticoids in the treatment of sudden hearing loss are all have good curative effect.Systemic application is selected by conventional treatment,and topical injection has a better effect in the hearing loss of low-middle frequencies. Key words: Hearing loss; Sudden; Glucocorticoids; Drug administration routes

Postauricular hypodermic injection to treat inner ear disorders: experimental feasibility study using magnetic resonance imaging and pharmacokinetic comparison

To investigate the feasibility of postauricular hypodermic injection for treating inner ear disorders, we compared perilymph pharmacokinetics for postauricular versus intravenous injection, using magnetic resonance imaging, in an animal model. Twelve albino guinea pigs were divided randomly into two groups and administered gadopentetate dimeglumine via either a postauricular or an intravenous bolus injection. A 7.0 Tesla magnetic resonance imaging system was used to assess the signal intensities of gadolinium-enhanced images of the cochlea, as a biomarker for changes in gadopentetate dimeglumine concentration in the perilymph. Pharmacokinetic parameters were calculated based on these signal intensity values. Guinea pigs receiving postauricular injection showed longer times to peak signal intensity, longer elimination half-life, longer mean residence time and a greater area under the signal-time curve (from pre-injection to the last time point) (p < 0.05). Postauricular injection shows potential as an efficient drug delivery route for the treatment of inner ear disorders.