Abstract
BACKGROUND: Managing refractory sudden sensorineural hearing loss (RSSHL) in patients with diabetes mellitus (DM) presents significant therapeutic challenges, highlighting the importance of identifying effective treatment strategies. AIM: To analyze the therapeutic effectiveness of intratympanic injection plus retroauricular injection for RSSHL complicated with DM. METHODS: This study included 84 patients with RSSHL complicated with DM from April 2021 to April 2024, all receiving routine treatment. Participants were categorized into the control group (40 cases), receiving an intratympanic injection of methylprednisolone sodium succinate (MPSS), and the research group (44 cases), treated with retroauricular MPSS injection the next day in addition to the treatment administered in the control group. The efficacy, adverse reactions (tympanic membrane perforation, middle ear infections, burning sensation, vertigo, and tinnitus), blood glucose (BG) [fasting BG (FBG), 2-hour postprandial BG (2hPBG), and glycosylated hemoglobin (HbA1c)], hearing thresholds at different frequencies (250 Hz, 500 Hz, and 1000 Hz), serum biochemical indexes [interleukin (IL)-6, C-reactive protein (CRP), and procalcitonin (PCT)], and quality of life assessed by the short-form 36 item health survey (SF-36) were comparatively analyzed. RESULTS: The research group demonstrated a markedly higher total effectiveness rate (81.82% vs 60.00%, P = 0.027) and a comparable incidence of total adverse reactions than the control group. Further, the research group exhibited notably reduced FBG, 2hPBG, HbA1c, IL-6, CRP, and PCT post-treatment (P < 0.01), which were lower compared with the pre-treatment levels and the control group (P < 0.05), as well as reduced hearing thresholds at different frequencies (250 Hz, 500 Hz, and 1000 Hz, P < 0.05). Furthermore, the post-treatment SF-36 scores of the research group in terms of energy, social functioning, role functioning, physical functioning, mental health, and overall health were all significantly improved than the pre-treatment levels and the control group (P < 0.05). CONCLUSION: The above results indicate that intratympanic plus retroauricular injections of MPSS are effective in treating RSSHL complicated with DM without increasing the incidence of adverse reactions, which has a health promotion value.