To observe the clinical efficacy and safety of retroauricular injection of dexamethasone sodium phosphate injection in the treatment of sudden deafness.

Patients with sudden deafness were divided into control group and treatment group according to actual treatment method. Both groups were given conventional treatment (neurotrophy and microcirculation improvement) according to guidelines. The control group received additional intravenous drip of methylprednisolone sodium succinate (80 mg once daily for 4 d, reduced to 40 mg for 4 d, then further reduced to 20 mg for 2 d). The treatment group was given retroauricular injection of dexamethasone (5 mg every other day) in addition to the control group’s regimen. Both groups were treated for 10 d. The efficacy, metabolomic differences, hearing recovery status, hemorheological indexes, and immune function indexes were compared between the two groups. Meanwhile, the safety was evaluated.

38 cases and 42 cases were included in the control group and the treatment group, respectively. After treatment, the effective rates in the treatment group and the control group were 80.95% (34 cases/42 cases) and 57.89% (22 cases/38 cases), with statistically significant difference (P<0.05). There were significant increases in 11 metabolites and significant decreases in 18 metabolites before treatment for sudden deafness. The four metabolites showing the most significant increases were ascorbic acid, tauroursodeoxycholic acid, D-pantothenic acid, and glucaric acid. The most significantly decreased metabolites were lysophosphatidylethanolamine and vanillic acid. After treatment, patients with sudden deafness in the effective group showed significant increases in 37 metabolites and significant decreases in 8 metabolites compared to the ineffective group. The three metabolites showing the most significant increases were L-leucine, undecanoylcarnitine, and lauroylcarnitine, while the three with the most notable decreases were L-histidine, 2-pyridylacetic acid, and D-pantothenic acid. After treatment, hearing thresholds under 0.5, kHz in the control group and the treatment group were (49.82±7.03) and (43.69±5.38) dB, respectively; hearing thresholds under 1.0 kHz were (58.14±7.39) and (46.33±6.25) dB, respectively; hearing thresholds under 2.0 kHz were (60.05±8.23) and (49.51±5.30) dB, respectively; hearing thresholds under 4.0 kHz were (62.29±8.14) and (51.36±5.87) dB, respectively, with statistically significant differences between two groups (P<0.05). After treatment, superoxide dismutase (SOD) levels in the control group and the treatment group were (94.65±14.06) and (99.72±13.56) μg·L^-1; malondialdehyde (MDA) levels were (4.36±0.51) and (3.94±0.40) μmol·L^-1, with statistically significant differences between groups (P<0.05). After treatment, plasma viscosity in the control group and the treatment group was (2.12±0.30) and (1.55±0.26) mPa·s; erythrocyte aggregation index was 3.38±0.30 and 2.97±0.19; low-shear viscosity was (10.13±1.60) and (9.06±1.19) mPa·s; high-shear viscosity was (5.96±0.39) and (5.33±0.31) mPa·s, with statistically significant differences between groups (P<0.05). After treatment, CD3⁺ in the control group and the treatment group was 57.76±4.70 and 63.52±5.46; CD4⁺ was 33.29±3.38 and 37.42±3.68; CD4⁺/CD8⁺ was 1.43±0.22 and 1.70±0.30; immunoglobulin (Ig) G levels were (12.16±1.12) and (10.23±0.93) g·L^-1; IgA levels were (2.36±0.23) and (2.11±0.15) g·L^-1, with statistically significant differences between groups (all P<0.05). No significant adverse reactions occurred in either group during the treatment.

Retroauricular injection of dexamethasone sodium phosphate injection is markedly effective in the treatment of sudden deafness, and it has advantages in improving metabolomic differences, hemorheology and immune function.