ABSTRACT
Objective To evaluate the therapeutic effects of early intratympanic steroid of different concentrations and types combined with systemic steroid on severe idiopathic sudden sensorineurl hearing loss(ISSNHL).Methods We reviewed 95 patients with unilateral ISSNHL from January 2012 to June 2016 in the Department of Otolaryngology of the People's Hospital of Changshou and according to the steroid treatment methods,Patients were divided into systemic steroid therapy alone group(group A,30 cases),early intratympanic steroid of low concentration combined with systemic steroid group (group B,32 cases) and early intratympanic steroid of high concentration combined with systemic steroid group (group C,33 cases).Results Total effective rates of the group A,group B and group C were 46.67 ％,56.25 ％,78.79％.Group C was significantly higher than that of group A and group B(P＜0.05);the average pure tone threshold improvement was (46.67±9.32) in group C which was better than group A (20.53±8.83) and group B(25.19± 7.46),the differences were stastically significant (P＜0.01).Conclusion Severe ISSNHL should be treated by intratympanic steroid of high concentration combined with systemic steroid as early as possible in order to rescue the hearing,the efficacy of which is much better than other steroid treatments so far.
ABSTRACT
Transforming growth factor-beta (TGF-beta) as a main switch has a crucial role in chronic rhinosinusitis (CRS) subtypes. The physiological functions of the secreted inactive TGF-beta are precisely regulated by suppressing factors, such as latency-associated peptide (LAP), latent TGF-beta-binding protein (LTBP) and fibrillin, as well as activating factors, such as integrins, proteases and thrombospondin-1. With progress in understanding the factors responsible for regulating TGF-beta functions, it has been revealed that the dysregulation of TGF-beta activation is closely associated with lung fibrosis and chronic obstructive pulmonary disease. Since the imbalance between TGF beta-regulating factors may be one of the main reasons for different phenotypes of CRS, we reviewed the advancement in the research of TGF-beta activation and its role in CRS pathogenesis, to provide insight into the CRS investigation in human.