Published online Jun 15, 2025. doi: 10.4239/wjd.v16.i6.99602
Revised: March 5, 2025
Accepted: April 9, 2025
Published online: June 15, 2025
Processing time: 190 Days and 2.9 Hours
Managing sudden deafness (SD) in patients with diabetes mellitus (DM) is particularly challenging due to the heightened risk of adverse effects associated with systemic drug administration. This study explores the potential of retroauricular subperiosteal injection as a localized drug delivery method for a more effective and safe treatment.
To compare the efficacy of retroauricular subperiosteal injection vs systemic intravenous glucocorticoid (GC) administration for SD in patients with DM and assess the effects on blood glucose levels.
A total of 128 cases of type 2 DM (T2DM) with SD diagnosed and treated in Zibo Central Hospital from February 2021 to July 2023 were divided into two groups: An observation group (66 cases receiving retroauricular subperiosteal injection of methylprednisolone) and a control group (62 cases receiving systemic intravenous administration of methylprednisolone). The two groups were compared in terms of therapeutic efficacy, hearing recovery, blood glucose level changes, and incidence of adverse reactions. Binary logistic regression was used to analyze the factors affecting therapeutic efficacy.
The observation group showed a significantly higher total effective rate (90.91%) compared with the control group (75.81%, P < 0.05). Additionally, pure-tone hearing threshold, fasting plasma glucose, and 2-hour postprandial blood glucose were significantly lower in the observation group compared with the control group (P < 0.05). The incidence of adverse reactions was also lower in the observation group than in the control group (7.58% vs 22.58%, P < 0.05). A T2DM course longer than 5 years and systemic intravenous GC administration were identified as independent risk factors for treatment inefficacy (P < 0.05).
In treating patients with diabetes and SD, retroauricular subperiosteal injection of methylprednisolone offers superior therapeutic efficacy and lower incidence of adverse reactions compared with systemic intravenous GC administration, with minimal impact on blood glucose.
Core Tip: Managing sudden deafness in patients with diabetes poses significant therapeutic challenges, particularly due to the limitations of systemic drug administration, prompting the exploration of retroauricular subperiosteal methylprednisolone injection as a potentially superior clinical approach. Our comprehensive analysis revealed that retroauricular subperiosteal injection of methylprednisolone yields significantly better therapeutic outcomes compared with systemic intravenous infusion and demonstrates enhanced safety profiles and minimal impact on blood glucose levels. This finding underscores its potential as a safer and more effective treatment strategy, offering substantial clinical value and practical significance.