[The role of word recognition score in outcomes assessmentof idiopathic sudden sensorineural hearing loss]

Objective:To investigate the change of word recognition score(WRS) during the treatment of patients with idiopathic sudden sensorineural hearing loss(ISSNHL) and explore the role of WRS in outcomes assessment of ISSNHL.Method:Thirty-seven patients diagnosed with ISSNHL,whose pure-tone average(PTA) has no change but WRS has improved after treatment,were analyzed retrospectively.The WRS and the test intensity for WRS of pre-treatment and those of post-treatment were compared statistically.Result:There is statistical significance between WRS of post-treatment and that of pre-treatment(P<0.01).The increase of WRS score is consistent with improvement of symptom in these patients.Conclusion:More attention needs to be paid to WRS during treatment of ISSNHL patients,especially those whose PTA has no improvement but patients feel better about their hearing,and WRS could be an important factor in terms of outcome assessment during treatment of ISSNHL patients for the further treatment.

[Analysis the relationship between the found ways and first diagnosis age for large vestibular aqueduct children]

OBJECTIVE

To explore the found ways and first diagnosis age of children with large vestibular aqueduct, and their relations with hearing loss.

METHOD

Medical histories of 122 cases of children diagnosed with large vestibular aqueduct by HRCT or MRI had been collected from January 2009 to April 2014 in our hospital children's hearing diagnosis center clinic. Found ways comprise of accepting universal newborn hearing screening (UNHS) group and unaccepting UNHS group. Accepting UNHS children were divided into two ears unpassing group, single ear unpassing group and passing group. The patients in unaccepting UNHS group were divided into not sensitive to sounds, speech stunting, sudden hearing loss, and other group. Analysis the relationship between the found ways and first diagnosis age and their relations with hearing loss.

RESULT

There are 84 cases (68.85%) accepting UNHS, the average age of first diagnosis was (17.24 ± 17.08) months; 37 cases (31.15%) are not accepting UNHS. The average age of first diagnosis was (30.92 ± 18.21) months. The average first diagnosis age of accepting UNHS group was more earlier than the unaccepting UNHS group. The difference was statistically signif- icant (P < 0.01). There were 57 cases (67.85%) whose two ears not pass UNHS; 15 cases (17.86%) single ear not pass; namely the referral rate was 85.71%; 12 cases (14.29%) pass the test. The first diagnosis age of passing UNHS group was more later than two ears unpassing group (P < 0.001). In the unaccepting UNHS group, the average first diagnosis age of not sensitive to sounds group (19.69 ± 11.16 months) was more earlier than words dysplasia group (37.13 ± 15.62 months) and sudden hearing loss group (47.40 ± 24.70 months) (P < 0.01). The difference in the degree of hearing loss between accepting UNHS and unaccepting UNHS group had no statistical significance (P > 0.05). In unaccepting UNHS group ,the average first diagnosis age of the mild-to-moderate hearing loss group was later than the very severe hearing loss group (P < 0.01).

CONCLUSION

Most of large vestibular aqueduct children can be found and receive diagnosis early by UNHS. But part of these patients with late-onset or progressive hearing loss, especially these with mild-to-moderate hearing loss cannot be found early, which should arouse our attention.

[Evaluation of the literatures of clinical studies on acupuncture and moxibustion for treatment of sensorineural hearing loss]

OBJECTIVE

To understand the survey of studies on acupuncture and moxibustion for treatment of sensorineural hearing loss at home.

METHODS

By searching China journal web, 60 correlative papers from Jan. 1994 to Aug. 2004 were found and analyzed.

RESULTS

Descriptive studies accounted for 71.7% and trial studies accounted for 28.3%. The diseases studied were mainly sudden deafness and the treatment methods were principally auricular acupuncture and body acupuncture. Most papers did not have definite diagnosis standard, and most criteria of therapeutic effects were self-stipulated, with no detail processing methods for the results, and only one paper reported adverse reaction.

CONCLUSION

The therapeutic effects of acupuncture and moxibustion on sensorineural hearing loss need to be confirmed with studies of higher quality.

Different treatment modalities of tinnitus at the EuromedClinic

A retrospective study at the ear, nose, and throat department of the EuromedClinic showed considerable improvements immediately after the end of the treatments for acute and for chronic tinnitus. Eighty percent of our patients suffering from acute tinnitus showed an improvement with intravenous medication without hyperbaric oxygen treatment, and 65.7% showed improvement with infusion therapy and hyperbaric oxygen. However, at 3 months and then later (long-term results), the figures decreased to 67% and 46%, respectively. In the chronic tinnitus group, the therapeutic effect dropped from 66.7% to 34% (with only intravenous medication) and from 60% to 28% (with combined therapy). These facts can explain the importance of beginning the treatment of patients suffering from tinnitus as early as possible (i.e., acute stage).

Treatment of sudden sensorineural hearing loss with a continuous epidural block

The efficacy of a continuous epidural block was evaluated in the treatment of 20 patients with sudden sensorineural hearing loss (SNHL). Ten patients were treated with continuous cervicothoracic epidural block (group A) and the other 10 were treated with stellate ganglion block (group B). No significant difference in factors affecting prognosis was noted between the groups. In the epidural block group 70% achieved substantial hearing improvement, while this occurred in only 30% of patients undergoing stellate ganglion block. These findings suggest that continuous epidural block can be effective in the treatment of sudden SNHL.

Current concepts in the diagnosis and treatment of sudden sensorineural hearing loss

Sudden hearing loss (SHL) has been a controversial topic in the literature for the past several decades. Although much theoretical work has been done regarding its diagnosis and treatment, no useful practical guidelines exist for application to current patient management. Many authors have discussed the various treatment protocols available to treat this entity, but only a handful of dated, clinical studies supporting these treatments are available. More recent studies applying treatment protocols including vasodilators, plasma expanders, anti-coagulants, and carbogen inhalations have shown no improvement over the rate of spontaneous recovery without therapy. Except in cases of therapy directed toward known predisposing factors, there is insufficient evidence in the literature to support medical treatment for SHL, although steroid therapy appears to be useful in selected patients. Our own review of 14 patients with SHL is presented. A standard diagnostic and therapeutic approach based on a comprehensive review of the literature is described that can be applied to most patients presenting with SHL.