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Lee JW, Kim H, Kong SK, Kim J, Choi SW, Oh SJ. The Effectiveness of Salvage Hyperbaric Oxygen Therapy Following Combined Steroid Therapy for Refractory Sudden Sensorineural Hearing Loss. Ann Otol Rhinol Laryngol 2024; 133:400-405. [PMID: 38197374 DOI: 10.1177/00034894231222692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
OBJECTIVE Hyperbaric oxygen therapy (HBOT) is an accepted treatment option for sudden sensorineural hearing loss (SSNHL), but it is still recommended in combination with corticosteroids. We investigated the efficacy of salvage HBOT in refractory SSNHL that does not respond to corticosteroid combination therapy. METHODS Eighty-four patients were included, who had unilateral SSNHL with an improvement of pure-tone average (PTA) less than 10 dB after using intratympanic plus systemic corticosteroids (combined therapy) as the initial therapy. The control group (n = 66) received no further treatment, and the HBOT group (n = 18) received additional treatment with HBOT (10 sessions in total with 2.5 atmospheres absolute for 1 hour). RESULTS No differences in PTA or WDS were found between the 2 groups. However, the mean hearing gain in the HBOT group (16.8 ± 4.49 dB) was significantly higher than that in the control group (4.45 ± 1.03 dB) (P = .015). The proportion of patients with hearing recovery (hearing gain of 10 dB or more) after treatment was significantly higher in HBOT group (38.9%) than in the control group (10.6%). CONCLUSIONS In patients with refractory SSNHL after steroid combined therapy, salvage HBOT showed a significant effect on hearing gain and recovery rate.
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Affiliation(s)
- Jung Woo Lee
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Hwabin Kim
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Soo-Keun Kong
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Otorhinolaryngology, College of Medicine, Pusan National University, Busan, Republic of Korea
| | - Jia Kim
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Sung-Won Choi
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Se-Joon Oh
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Otorhinolaryngology, College of Medicine, Pusan National University, Busan, Republic of Korea
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Nourizadeh N, Rezaiee N, Rajati M, Dabiri S, Afzalzadeh MR, Hasanabadi K. Evaluation of Sudden Sensory-Neural Hearing Loss Patients Treated with Systemic Steroids with Additional Intratympanic Dexamethasone Injection in Different Intervals; a Clinical Trial Study. Indian J Otolaryngol Head Neck Surg 2023; 75:568-573. [PMID: 37206837 PMCID: PMC10188730 DOI: 10.1007/s12070-023-03641-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 02/23/2023] [Indexed: 03/17/2023] Open
Abstract
Sudden Sensory-Neural Hearing Loss (SSNHL) is one of the most important otologic emergency. Although adding intratympanic (IT) steroids to systematic steroid may be beneficial, the exact timing of the IT injections to provide the best response needs further investigations. To compare different protocols in treting sudden sensorineural hearing loss. We performed a clinical trial study on 120 patients from October 2021 to February 2022. All patients were prescribed 1 mg/Kg daily oral prednisolone. After randomization to three groups, the control group received standard twice a week IT steroid injections in 12 days (four total injections) while intervention groups 1 and 2 received once and twice a day IT injections for ten days. Audiometric study repeated 10-14 days after the last injection and assessed based on the Siegel criteria. We used the Chi-Square, Analysis of Variance (ANOVA), Kruskal-Wallis's tests where appropriate. The most clinical improvement was found in the standard treatment group, and group-2 had the greatest number of patients with no improvement; however, no overall significant difference was observed among the three groups (p-value: 0.066; Pearson Chi-Square). Less frequent IT injections in patients already on systemic steroids provide similar results to more frequent injections. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-03641-4.
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Affiliation(s)
- Navid Nourizadeh
- Sinus and Surgical Endoscopic Research Center, Department of Otorhinolaryngology, School of Medicine, Mashhad University of Medical Sciences, 9176717671 Mashhad, Iran
| | - Naeeme Rezaiee
- Sinus and Surgical Endoscopic Research Center, Department of Otorhinolaryngology, School of Medicine, Mashhad University of Medical Sciences, 9176717671 Mashhad, Iran
| | - Mohsen Rajati
- Sinus and Surgical Endoscopic Research Center, Department of Otorhinolaryngology, School of Medicine, Mashhad University of Medical Sciences, 9176717671 Mashhad, Iran
| | - Sasan Dabiri
- Otolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohamad Reza Afzalzadeh
- Sinus and Surgical Endoscopic Research Center, Department of Otorhinolaryngology, School of Medicine, Mashhad University of Medical Sciences, 9176717671 Mashhad, Iran
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Kim H, Kong SK, Kim J, Lee HM, Choi SW, Lee IW, Oh SJ. The Optimized Protocol of Hyperbaric Oxygen Therapy For Sudden Sensorineural Hearing Loss. Laryngoscope 2023; 133:383-388. [PMID: 35548932 DOI: 10.1002/lary.30181] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/05/2022] [Accepted: 04/30/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE This study aimed to determine the optimal protocol of hyperbaric oxygen therapy (HBOT) according to various treatment settings for sudden sensorineural hearing loss (SSNHL). METHODS A 112 patients with SSNHL were enrolled in this prospective study. All patients were treated with systemic steroid therapy, intratympanic steroid therapy, and HBOT. According to the pressure and duration of HBOT (10 sessions in total), the patients were divided into three groups: group 1, 2.5 atmospheres absolute (ATA) for 1 h; group 2, 2.5 ATA for 2 h; and group 3, 1.5 ATA for 1 h. The pure-tone average (PTA), word discrimination score (WDS), and mean gain were compared. RESULTS A total of 105 patients completed the 3-month follow-up, and 6 patients were excluded. Differences among groups were found in PTA, WDS, and mean gain. In the post-hoc analysis, group 3 had significantly lower WDS and mean gain than groups 1 and 2; however, group 2 showed no significant differences from group 1. The proportion of patients with hearing recovery after treatment was significantly higher in group 1 (57.6%) and group 2 (58.8%) than in group 3 (31.3%). CONCLUSIONS When HBOT (10 sessions) was combined with corticosteroids as the initial therapy for SSNHL, a higher pressure (1.5 ATA vs. 2.5 ATA) provided better treatment results; however, increasing the duration (1 h vs. 2 h) under 2.5 ATA did not result in a significant difference. Therefore, HBOT for SSNHL may be performed at 2.5 ATA for 1 h in 10 sessions. Laryngoscope, 133:383-388, 2023.
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Affiliation(s)
- Hwabin Kim
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Soo-Keun Kong
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.,Department of Otorhinolaryngology, College of Medicine, Pusan National University, Busan, Republic of Korea
| | - Jia Kim
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Hyun-Min Lee
- Department of Otorhinolaryngology and Biomedical Research Institute, Yangsan Pusan National University Hospital, Yangsan, Republic of Korea
| | - Sung-Won Choi
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Il-Woo Lee
- Department of Otorhinolaryngology, College of Medicine, Pusan National University, Busan, Republic of Korea.,Department of Otorhinolaryngology and Biomedical Research Institute, Yangsan Pusan National University Hospital, Yangsan, Republic of Korea
| | - Se-Joon Oh
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.,Department of Otorhinolaryngology, College of Medicine, Pusan National University, Busan, Republic of Korea
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Idiopathic sudden sensorineural hearing loss: A critique on corticosteroid therapy. Hear Res 2022; 422:108565. [PMID: 35816890 DOI: 10.1016/j.heares.2022.108565] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 06/10/2022] [Accepted: 06/25/2022] [Indexed: 11/22/2022]
Abstract
Idiopathic sudden sensorineural hearing loss (ISSNHL) is a condition affecting 5-30 per 100,000 individuals with the potential to significantly reduce one's quality of life. The true incidence of this condition is not known because it often goes undiagnosed and/or recovers within a few days. ISSNHL is defined as a ≥30 dB loss of hearing over 3 consecutive audiometric octaves within 3 days with no known cause. The disorder is typically unilateral and most of the cases spontaneously recover to functional hearing within 30 days. High frequency losses, ageing, and vertigo are associated with a poorer prognosis. Multiple causes of ISSNHL have been postulated and the most common are vascular obstruction, viral infection, or labyrinthine membrane breaks. Corticosteroids are the standard treatment option but this practice is not without opposition. Post mortem analyses of temporal bones of ISSNHL cases have been inconclusive. This report analyzed ISSNHL studies administering corticosteroids that met strict inclusion criteria and identified a number of methodologic shortcomings that compromise the interpretation of results. We discuss the issues and conclude that the data do not support present treatment practices. The current status on ISSNHL calls for a multi-institutional, randomized, double-blind trial with validated outcome measures to provide science-based treatment guidance.
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Prognostic Factors Influencing the Tinnitus Improvement After Idiopathic Sudden Sensorineural Hearing Loss Treatment. Otol Neurotol 2022; 43:e613-e619. [PMID: 35709422 DOI: 10.1097/mao.0000000000003546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE Logistic regression analysis was used to explore the factors that influence tinnitus improvement after idiopathic sudden sensorineural hearing loss (ISSNHL) treatment. MATERIALS AND METHODS In this retrospective study, 137 ISSNHL patients with tinnitus were recruited at the Sun Yatsen Memorial Hospital of Sun Yat-sen University, China. They underwent audiological examinations, vestibular assessments, tinnitus examinations, a Tinnitus Handicap Inventory (THI) assessment and ISSNHL treatments. Logistic regression analysis was performed to investigate factors that affected tinnitus improvement. RESULTS Participants were divided into an effective group (73 patients) and noneffective group (64 patients) according to THI scores before and after treatment. The effective group had better averaged hearing threshold than the noneffective group (effective group vs. noneffective group: 74.47 vs. 87.66 dB HL; t = 3.03, p < 0.05). Additionally, before intervention there were significant difference in profound audiogram configuration (effective group vs. noneffective group: 17.81% vs. 46.88%, x2 = 23.63; p < 0.001), mid tinnitus pitch (effective group vs. noneffective group: 19.18% vs. 35.94%, x2 = 6.58; p = 0.037) and mean THI scores (effective group vs. noneffective group: 57.07 ± 22.27 vs. 36.78 ± 24.41, t = -5.09, p < 0.001) between the effective and noneffective tinnitus groups. Logistic regression analysis showed that audiogram configurations (profound audiogram: OR = 0.10, 95% CI 0.01-0.72, p = 0.022), tinnitus pitch (mid tinnitus pitch: OR = 0.16, 95% CI 0.05-0.57, p = 0.004) and THI scores (OR = 1.05, 95% CI 1.03-1.07, p < 0.001) were independent factors associated with tinnitus improvement. CONCLUSION Audiogram configuration, tinnitus pitch, and THI scores before intervention appear to be predictive of the effectiveness of acute tinnitus improvement following ISSNHL treatment.
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Lee HJ, Park Y, Lee JM, Yoon C, Kong TH, Jeon E. Comparison of Auditory Outcomes between Inpatient- and Outpatient-Based Treatment in Sudden Sensorineural Hearing Loss. J Clin Med 2022; 11:jcm11113123. [PMID: 35683508 PMCID: PMC9181492 DOI: 10.3390/jcm11113123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/23/2022] [Accepted: 05/30/2022] [Indexed: 01/27/2023] Open
Abstract
Objective: The primary treatment for sudden hearing loss is high-dose steroid therapy. In some countries, hospitalization has been taken for granted. Although most countries appear to treat sudden hearing loss on an outpatient basis, some other countries have considered hospitalization as necessary. Only a few studies have been conducted on the effect of hospitalization on hearing outcomes. Therefore, we compared the hearing outcome of inpatient- and outpatient-based treatments to determine whether hospitalization affects the recovery of sudden hearing loss. Methods: We conducted a retrospective case review of patients diagnosed with sudden sensorineural hearing loss (SSNHL). In total, 439 patients with SSNHL were enrolled and categorized as either inpatients (group I) or outpatients (group O). Pure-tone audiometry was initially performed before the treatment and 3 months post-treatment. “Recovery” was defined as a hearing gain of 15 dB HL and a final hearing of better than 25 dB. “No recovery” was defined as an improvement of hearing gain of <15 dB 3 months after treatment. To exclude the effect of the level of pretreatment hearing loss, we divided the patients into three subgroups based on their hearing level: <40 dB, 40−70 dB, and >70 dB. To assess the effect of the treatment modality, the patients were divided into three treatment subgroups: systemic steroids (SS), intratympanic steroids (ITS), and a combination of both (SS and ITS). Results: The pretreatment hearing level was significantly higher in group I (61.5 ± 25.4 dB) than in group O (50.3 ± 23.0 dB; p < 0.05). The hearing gain was significantly higher in group I (33.3 ± 24.4 dB) than in group O (24.0 ± 21.8 dB; p < 0.05). The “Recovery” ratio was significantly higher in group I (70.2%) than in group O (63.1%) (p < 0.05). A repeated measures ANOVA was performed to assess the statistical differences between hospitalization, treatment modalities, and pretreatment subgroups. The inpatient group showed a significant hearing improvement in all SSNHL patients (p < 0.05). There was a significant hearing improvement in the inpatient group with pretreatment hearing <40 and 40−70 dB (p < 0.05). There was no significant difference between the inpatient and outpatient groups in pretreatment hearing >70 dB (p > 0.05). Conclusions: This retrospective study showed that inpatient treatment for sudden hearing loss is more beneficial for hearing improvement than outpatient treatment. The positive effect of inpatient treatment appears to be significant in patients with a pretreatment hearing level of 70 dB or less.
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Affiliation(s)
- Hyun-Jin Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 21431, Korea; (H.-J.L.); (Y.P.)
| | - Yesai Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 21431, Korea; (H.-J.L.); (Y.P.)
| | - Jeon-Mi Lee
- Department of Otorhinolaryngology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang 10380, Korea;
| | - Chulyoung Yoon
- Department of Biostatistics, Yonsei University Wonju College of Medicine, Wonju 26426, Korea;
- Department of Otorhinolaryngology-Head and Neck Surgery, Yonsei University Wonju College of Medicine, Wonju 26426, Korea;
| | - Tae-Hoon Kong
- Department of Otorhinolaryngology-Head and Neck Surgery, Yonsei University Wonju College of Medicine, Wonju 26426, Korea;
| | - Eunju Jeon
- Department of Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 21431, Korea; (H.-J.L.); (Y.P.)
- Correspondence: ; Tel.: +82-32-280-5903; Fax: +82-50-4411-7964
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Chen Y, Li H, Liu B, Gao W, Yang A, Lv K, Xia H, Zhang W, Yu H, Liu J, Liu X, Wang Y, Han H, Ma G. Cerebral Blood Flow Pattern Changes in Unilateral Sudden Sensorineural Hearing Loss. Front Neurosci 2022; 16:856710. [PMID: 35356053 PMCID: PMC8959761 DOI: 10.3389/fnins.2022.856710] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/15/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThis study analyzed the differences in the cerebral blood flow (CBF) between unilateral Sudden Sensorineural Hearing Loss (SSNHL) patients and healthy controls (HCs). We also investigated CBF differences in auditory-related areas in patients with left- and right-sided SSNHL (lSSNHL and rSSNHL) and HCs. We further explore the correlation between unilateral SSNHL characteristics and changes in the CBF.Methods36 patients with unilateral SSNHL (15 males and 21 females, 40.39 ± 13.42 years) and 36 HCs (15 males and 21 females, 40.39 ± 14.11 years) were recruited. CBF images were collected and analyzed using arterial spin labeling (ASL). CereFlow software was used for the post-processing of the ASL data to obtain the CBF value of 246 subregions within brainnetome atlas (BNA). The Two-sample t-test was used to compare CBF differences between SSNHL patients and HCs. One-way ANOVA or Kruskal-Wallis test was used to compare the CBF difference of auditory-related areas among the three groups (lSSNHL, rSSNHL, and HCs). Then, the correlation between CBF changes and specific clinical characteristics were calculated.ResultsThe SSNHL patients exhibited decreased CBF in the bilateral middle frontal gyrus (MFG, MFG_7_1 and MFG_7_3), the contralateral precentral gyrus (PrG, PrG_6_3) and the bilateral superior parietal lobule (SPL, bilateral SPL_5_1, SPL_5_2, and ipsilateral SPL_5_4), p < 0.0002. Compared with HCs, unilateral SSNHL patients exhibited increased rCBF in the bilateral orbital gyrus (OrG, OrG_6_5), the bilateral inferior temporal gyrus (ITG, contralateral ITG_7_1 and bilateral ITG_7_7), p < 0.0002. lSSNHL showed abnormal CBF in left BA21 caudal (p = 0.02) and left BA37 dorsolateral (p = 0.047). We found that the CBF in ipsilateral MFG_7_1 of SSNHL patients was positively correlated with tinnitus Visual Analog Scale (VAS) score (r = 0.485, p = 0.008).ConclusionOur preliminary study explored CBF pattern changes in unilateral SSNHL patients in auditory-related areas and non-auditory areas, suggesting that there may exist reduced attention and some sensory compensation in patients with SSNHL. These findings could advance our understanding of the potential pathophysiology of unilateral SSNHL.
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Affiliation(s)
- Yue Chen
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Haimei Li
- Department of Radiology, Fuxing Hospital, Capital Medical University, Beijing, China
| | - Bing Liu
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Wenwen Gao
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Aocai Yang
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Kuan Lv
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Hui Xia
- Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing, China
| | - Wenwei Zhang
- Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing, China
| | - Hongwei Yu
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Jian Liu
- Department of Ultrasound Diagnosis, China-Japan Friendship Hospital, Beijing, China
| | - Xiuxiu Liu
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Yige Wang
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Honglei Han
- Department of Otolaryngology, China-Japan Friendship Hospital, Beijing, China
- Honglei Han,
| | - Guolin Ma
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
- *Correspondence: Guolin Ma,
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Zou Y, Ma H, Liu B, Li D, Liu D, Wang X, Wang S, Fan W, Han P. Disrupted Topological Organization in White Matter Networks in Unilateral Sudden Sensorineural Hearing Loss. Front Neurosci 2021; 15:666651. [PMID: 34321993 PMCID: PMC8312563 DOI: 10.3389/fnins.2021.666651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/10/2021] [Indexed: 12/12/2022] Open
Abstract
Sudden sensorineural hearing loss (SSNHL) is a sudden-onset hearing impairment that rapidly develops within 72 h and is mostly unilateral. Only a few patients can be identified with a defined cause by routine clinical examinations. Recently, some studies have shown that unilateral SSNHL is associated with alterations in the central nervous system. However, little is known about the topological organization of white matter (WM) networks in unilateral SSNHL patients in the acute phase. In this study, 145 patients with SSNHL and 91 age-, gender-, and education-matched healthy controls were evaluated using diffusion tensor imaging (DTI) and graph theoretical approaches. The topological properties of WM networks, including global and nodal parameters, were investigated. At the global level, SSNHL patients displayed decreased clustering coefficient, local efficiency, global efficiency, normalized clustering coefficient, normalized characteristic path length, and small-worldness and increased characteristic path length (p < 0.05) compared with healthy controls. At the nodal level, altered nodal centralities in brain regions involved the auditory network, visual network, attention network, default mode network (DMN), sensorimotor network, and subcortical network (p < 0.05, Bonferroni corrected). These findings indicate a shift of the WM network topology in SSNHL patients toward randomization, which is characterized by decreased global network integration and segregation and is reflected by decreased global connectivity and altered nodal centralities. This study could help us understand the potential pathophysiology of unilateral SSNHL.
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Affiliation(s)
- Yan Zou
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hui Ma
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bo Liu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dan Li
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dingxi Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | | - Siqi Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenliang Fan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Han
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Amizadeh M, Mozafarnia K, Moslemikia J, Naghibzadeh-Tahami A. Combination of Pulse Steroid with Intratympanic Injections in Sudden Sensorineural Hearing Loss. IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY 2021; 33:9-13. [PMID: 33654685 PMCID: PMC7897433 DOI: 10.22038/ijorl.2020.43887.2452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Introduction Oral prednisolone was suggested as the first step to treat idiopathic sudden sensorineural hearing loss (ISSHL). This study aimed to investigate the effect of pulse therapy with methylprednisolone and intratympanic methylprednisolone, compared to traditional oral prednisolone therapy on patients with ISSHL. Material and Methods This randomized control trial included an experimental group receiving 500 mg intravenous methylprednisolone for three sequential days, followed by 1 mg/kg oral prednisolone for 11 days, and intratympanic Depo-Medrol four times twice a week. On the other hand, the control group received 1 mg/kg oral prednisolone for 14 days. Hearing change was assessed through pure tone audiometry. Subsequently, hearing recovery was investigated and analyzed in this study. Result This study was conducted on 51 patients who were divided into two groups of experimental (n=26) and control (n=25). The result revealed no significant difference between the two groups in terms of hearing improvement (P=0.28). Conclusion This revealed no added benefit in pulse steroids combined with intratympanic injections in cases with sudden hearing loss.
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Affiliation(s)
- Maryam Amizadeh
- Clinical Research Development Unit, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Keramat Mozafarnia
- Clinical Research Development Unit, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Javad Moslemikia
- Clinical Research Unit, Jiroft University of Medical Science, Jiroft, Iran
| | - Ahmad Naghibzadeh-Tahami
- Modeling of Health Research Center, Institute for Futures Studies in Health, Kerman university ofMedical Science, Kerman, Iran
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Nimodipine and Steroid Combination Therapy for Idiopathic Sudden Sensorineural Hearing Loss. Otol Neurotol 2020; 41:e783-e789. [PMID: 32558748 DOI: 10.1097/mao.0000000000002695] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the treatment outcomes of nimodipine and steroid combination therapy for idiopathic sudden sensorineural hearing loss (ISSNHL). STUDY DESIGN Retrospective case review. SETTING Tertiary referral center. PATIENTS Seventy-eight patients who were diagnosed with ISSNHL were divided into two group based on the treatment strategies used: steroid+nimodipine (SN, n = 36) and steroid only (SO, n = 42) groups. Based on the level of hearing loss before treatment, subgroup analysis (<90 dB HL, SN-S versus SO-S groups; ≥90 dB HL, SN-P versus SO-P groups) was performed. INTERVENTIONS Nimodipine+dexamethasone versus dexamethasone alone. MAIN OUTCOME MEASURES Hearing thresholds and complete/partial recovery rate after treatment. RESULTS Hearing thresholds after treatment were not significantly different between the SN and SO groups (46.8 ± 29.4 versus 54.8 ± 27.6 dB HL, p = 0.218). However, the complete recovery rate was significantly higher in the SN group than in the SO group (41.7% versus 16.8%, p = 0.014). In subgroup analysis, the complete recovery rate was significantly higher in the SN-S group than in the SO-S group (60.9% versus 19.2%, p = 0.003), whereas the difference between the SN-P and SO-P groups was not significant (7.7% versus 12.5%, p = 0.672). The cumulative incidence of complete recovery was significantly higher in SN-S group than in the SO-S group (p = 0.005); the mean recovery time was 4.4 weeks (95% confidence interval [CI], 2.8-6.1) in the SN-S group and 8.8 weeks (95% CI, 7.0-10.5) in the SO-S group. CONCLUSIONS The results of this study suggest that nimodipine and steroid combination therapy for ISSNHL results in a higher complete recovery rate than steroid alone in patients with moderate to severe hearing loss.
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Lyu Y, Zeng F, Yan M, Zhou Z, Zhang W, Liu M, Ke C. Comparison of 2 Different Intratympanic Methylprednisolone Injection Schedules in Combination With Intravenous Dexamethasone for Unilateral Sudden Sensorineural Hearing Loss. EAR, NOSE & THROAT JOURNAL 2020; 100:309S-316S. [PMID: 32070130 DOI: 10.1177/0145561320904816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Sudden sensorineural hearing loss is a common otologic disease in clinic. Systemic and intratympanic steroid treatment have been proved to be effective, but the regimens vary from center to center. The purpose of the study is to analyze the effects of the combined application of intravenous dexamethasone and intratympanic methylprednisolone injection in different time strategies for the treatment of unilateral sudden sensorineural hearing loss. A retrospective chart review was performed for the period from March 2016 to June 2018 at our Department of Otorhinolaryngology-Head and Neck Surgery. A total number of 61 patients who met the academy criteria for unilateral sudden hearing loss were included and grouped based on the time to introduce intratympanic methylprednisolone. All the patients received intravenous dexamethasone 10 mg once daily for 5 days, followed 5 mg once daily for the next 7 days. Intratympanic methylprednisolone (40 mg) was injected every other day 4 times into all patients. This regimen was commenced on day 1 in group 1 and on day 6 in group 2. The pre and posttreatment pure-tone audiograms were analyzed. Sixty-one patients met our inclusion criteria. No significant differences were observed between patients' demographics or pretreatment hearing thresholds. In the 3 months posttreatment pure-tone audiogram assessment, the mean hearing threshold improvement were similar between groups with no frequency specificity. The curative rate in both groups were similar and satisfying. Two patients with diabetes mellitus had persistent small perforations. Some patients had other transient discomfort that disappeared before discharge. The different timing of initiation of intratympanic methylprednisolone injection does not significantly affect the outcome of the treatment for sudden sensorineural hearing loss. Thus, we suggest that intratympanic steroid injection should not be applied as a first-line method except for patients who do not respond early to systemic steroid therapy.
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Affiliation(s)
- Yanlu Lyu
- Department of Otorhinolaryngology-Head and Neck Surgery, 12387Shenzhen People's Hospital, 2nd Clinical Medical College of Jinan University, 1st Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Fanqian Zeng
- Department of Otorhinolaryngology-Head and Neck Surgery, 12387Shenzhen People's Hospital, 2nd Clinical Medical College of Jinan University, 1st Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Min Yan
- Department of Otorhinolaryngology-Head and Neck Surgery, 12387Shenzhen People's Hospital, 2nd Clinical Medical College of Jinan University, 1st Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Zhou Zhou
- Department of Otorhinolaryngology-Head and Neck Surgery, 12387Shenzhen People's Hospital, 2nd Clinical Medical College of Jinan University, 1st Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Wei Zhang
- Department of Otorhinolaryngology-Head and Neck Surgery, 12387Shenzhen People's Hospital, 2nd Clinical Medical College of Jinan University, 1st Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Ming Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, 12387Shenzhen People's Hospital, 2nd Clinical Medical College of Jinan University, 1st Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Chaoyang Ke
- Department of Otorhinolaryngology-Head and Neck Surgery, 12387Shenzhen People's Hospital, 2nd Clinical Medical College of Jinan University, 1st Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, China
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Herrera M, Berrocal JRG, Arumí AG, Lavilla MJ, Plaza G. Update on consensus on diagnosis and treatment of idiopathic sudden sensorineural hearing loss. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2019. [DOI: 10.1016/j.otoeng.2018.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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13
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Suzuki H, Kawaguchi R, Wakasugi T, Do BH, Kitamura T, Ohbuchi T. Efficacy of Intratympanic Steroid on Idiopathic Sudden Sensorineural Hearing Loss: An Analysis of Cases With Negative Prognostic Factors. Am J Audiol 2019; 28:308-314. [PMID: 31046392 DOI: 10.1044/2018_aja-18-0085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Purpose We retrospectively studied the efficacy of intratympanic steroid administration in comparison with hyperbaric oxygen (HBO) therapy for idiopathic sudden sensorineural hearing loss (ISSNHL) with negative prognostic factors. Method We enrolled 301 patients (302 ears) with ISSNHL (average hearing level at 250-4000 Hz ≥ 40 dB; time from onset to treatment ≤ 30 days). From August 2002 to March 2009, 174 patients (174 ears) received systemic steroid plus HBO therapy (HBO group), and from June 2015 to January 2018, 127 patients (128 ears) received systemic plus intratympanic steroid (IT group). Hearing outcomes were evaluated by 6 indices: cure rate, marked-recovery rate (percent of patients with hearing gain ≥ 30 dB), recovery rate (percent of patients with hearing gain ≥ 10 dB), hearing gain, hearing level after treatment, and percent hearing improvement compared to the unaffected contralateral ear. Results The recovery rate was significantly higher in the IT group than in the HBO group (80.5% vs. 68.4%, p = .019). The IT group showed a higher recovery rate than the HBO group in patients aged ≥ 60 years ( p = .010), patients with early (≤ 7 days from onset) treatment ( p = .005), patients with initial hearing levels ≥ 90 dB ( p = .037), and patients with vertigo/dizziness ( p = .040). The IT group also showed higher hearing gain and percent hearing improvement than the HBO group in patients with vertigo/dizziness ( p = .046 and p = .026, respectively). Conclusions Systemic plus intratympanic steroid is more effective for ISSNHL than systemic steroid plus HBO, particularly in patients with negative prognostic factors, such as old age, profound hearing loss, and/or presence of vertigo/dizziness.
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Affiliation(s)
- Hideaki Suzuki
- Department of Otorhinolaryngology—Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health Japan, Kitakyushu
| | - Rintaro Kawaguchi
- Department of Otorhinolaryngology—Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health Japan, Kitakyushu
| | - Tetsuro Wakasugi
- Department of Otorhinolaryngology—Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health Japan, Kitakyushu
| | - Ba Hung Do
- Department of Otorhinolaryngology—Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health Japan, Kitakyushu
| | - Takuro Kitamura
- Department of Otorhinolaryngology—Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health Japan, Kitakyushu
| | - Toyoaki Ohbuchi
- Department of Otorhinolaryngology—Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health Japan, Kitakyushu
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Cai Y, Chen S, Chen Y, Li J, Wang CD, Zhao F, Dang CP, Liang J, He N, Liang M, Zheng Y. Altered Resting-State EEG Microstate in Idiopathic Sudden Sensorineural Hearing Loss Patients With Tinnitus. Front Neurosci 2019; 13:443. [PMID: 31133786 PMCID: PMC6514099 DOI: 10.3389/fnins.2019.00443] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 04/17/2019] [Indexed: 12/26/2022] Open
Abstract
In order to clarify the central reorganization in acute period of hearing loss, this study explored the aberrant dynamics of electroencephalogram (EEG) microstates and the correlations with the features of idiopathic sudden sensorineural hearing loss (ISSNHL) and tinnitus. We used high-density EEG with 128 channels to investigate alterations in microstate parameters between 25 ISSNHL patients with tinnitus and 27 healthy subjects. This study also explored the associations between microstate characteristics and tinnitus features. Microstates were clustered into four categories. There was a reduced presence of microstate A in amplitude, coverage, lifespan, frequency and an increased presence of microstate B in frequency in ISSNHL patients with tinnitus. According to the syntax analysis, a reduced transition from microstate C to microstate A and an increased transition from microstate C to microstate B were found in ISSNHL subjects. In addition, the significant negative correlations were found between Tinnitus Handicap Inventory (THI) scores and frequency of microstate A as well as between THI scores and the probability of transition from microstate D to microstate A. While THI was positively correlated with the transition probability from microstate D to microstate B. To sum up, the significant differences in the characteristics of resting-state EEG microstates were found between ISSNHL subjects with tinnitus and healthy controls. This study suggests that the alterations of central neural networks occur in acute stage of hearing loss and tinnitus. And EEG microstate may be considered as a useful tool to study the whole brain network in ISSNHL patients.
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Affiliation(s)
- Yuexin Cai
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Suijun Chen
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Yanhong Chen
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Jiahong Li
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Chang-Dong Wang
- School of Data and Computer Science, Sun Yat-sen University, Guangzhou, China
| | - Fei Zhao
- Department of Speech Language Therapy and Hearing Science, Cardiff Metropolitan University, Cardiff, United Kingdom.,Department of Hearing and Speech Science, Xinhua College, Sun Yat-sen University, Guangzhou, China
| | - Cai-Ping Dang
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.,Department of Psychology, Guangzhou Medical University, Guangzhou, China
| | - Jianheng Liang
- College of Mathematics and Informatics, South China Agricultural University, Guangzhou, China
| | - Nannan He
- College of Mathematics and Informatics, South China Agricultural University, Guangzhou, China
| | - Maojin Liang
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Yiqing Zheng
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
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Chu CH, Chiou SR, Wang MC, Shiao AS, Tu TY, Lin LY, Huang CY, Liao WH. The Efficacy of Concurrent or Sequential Intravenous and Intratympanic Steroid for Idiopathic Sudden Sensorineural Hearing Loss. Audiol Neurootol 2018; 23:277-284. [DOI: 10.1159/000494966] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 10/29/2018] [Indexed: 11/19/2022] Open
Abstract
Objective: The purpose of this retrospective study was to investigate the difference in treatment outcomes for patients with idiopathic sudden sensorineural hearing loss (SSNHL) undergoing concurrent or sequential intravenous (IV) and intratympanic (IT) steroid therapies. Methods: Patients with idiopathic SSNHL admitted to Taipei Veterans Hospital from August 2011 to August 2012 were enrolled. Patients were treated with both IV dexamethasone 5 mg b.i.d. for 5 days, then tapered over 6 days, and IT injections of dexamethasone 5 mg daily. The administration of IV and IT steroids was given either concurrently or sequentially (IV steroid was administered from days 1–5 followed by IT steroid treatment starting on day 4 or day 5). The hearing outcomes of the concurrent and sequential groups were analyzed. Results: Overall, after ≥2 months following treatment, across frequencies ranging from 250 to 8,000 Hz and pure-tone average (PTA) assessments, hearing improvements were similar between treatment groups, except at the frequencies of 4,000 and 8,000 Hz where the concurrent treatment group had greater hearing gain than the sequential group (4,000 Hz: 30.68 ± 28.96 vs. 14.52 ± 24.06 dB, respectively, p = 0.042; 8,000 Hz: 22.62 ± 23.59 vs. 7.67 ± 21 dB, p = 0.030). Across frequencies and PTA assessments, a similar percentage of patients had ≥20-dB gains in hearing compared with patients treated sequentially, except at 8,000 Hz where a greater percentage of patients in the concurrent group (57.1%) than the sequential group (23.3%) (p = 0.014) had ≥20-dB hearing gains. Conclusion: The findings suggest that both concurrent and sequential treatment improve hearing in patients with idiopathic SSNHL, and that concurrent treatment may show greater benefit than sequential therapy, particularly at high frequencies.
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16
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Herrera M, García Berrocal JR, García Arumí A, Lavilla MJ, Plaza G. Update on consensus on diagnosis and treatment of idiopathic sudden sensorineural hearing loss. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2018; 70:290-300. [PMID: 30093087 DOI: 10.1016/j.otorri.2018.04.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 04/18/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Idiopathic sudden sensorineural hearing loss (ISSNHL) is a sudden, unexplained unilateral hearing loss. OBJECTIVES To update the Spanish Consensus on the diagnosis, treatment and follow-up of ISSNHL. MATERIAL AND METHODS After a systematic review of the literature from 1966 to March 2018, on MESH terms «(acute or sudden) hearing loss or deafness», a third update was performed, including 1508 relevant papers. RESULTS Regarding diagnosis, 11ISSNHL is clinically suspected, the following diagnostic tests are mandatory: otoscopy, acumetry, tonal audiometry, speech audiometry, and tympanometry, to discount conductive causes. After clinical diagnosis has been established, and before treatment is started, a full analysis should be performed. An MRI should then be requested, ideally performed during the first 15 days after diagnosis, to discount specific causes and to help to understand the physiopathological mechanisms in each case. Although treatment is very controversial, due to its effect on quality of life after ISSNHL and the few rare adverse effects associated with short-term steroid treatment, this consensus recommends that all patients should be treated with steroids, orally and/or intratympanically, depending on each patient. In the event of failure of systemic steroids, intratympanic rescue is also recommended. Follow-up should be at day 7, and after 12 months. CONCLUSION By consensus, results after treatment should be reported as absolute decibels recovered in pure tonal audiometry and as improvement in speech audiometry.
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Affiliation(s)
- Mayte Herrera
- Servicio de Otorrinolaringología, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, Madrid, España.
| | - José Ramón García Berrocal
- Servicio de Otorrinolaringología, Hospital Universitario Puerta de Hierro Majadahonda, Universidad Autónoma, Madrid, España
| | - Ana García Arumí
- Servicio de Otorrinolaringología, Hospital Vall d'Hebron, Universidad Autónoma, Barcelona, España
| | - María José Lavilla
- Servicio de Otorrinolaringología, Hospital Clínico, Universidad de Zaragoza, España
| | - Guillermo Plaza
- Servicio de Otorrinolaringología, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, Madrid, España
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Yoshida T, Sone M, Kitoh R, Nishio SY, Ogawa K, Kanzaki S, Hato N, Fukuda S, Hara A, Ikezono T, Ishikawa K, Iwasaki S, Kaga K, Kakehata S, Matsubara A, Matsunaga T, Murata T, Naito Y, Nakagawa T, Nishizaki K, Noguchi Y, Sano H, Sato H, Suzuki M, Shojaku H, Takahashi H, Takeda H, Tono T, Yamashita H, Yamasoba T, Usami SI. Idiopathic sudden sensorineural hearing loss and acute low-tone sensorineural hearing loss: a comparison of the results of a nationwide epidemiological survey in Japan. Acta Otolaryngol 2017; 137:S38-S43. [PMID: 28366083 DOI: 10.1080/00016489.2017.1297539] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the differences between idiopathic sudden sensorineural hearing loss (SSNHL), and acute low-tone sensorineural hearing loss (ALHL) using the results of a nationwide survey database in Japan and to analyze the variables associated with their clinical features and the severity of hearing impairment, treatment, and prognosis. METHODS Participants were patients registered between April 2014 and March 2016 in a multicenter epidemiological survey database involving 30 university hospitals and medical centers across Japan. Statistical analysis was performed to clarify the factors associated with their clinical characteristics and the severity of hearing impairment, treatment, and prognosis. RESULTS Idiopathic SSNHL and ALHL differed significantly in terms of male-to-female ratio, age distribution, and time from onset to start of treatment. The treatment methods and hearing prognosis also differed markedly between the two diseases. A majority (92%) of idiopathic SSNHL patients were administered some type of corticosteroid, while half of the ALHL patients received corticosteroids and a diuretic agent. CONCLUSION The results suggested that idiopathic SSNHL and ALHL belonged to different categories of inner ear disease.
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Affiliation(s)
- Tadao Yoshida
- Department of Otorhinolaryngology, Nagoya University, Graduate School of Medicine, Nagoya, Japan
| | - Michihiko Sone
- Department of Otorhinolaryngology, Nagoya University, Graduate School of Medicine, Nagoya, Japan
| | - Ryosuke Kitoh
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shin-ya Nishio
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kaoru Ogawa
- Department of Otorhinolaryngology Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Sho Kanzaki
- Department of Otorhinolaryngology Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Naohito Hato
- Department of Otolaryngology, Ehime University School of Medicine, Toon, Japan
| | - Satoshi Fukuda
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Akira Hara
- Department of Otolaryngology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Tetsuo Ikezono
- Department of Otorhinolaryngology, Saitama School of Medicine, Moroyama, Japan
| | - Kotaro Ishikawa
- Department of Otolaryngology, Hospital, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan
| | - Satoshi Iwasaki
- Department of Otolaryngology, International University of Health and Welfare, Mita Hospital, Minato, Tokyo, Japan
| | - Kimitaka Kaga
- Division of Hearing and Balance Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Seiji Kakehata
- Department of Otorhinolaryngology, Yamagata University School of Medicine, Yamagata, Japan
| | - Atsushi Matsubara
- Department of Otorhinolaryngology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tatsuo Matsunaga
- Division of Hearing and Balance Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Takaaki Murata
- Department of Otolaryngology, Gunma University Graduate School of Medicine, Maebashi-City, Japan
| | - Yasushi Naito
- Department of Otolaryngology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Takashi Nakagawa
- Department of Otorhinolaryngology, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Kazunori Nishizaki
- Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmacy, Okayama, Japan
| | - Yoshihiro Noguchi
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hajime Sano
- Department of Otolaryngology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Hiroaki Sato
- Department of Otorhinolaryngology, Iwate Medical University, Morioka, Japan
| | - Mikio Suzuki
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan
| | - Hideo Shojaku
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Toyama, Toyama, Japan
| | - Haruo Takahashi
- Department of Otolaryngology, Nagasaki University Faculty of Medicine, Nagasaki, Japan
| | - Hidehiko Takeda
- Department of Otolaryngology, Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan
| | - Testuya Tono
- Department of Otolaryngology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Hiroshi Yamashita
- Department of Otolaryngology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Tatsuya Yamasoba
- Department of Otolaryngology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - Shin-ichi Usami
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
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Wasano K, Tomisato S, Yamamoto S, Suzuki N, Kawasaki T, Ogawa K. Successful continual intratympanic steroid injection therapy in a patient with refractory sensorineural hearing loss accompanied by relapsing polychondritis. Auris Nasus Larynx 2016; 44:489-492. [PMID: 27552828 DOI: 10.1016/j.anl.2016.07.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 07/11/2016] [Accepted: 07/29/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To report the treatment efficacy of continual intratympanic steroid injection (ITSI) therapy in a patient with refractory sensorineural hearing loss accompanied by relapsing polychondritis. PATIENT A 49-year-old female diagnosed with relapsing polychondritis at the age of 45 years and who had been treated with corticosteroids and immunosuppressants developed sensorineural hearing loss in the left ear. INTERVENTION Her unilateral hearing loss did not recover despite receiving one cyclophosphamide pulse treatment, one methylprednisolone pulse treatment, and weekly leukapheresis. Thus, we decided to initiate weekly ITSI therapy. MAIN OUTCOME MEASURE Pure tone audiometry. RESULTS A week after the first ITSI treatment, the patient's hearing improved. We continued ITSI therapy and attempted to extend the interval between treatments, but her hearing worsened when ITSI therapy was delivered at 2- to 3-week intervals. Thus, we returned ITSI therapy to once per week for 21 months (total of 71 treatments). She experienced no adverse events, like tympanic perforation, and 1 year after terminating the therapy, her hearing remained stable and did not worsen. CONCLUSIONS Continual, weekly ITSI therapy was effective in treating sensorineural hearing loss accompanied by relapsing polychondritis. ITSI therapy may be a promising treatment option for sensorineural hearing loss caused by autoimmune disease.
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Affiliation(s)
- Koichiro Wasano
- Department of Otolaryngology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan; Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan.
| | - Shuta Tomisato
- Department of Otolaryngology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan
| | - Sayuri Yamamoto
- Department of Otolaryngology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan
| | - Noriomi Suzuki
- Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Taiji Kawasaki
- Department of Otolaryngology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan
| | - Kaoru Ogawa
- Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
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19
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rb. [The combinations works better in sudden deafness]. MMW Fortschr Med 2016; 158:9. [PMID: 27071559 DOI: 10.1007/s15006-016-8032-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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