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Braverman I, Elziere M, Komazec Z, Cohen-Vaizer M, Kalcioglu MT, Chrobok V, Kazmer I, Hilly O, Esteve-Fraysse MJ, Doweck I, Glotin AL, Fitoussi S, Laredo J, Honnet G. Efficacy and safety of SENS-401 in sudden sensorineural hearing loss: The AUDIBLE-S randomized placebo-controlled phase IIb trial. Am J Otolaryngol 2024; 45:104480. [PMID: 39173396 DOI: 10.1016/j.amjoto.2024.104480] [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: 07/24/2024] [Accepted: 08/01/2024] [Indexed: 08/24/2024]
Abstract
PURPOSE Safety and efficacy of SENS-401, a serotonin type 3 (5-HT3) receptor antagonist and calcineurin inhibitor, in patients with acute sudden sensorineural hearing loss (SSNHL). METHODS Multicentre randomized, double blind, placebo-controlled trial enrolled adult subjects with sudden sensorineural hearing loss (SSNHL) or unilateral/bilateral acute acoustic trauma leading to SSNHL within 96 h of disease onset. Subjects were randomly assigned to one of the three oral dose groups: 29 mg, 43.5 mg or placebo given twice daily for 28 days. The primary endpoint was the change from baseline in Pure Tone Average (PTA) in the affected ear to the end of treatment visit (day 28). Subjects were further followed up 8 weeks after the end of the treatment period (day 84). RESULTS A total of 115 subjects were randomized. SENS-401 was well tolerated. Although the primary efficacy endpoint was not met at day 28, post-hoc analyses revealed clinically significant and meaningful efficacy outcomes with SENS-401 when compared to placebo in a substantial group of participants diagnosed with idiopathic SSNHL and who had received corticosteroid treatment. Notable improvements were observed in the PTA change from baseline, the complete hearing recovery rate, and the Word Recognition Score (WRS), particularly at day 84. The responder rate consistently favored treated subjects over those who received the placebo. CONCLUSION While the primary endpoint was not achieved at the end of the treatment period, the study revealed consistently positive efficacy results of clinical relevance in patients with idiopathic SSNHL who received SENS-401, particularly in the 8-weeks follow-up phase after the completion of the treatment.
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Affiliation(s)
- Itzhak Braverman
- Hillel Yaffe Medical Centre, Ha'shalom, PObox 169, 38100 Hadera, Israel.
| | - Maya Elziere
- Hôpital Européen de Marseille, 6 rue Désirée Clary, 13003 Marseille, France
| | | | | | - Mahmut Tayyar Kalcioglu
- Istambul Medeyinet University Goztepe, Pr Dr Suleyman Yalcin City Hospital, Department of Otorhinolaryngology, Istambul, Turkey
| | - Viktor Chrobok
- Fakultni nemocnice Hradec Kralove -Klinika otorinolaryngologie a chirurgie hlavy a krku, Sokolská 581, 500 05 Hradec Králové, Czech Republic
| | - Igor Kazmer
- Janosikovo Nabrezie 1212, Liptovsky Mikulas 03101, Slovakia
| | - Ohad Hilly
- Rabin Medical Center, Zeev Jabotinsky 39, Petach Tikva 4341492, Israel
| | | | - Ilana Doweck
- Lady Davis Carmel Medical Center, Michal Street 7, Haifa 3436212, Israel
| | | | - Serge Fitoussi
- 375 rue du Professeur Joseph Blayac, 34080 Montpellier, France.
| | - Judith Laredo
- 375 rue du Professeur Joseph Blayac, 34080 Montpellier, France
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Aliyeva A, Edizer DT. Efficacy of intratympanic steroid therapy for severe and profound sudden sensorineural hearing loss. Am J Otolaryngol 2024; 45:104170. [PMID: 38101127 DOI: 10.1016/j.amjoto.2023.104170] [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] [Received: 11/13/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Intratympanic steroids (ITS) in treating sudden sensorineural hearing loss (SSNHL) have become more widespread. AIM This study investigates whether ITS treatment provides additional benefits when combined with systemic steroids (SS) in patients with severe and profound SSNHL. MATERIALS AND METHODS Patients diagnosed with severe and profound SSNHL were divided into two groups: SS group and SS combined with ITS group. Pure-tone audiometry was performed before and three months after treatment completion. The pure-tone average (PTA), frequency-specific hearing gains, and average values were compared between the groups. RESULTS The study included 57 patients (27 SS, 30 ITS), with a mean age of 50.09 ± 15.56. Before treatment: SS PTA 84.40 ± 15 dB HL, ITS 87.50 ± 9.38 dB HL (p = 0.36). After treatment: SS 62.2 ± 23.13 dB HL, ITS 65.17 ± 12.19 dB HL (p = 0.55). Average hearing gain: SS 22.19 ± 13.81 dB HL, ITS 22.33 ± 12.24 dB HL (p = 0.96). Frequency-specific gains were similar (p > 0.05). SS group: 12 slight improvement, 10 no improvement, 3 partial, 2 complete recovery. ITS group: 23 slight improvement, 6 no improvement, 1 partial. CONCLUSION In our study, combining ITS with SS treatment did not provide additional benefits in treating severe and profound SSNHL.
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Affiliation(s)
- Aynur Aliyeva
- The Division of the Otolaryngology, The Cincinnati Children's Hospital Medical Center, OH, USA; Neuroscience Doctoral Program, Yeditepe University, Istanbul, Turkey.
| | - Deniz Tuna Edizer
- Department Of Otorhinolaryngology, School of Medicine, Acibadem University, Istanbul, Turkey
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Choi Y, Han SJ, Kim SK, Hong SM. The therapeutic effect of hyperbaric oxygen therapy in patients with severe to profound idiopathic sudden sensorineural hearing loss. Sci Rep 2024; 14:3321. [PMID: 38337013 PMCID: PMC10858205 DOI: 10.1038/s41598-024-53978-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 02/07/2024] [Indexed: 02/12/2024] Open
Abstract
The optimal treatment for sudden sensorineural hearing loss (SSNHL) is unclear. Hyperbaric oxygen therapy (HBOT) has been suggested as a viable option for treatment of SSNHL as it improves vascular dysfunction. In this study, we evaluated the therapeutic effects of HBOT by retrospectively reviewing the records of 2206 patients with SSNHL. 54 who had received HBOT were selected for the HBOT groups, while 59 age-matched controls who had not were selected for the control groups. The HBOT and control groups were divided into subgroups according to intratympanic steroid (ITS) use. Groups A-D had received oral steroids + HBOT, oral steroids only, oral steroids + ITS + HBOT, and oral steroids + ITS, respectively. Of the 113 SSNHL patients, 21 had diabetes mellitus (DM) (2, 0, 9, and 10 patients in Groups A-D, respectively). There was no notable difference in hearing improvement between patients receiving HBOT and those in the control group. However, among diabetic patients, those who underwent HBOT demonstrated a significant improvement in hearing when compared to the control group. The combination of HBOT and steroids could potentially be beneficial for treating severe to profound SSNHL patients with DM.
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Affiliation(s)
- Yeso Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, #7 Keunjaebong-gil, Hwaseong-si, 18450, Korea
| | - Sung Jun Han
- Department of Otorhinolaryngology-Head and Neck Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, #7 Keunjaebong-gil, Hwaseong-si, 18450, Korea
| | - Sung Kyun Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, #7 Keunjaebong-gil, Hwaseong-si, 18450, Korea
| | - Seok Min Hong
- Department of Otorhinolaryngology-Head and Neck Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, #7 Keunjaebong-gil, Hwaseong-si, 18450, Korea.
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Espinosa-Arce CB, Garcia-Lara LFI, Martinez-Servin ML, Villa AR, Ramirez-Gil LS. Exploring Audiologic Outcomes in Sudden Sensorineural Hearing Loss: A Retrospective Analysis. Cureus 2024; 16:e52977. [PMID: 38406131 PMCID: PMC10893993 DOI: 10.7759/cureus.52977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2024] [Indexed: 02/27/2024] Open
Abstract
Objective This retrospective study aims to present the audiologic outcomes of patients aged 18 years and above who underwent treatment for sudden sensorineural hearing loss (SSNHL) at the tertiary Hospital Central Sur Petróleos Mexicanos in Mexico City, Mexico, between January 2000 and December 2015. Main outcome measures The main outcome measures were patient demographics (age, sex, comorbidities) time from symptom onset to diagnosis and treatment initiation, initial threshold, treatment details (type, dosage, duration), adverse effects, audiometry at diagnosis and at the end of treatment, follow-up duration, and pure-tone average. Results A total of 72 patients were included, with a mean follow-up duration of four months. Comorbidities such as type 2 diabetes mellitus, hypertension, and hypertriglyceridemia were observed in a significant portion of patients. However, these conditions and the use of salvage therapy and adjuvant drugs did not impact hearing recovery. A longer delay from symptom onset to medical attention was associated with a lower gain in decibels (p=0.307). Diabetic patients who received steroid treatment showed a significant gain of at least 15 dB, indicating the greatest benefit in this subgroup. Conclusions Adjuvant drugs may be unnecessary and ineffective in treating SSNHL. Metabolic disorders may be linked to the development of SSNHL. Steroid treatment is the only effective therapeutic option for improving hearing recovery in diabetic patients. Early initiation of treatment after symptom onset is crucial for maximizing auditory recovery.
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Affiliation(s)
- Cecilia Belen Espinosa-Arce
- Department of Otolaryngology-Head and Neck Surgery, Hospital Angeles Metropolitano, Mexico, MEX
- Department of Otolaryngology-Head and Neck Surgery, Hospital Central Sur Petróleos Mexicanos, Mexico, MEX
- Department of Otolaryngology-Head and Neck Surgery, Instituto Mexicano de Otologia y Neurotologia, Mexico, MEX
| | - Leon Felipe I Garcia-Lara
- Department of Otolaryngology-Head and Neck Surgery, Hospital Central Sur Petróleos Mexicanos, Mexico, MEX
| | | | - Antonio R Villa
- Department of Investigation, Faculty of Medicine, Universidad Nacional Autonoma de Mexico, Mexico, MEX
| | - L Stefano Ramirez-Gil
- Department of Otolaryngology-Head and Neck Surgery, Hospital Angeles Metropolitano, Mexico, MEX
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Lemons K, Archambault E, Anderson M, Kaizer A, Baiduc RR. Recovery From Idiopathic Sudden Sensorineural Hearing Loss: Association With Cardiovascular Disease Risk. Am J Audiol 2023; 32:865-877. [PMID: 37748022 DOI: 10.1044/2023_aja-22-00135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023] Open
Abstract
PURPOSE The purpose of this study is to investigate the association between cardiovascular disease (CVD) risk factors and idiopathic sudden sensorineural hearing loss (ISSNHL) disease severity and recovery. METHOD A retrospective medical chart review was performed on 90 patients (n = 48 men; Mage = 59.8 years, SD = 15.8) evaluated for ISSNHL. Major CVD risk factors (current tobacco smoking, diabetes, total cholesterol ≥ 240 mg/dl or treatment, and hypertension [systolic blood pressure [BP]/diastolic BP ≥ 140/ ≥ 90 mmHg or treatment]) determined two CVD risk groups: lower (no major risk factors) and higher (one or more risk factors). Two pure-tone averages (PTAs) were computed: PTA0.5,1,2 and PTA3,4,6,8. Complete recovery of ISSNHL was defined as PTAinitial - PTAfollow-up ≥ 10 dB. Logistic regression estimated the odds of ISSNHL recovery by CVD risk status adjusting for age, sex, body mass index, noise exposure, and treatment. RESULTS Most patients (67.8%) had one or more CVD risk factors. Severity of initial low- and high-frequency hearing loss was similar between CVD risk groups. Recovery was 53.2% for PTA0.5,1,2 and 32.9% for PTA3,4,6,8. With multivariable adjustment, current/former smoking was associated with lower odds of PTA0.5,1,2 recovery (OR = 0.27; 95% CI [0.08, 0.92]). Neither higher CVD risk status nor individual CVD risk factors had a significant association with recovery. For every one-unit increase in Framingham Risk Score, odds of PTA3,4,6,8 recovery were 0.95 times lower (95% CI [0.90, 1.00]) after accounting for age, sex, body mass index, noise exposure, and treatment/time-to-treatment grouping (p = .056). CONCLUSIONS The prognosis of low-frequency ISSNHL recovery is worse among current/former smokers than nonsmokers. Other CVD risk factors and aggregate risk are not significantly related to recovery.
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Affiliation(s)
- Katherine Lemons
- Department of Speech, Language, and Hearing Sciences, University of Colorado Boulder
| | - Emily Archambault
- Department of Speech, Language, and Hearing Sciences, University of Colorado Boulder
| | - Melinda Anderson
- Department of Otolaryngology - Head & Neck Surgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
| | - Alexander Kaizer
- Center for Innovative Design & Analysis, Department of Biostatistics & Informatics, University of Colorado School of Public Health, Aurora
| | - Rachael R Baiduc
- Department of Speech, Language, and Hearing Sciences, University of Colorado Boulder
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Liu Y, Wu W, Li S, Zhang Q, He J, Duan M, Yang J. Clinical characteristics and prognosis of sudden sensorineural hearing loss in single-sided deafness patients. Front Neurol 2023; 14:1230340. [PMID: 37830094 PMCID: PMC10565856 DOI: 10.3389/fneur.2023.1230340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 09/11/2023] [Indexed: 10/14/2023] Open
Abstract
Background Sudden sensorineural hearing loss (SSNHL) in patients with single-sided deafness (SSD) is rare. The prognosis of the sole serviceable hearing ear is very important for these patients. However, the clinical characteristics and prognosis of SSNHL in SSD patients are not well-documented. Objective This study aimed to investigate the clinical features and treatment outcomes of SSNHL in SSD patients. Methods Clinical data of 36 SSD patients and 116 non-SSD patients with unilateral SSNHL from January 2013 to December 2022 were retrospectively investigated. The clinical characteristics of the SSD patients were analyzed. All SSD patients were treated with intratympanic steroids plus intravenous steroids. Pure-tone average (PTA) and word recognition score (WRS) before and after treatment were recorded. The hearing recovery of SSNHL in SSD patients in comparison with non-SSD patients was explored. Auditory outcomes in SSD patients with different etiologies were also compared. Results Initial hearing threshold showed no significant differences between the SSD group and the non-SSD group (66.41 ± 24.64 dB HL vs. 69.21 ± 31.48 dB HL, p = 0.625). The SSD group had a higher post-treatment hearing threshold (median (interquartile range, IQR) 53.13(36.56) dB HL) than the non-SSD group (median 32.50(47.5) dB HL, p < 0.01). Hearing gains (median 8.75(13.00) dB) and the rate of significant recovery (13.89%) were lower in the SSD group than in the non-SSD group (median 23.75(34.69) dB, 45.69%). The etiology of SSD was classified as SSNHL, special types of infection, chronic otitis media, and unknown causes. SSNHL accounted for the maximum proportion (38.9%) of causes of SSD in the SSD group. Hearing gains were lower in the SSNHL-SSD group than in other causes of the SSD group. A binary logistic regression analysis demonstrated that SSD serves as an indicator of unfavorable hearing recovery outcomes (OR = 5.264, p < 0.01). Conclusion The prognosis of SSNHL in SSD patients is unsatisfactory. SSNHL accounts for the maximum proportion of causes of SSD in this group of patients. For SSD patients caused by SSNHL, less hearing improvement after treatment was expected when SSNHL occurred in the contralateral ear in comparison with SSD patients with other causes.
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Affiliation(s)
- Yupeng Liu
- Department of Otorhinolaryngology-Head & Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Wenjin Wu
- Department of Otorhinolaryngology-Head & Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Shuna Li
- Department of Otorhinolaryngology-Head & Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Qing Zhang
- Department of Otorhinolaryngology-Head & Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Jingchun He
- Department of Otorhinolaryngology-Head & Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Maoli Duan
- Ear Nose and Throat Patient Area, Trauma and Reparative Medicine Theme, Karolinska University Hospital, Stockholm, Sweden
- Division of Ear, Nose and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Jun Yang
- Department of Otorhinolaryngology-Head & Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
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Sun H, Jiang W, Wang J. The prognostic value of peripheral blood parameters on all-frequency sudden sensorineural hearing loss. Braz J Otorhinolaryngol 2023; 89:101302. [PMID: 37634408 PMCID: PMC10472238 DOI: 10.1016/j.bjorl.2023.101302] [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] [Received: 11/18/2022] [Revised: 05/10/2023] [Accepted: 08/06/2023] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVE To determine whether peripheral blood parameters have any predictive value for all-frequency Sudden Sensorineural Hearing Loss (SSNHL). METHODS We chose 78 individuals with all-frequency SSNHL who had been admitted to our department. They were divided into two groups: the effective group and the ineffective group. In patients with all-frequency SSNHL, the prognostic variables, including peripheral blood tests and clinical traits, were examined by a logistic regression analysis. In addition, the predictive value was carried out. RESULTS The effective rate of all-frequency SSNHL was 61.5%. Pre-treatment hearing level and the proportion of patients with diabetes were both significantly lower in the effective group than in the ineffective group (p = 0.024 and 0.000, respectively). The levels of fibrinogen and C-reactive protein were also significantly different between the two groups (p = 0.001 and 0.025, respectively). Pre-treatment hearing level and fibrinogen level both significantly impacted the prognosis of all-frequency SSNHL (p = 0.032 and 0.002, respectively), according to a logistic regression analysis. Furthermore, the prognosis was significantly predicted by both fibrinogen level and pre-treatment hearing level (p = 0.001 and 0.0002, respectively). The receiver operating characteristic curve showed that the fibrinogen level had a sensitivity of 85.4% and a specificity of 60.0% for predicting the prognosis of all-frequency SSNHL. CONCLUSION For the prognosis of all-frequency SSNHL, the fibrinogen level can be regarded as a useful predictor. The level of C-reactive protein, however, does not have a significant prognostic effect on predicting all-frequency SSNHL. Therefore, more attention should be devoted to the level of fibrinogen in the acute period of all-frequency SSNHL. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Hongcun Sun
- The Affiliated People's Hospital of Ningbo University, Department of Otorhinolaryngology-Head and Neck Surgery, Ningbo, China.
| | - Wenbo Jiang
- The Affiliated People's Hospital of Ningbo University, Department of Otorhinolaryngology-Head and Neck Surgery, Ningbo, China
| | - Jian Wang
- The Affiliated People's Hospital of Ningbo University, Department of Otorhinolaryngology-Head and Neck Surgery, Ningbo, China
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Yang Y, Gao D, Ma X, Shen J, Zhang Q, Chen X, Zhang Q, Jin Y, Chen J, Duan M, Yang J. Abnormal posterior semicircular canal function may predict poor prognosis in patients with severe and profound ISSNHL. Front Neurol 2023; 14:1123165. [PMID: 36793494 PMCID: PMC9922886 DOI: 10.3389/fneur.2023.1123165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 01/11/2023] [Indexed: 01/31/2023] Open
Abstract
Background Severe and profound idiopathic sudden sensorineural hearing loss (ISSNHL) generally leads to unfavorable prognosis, and has a considerable impact on patient quality of life. However, related prognostic factors remain controversial. Objective To elaborate the relationship between vestibular function impairment and the prognosis of patients with severe and profound ISSNHL, and investigated the relevant factors affecting prognosis. Methods Forty-nine patients with severe and profound ISSNHL were divided into good outcome group [GO group, pure tone average (PTA) improvement > 30 dB] and poor outcome group (PO group, PTA improvement ≤ 30 dB) according to hearing outcomes. The clinical characteristics and the proportion of abnormal vestibular function tests in these two groups were analyzed by univariate analysis, and multivariable logistic regression analysis was performed for parameters with significant differences. Results Forty-six patients had abnormal vestibular function test results (46/49, 93.88%). The number of vestibular organ injuries was 1.82 ± 1.29 in all patients, with higher mean numbers in PO group (2.22 ± 1.37) than in GO group (1.32 ± 0.99). Univariate analysis revealed no statistical differences between the GO and PO groups in terms of gender, age, side of the affected ear, vestibular symptoms, delayed treatment, instantaneous gain value of horizontal semicircular canal, regression gain value of vertical semicircular canal, abnormal rates of oVEMP, cVEMP, caloric test and vHIT in anterior and horizontal semicircular canal, however, significant differences were found in the initial hearing loss and abnormal vHIT of posterior semicircular canal (PSC). Multivariable analysis revealed that only PSC injury was an independent risk factor for predicting the prognosis of patients with severe and profound ISSNHL. Patients with abnormal PSC function had worse initial hearing impairment and prognosis than patients with normal PSC function. The sensitivity of abnormal PSC function in predicting poor prognosis in patients with severe and profound ISSNHL was 66.67%, specificity was 95.45%, and positive and negative likelihood ratios were 14.65 and 0.35, respectively. Conclusion Abnormal PSC function is an independent risk factor for poor prognosis in patients with severe and profound ISSNHL. Ischemia in the branches of the internal auditory artery supplying the cochlea and PSC may be the underlying mechanism.
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Affiliation(s)
- Yang Yang
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Dekun Gao
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Xiaobao Ma
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Jiali Shen
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Qin Zhang
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Xiangping Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Qing Zhang
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Yulian Jin
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Jianyong Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China,*Correspondence: Jianyong Chen ✉
| | - Maoli Duan
- Division of Ear, Nose and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden,Maoli Duan ✉
| | - Jun Yang
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China,Jun Yang ✉
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Chen I, Eligal S, Menahem O, Salem R, Sichel JY, Perez R, Shaul C. Time from sudden sensory neural hearing loss to treatment as a prognostic factor. Front Neurol 2023; 14:1158955. [PMID: 37122288 PMCID: PMC10140592 DOI: 10.3389/fneur.2023.1158955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 03/24/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction The widely accepted treatment for sudden sensorineural hearing loss (SSNHL) is corticosteroid treatment (oral or intratympanic). The main goal of this work is to define the significance of the time between symptom onset and treatment initiation, as well as other prognostic factors, for hearing improvement. Methods This retrospective study included 666 patients treated for SSNHL. Demographic data, audiometry, treatment method, time since symptom onset, and associated symptoms were recorded for each patient. The patients were divided into five groups according to the treatment initiation time-half a week, one week, 2 weeks, 3 weeks, or 4 weeks and over-after symptom onset. The degree of improvement was assessed by comparing the audiometry at the beginning and the end of the treatment. Results The average period of hearing loss from symptom onset to treatment initiation was 10.8 days. Significant differences were found between the groups of half a week, one week, and 2 weeks and the groups of 3 weeks and 4 weeks and over (each separately, p < 0.001). No difference was found between the half-week, one-week, and two-week groups, nor was there a difference between the three-week and four-week-and-over groups. A correlation was found between the treatment initiation time in days and the degree of improvement in hearing for both speech recognition threshold (SRT) and discrimination, R = 0.26 p < 0.001 and R = 0.17 p < 0.001, respectively. No correlation was found for gender, age of the patients, comorbidities, or associated symptoms. Conclusion The threshold for treatment initiation time is up to 2 weeks, after which the amplitude of hearing improvement decreases significantly. The other prognostic factors measured were not found to be statistically significant predictors.
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Wu Y, Song Z, Wang Y, Zhao H, Ren T, Jing J, Gao N, Qiao L, Wang J. Optimal timing of salvage intratympanic steroids in idiopathic sudden sensorineural hearing loss. Laryngoscope Investig Otolaryngol 2022; 7:1559-1567. [PMID: 36258873 PMCID: PMC9575068 DOI: 10.1002/lio2.909] [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: 06/06/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background Salvage intratympanic steroids (ITS) works in patients with idiopathic sudden sensorineural hearing loss (ISSNHL) after failure of initial therapy, but optimal timing of administration is unknown. Methods Two hundred and seventy patients with ISSNHL were included. Among them, 180 were treated with ITS and standard medical treatment (SMT) and the other 90 received SMT along. The hearing threshold before and after salvage treatment were compared. The relationship between the salvage starting time and hearing recovery was analyzed. Results The hearing of ITS group improved more than that of the SMT group in all frequency bands. The effect of both strategies decreases with the delay of the starting time. ITS can improve hearing even if being administrated 5 weeks after onset while SMT failed after 3 weeks. Conclusion Patients with profound ISSNHL can obtain extra hearing recovery from salvage ITS. The earlier salvage starts, the greater the patient benefits.
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Affiliation(s)
- Yongzhen Wu
- Department of Otology and Skull Base SurgeryEye Ear Nose & Throat Hospital, Fudan UniversityShanghaiChina
- National Health Commission Key Laboratory of Hearing MedicineShanghaiChina
| | - Zijun Song
- Department of Otology and Skull Base SurgeryEye Ear Nose & Throat Hospital, Fudan UniversityShanghaiChina
- National Health Commission Key Laboratory of Hearing MedicineShanghaiChina
| | - Yi Wang
- Department of Otology and Skull Base SurgeryEye Ear Nose & Throat Hospital, Fudan UniversityShanghaiChina
- National Health Commission Key Laboratory of Hearing MedicineShanghaiChina
| | - Hui Zhao
- Department of Otology and Skull Base SurgeryEye Ear Nose & Throat Hospital, Fudan UniversityShanghaiChina
- National Health Commission Key Laboratory of Hearing MedicineShanghaiChina
| | - Tongli Ren
- Department of Otology and Skull Base SurgeryEye Ear Nose & Throat Hospital, Fudan UniversityShanghaiChina
- National Health Commission Key Laboratory of Hearing MedicineShanghaiChina
| | - Jianghua Jing
- Department of Otology and Skull Base SurgeryEye Ear Nose & Throat Hospital, Fudan UniversityShanghaiChina
- National Health Commission Key Laboratory of Hearing MedicineShanghaiChina
| | - Na Gao
- Department of Otology and Skull Base SurgeryEye Ear Nose & Throat Hospital, Fudan UniversityShanghaiChina
- National Health Commission Key Laboratory of Hearing MedicineShanghaiChina
| | - Liang Qiao
- Department of Gastroenterology Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Jing Wang
- Department of Otology and Skull Base SurgeryEye Ear Nose & Throat Hospital, Fudan UniversityShanghaiChina
- National Health Commission Key Laboratory of Hearing MedicineShanghaiChina
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11
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Chen SL, Hu CY, Chan KC, Chin SC, Ho CY. Prognostic factors in elderly patients after an intra-tympanic steroid injection for idiopathic sudden sensorineural hearing loss. Am J Otolaryngol 2022; 43:103528. [PMID: 35691052 DOI: 10.1016/j.amjoto.2022.103528] [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: 05/02/2022] [Accepted: 05/30/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Idiopathic sudden sensorineural hearing loss (ISSNHL) presents with emergent hearing impairment and is mainly treated with steroids. However, limited data exist regarding the prognostic factors among elderly patients (>65 years old) who receive an intra-tympanic steroid injection (ITSI). Therefore, we investigated the prognostic factors in these patients. METHODS Between July 2016 and March 2022, we retrospectively enrolled 105 elderly patients (>65 years old) with unilateral ISSNHL who were treated with an ITSI, and recorded their clinical and audiological variables. RESULTS The patients had a mean age of 72.03 ± 6.33 years and mean hearing level gain of 22.86 ± 21.84 dB, speech reception threshold (SRT) gain of 15.77 ± 35.27 dB, and speech discrimination score (SDS) gain of 19.54 ± 27.81 %. According to Siegel's criteria, 5 (4.76 %), 44 (41.91 %), 46 (43.81 %), and 10 (9.52 %) patients had complete recovery, partial recovery, slight improvement, and no improvement, respectively. In the univariate analysis, vertigo (odds ratio [OR] = 0.290, 95 % confidence interval [CI]: 0.130-0.651, p = 0.002) and profound hearing loss on pure tone audiometry (PTA; OR = 0.233, 95 % CI: 0.101-0.536, p = 0.004) were negative prognostic factors among elderly ISSNHL patients. In the multivariate analysis, vertigo (OR = 0.300, 95 % CI: 0.128-0.705, p = 0.005) and profound pure tone audiometry (OR = 0.240, 95 % CI: 0.101-0.570, p = 0.001) were independent adverse prognostic factors among elderly ISSNHL patients. CONCLUSIONS We demonstrated the treatment outcomes of 105 elderly ISSNHL patients after an ITSI. Vertigo and profound PTA are independent adverse risk factors among elderly ISSNHL patients, and patients with these risk factors require active treatment.
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12
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Wang Y, Gao G, Wang L, Ma X, Yu L, Ye F. Association Between the Number of Intratympanic Steroid Injections and Hearing Recovery in Sudden Sensorineural Hearing Loss. Front Neurol 2022; 12:798569. [PMID: 34970216 PMCID: PMC8712747 DOI: 10.3389/fneur.2021.798569] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 11/22/2021] [Indexed: 11/13/2022] Open
Abstract
The frequency of intratympanic (IT) steroid injection varies from once daily to once weekly or less among studies and does not reach a uniform standard. This study investigated the potential association between the number of IT steroid injections and hearing recovery to determine the optimal number in sudden sensorineural hearing loss (SSNHL) patients. A retrospective study involving 233 SSNHL patients receiving IT steroids plus batroxobin within 7 days of onset was performed. Patients were followed up for 3 months. More than 15 dB of HL improvement in the pretreatment pure tone average (PTA) was defined as effective. The effective group had a higher IT injection numbers than the ineffective group (≥ 6 times: 84.6 vs. 61.1, p < 0.001). Regardless of the unadjusted model or adjusted model, patients who received more frequent IT steroid injections seemed more likely to recover hearing (unadjusted model, OR, 95% CI: 1.25, 1.06-1.48; p = 0.007; adjusted model, OR, 95% CI: 1.21, 1.01-1.45; p = 0.044). Six IT injections had the highest rate of hearing recovery (79.1%). In conclusion, IT injection number was an independent factor that was positively associated with hearing recovery, and the optimal number of IT steroid injections was 6. Batroxobin plus higher number of IT steroid injections showed more effective for treating SSNHL.
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Affiliation(s)
- Yixu Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, People's Hospital, Peking University, Beijing, China
| | - Ge Gao
- Department of Radiology, First Hospital, Peking University, Beijing, China
| | - Le Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, First Affiliated Hospital of Zheng Zhou University, Zhengzhou, China
| | - Xin Ma
- Department of Otorhinolaryngology, Head and Neck Surgery, People's Hospital, Peking University, Beijing, China
| | - Lisheng Yu
- Department of Otorhinolaryngology, Head and Neck Surgery, People's Hospital, Peking University, Beijing, China
| | - Fanglei Ye
- Department of Otorhinolaryngology, Head and Neck Surgery, First Affiliated Hospital of Zheng Zhou University, Zhengzhou, China
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Xiao L, Su S, Liang J, Jiang Y, Shu Y, Yao H, Ding L. Clinical features and prognostic factors of children with profound sudden sensorineural hearing loss. Front Pediatr 2022; 10:1023781. [PMID: 36419913 PMCID: PMC9676955 DOI: 10.3389/fped.2022.1023781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 10/11/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To investigate the clinical features and factors affecting the prognosis of children with profound sudden sensorineural hearing loss (SSNHL). METHODS We retrospectively analyzed the clinical data of 147 children with profound SSNHL who received inpatient treatment at our department from January 2016 to January 2021. All children were administered with systemic steroid therapy and/or intratympanic steroid (ITS) treatment for 2 weeks. Statistical analyses were performed for the clinical features, treatment effectiveness, and factors affecting the prognosis using SPSS 23.0. RESULTS The median age of the study population was 8 (6-10) years. The median treatment onset time was 8 (4-20) days. The most common concomitant symptom was tinnitus (45.58%). Laboratory findings showed that the percentages of children with abnormal leukocytes was 25.85%, abnormal platelet counts was 17.01%, abnormal cytomegalovirus IgG antibodies was 36.73% and abnormal Epstein-Barr (EB) virus IgG antibodies was 41.50%. The overall recovery rate of the treatment was 20.04%. The univariate analysis showed that age, treatment onset time, tinnitus, and ITS treatment were associated with the prognosis (p < 0.05). Regarding laboratory findings, the neutrophil count, lymphocyte count, and neutrophil-to-lymphocyte ratio differed significantly between the effective and invalid treatment effect groups (p < 0.05). The multivariable logistic regression analysis showed that treatment onset time [odds ratio (OR) = 0.936, 95% confidence interval (CI): 0.881-0.994] and ITS treatment (OR = 0.174, 95% CI: 0.044-0.0687) correlated with hearing recovery (p < 0.05). CONCLUSION In this study, the earlier the treatment start time of children with profound SSNHL, the better was the prognosis. Further, ITS could be an effective treatment option.
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Affiliation(s)
- Ling Xiao
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Shuping Su
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Jia Liang
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Ying Jiang
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Yan Shu
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Hongbing Yao
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Ling Ding
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
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14
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Early S, van der Valk JC, Frijns JHM, Stankovic KM. Accelerated Long-Term Hearing Loss Progression After Recovery From Idiopathic Sudden Sensorineural Hearing Loss. Front Neurol 2021; 12:738942. [PMID: 34956043 PMCID: PMC8693444 DOI: 10.3389/fneur.2021.738942] [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: 07/09/2021] [Accepted: 10/19/2021] [Indexed: 11/26/2022] Open
Abstract
Background and Introduction: Idiopathic sudden sensorineural hearing loss (ISSNHL) is characterized by rapid onset, typically unilateral presentation, and variable recovery. This case-control observational study aimed to improve patient counseling by objectively characterizing long-term hearing loss progression following ISSNHL, using sequential audiometry in the largest-to-date cohort of patients with ISSNHL. Methods: Patients diagnosed with ISSNHL at a tertiary referral hospital from 1994 through 2018 with sequential audiometry were studied. Case controls with sensorineural hearing loss (SNHL) were matched by age, sex, baseline hearing status, and frequency of sequential audiometry. Hearing loss progression was quantified using Kaplan–Meier (K–M) analysis to account for variable follow-up duration. A subgroup analysis was performed by age, sex, preexisting comorbidities, ISSNHL-associated symptoms, ISSNHL treatment, and degree of post-ISSNHL hearing recovery. Results: A total of 660 patients were identified with ISSNHL. In patients with post-ISSNHL recovery to good hearing [pure tone average (PTA) <30 dB and word recognition score (WRS) > 70%], median time to progression to non-serviceable (PTA > 50 dB or WRS <50%) SNHL was 16.4 years. In patients with incomplete post-ISSNHL hearing recovery, contralateral ears were also at significantly higher risk of SNHL progression over the following 12-year period. Male sex was associated with increased risk of SNHL progression [odds ratio (OR) 3.45 male vs. female] at 5-year follow up. No other subgroup factors influenced the likelihood of SNHL progression. Discussion and Conclusion: Patients should be counseled on continued risk to long-term hearing after stabilization of hearing post-ISSNHL, with particular emphasis on greater risk to the contralateral ear in those with incomplete ipsilateral recovery.
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Affiliation(s)
- Samuel Early
- Eaton-Peabody Laboratories, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, United States.,Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, United States.,Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California, San Diego Medical Center, San Diego, CA, United States
| | - Jens C van der Valk
- Eaton-Peabody Laboratories, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, United States.,Leiden University Medical Center, Leiden, Netherlands
| | - Johan H M Frijns
- Leiden University Medical Center, Leiden, Netherlands.,Department of Otolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, Netherlands.,Leiden Institute for Brain and Cognition, Leiden, Netherlands
| | - Konstantina M Stankovic
- Eaton-Peabody Laboratories, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, United States.,Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, United States.,Department of Otolaryngology Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, United States
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15
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Kwak C, Seo YJ, Yoon C, Lee J, Han W. The value of having an initial word recognition score for a precise prognosis of idiopathic sudden sensorineural hearing loss. Auris Nasus Larynx 2021; 49:554-563. [PMID: 34772562 DOI: 10.1016/j.anl.2021.10.005] [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] [Received: 08/08/2021] [Revised: 09/27/2021] [Accepted: 10/13/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Although the hearing thresholds of patients with idiopathic sudden sensorineural hearing loss (ISSNHL) closely relate to the prognosis that results in progressive floor effects, many studies have usually used hearing thresholds as the main outcome of the measurement of prognostic factors. The present study aimed to identify the prognostic factors related to initial hearing tests and speculates the effects of word recognition score (WRS) on the prognoses for patients with ISSNHL. METHODS Between March 2011 and November 2020, we retrospectively reviewed chart profiles of 2,636 ISSNHL patients. The 180 patients who met the inclusion criteria were asked to participate in the present study. Based on their initial WRS, all these patients were divided into good WRS (GW) and poor WRS (PW) groups with 52% as the cut-off points. Demographic, clinical, and audiological variables, such as age, onset time, duration of treatment, gender, ear side, comorbidities (i.e., hypertension, diabetes mellitus, tinnitus, dizziness), hearing configuration (i.e., ascending, descending, flat, irregular, and profound), treatment options (i.e., systemic corticosteroid therapy per oral, intratympanic steroid injection, and hyperbaric oxygen therapy), and WRS were analyzed as being underlying prognostic factors. RESULTS Both groups showed significantly different distributions for hearing thresholds and hyperbaric oxygen therapy (HBOT) as general characteristics. The results of a multivariate logistic regression analysis showed that the odds ratio (OR) of age (OR: 0.96, 95% CI: 0.59 - 24.25), duration of treatment (OR: 0.98, 95% CI: 0.96 - 1.00), ascending configuration (OR: 4.97, 95% CI: 1.64 - 16.62), irregular configuration (OR: 4.58, 95% CI: 1.62 - 13.79), and WRS (OR: 1.01, 95% CI: 1.00 - 1.02) were the significant prognostic factors for all the patients. Further analysis of those patients with WRS under 52% cut-off points showed that an ascending configuration (OR: 5.87, 95% CI: 1.18 - 35.99), irregular configuration (OR: 8.03, 95% CI: 1.69 - 46.30), and WRS (OR: 1.05, 95% CI: 1.01 - 1.10) significantly affected the prognosis. As the initial WRS of ISSNHL patients decreased, the OR of the WRS itself increased. These results suggested that the importance of WRS as the prognostic factor was stressed for PW patients. CONCLUSION The age, duration of treatment, initial hearing configuration (ascending and irregular types), and WRS were the significant prognostic factors for patients with ISSNHL. It was learned that WRS could be a remarkable prognostic factor to consider, especially for ISSNHL patients with poor WRS.
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Affiliation(s)
- Chanbeom Kwak
- Laboratory of Hearing and Technology, Research Institute of Audiology and Speech Pathology, College of Natural Sciences, Hallym University, Chuncheon, Korea; Division of Speech Pathology and Audiology, College of Natural Sciences, Hallym University, Chuncheon, Korea
| | - Young Joon Seo
- Department of Otorhinolaryngology, Yonsei University Wonju College of Medicine, Wonju, Korea; Research Institute of Hearing Enhancement, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - ChulYoung Yoon
- Department of biostatistics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - JuHyung Lee
- Department of biostatistics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Woojae Han
- Laboratory of Hearing and Technology, Research Institute of Audiology and Speech Pathology, College of Natural Sciences, Hallym University, Chuncheon, Korea; Division of Speech Pathology and Audiology, College of Natural Sciences, Hallym University, Chuncheon, Korea.
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16
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Goshtasbi K, Chua JT, Risbud A, Sarna B, Jamshidi S, Abouzari M, Djalilian HR. Treatment of Long-term Sudden Sensorineural Hearing Loss as an Otologic Migraine Phenomenon. Otol Neurotol 2021; 42:1001-1007. [PMID: 33710150 PMCID: PMC8282717 DOI: 10.1097/mao.0000000000003111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To describe a cohort of patients presenting with long-term sudden sensorineural hearing loss (SSNHL) treated with prophylactic migraine and intratympanic steroid therapy. METHODS Patients presenting to a neurotology clinic at least 6 weeks from SSNHL onset were included. All patients received migraine prophylactic medication (nortriptyline, topiramate, and/or verapamil) and lifestyle changes for at least 6 weeks, as well as intratympanic steroid injections, if appropriate. RESULTS Twenty-one patients (43% female) with a mean age of 64 ± 11 years who presented 9 ± 8 months (median = 5) from symptom onset were included. Posttreatment hearing thresholds were significantly improved compared with pretreatment thresholds at 500 Hz (49 ± 19 dB versus 55 ± 20 dB, p = 0.01), 1000 Hz (52 ± 19 dB versus 57 ± 21 dB, p = 0.03), low-frequency pure-tone average (53 ± 15 dB versus 57 ± 17 dB, p = 0.01), and speech-frequency pure-tone average (57 ± 13 dB versus 60 ± 15 dB, p = 0.02). Posttreatment word-recognition-score (WRS) and speech-recognition-threshold (SRT) were also significantly improved (45 ± 28% versus 70 ± 28% and 57 ± 18 dB versus 50 ± 16 dB, respectively, both p < 0.01). Notably, ≥15% improvement in WRS and ≥10 dB improvement in SRT was observed in 13 (68%) and 8 (40%) patients, respectively. Of the 11 patients who presented with initial < 50% WRS, 8 (73%) had improved posttreatment >50% WRS with an average improvement of 39 ± 9%. CONCLUSIONS Migraine medications in addition to intratympanic steroid injections significantly improved SRT and hearing frequencies in 40% and 29% of SSNHL patients, respectively, while significant WRS recovery was observed in most (68%) patients. This suggests SSNHL may be an otologic migraine phenomenon, which may be at least partially reversible even after the traditional 30-day postonset window.
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Affiliation(s)
- Khodayar Goshtasbi
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, USA
| | - Janice T. Chua
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, USA
| | - Adwight Risbud
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, USA
| | - Brooke Sarna
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, USA
| | - Shahrnaz Jamshidi
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, USA
| | - Mehdi Abouzari
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, USA
| | - Hamid R. Djalilian
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, USA
- Department of Biomedical Engineering, University of California, Irvine, USA
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Elias TGA, Monsanto RDC, do Amaral JB, Oyama LM, Maza PK, Penido NDO. Evaluation of Oxidative-Stress Pathway and Recovery of Sudden Sensorineural Hearing Loss. Int Arch Otorhinolaryngol 2021; 25:e428-e432. [PMID: 34377180 PMCID: PMC8321640 DOI: 10.1055/s-0040-1714130] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 06/05/2020] [Indexed: 01/22/2023] Open
Abstract
Introduction Although the pathogenesis of sudden sensorineural hearing loss (SSNHL) has been discussed in the literature, many unclear points remain. Several authors have hypothesized that oxidative stress plays a role in the pathogenesis of noise-related hearing loss, as well as in drug- and aging-related hearing loss. Reactive oxygen species (ROS) may contribute to the pathogenesis of SSNHL in a similar way as in cases of ototoxicity, noise-induced hearing loss and presbyacusis. Objective The aim of the present study was to find potential peripheral biomarkers to show the levels of oxidative stress in samples of peripheral blood collected from SSNHL patients with and withouth metabolic disease. Methods In total, 80 consecutive patients with SSNHL were evaluated in the otolaryngology emergency room and outpatient clinic of a tertiary hospital between May 2017 and May 2019. All patients underwent detailed anamnesis, physical examination, audiometry, magnetic resonance imaging (MRI) of the inner ears, and blood tests for serum lipids and plasma activity of thiobarbituric acid reactive species (TBARS). Results No significant effect of malondialdehyde (MDA) activity was observed regarding the hearing recovery of patients who developed SSNHL. Conclusion We did not observe a significant correlation between the concentration of TBARs in the peripheral blood or the presence of arterial hypertension and the severity of the initial hearing loss or the prognosis of hearing recovery in patients with SSNHL. The concentration of TBARs in the peripheral blood may not adequately represent the abnormalities that occur in the intracoclear environment.
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Affiliation(s)
- Thaís Gomes Abrahão Elias
- Department of Otolaryngology, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, SP, Brazil
| | - Rafael da Costa Monsanto
- Department of Otolaryngology, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, SP, Brazil
| | - Jonatas Bussador do Amaral
- Department of Otolaryngology, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, SP, Brazil
| | - Lila Missae Oyama
- Department of Nutrition Physiology, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, SP, Brasil
| | - Paloma Korehisa Maza
- Department of Nutrition Physiology, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, SP, Brasil
| | - Norma de Oliveira Penido
- Department of Otolaryngology, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, SP, Brazil
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The role of serum salusin alpha and beta levels and atherosclerotic risk factors in idiopathic sudden hearing loss pathogenesis. Eur Arch Otorhinolaryngol 2021; 279:1311-1316. [PMID: 33870451 DOI: 10.1007/s00405-021-06804-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim of this study was to investigate the importance of atherosclerosis in the pathogenesis of sudden hearing loss by evaluating the newly discovered markers, serum salusin-α and salusin-β. We also aimed to evaluate atherosclerosis risk factors, such as lipid profile, smoking, body mass index, waist circumference and mean blood pressure of the patients. METHODS Fifty-two patients diagnosed with sudden hearing loss (study group) and fifty healthy people (control group) were included in the study. Detailed history was taken from the patients and risk factors for atherosclerosis, such as smoking, body mass index, waist circumference, lipid profile, mean blood pressure and serum salusin-α and salusin-β levels, were evaluated. The study group was divided into recovery group (subgroup I) and non-recovery group (subgroup II). RESULTS The salusin-β median value was found to be significantly higher in the study group compared to the control group (p < 0.05). The salusin-β median value was found to be significantly higher in subgroup 2 and was found to be a poor prognostic factor (p < 0.05). CONCLUSION From the results obtained in this study, it is thought that salusin-β peptide is increased in patients with sudden hearing loss and it can be evaluated as a poor prognostic factor.
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Song MH, Jung SY, Gu JW, Shim DB. Therapeutic efficacy of super-high-dose steroid therapy in patients with profound sudden sensorineural hearing loss: a comparison with conventional steroid therapy. Acta Otolaryngol 2021; 141:152-157. [PMID: 33176548 DOI: 10.1080/00016489.2020.1842493] [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: 10/23/2022]
Abstract
BACKGROUND In patients with sudden sensorineural hearing loss (SSNHL), steroid therapy is an optional treatment method, but there is controversy about its dose. OBJECTIVE We aimed to compare the efficacy of super-high-dose steroid therapy with that of conventional steroid therapy in patients with profound SSNHL (pSSNHL). MATERIAL AND METHODS Fifty-two patients diagnosed with pSSNHL between March 2010 and May 2017 were divided into the following groups based on their steroid regimen: a conventional steroid regimen (prednisolone at 1.0 mg/kg/day for 10 days) was applied in Group 1, and a super-high-dose steroid regimen (prednisolone at 1.5 mg/kg/day for 14 days) was applied in Group 2. The treatment outcomes were compared between the groups at 2 and 4 weeks after the initial treatment by use of Siegel's criteria. RESULTS Of the 52 patients, 31 were classified into Group 1 and 21 into Group 2. When comparing the proportion of patients in complete or partial recovery by Siegel's criteria, the recovery rate was significantly higher in Group 2 than in Group 1 (19% vs 0%, p = .022 at 2 weeks; 35.7% vs 7.4%, p = 0.035 at 4 weeks). CONCLUSIONS AND SIGNIFICANCE Patients with pSSNHL treated using the super-high-dose steroid regimen demonstrated better recovery rates to serviceable hearing than did those treated using the conventional steroid regimen without significant complications.
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Affiliation(s)
- Mee Hyun Song
- Department of Otorhinolaryngology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - Su Young Jung
- Department of Otorhinolaryngology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - Ja Won Gu
- Department of Otorhinolaryngology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - Dae Bo Shim
- Department of Otorhinolaryngology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
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Wang Y, Wang L, Jing Y, Yu L, Ye F. Association Between Hearing Characteristics/Prognosis and Vestibular Function in Sudden Sensorineural Hearing Loss With Vertigo. Front Neurol 2020; 11:579757. [PMID: 33391149 PMCID: PMC7773829 DOI: 10.3389/fneur.2020.579757] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 11/30/2020] [Indexed: 12/02/2022] Open
Abstract
Sudden sensorineural hearing loss (SSNHL) patients with vertigo have a poorer prognosis. However, the factors associated with hearing recovery remain uncertain. This retrospective study was to evaluate the association between hearing characteristics/hearing recovery and the patterns of vestibulocochlear lesions in SSNHL patients with vertigo. Patients were classified into groups according to the patterns of vestibular dysfunction. We not only compared hearing characteristics and prognosis among subgroups but also determined the potential association between vestibular lesion location and hearing recovery. The shapes of the audiogram differed significantly between patients with normal vestibular function and patients with vestibular dysfunction (p = 0.022). Patients whose audiogram indicated profound hearing loss were 3.89 times more likely to have vestibular dysfunction than those whose audiogram shape indicated low-frequency hearing loss (95% CI, 1.02–14.86, p = 0.047). Patients who had saccule dysfunction were 0.11 times as likely to have hearing recovery than those who had normal saccule function (95% CI, 0.11–0.31, p = 0.001). When adjusted for sex and age, patients who had saccule dysfunction were 0.07 times as likely to have hearing recovery than those who had normal saccule function (95% CI, 0.02–0.22, p = 0.001). Abnormal results following cVEMP testing may be a potential predictive factor for poor hearing recovery.
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Affiliation(s)
- Yixu Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, People's Hospital, Peking University, Beijing, China
| | - Le Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, First Affiliated Hospital of Zheng Zhou University, Zhengzhou, China
| | - Yuanyuan Jing
- Department of Otorhinolaryngology, Head and Neck Surgery, People's Hospital, Peking University, Beijing, China
| | - Lisheng Yu
- Department of Otorhinolaryngology, Head and Neck Surgery, People's Hospital, Peking University, Beijing, China
| | - Fanglei Ye
- Department of Otorhinolaryngology, Head and Neck Surgery, First Affiliated Hospital of Zheng Zhou University, Zhengzhou, China
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Choi JW, Lee CK, Kim SB, Lee DY, Ko SC, Park KH, Choi SJ. Potential benefits of salvage intratympanic dexamethasone injection in profound idiopathic sudden sensorineural hearing loss. Eur Arch Otorhinolaryngol 2020; 277:2219-2227. [PMID: 32296977 DOI: 10.1007/s00405-020-05967-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/03/2020] [Indexed: 01/23/2023]
Abstract
PURPOSES To compare hearing recovery levels after initial treatment or salvage intratympanic dexamethasone injection (ITDI), and to find the prognostic factor on salvage ITDI therapy in profound ISSNHL. METHODS We retrospectively reviewed 115 patients with profound ISSNHL. All patients were treated with combination or systemic steroid therapy as the initial treatment. Next, we used salvage ITDI therapy on patients who showed slight or no improvement according to Siegel's criteria. To find the prognostic factors for the effectiveness of salvage ITDI therapy, we analyzed clinical data, such as, age, sex, vertigo, symptom duration, diabetes, hypertension, initial PTA, pre-salvage PTA, and treatment methods, using multiple regression analyses. RESULTS The rate of serviceable hearing recovery were 10.4% (12/115) in the initial-treatment group and 20.4% (21/103) in the salvage group. The difference was statistically significant (p = 0.041). Pre-salvage PTA, diabetes mellitus, and symptom duration were affective factors for the effectiveness of salvage ITDI therapy in profound ISSNHL refractory to initial treatment, with odds ratios of 1.169 (95% confidence interval, 1.088-1.256), 0.069 (95% confidence interval, 0.005-0.889), and 9.242 (95% confidence interval, 1.079-79.146). CONCLUSIONS Salvage therapy should be considered for profound ISSNHL, which is expected to result in poor prognosis or hearing recovery: ITSI therapy might be an effective treatment as salvage therapy.
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Affiliation(s)
- Jin Woong Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Chi Kyou Lee
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Soonchunhyang University, Cheonan Hospital, Cheonan, Republic of Korea
| | - Sang Bin Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Soonchunhyang University, Cheonan Hospital, Cheonan, Republic of Korea
| | - Dong Yun Lee
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Soonchunhyang University, Cheonan Hospital, Cheonan, Republic of Korea
| | - Sung Chul Ko
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Soonchunhyang University, Cheonan Hospital, Cheonan, Republic of Korea
| | - Kye Hoon Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Soonchunhyang University, Cheonan Hospital, Cheonan, Republic of Korea
| | - Seong Jun Choi
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Soonchunhyang University, Cheonan Hospital, Cheonan, Republic of Korea.
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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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Efficacy and Safety of AM-111 in the Treatment of Acute Unilateral Sudden Deafness-A Double-blind, Randomized, Placebo-controlled Phase 3 Study. Otol Neurotol 2020; 40:584-594. [PMID: 31083077 PMCID: PMC6553962 DOI: 10.1097/mao.0000000000002229] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective: To confirm the efficacy and safety of AM-111 (brimapitide), a cell-penetrating c-Jun N-terminal Kinase (JNK) inhibitor, in patients suffering from severe to profound acute unilateral idiopathic sudden sensorineural hearing loss (ISSNHL). Study design: Prospective, double-blind, randomized, placebo-controlled phase 3 study with follow-up visits on Days 3, 7, 28, and 91. Setting: Fifty-one European and Asian sites (tertiary referral centers, private ENT practices). Patients: Two hundred fifty-six patients aged 18 to 65 years presenting within 72 hours following ISSNHL onset with mean hearing loss ≥ 40 dB and mean threshold ≥ 60 dB at the 3 worst affected contiguous test frequencies. Interventions: Single-dose intratympanic injection of AM-111 (0.4 or 0.8 mg/ml) or placebo; oral prednisolone as reserve therapy if hearing improvement < 10 dB at Day 7. Main outcome measures: Hearing improvement to Day 28 was the primary efficacy endpoint; complete hearing recovery, frequency of reserve therapy used, complete tinnitus remission, improvement in word recognition were secondary endpoints. Safety was evaluated by the frequency of clinically relevant hearing deterioration and adverse events. Results: While the primary efficacy endpoint was not met in the overall study population, post-hoc analysis showed a clinically relevant and nominally significant treatment effect for AM-111 0.4 mg/ml in patients with profound ISSNHL. The study drug and the administration procedure were well tolerated. Conclusions: AM-111 provides effective otoprotection in case of profound ISSNHL. Activation of the JNK stress kinase, AM-111's pharmacologic target, seems to set in only following pronounced acute cochlear injury associated with large hearing threshold shifts.
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Abstract
OBJECTIVE To investigate the characteristics, treatment, and prognostic factors of sudden sensorineural hearing loss (SSNHL) in children. METHODS Seventy-five cases (78 ears) of SSNHL in children from February 2011 to June 2016 were retrospectively analyzed. We scrutinized the clinical manifestations, audiological assessments, and serologic examinations of these pediatric cases by univariate and multivariate logistic analysis methods. The patients were divided into four groups according to their audiometric curve type: ascending, descending, flat, and profound. RESULTS Of the 75 patients (78 ears), 25 patients were in the ascending group (32.00%), 9 patients were in the descending group (12.00%), 17 patients were in the flat group (22.67%), and 24 patients were in the profound group (32.32%). The overall recovery rates (complete + partial + slight) of the different groups were as follows: ascending group, 96.00%; flat group, 76.47%; profound group, 50.00%; and descending group, 44.44%. The overall recovery rate of all patients was 70.67%. The multivariate logistic analysis showed that the type of audiometric curve and the interval from onset to intervention were two independent risk factors that correlated with the prognosis of SSNHL in children. Some children had positive cytomegaoviyns, rubella virus, and herpes simplex virus immunoglobulin G antibodies. Twenty-one children were treated with additional intratympanic methylprednisolone as salvage therapy and 13 of these children showed improved (complete + partial + slight) recoveries. Three children had postauricular compound betamethasone injections, but none of them showed improvement. One of three children recovered slightly after treatment with intratympanic methylprednisolone combined with postauricular betamethasone injection. CONCLUSIONS The prognosis of SSNHL in children is closely related to the type of audiometric curve and the onset of treatment. Intratympanic methylprednisolone and compound betamethasone injected postauricularly could be effective for SSNHL in children.
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Yu H, Li H. Association of Vertigo With Hearing Outcomes in Patients With Sudden Sensorineural Hearing Loss: A Systematic Review and Meta-analysis. JAMA Otolaryngol Head Neck Surg 2019; 144:677-683. [PMID: 29931169 DOI: 10.1001/jamaoto.2018.0648] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Importance Sudden sensorineural hearing loss (SSHL) accompanied by vertigo may portend a negative prognosis in the hearing outcome. Objective To investigate the association of vertigo with prognosis of hearing variables in SSHL. Data Sources A literature search of eligible studies was performed in PubMed, Web of Science, and Embase from September 26, 1973, through September 26, 2017. Studies published in English were retrieved with no restrictions on the date of publication. References were identified by screening the proceedings of relevant reviews, and annual meeting and other correlative papers were scanned manually for enrollment. Study Selection All original research studies and retrospective or prospective studies focusing on the role of vertigo in the prognosis for the hearing outcome of SSHL were systematically retrieved. Studies that did not include data regarding the association between the rate of hearing recovery and vertigo were excluded, as were reviews, comments, case reports, editorials, letters, and practice guidelines. Data Extraction and Synthesis Data were extracted and evaluated by 2 researchers. Data extracted included research type, number of participants with or without vertigo, treatment regime, definition of pure-tone average, criteria for hearing improvement, and length of follow-up. The quality of included studies was evaluated using the Newcastle-Ottawa Scale (scores range from 0-9, with a score of ≥6 indicating a high-quality study). The data were synthesized in Mantel-Haenszel models; the aggregate results were estimated in forest plots. Main Outcomes and Measures Association of vertigo with the prognosis for the hearing outcome of SSHL. Results Of the 4814 unique patients identified in 10 studies, 1709 were included in the SSHL group with vertigo and 3105 were included in SSHL group without vertigo. The Newcastle-Ottawa Scale score of each study selected was greater than 7. The recovery rate of hearing was 42.13% in the group with vertigo, compared with 60.29% in the group without vertigo. Vertigo was significantly associated with a worse hearing recovery (odds ratio, 2.22; 95% CI, 1.54-3.20; I2 = 74%). Similar results were obtained in subgroup analyses of the grading system using the Siegel criteria and systemic corticosteroid therapy. However, no association of vertigo with the prognosis of SSHL was observed within the subgroup receiving intratympanic corticosteroids (odds ratio, 1.78; 95% CI, 0.64-4.94; I2 = 70%). Conclusions and Relevance Current evidence revealed that vertigo may be negatively associated with hearing recovery in patients with SSHL, except in a subgroup that received intratympanic corticosteroids. Corticosteroid injection may be more effective for treatment of SSHL accompanied by vertigo; future studies are needed to determine whether treatment of vertigo might contribute to the recovery of SSHL.
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Affiliation(s)
- Huiqian Yu
- ENT Institute, Otorhinolaryngology Department, Eye and ENT Hospital of Fudan University, Shanghai, China.,Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Huawei Li
- ENT Institute, Otorhinolaryngology Department, Eye and ENT Hospital of Fudan University, Shanghai, China.,Institutes of Biomedical Sciences, Fudan University, Shanghai, China
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Kim J, Jeong J, Ha R, Sunwoo W. Heparin therapy as adjuvant treatment for profound idiopathic sudden sensorineural hearing loss. Laryngoscope 2019; 130:1310-1315. [PMID: 31397902 DOI: 10.1002/lary.28231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 07/14/2019] [Accepted: 07/23/2019] [Indexed: 02/04/2023]
Abstract
OBJECTIVES/HYPOTHESIS This study aimed to provide evidence of whether unfractionated heparin used as adjuvant therapy in conjunction with systemic corticosteroid therapy improves hearing recovery in patients with profound idiopathic sudden sensorineural hearing loss (ISSNHL), and to compare the effect of this treatment with those of additional intratympanic corticosteroid therapy. STUDY DESIGN Retrospective chart review. METHODS Eighty-seven patients with profound ISSNHL (≥90 dB) and who had been admitted at a tertiary referral center between 2010 and 2018 were retrospectively reviewed, 67 patients for additional intratympanic corticosteroid injection (ITSI) (ITSI group) and 21 for adjuvant heparin therapy (heparin group). Hearing recovery was evaluated by grade assessment according to the American Academy of Otolaryngology-Head and Neck Surgery criteria. RESULTS Of the patients in the heparin group, 42.8% recovered serviceable hearing, which was significantly higher than the recovery rates (19.7%) of those in the ITSI group. Particularly, in patients with pretreatment hearing level of 90 to 100 dB, adjuvant heparin therapy enhanced therapeutic effects with a significant hearing recovery rate of 80%. However, in patients with initial hearing level >100 dB, the rates of significant hearing recovery in the two groups were roughly equal and remained unsatisfactory (8.1% in the ITSI group and 9.1% in the heparin group). CONCLUSIONS The results of this study suggest that the treatment of profound ISSNHL with adjuvant heparin therapy, in combination with systemic steroid therapy, results in higher hearing recovery rates when compared to combined local and systemic corticosteroid therapy, without serious complications. LEVEL OF EVIDENCE 3b Laryngoscope, 130:1310-1315, 2020.
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Affiliation(s)
- Junsuk Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Jinuk Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Ryun Ha
- Department of Otorhinolaryngology-Head and Neck Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Woongsang Sunwoo
- Department of Otorhinolaryngology-Head and Neck Surgery, Gachon University Gil Medical Center, Incheon, Korea
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Wei FQ, Wen L, Chen K, Liu M, Wu X. Different prognoses in patients with profound sudden sensorineural hearing loss. Acta Otolaryngol 2019; 139:598-603. [PMID: 31050574 DOI: 10.1080/00016489.2019.1605195] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Inner ear hemorrhage is increasingly recognized as a cochlear lesion that can cause profound sudden sensorineural hearing loss (SSNHL). Objectives: To investigate changes of cochlear and vestibular function and to compare therapeutic recovery from profound SSNHL induced by different etiologies. Material and methods: Eighty patients with profound SSNHL (≥90 dB) were divided into an inner ear hemorrhage group and a non-inner ear hemorrhage group by MRI. Statistical analysis was performed to compare the therapeutic effects from vertigo and hearing loss and the outcomes of follow-up in the two groups. Results: There were significant differences between the two groups in terms of the overall 14-day therapeutic response rate (20 vs. 48%), the incidence of imbalance (26.7 vs. 6%), the incidence of semicircular canal dysfunction on the affected side (60 vs. 20%), the incidence of abnormal C-VEMP and O-VEMP on the affected side (63.3 vs. 38%; and 60 vs. 30%, respectively), the average hearing threshold (74.2 ± 10.7 vs. 53.6 ± 11.4 dB), and the word recognition score (65.5 ± 21.7 vs. 83.5 ± 24.5%) at a 12-month follow-up. Conclusions and significance: A higher percentage of patients with profound SSNHL induced by inner ear hemorrhage were associated with vertigo and had a poor prognosis.
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Affiliation(s)
- Fan-Qin Wei
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Lanying Wen
- Department of ENT, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Kaitian Chen
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Min Liu
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xuan Wu
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Seo CG, Kim KJ, Park E, Kim NH, Kim JH, Kim HY, Kim SG, Kim KJ. Untreated primary hypothyroidism with simultaneous rhabdomyolysis, pericardial effusion, and sudden sensorineural hearing loss: a case report. BMC Endocr Disord 2019; 19:52. [PMID: 31113413 PMCID: PMC6530099 DOI: 10.1186/s12902-019-0379-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 05/09/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Hypothyroidism, one of the prevalent endocrine disorders worldwide, has a broad spectrum of clinical manifestations, from an asymptomatic condition to myxedema coma. Although the majority of patients with hypothyroidism have minor clinical symptoms, which are recovered with levothyroxine treatment, some patients occasionally do experience fatal complications. Here we report, for the first time, the case of a patient who had hypothyroidism with simultaneous occurrence of rhabdomyolysis with acute kidney injury, moderate pericardial effusion, and sudden sensorineural hearing loss. CASE PRESENTATION A 57-year-old man with a previous history of dyslipidemia and untreated hypothyroidism was admitted to the hospital due to shortness of breath, lethargy, lower extremity discomfort, and unilateral hearing loss. Laboratory results revealed rhabdomyolysis with acute kidney injury and severe hypothyroidism. We detected cardiomegaly without lung parenchymal infiltration on chest radiography and moderate pericardial effusion on transthoracic echocardiography. We performed pure tone audiometry and identified profound unilateral sensorineural hearing loss. Aggressive fluid resuscitation, levothyroxine treatment, and systemic and intratympanic steroid therapy alleviated the patient's severe hypothyroidism, rhabdomyolysis, and pericardial effusion; however, sensorineural hearing loss was not fully recovered. CONCLUSIONS Early recognition of life-threatening complications is important in patients with severe hypothyroidism to prevent adverse outcomes. This case suggests that hypothyroidism should be considered in patients who have rhabdomyolysis with acute kidney disease and pericardial effusion. Moreover, sudden sensorineural hearing loss should be kept in mind as a rare complication of hypothyroidism.
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Affiliation(s)
- Chung Gyo Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841 Republic of Korea
| | - Kyoung Jin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841 Republic of Korea
| | - Euyhyun Park
- Department of Otolaryngology-Head and Neck Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Nam Hoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841 Republic of Korea
| | - Joo Hyung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841 Republic of Korea
| | - Hee Young Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841 Republic of Korea
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841 Republic of Korea
| | - Kyeong Jin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841 Republic of Korea
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Lechner M, Sutton L, Ferguson M, Abbas Y, Sandhu J, Shaida A. Intratympanic Steroid Use for Sudden Sensorineural Hearing Loss: Current Otolaryngology Practice. Ann Otol Rhinol Laryngol 2019; 128:490-502. [PMID: 30770021 DOI: 10.1177/0003489419828759] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate the current practice of intratympanic steroid (ITS) injection for sudden sensorineural hearing loss (SSNHL) in the United Kingdom and link the data with data from the United States and continental Europe. METHODS A survey of 21 questions was distributed to members of the British Society of Otology using an online survey platform via ENT UK. Data obtained from UK otolaryngologists (n = 171) were integrated with previously published data from other countries, including the United States (n = 63) and continental Europe (n = 908). RESULTS In the United Kingdom, 62% of responding otolaryngologists use ITS injection for SSNHL, while 38% do not. Of those using ITS, 59% use it as first-line treatment, either using it in conjunction with oral steroids (51%) or using it as monotherapy (8%). Of those that use ITS, a majority (83%) use it as salvage therapy when primary treatment with systemic steroids has failed, and similar results are found in the continental Europe and US surveys. The most commonly used preparation is dexamethasone. Responses to questions regarding treatment regimes used are enlightening and show considerable variation in the treatment regimes used within and between countries. CONCLUSIONS There is a wide variation in practice with regards to ITS for SSNHL hearing loss in the United Kingdom, United States, and continental Europe. In the absence of protocols or definitive guidance from published literature, knowledge of contemporary practice may help guide or encourage reevaluation of clinical practice and will help guide the design of future clinical trials.
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Affiliation(s)
- Matt Lechner
- 1 Royal National Throat, Nose and Ear Hospital, University College London Hospitals NHS Trust, London, UK.,2 Royal London Hospital, Barts Health NHS Trust, London, UK.,3 UCL Cancer Institute, University College London, London, UK
| | - Liam Sutton
- 1 Royal National Throat, Nose and Ear Hospital, University College London Hospitals NHS Trust, London, UK
| | - Mark Ferguson
- 1 Royal National Throat, Nose and Ear Hospital, University College London Hospitals NHS Trust, London, UK
| | - Yasmin Abbas
- 2 Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Jaswinder Sandhu
- 4 Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Azhar Shaida
- 1 Royal National Throat, Nose and Ear Hospital, University College London Hospitals NHS Trust, London, UK
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Thomas JP, Drewermann S, Voelter C, Dazert S. Prognostic factors regarding the hearing outcome in severe to profound sudden sensorineural hearing loss treated by tympanotomy and sealing of labyrinthine windows after ineffective systemic corticosteroid application. Eur Arch Otorhinolaryngol 2018; 275:1749-1758. [PMID: 29855690 DOI: 10.1007/s00405-018-5023-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 05/26/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE Tympanotomy and sealing of labyrinthine membranes has become in some centers used to treat severe to profound sudden sensorineural hearing loss refractory to conservative treatment. The aim of this retrospective study was to determine which preoperative factors influence the likelihood of postoperative recovery according to different audiological assessment criteria. METHODS The mean final hearing threshold, the hearing improvement, the probability of a complete recovery according to two different classifications, and probability of a significant recovery of 136 adult subjects were studied by univariate and multivariate analyses. RESULTS The subject's mean postoperative 4-pure-tone-average was 63.9 ± 35.9 dB, the mean improvement was 42.8 ± 32.6 dB. Depending on the classification system used, 18.4-28.0% of subjects experienced a complete recovery. 77.2% of subjects had a significant hearing improvement. History of a pressure change (odds ratio (OR):4.6) was the only positive prognostic factor for hearing improvement. It also enhanced probability of experiencing a complete hearing recovery (OR: 2.8-6.3). Preoperative total deafness (OR: 1.5-1.9) and vertigo (OR: 3.3-4.6) were negative prognostic factors for the mean final hearing threshold and the probability of a complete hearing recovery. Patients with a preceding pressure change event achieved a complete recovery in 45.5-50.0%, those without such an event recovered completely only in 13.2-23.7%. CONCLUSION Evaluating prognostic factors and the rate of complete hearing recovery are influenced by the underlying assessment parameters. In addition to the mean postoperative hearing threshold and hearing gain, the probability of regaining a serviceable hearing is clinically important for the individual and should be added to the assessment criteria in future studies.
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Affiliation(s)
- Jan Peter Thomas
- Department of Otolaryngology, Head and Neck Surgery, St. Elisabeth-Hospital, Ruhr University Bochum, Bleichstr. 15, 44787, Bochum, Germany.
| | - Silke Drewermann
- Department of Otolaryngology, Head and Neck Surgery, St. Elisabeth-Hospital, Ruhr University Bochum, Bleichstr. 15, 44787, Bochum, Germany
- Medical Supply Centre of the Federal Armed Forces, Bremerhavener Heerstr. 10, 27711, Osterholz-Scharmbeck, Germany
| | - Christiane Voelter
- Department of Otolaryngology, Head and Neck Surgery, St. Elisabeth-Hospital, Ruhr University Bochum, Bleichstr. 15, 44787, Bochum, Germany
| | - Stefan Dazert
- Department of Otolaryngology, Head and Neck Surgery, St. Elisabeth-Hospital, Ruhr University Bochum, Bleichstr. 15, 44787, Bochum, Germany
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Surgical indications or inclusion/exclusion criteria of explorative tympanotomy on sudden sensorineural hearing. Am J Otolaryngol 2018; 39:365-366. [PMID: 29402523 DOI: 10.1016/j.amjoto.2018.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 01/28/2018] [Indexed: 11/20/2022]
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Anyah A, Mistry D, Kevern E, Markiewicz K. Idiopathic Sudden Sensorineural Hearing Loss: Average Time Elapsed Before Presentation to the Otolaryngologist and Effectiveness of Oral and/or Intratympanic Steroids in Late Presentations. Cureus 2017; 9:e1945. [PMID: 29468101 PMCID: PMC5812532 DOI: 10.7759/cureus.1945] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objectives To determine how long after symptom onset that the average patient with an idiopathic sudden sensorineural hearing loss (ISSNHL) presents to the otolaryngology clinic. In late presentations, to determine the time to presentation cutoff after which intervention may not be effective. To evaluate the effectiveness of oral steroids versus a combination of oral and intratympanic steroid therapy in late presentations of ISSNHL. Methods and procedures Sixty-four patients met inclusion criteria after chart review of 2,037 patients seen at Metro Health Hospital from 2006 to 2016 for sensorineural hearing loss. All sixty-four patients were used to calculate the average time to presentation, but only 40 were included to evaluate treatment efficacy because 24 were lost to follow-up or declined treatment. Audiograms were analyzed for baseline status and response to treatment. Therapy was either oral steroids or intratympanic (IT) steroids. Thirty-nine of the 40 treated patients received oral steroid therapy. Eighteen of these 39 patients received both oral and IT steroids. One patient received IT steroids only. Results For all 64 patients in the study, the average time to presentation was 55 days, ranging from one day to 240 days. Data for 32 of the 40 treated patients were analyzed. These patients were further divided into smaller groups: Group 1 (N = 11) - treatment within seven days of symptom onset, Group 2 (N = 17) - time to treatment greater than seven days but less than 90 days of symptom onset, and Group 3 (N = 4) - greater than 90 days of symptom onset. In Group 2, there was a significant improvement in pure tone average (P-value: 0.005). Forty-seven percent of patients in this group had objective treatment response utilizing Wilson’s criteria. Two patients had a complete recovery and six had a partial recovery. Hearing gains ranged from 10 dB (decibels) to 23 dB. Sixty-three percent of patients with objective improvement also had subjective improvement. In Group 3, none of the patients met Wilson’s criteria for recovery. There was no statistically significant difference in response between patients treated with oral steroids only versus a combination of oral and IT steroids. Conclusion Patients with ISSNHL present to an otolaryngologist on average 55 days after symptom onset. There is statistically and clinically significant response to treatment in late presenters. Improvement can be seen up to three months from symptom onset. Oral steroid therapy is effective. IT steroid therapy may have an added benefit.
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Affiliation(s)
- Anwuli Anyah
- Otolaryngology, Metro Health Hospital - University of Michigan
| | - Devin Mistry
- Otolaryngology, Metro Health Hospital - University of Michigan
| | - Erin Kevern
- Otolaryngology, Metro Health Hospital - University of Michigan
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Characteristics and Spontaneous Recovery of Tinnitus Related to Idiopathic Sudden Sensorineural Hearing Loss. Otol Neurotol 2017; 37:634-41. [PMID: 27228021 PMCID: PMC4912237 DOI: 10.1097/mao.0000000000001081] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the characteristics and spontaneous recovery of tinnitus related to idiopathic sudden sensorineural hearing loss (ISSNHL). Study Design: Retrospective analysis from two randomized placebo-controlled clinical trials for treatment of ISSNHL within 48 hours from onset (Study A), or of tinnitus related to ISSNHL within 3 months from onset (Study B). Setting: Forty-eight European sites (academic tertiary referral centers, private ENT practices). Patients: One hundred thirteen adult patients of which 65 with hearing loss ≥30 dB (Study A) and 48 with persistent acute tinnitus (Study B) at baseline. Interventions: Intratympanic (i.t.) injection of placebo gel in single dose or in triple dose during 3 consecutive days. Main Outcome Measures: Frequency of tinnitus, subjective tinnitus loudness, rates of complete tinnitus remission, and complete hearing recovery during 3 months follow-up. Results: In acute ISSNHL, tinnitus loudness decreased rapidly in cases of mild-moderate hearing loss, and tinnitus had completely resolved in two-thirds of patients after 3 months. Hearing recovery preceded tinnitus resolution. When associated with severe-profound hearing loss, tinnitus improved significantly less. Complete hearing recovery and full tinnitus remission were both about three times more frequent in mild-moderate hearing loss patients than in severe-profound cases. Improvement in tinnitus loudness over time can be approximated by a negative exponential function. Conclusions: Prognosis for ISSNHL-related tinnitus is relatively poor in case of severe-profound hearing loss and the longer it has persisted. Alleviation or management of tinnitus should be a key therapeutic objective especially in pronounced ISSNHL cases.
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Yoo MH, Lim WS, Park JH, Kwon JK, Lee TH, An YH, Kim YJ, Kim JY, Lim HW, Park HJ. Simultaneous versus Sequential Intratympanic Steroid Treatment for Severe-to-Profound Sudden Sensorineural Hearing Loss. Audiol Neurootol 2017; 21:399-405. [PMID: 28384627 DOI: 10.1159/000464095] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 02/09/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Severe-to-profound sudden sensorineural hearing loss (SSNHL) has a poor prognosis. We aimed to compare the efficacy of simultaneous and sequential oral and intratympanic steroids for this condition. METHODS Fifty patients with severe-to-profound SSNHL (>70 dB HL) were included from 7 centers. The simultaneous group (27 patients) received oral and intratympanic steroid injections for 2 weeks. The sequential group (23 patients) was treated with oral steroids for 2 weeks and intratympanic steroids for the subsequent 2 weeks. Pure-tone averages (PTA) and word discrimination scores (WDS) were compared before treatment and 2 weeks and 1 and 2 months after treatment. Treatment outcomes according to the modified American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) criteria were also analyzed. RESULTS The improvement in PTA and WDS at the 2-week follow-up was 23 ± 21 dB HL and 20 ± 39% in the simultaneous group and 31 ± 29 dB HL and 37 ± 42% in the sequential group; this was not statistically significant. Complete or partial recovery at the 2-week follow-up was observed in 26% of the simultaneous group and 30% of the sequential group; this was also not significant. The improvement in PTA and WDS at the 2-month follow-up was 40 ± 20 dB HL and 37 ± 35% in the simultaneous group and 41 ± 25 dB HL and 48 ± 41% in the sequential group; this was not statistically significant. Complete or partial recovery at the 2-month follow-up was observed in 33% of the simultaneous group and 35% of the sequential group; this was also not significant. Seven patients in the sequential group did not need intratympanic steroid injections for sufficient improvement after oral steroids alone. CONCLUSIONS Simultaneous oral/intratympanic steroid treatment yielded a recovery similar to that produced by sequential treatment. Because the addition of intratympanic steroids can be decided upon based on the improvement after an oral steroid, the sequential regimen can be recommended to avoid unnecessary intratympanic injections.
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Affiliation(s)
- Myung Hoon Yoo
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
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Weiss D, Böcker AJ, Koopmann M, Savvas E, Borowski M, Rudack C. Predictors of hearing recovery in patients with severe sudden sensorineural hearing loss. J Otolaryngol Head Neck Surg 2017; 46:27. [PMID: 28376930 PMCID: PMC5379569 DOI: 10.1186/s40463-017-0207-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 03/27/2017] [Indexed: 11/20/2022] Open
Abstract
Background Sudden sensorineural hearing loss (SSHL) is a disease, which severely affects the patient’s social and relational life. The underlying pathomechanisms have not been finally clarified yet and outcome is not predictable. Methods We conducted a retrospective study in order to identify parameters that influence hearing recovery. The data base contains results of basic otoneurological tests and clinical parameters of 198 patients with idiopathic SSHL of at least 60 dB in at least four frequencies, diagnosed and treated at the University Hospital of Münster, Germany, between 1999 and 2015. Hearing recovery was measured by pure tone audiometry. Results Multivariate linear and logistic regression analyses indicate that the chance as well as the magnitude of hearing recovery is higher for patients with normal caloric testing than for patients with pathological caloric testing. However, for the subgroup of patients who attained a hearing recovery, the caloric testing result was not found to influence the magnitude. Instead, the magnitude was noticeably lower for patients within this subgroup who had a previous hearing loss. Furthermore, we found indications that the magnitude is higher for men than for women and that receiving a high-dose steroid therapy is associated with a higher chance and magnitude of a hearing recovery. Conclusions We conclude that SSHL associated with disorders of the vestibular system or previous hearing loss represent special sub-entities of SSHL that may be caused by unique pathophysiological mechanisms and are associated with worse outcome. Furthermore, our data support the importance of elevated dosage of steroids in SSHL therapy.
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Affiliation(s)
- Daniel Weiss
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Münster, Kardinal-von-Galen-Ring 10, Münster, 48149, Germany.
| | - Armin Julius Böcker
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Münster, Kardinal-von-Galen-Ring 10, Münster, 48149, Germany
| | - Mario Koopmann
- Practice for Otorhinolaryngology, Head and Neck Surgery, Meckenemstrasse 26, Bocholt, 46395, Germany
| | - Eleftherios Savvas
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Münster, Kardinal-von-Galen-Ring 10, Münster, 48149, Germany
| | - Matthias Borowski
- Institute of Biostatistics and Clinical Research, University of Münster, Schmeddingstrasse 56, Münster, 48149, Germany
| | - Claudia Rudack
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Münster, Kardinal-von-Galen-Ring 10, Münster, 48149, Germany
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Ganesan P, Kothandaraman PP, Swapna S, Manchaiah V. A Retrospective Study of the Clinical Characteristics and Post-treatment Hearing Outcome in Idiopathic Sudden Sensorineural Hearing Loss. Audiol Res 2017; 7:168. [PMID: 28286637 PMCID: PMC5337819 DOI: 10.4081/audiores.2017.168] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 01/02/2017] [Indexed: 01/01/2023] Open
Abstract
The purpose of this retrospective study was to analyze the clinical characteristics and document hearing recovery in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). 122 patients diagnosed with unilateral ISSNHL, from March 2009 to December 2014, were treated with oral steroids and pentoxifylline. Hearing change was evaluated by comparing pre-treatment and post-treatment pure-tone average (PTA) (500, 1K, and 2K Hz), and categorized into complete, partial, and no recovery of hearing. T-test, Wilcoxon Signed Rank test and Regression analysis were employed to analyze the statistical significance. Of the 122 patients, seventy-one (58%) had complete recovery and 34 (28%) had partial recovery. The average pre-treatment PTA was 78.3±16.9 dB whereas post-treatment average was 47.0±20.8 dB, showing statistically significant improvement (t=24.89, P≤0.001). The factors such as presence of tinnitus (P=0.005) and initial milder hearing loss (P=0.005) were found to be significant predictors for hearing recovery. Conventional steroid regimes produced a recovery rate in ISSNHL, which exceeds the spontaneous recovery rate. The current study results highlight the importance of medical treatment in the management of ISSNHL.
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Affiliation(s)
- Purushothaman Ganesan
- Expert Hearing Solutions, Wall Street Audiology Inc. , Saskatoon, Saskatchewan, Canada
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Dedhia K, Chi DH. Pediatric sudden sensorineural hearing loss: Etiology, diagnosis and treatment in 20 children. Int J Pediatr Otorhinolaryngol 2016; 88:208-12. [PMID: 27497416 DOI: 10.1016/j.ijporl.2016.07.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 07/01/2016] [Accepted: 07/02/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES 1. To report our experience in children with sudden-onset sensorineural hearing loss (SSNHL). 2. To describe the etiology and management of children with SSNHL. METHODS Retrospective review of 20 children with SSNHL, from 2000 to 2013 at a tertiary pediatric facility. Patients had the following inclusion criteria: history of normal hearing, hearing loss occurring in less than 3 days, and audiogram documentation. RESULTS The average age of patients presenting with SSNHL is 11 years 3 months (22months-18years). Only 6 (30%) children presented prior to 2 weeks. Tinnitus (55%) was the most common associated symptoms followed by otalgia (25%), and vertigo (20%). Eight patients had bilateral hearing loss, 6 only right and 6 only left. Hearing loss severity ranged from profound (45%) being most common to mild. Etiology was unknown (30%), viral (25%), anatomic abnormality (25%), Meniere's disease (5%), autoimmune (5%), perilymphatic fistula (5%), and suppurative labyrinthitis (5%). Eight patients had initial treatment with oral steroids of which 50% had improvement on audiograms. Two patients underwent intratympanic injections, both showed improvement. Of the 12 patients with no treatment, only 1 had improved hearing. CONCLUSIONS The true incidence of pediatric SSNHL is not well established in our literature. Unique aspects of pediatric SSNHL are delayed presentation and higher percent of anatomic findings. In our study 70% presented more than 2 weeks after experiencing symptoms. Anatomic abnormalities are in 40% of patients. Hearing improvement occurred in 50% of children treated with oral steroids. Intratympanic steroid treatment is another option but may have practical limitation in the pediatric population.
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Affiliation(s)
- Kavita Dedhia
- Department of Otolaryngology, Emory University, Atlanta, GA, USA
| | - David H Chi
- Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA.
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Lee HY, Kim DK, Park YH, Cha WW, Kim GJ, Lee SH. Prognostic factors for profound sudden idiopathic sensorineural hearing loss: a multicenter retrospective study. Eur Arch Otorhinolaryngol 2016; 274:143-149. [PMID: 27544193 DOI: 10.1007/s00405-016-4276-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 08/18/2016] [Indexed: 10/21/2022]
Abstract
The aim of this study was to assess the outcomes of various treatment modalities for profound idiopathic sudden sensorineural hearing loss (ISSNHL) and confirm the prognostic factors. In total, 191 patients were enrolled after a thorough medical chart review of patients diagnosed with unilateral, profound ISSNHL (≥90 dB). Epidemiological profiles, therapeutic regimens, and the results of pure tone audiometry tests were recorded for all patients. Final recovery was assessed according to Siegel's criteria and by comparing the final hearing level of the affected ear with that of the unaffected ear. The mean follow-up duration and the final hearing level were 75 ± 54 days and 77 ± 24 dB, respectively. None of the evaluated prognostic factors were significantly associated with complete recovery (<25 dB). However, improved hearing in both ears, the absence of dizziness, the use of lipo-prostaglandin E1 (lipo-PGE1), and the use of plasma volume expanders were independently associated with a final hearing level of up to 45 dB (p < 0.05). Steroid dose reduction, worse initial hearing, and non-use of lipo-PGE1 increased the possibility of no recovery. Although the efficacy of oral steroid treatment for profound ISSNHL has been questioned, steroid dose reduction was significantly associated with no recovery. Therefore, adequate oral corticosteroid doses should be considered in the absence of contraindications. In addition, the use of lipo-PGE1 and/or a plasma volume expander seems preferable for better recovery, and their use for the management of profound ISSNHL should be considered.
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Affiliation(s)
- Ho Yun Lee
- Department of Otolaryngology-Head and Neck Surgery, Eulji University College of Medicine, Daejeon, South Korea
| | - Dong-Kee Kim
- Department of Otolaryngology-Head and Neck Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daeheung-dong, Jung-gu, Daejeon, South Korea.
| | - Yong-Ho Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chungnam National University, 282 Munwha-ro, Jung-gu, Daejeon, South Korea. .,Brain Research Institute, College of Medicine, Chungnam National University, Daejeon, South Korea.
| | - Wang Woon Cha
- Department of Otolaryngology-Head and Neck Surgery, Eulji University College of Medicine, Daejeon, South Korea
| | - Geun Jeon Kim
- Department of Otolaryngology-Head and Neck Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daeheung-dong, Jung-gu, Daejeon, South Korea
| | - Seung Hun Lee
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chungnam National University, 282 Munwha-ro, Jung-gu, Daejeon, South Korea.,Brain Research Institute, College of Medicine, Chungnam National University, Daejeon, South Korea
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Härkönen K, Kivekäs I, Rautiainen M, Kotti V, Vasama JP. Quality of Life and Hearing Eight Years After Sudden Sensorineural Hearing Loss. Laryngoscope 2016; 127:927-931. [PMID: 27328455 DOI: 10.1002/lary.26133] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Revised: 05/12/2016] [Accepted: 05/17/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS To explore long-term hearing results, quality of life (QoL), quality of hearing (QoH), work-related stress, tinnitus, and balance problems after idiopathic sudden sensorineural hearing loss (ISSNHL). STUDY DESIGN Cross-sectional study. METHODS We reviewed the audiograms of 680 patients with unilateral ISSNHL on average 8 years after the hearing impairment, and then divided the patients into two study groups based on whether their ISSNHL had recovered to normal (pure tone average [PTA] ≤ 30 dB) or not (PTA > 30 dB). The inclusion criteria were a hearing threshold decrease of 30 dB or more in at least three contiguous frequencies occurring within 72 hours in the affected ear and normal hearing in the contralateral ear. Audiograms of 217 patients fulfilled the criteria. We reviewed their medical records; measured present QoL, QoH, and work-related stress with specific questionnaires; and updated the hearing status. RESULTS Poor hearing outcome after ISSNHL was correlated with age, severity of hearing loss, and vertigo together with ISSNHL. Quality of life and QoH were statistically significantly better in patients with recovered hearing, and the patients had statistically significantly less tinnitus and balance problems. During the 8-year follow-up, the PTA of the affected ear deteriorated on average 7 dB, and healthy ear deteriorated 6 dB. CONCLUSION Idiopathic sudden sensorineural hearing loss that failed to recover had a negative impact on long-term QoL and QoH. The hearing deteriorated as a function of age similarly both in the affected and the healthy ear, and there were no differences between the groups. The cumulative recurrence rate for ISSNHL was 3.5%. LEVEL OF EVIDENCE 4 Laryngoscope, 127:927-931, 2017.
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Affiliation(s)
- Kati Härkönen
- Department of Otorhinolaryngology, Tampere University Hospital and School of Medicine, University of Tampere, Finland.,Department of Anatomy, Tampere University Hospital and School of Medicine, University of Tampere, Finland
| | - Ilkka Kivekäs
- Department of Otorhinolaryngology, Tampere University Hospital and School of Medicine, University of Tampere, Finland.,Department of Ear and Oral Diseases, Tampere University Hospital, Tampere, Finland
| | - Markus Rautiainen
- Department of Otorhinolaryngology, Tampere University Hospital and School of Medicine, University of Tampere, Finland.,Department of Ear and Oral Diseases, Tampere University Hospital, Tampere, Finland
| | - Voitto Kotti
- Department of Ear and Oral Diseases, Tampere University Hospital, Tampere, Finland
| | - Juha-Pekka Vasama
- Department of Ear and Oral Diseases, Tampere University Hospital, Tampere, Finland
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Leung MA, Flaherty A, Zhang JA, Hara J, Barber W, Burgess L. Sudden Sensorineural Hearing Loss: Primary Care Update. HAWAI'I JOURNAL OF MEDICINE & PUBLIC HEALTH : A JOURNAL OF ASIA PACIFIC MEDICINE & PUBLIC HEALTH 2016; 75:172-174. [PMID: 27413627 PMCID: PMC4928516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The primary care physician's role in recognizing sudden sensorineural hearing (SSNHL) loss and delivering initial treatment is critical in the management of the syndrome. This role involves recognizing its clinical symptoms, distinguishing it from conductive hearing loss with the Weber tuning fork or the Rauch hum test, and urgent administration of high dose oral corticosteroids. Diagnosis and treatment should not be delayed for audiometric testing or referral to otolaryngology. This paper provides an update on the initial evaluation and treatment of this syndrome based on the literature and clinical guideline recommendations.
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Affiliation(s)
- Marcia A Leung
- John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI
| | - Anna Flaherty
- John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI
| | - Julia A Zhang
- John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI
| | - Jared Hara
- John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI
| | - Wayne Barber
- John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI
| | - Lawrence Burgess
- John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI
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Pal'chun VT, Guseva AL, Levina YV, Chistov SD. [The specific clinical features of acute sensorineural loss of hearing associated with vertigo]. Vestn Otorinolaringol 2016; 81:8-12. [PMID: 26977560 DOI: 10.17116/otorino20168118-12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The objective of the present study was to estimate the prevalence of vertigo and to determine the type of the lesion of the vestibular analyzer in the patients presenting with acute sensorineural loss of hearing (ASNLH). The secondary objective was to evaluate the possibility of the restoration of the auditory thresholds. The results of the examination and treatment of 94 patients suffering from ASNLH are presented. It was shown that the development of acute sensorineural loss of hearing was accompanied by unilateral peripheral vestibulopathy in 22.3% of the patients. In 5.3% of these cases, dizziness could be attributed to benign paroxysmal positional vertigo and canalolythias is of the posterior semicircular canal on the side of hearing impairment. It is concluded that the presence of the clinical signs of lesions of the vestibular analyzer and peripheral vestibular dysfunction in the form of latent spontaneous nystagmus without gaze fixation and/or asymmetric nystagmus with unilateral weakness in the caloric test is a negative prognostic factor for the restoration of the auditory thresholds in the patients presenting with acute sensorineural loss of hearing.
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Affiliation(s)
- V T Pal'chun
- N.I. Pirogov Russian National Research Medical University, Russian Ministry of Health, Moscow, Russia, 117997
| | - A L Guseva
- N.I. Pirogov Russian National Research Medical University, Russian Ministry of Health, Moscow, Russia, 117997
| | - Yu V Levina
- N.I. Pirogov Russian National Research Medical University, Russian Ministry of Health, Moscow, Russia, 117997
| | - S D Chistov
- N.I. Pirogov Russian National Research Medical University, Russian Ministry of Health, Moscow, Russia, 117997
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Abstract
OBJECTIVE Sudden hearing loss (SHL) is a disease, isolated or associated with vertigo, of unknown etiology. The aim of this study was to identify the prognostic factors for hearing recovery. METHODS In this retrospective study, we analyzed 287 cases of SHL (mean age 42). Tonal threshold audiometry, BAEP, and RM were the diagnostic procedures for clinical balance of the patient. The therapy used the following: corticosteroids, osmotic diuretic infusion, and vasoactives. All the factors were evaluated through statistical tests, Spearman test, and linear logistic regression. RESULTS In our study, we observed that 39.3% of patients improved, 27.9% remained unchanged, 29% had complete recovery, and 3.8% worsened. Therapy was not related to the degree of recovery from hearing loss, whereas young age, delayed diagnosis, and audiometric curve type were the three factors related to the degree of hearing recovery. CONCLUSIONS In our study, we report a better overall recovery rate compared with spontaneous recovery. In particular, early treated patients as well as patients with upsloping hearing loss frequently recovered after treatment. Age, time between onset and treatment, and audiogram type were shown to be significantly related to outcome.
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Lin HC, Wang CH, Chou YC, Shih CP, Chu YH, Lee JC, Chen HC. The correlation between lipoprotein ratios and hearing outcome in idiopathic sudden sensorineural hearing loss patients. Clin Otolaryngol 2015; 40:355-62. [DOI: 10.1111/coa.12382] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2015] [Indexed: 12/17/2022]
Affiliation(s)
- H.-C. Lin
- Department of Otolaryngology-Head and Neck Surgery; Tri-Service General Hospital; National Defense Medical Center; Taipei Taiwan
| | - C.-H. Wang
- Department of Otolaryngology-Head and Neck Surgery; Tri-Service General Hospital; National Defense Medical Center; Taipei Taiwan
| | - Y.-C. Chou
- School of Public Health; National Defense Medical Center; Taipei Taiwan
| | - C.-P. Shih
- Department of Otolaryngology-Head and Neck Surgery; Tri-Service General Hospital; National Defense Medical Center; Taipei Taiwan
| | - Y.-H. Chu
- Department of Otolaryngology-Head and Neck Surgery; Tri-Service General Hospital; National Defense Medical Center; Taipei Taiwan
| | - J.-C. Lee
- Department of Otolaryngology-Head and Neck Surgery; Tri-Service General Hospital; National Defense Medical Center; Taipei Taiwan
| | - H.-C. Chen
- Department of Otolaryngology-Head and Neck Surgery; Tri-Service General Hospital; National Defense Medical Center; Taipei Taiwan
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44
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Eftekharian A, Amizadeh M. Pulse steroid therapy in idiopathic sudden sensorineural hearing loss: A randomized controlled clinical trial. Laryngoscope 2015; 126:150-5. [DOI: 10.1002/lary.25244] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 01/08/2015] [Accepted: 02/10/2015] [Indexed: 01/12/2023]
Affiliation(s)
- Ali Eftekharian
- Department of Otorhinolaryngology; Shahid-Beheshti University of Medical Sciences; Tehran Iran
| | - Maryam Amizadeh
- Department of Otorhinolaryngology; Shahid-Beheshti University of Medical Sciences; Tehran Iran
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45
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Kawano T, Matsuura M, Yuda K, Matsushima A, Ishitoya J, Sakuma Y, Yamashita Y, Ikoma R, Takahashi M, Oridate N. Intratympanic Steroid Treatment for Severe Idiopathic Sudden Sensorineural Hearing Loss. ACTA ACUST UNITED AC 2015; 118:867-74. [DOI: 10.3950/jibiinkoka.118.867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Toshiro Kawano
- Department of Otolaryngology, Nishi-Yokohama International Hospital
| | - Masaki Matsuura
- Department of Otolaryngology, Nishi-Yokohama International Hospital
| | - Keiko Yuda
- Department of Otolaryngology, Nishi-Yokohama International Hospital
| | - Akemi Matsushima
- Department of Otolaryngology, Nishi-Yokohama International Hospital
| | | | - Yasunori Sakuma
- Department of Otolaryngology, Yokohama City University Medical Center
| | - Yukiko Yamashita
- Department of Otolaryngology, Yokohama City University Medical Center
| | - Ryo Ikoma
- Department of Otolaryngology, Yokohama Minami-Kyousai Hospital
| | - Masahiro Takahashi
- Department of Otolaryngology, Head and Neck Surgery, Yokohama City University Graduate School of Medicine
| | - Nobuhiko Oridate
- Department of Otolaryngology, Head and Neck Surgery, Yokohama City University Graduate School of Medicine
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46
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Rah YC, Park KT, Yi YJ, Seok J, Kang SI, Kim YH. Successful treatment of sudden sensorineural hearing loss assures improvement of accompanying tinnitus. Laryngoscope 2014; 125:1433-7. [DOI: 10.1002/lary.25074] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Yoon C. Rah
- Department of Otorhinolaryngology-Head and Neck Surgery; Boramae Medical Center, Seoul National University College of Medicine; Seoul South Korea
| | - Kyung T. Park
- Department of Otorhinolaryngology-Head and Neck Surgery; Boramae Medical Center, Seoul National University College of Medicine; Seoul South Korea
| | - Yeo-Jeen Yi
- Department of Otorhinolaryngology-Head and Neck Surgery; Boramae Medical Center, Seoul National University College of Medicine; Seoul South Korea
| | - Jungirl Seok
- Department of Otorhinolaryngology-Head and Neck Surgery; Boramae Medical Center, Seoul National University College of Medicine; Seoul South Korea
| | - Seong I. Kang
- Department of Otorhinolaryngology-Head and Neck Surgery; Boramae Medical Center, Seoul National University College of Medicine; Seoul South Korea
| | - Young H. Kim
- Department of Otorhinolaryngology-Head and Neck Surgery; Boramae Medical Center, Seoul National University College of Medicine; Seoul South Korea
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47
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Lionello M, Staffieri C, Breda S, Turato C, Giacomelli L, Magnavita P, de Filippis C, Staffieri A, Marioni G. Uni- and multivariate models for investigating potential prognostic factors in idiopathic sudden sensorineural hearing loss. Eur Arch Otorhinolaryngol 2014; 272:1899-906. [DOI: 10.1007/s00405-014-2992-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Accepted: 03/01/2014] [Indexed: 11/24/2022]
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