Glucocorticoid and Breviscapine Combination Therapy Versus Glucocorticoid Alone on Sudden Sensorineural Hearing Loss in Patients with Different Audiometric Curves

Clinical characteristics and prognosis of sudden sensorineural hearing loss in single-sided deafness patients

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.

Bone-turnover biomarkers as potential prognostic factors in sudden sensorineural hearing loss: A prospective cohort study

Objectives

This study aims to explore the relationship between bone-turnover biomarkers and the recovery of SSNHL to provide clues for further improvements in etiological research and predictors.

Methods

The medical history, hearing thresholds, biomarkers of bone-turnover, and related hormones of 117 SSNHL patients were collected prospectively between August 2018 and December 2021. Linear correlation and logistic regression models were applied to examine the association between bone-turnover biomarkers and the prognosis of SSNHL.

Results

Age, the incidence of vertigo, pure tone average of the impaired frequencies (PTAimpairedfre), and the levels of bone turnover [including alkaline phosphatase (ALP), β-carboxy terminal crosslinked telopeptide of type 1 collagen (β-CTX), and N-terminal-midfragment of osteocalcin (N-MID)] were higher in the nonresponders than responders (P &lt; 0.05). Logistic regression showed that the age (OR = 1.035, P = 0.027), time to treatment (OR = 1.157, P = 0.038), PTAimpairedfre (OR = 1.031, P = 0.008), and β-CTX (OR = 1.004, P = 0.001) were independent risk factors for the prognosis of SSNHL. In the women SSNHL subgroup, age, postmenopause percentage, PTAimpairedfre, the activity of ALP, levels of β-CTX, and N-MID were significantly higher in the nonresponders than the responders (P &lt; 0.05). Compared to the men SSNHL subgroup, β-CTX has a higher correlation coefficient and predictive efficiency in the women SSNHL subgroup, and logistic regression showed that β-CTX (OR = 1.004, P = 0.004) was an independent risk factor for the women SSNHL.

Conclusions

Bone-turnover biomarkers are risk factors for poor prognosis in SSNHL, especially β-CTX. The differences were significant in women SSNHL, which may be related to the rapid regression of estrogen after menopause that leads to the occurrence of osteoporosis with a high conversion rate.

Efficacy of Mesotympanum Injection and Posterior Auricular Injection in Sudden Hearing Loss of Diabetes Patients

The efficacy of tympanum injection and posterior auricular injection in diabetes with sudden hearing loss (SHL) was analyzed. A mobile terminal-based portable pure tone audiometry system and its processing method were established. Based on mobile terminals, a portable pure tone audiometry system including an Android system, pure sound signal generation, pure tone hearing threshold, and client module was established. A masking model and self-adaptive algorithm were used to detect and reduce noise. Besides, the performance of the portable pure tone audiometry system was detected. A total of 46 diabetes patients with SHL diagnosed at the otolaryngology department in BeiChen Hospital between August 2019 and November 2021 were selected as the research objects and randomly divided into the retroauricular group (posterior auricular injection) and the tympanic group (tympanum injection). Each group included 23 cases. All patients received pure tone audiometry (PTA) before and after the treatment. The changes in fasting blood glucose (FPG), 2h postprandial blood glucose (2hPG), and glycosylated hemoglobin (HbA1c) of the patients were monitored before and after the treatment. Besides, tinnitus loudness visual analog scale (VAS), pain VAS, efficacy, and the incidence of adverse reactions of the patients in two groups were compared. The results indicated that the hear threshold error detected by the medical audiometer and a portable pure tone audiometry system was within 2dB. Before the optimization, there was an error of about 10dB between the hear thresholds detected by the self-adaptive algorithm and a medical audiometer. After the treatment, the hear threshold and average PTA of the patients in the retroauricular and the tympanic groups under different frequencies were both reduced compared with those before the treatment (P < 0.05). The tinnitus VAS score in the retroauricular group was decreased more notably than that in tympanic group (P < 0.01), and the pain VAS score was much lower than that in the tympanic group (P < 0.001). The comparison of FPG, 2hPG, HbA1c, the proportions of cured, significantly effective, effective, ineffective patients, and the total effective rate in the patients in the retroauricular and the tympanic groups before and after the treatment all showed no statistical differences (P > 0.05). The incidence of adverse reactions in tympanic group after the treatment was dramatically higher than that in retroauricular group (P < 0.001). The above results demonstrated that posterior auricular injection showed potential application values in the treatment of SHL with diabetes and established a portable pure tone audiometry system as well as its noise processing method.

Ameliorative effect of scutellarin on acute alcohol brain injury in mice

Drinking culture has high significance in both China and the world, whether in the entertainment sector or in social occasions; according to the World Health Organization's 2018 Global Alcohol and Health Report, about 3 million people died from excessive drinking in 2016, accounting for 5.3% of the total global deaths that year. Oxidative stress and inflammation are the most common pathological phenomena caused by alcohol abuse (Snyder et al., 2017). Scutellarin, a kind of flavonoid, is one of the main active ingredients extracted from breviscapine. It exerts anti-inflammatory, antioxidant, and vasodilation effects, and has been used to treat cardiovascular diseases and alcoholic liver injury. Although scutellarin can effectively alleviate multi-target organ injury induced by different forms of stimulation, its protective effect on alcoholic brain injury has not been well-defined. Therefore, the present study established an acute alcohol mice brain injury model to explore the effect of scutellarin on acute alcoholic brain injury. The study was carried out based on the targets of oxidative stress and inflammation, which is of great significance for the targeted therapy of clinical alcohol diseases.

Serum Albumin Levels as a Potential Marker for the Predictive and Prognostic Factor in Sudden Sensorineural Hearing Loss: A Prospective Cohort Study

Objectives: As a common otology emergency, sudden sensorineural hearing loss (SSNHL) has a great impact on quality of life. The diagnosis and treatment of SSNHL remain challenging. This study aims to identify and investigate the association of liver functions with SSNHL.

Methods: A total of 135 SSNHL patients and 135 sex- and age-matched controls were prospectively enrolled. The baseline and clinical characteristics, along with liver function levels of participators, were collected. Linear correlation, logistic regression, and receiving operator characteristic curve analysis tests were applied to examine the association between liver function levels and SSNHL.

Results: There were no differences in baseline characteristics between SSNHL and control groups. The albumin (ALB) level of the SSNHL group was significantly lower than that in the control group (p < 0.001). The logistic regression showed that the low ALB level may be a predictive factor of SSNHL with an adjusted OR of 0.809 (95% CI, 0.742–0.882, p < 0.001). By comparing the indicators of different prognosis groups, we found that the effective group had a significantly lower hearing impair onset and higher ALB (p = 0.001) and AGR (p = 0.003) levels than the ineffective group. Logistic regression revealed that the hearing level onset (OR, 0.976; 95% CI, 0.956–0.997; p = 0.026) and ALB level (OR, 1.181; 95% CI, 1.071–1.301; p = 0.001) showed strong associations with treatment outcome.

Conclusions: Lower ALB levels, within the normal ranges, were associated with the occurrence and unfavorable outcome of SSNHL. However, further research on the underlying mechanisms needs to be conducted.