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Tsai Do BS, Bush ML, Weinreich HM, Schwartz SR, Anne S, Adunka OF, Bender K, Bold KM, Brenner MJ, Hashmi AZ, Keenan TA, Kim AH, Moore DJ, Nieman CL, Palmer CV, Ross EJ, Steenerson KK, Zhan KY, Reyes J, Dhepyasuwan N. Clinical Practice Guideline: Age-Related Hearing Loss. Otolaryngol Head Neck Surg 2024; 170 Suppl 2:S1-S54. [PMID: 38687845 DOI: 10.1002/ohn.750] [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: 02/28/2024] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE Age-related hearing loss (ARHL) is a prevalent but often underdiagnosed and undertreated condition among individuals aged 50 and above. It is associated with various sociodemographic factors and health risks including dementia, depression, cardiovascular disease, and falls. While the causes of ARHL and its downstream effects are well defined, there is a lack of priority placed by clinicians as well as guidance regarding the identification, education, and management of this condition. PURPOSE The purpose of this clinical practice guideline is to identify quality improvement opportunities and provide clinicians trustworthy, evidence-based recommendations regarding the identification and management of ARHL. These opportunities are communicated through clear actionable statements with explanation of the support in the literature, evaluation of the quality of the evidence, and recommendations on implementation. The target patients for the guideline are any individuals aged 50 years and older. The target audience is all clinicians in all care settings. This guideline is intended to focus on evidence-based quality improvement opportunities judged most important by the guideline development group (GDG). It is not intended to be a comprehensive, general guide regarding the management of ARHL. The statements in this guideline are not intended to limit or restrict care provided by clinicians based on their experience and assessment of individual patients. ACTION STATEMENTS The GDG made strong recommendations for the following key action statements (KASs): (KAS 4) If screening suggests hearing loss, clinicians should obtain or refer to a clinician who can obtain an audiogram. (KAS 8) Clinicians should offer, or refer to a clinician who can offer, appropriately fit amplification to patients with ARHL. (KAS 9) Clinicians should refer patients for an evaluation of cochlear implantation candidacy when patients have appropriately fit amplification and persistent hearing difficulty with poor speech understanding. The GDG made recommendations for the following KASs: (KAS 1) Clinicians should screen patients aged 50 years and older for hearing loss at the time of a health care encounter. (KAS 2) If screening suggests hearing loss, clinicians should examine the ear canal and tympanic membrane with otoscopy or refer to a clinician who can examine the ears for cerumen impaction, infection, or other abnormalities. (KAS 3) If screening suggests hearing loss, clinicians should identify sociodemographic factors and patient preferences that influence access to and utilization of hearing health care. (KAS 5) Clinicians should evaluate and treat or refer to a clinician who can evaluate and treat patients with significant asymmetric hearing loss, conductive or mixed hearing loss, or poor word recognition on diagnostic testing. (KAS 6) Clinicians should educate and counsel patients with hearing loss and their family/care partner(s) about the impact of hearing loss on their communication, safety, function, cognition, and quality of life (QOL). (KAS 7) Clinicians should counsel patients with hearing loss on communication strategies and assistive listening devices. (KAS 10) For patients with hearing loss, clinicians should assess if communication goals have been met and if there has been improvement in hearing-related QOL at a subsequent health care encounter or within 1 year. The GDG offered the following KAS as an option: (KAS 11) Clinicians should assess hearing at least every 3 years in patients with known hearing loss or with reported concern for changes in hearing.
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Affiliation(s)
| | - Matthew L Bush
- University of Kentucky Medical Center, Lexington, Kentucky, USA
| | | | | | | | | | - Kaye Bender
- Mississippi Public Health Association, Jackson, Mississippi, USA
| | | | | | | | | | - Ana H Kim
- Columbia University Medical Center, New York, New York, USA
| | | | - Carrie L Nieman
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | | | | | | | - Joe Reyes
- American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
| | - Nui Dhepyasuwan
- American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
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Tsai Do BS, Bender K, Keenan TA, Palmer CV, Ross EJ, Reyes J, Dhepyasuwan N. Plain Language Summary: Age-Related Hearing Loss. Otolaryngol Head Neck Surg 2024; 170:1228-1233. [PMID: 38682759 DOI: 10.1002/ohn.751] [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: 02/29/2024] [Revised: 03/16/2024] [Accepted: 03/19/2024] [Indexed: 05/01/2024]
Abstract
The plain language summary explains age-related hearing loss to patients, families, and care partners. The summary is for any patient aged 50 years and older, families, and care partners. It is based on the 2024 "Clinical Practice Guideline: Age-Related Hearing Loss." This plain language summary is a companion publication to the full guideline, which provides greater detail for clinicians. Guidelines and their recommendations may not apply to every patient, but they can be used to find best practices and quality improvement opportunities.
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Affiliation(s)
| | - Kaye Bender
- Mississippi Public Health Association, Jackson, Mississippi, USA
| | | | | | | | - Joe Reyes
- Department of Research and Quality, American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
| | - Nui Dhepyasuwan
- Department of Research and Quality, American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
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Meliante LA, Piccotti G, Tanga L, Giammaria S, Manni G, Coco G. Glaucoma, Pseudoexfoliation and Hearing Loss: A Systematic Literature Review. J Clin Med 2024; 13:1379. [PMID: 38592217 PMCID: PMC10931971 DOI: 10.3390/jcm13051379] [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: 12/29/2023] [Revised: 02/18/2024] [Accepted: 02/23/2024] [Indexed: 04/10/2024] Open
Abstract
Purpose: To investigate the relationship between glaucoma, pseudoexfoliation and hearing loss (HL). Methods: A systematic literature search following PRISMA guidelines was conducted using the PubMed, Embase, Scopus and Cochrane databases from 1995 up to 28 August 2023. Results: Thirty studies out of the 520 records screened met the inclusion criteria and were included. Most articles (n = 20) analysed the association between pseudoexfoliation syndrome (XFS) and HL, showing XFS patients to have higher prevalence of sensorineural hearing loss (SNHL) at both speech frequencies (0.25, 0.5, 1 and 2 kHz), and higher frequencies (4 and 8 kHz) compared to controls in most cases. No significant differences in prevalence or level of HL between XFS and pseudoexfoliative glaucoma (XFG) were detected in most studies. Eight articles analysed the relationship between primary open-angle glaucoma (POAG) and HL. Overall, a positive association between the two conditions was highlighted across all studies except for two cases. Similarly, articles focusing on NTG and HL (n = 4) showed a positive association in most cases. The role of autoimmunity and, in particular, the presence of antiphosphatidylserine antibodies (APSA) in patients with NTG and HL suggested an underlying autoimmune or vascular mechanism contributing to their pathogenesis. Only one study analysed the relationship between angle-closure glaucoma (ACG) and HL, showing higher incidence of ACG in patients with SNHL compared to normal hearing controls. Conclusions: Most studies detected an association between XFS and HL as well as POAG/NTG/ACG and HL, suggesting the presence of a similar pathophysiology of neurodegeneration. However, given the strength of the association of XFS with HL, it remains unclear whether the presence of XFG is further associated with SNHL. Further research specifically targeted to assess the correlation between glaucoma, XFS and HL is warranted to provide a more comprehensive understanding of this association.
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Affiliation(s)
- Laura Antonia Meliante
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (L.A.M.); (G.P.); (G.C.)
| | - Giulia Piccotti
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (L.A.M.); (G.P.); (G.C.)
| | - Lucia Tanga
- IRCCS—Fondazione Bietti, 00184 Rome, Italy; (L.T.); (S.G.)
| | - Sara Giammaria
- IRCCS—Fondazione Bietti, 00184 Rome, Italy; (L.T.); (S.G.)
| | - Gianluca Manni
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (L.A.M.); (G.P.); (G.C.)
- IRCCS—Fondazione Bietti, 00184 Rome, Italy; (L.T.); (S.G.)
| | - Giulia Coco
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (L.A.M.); (G.P.); (G.C.)
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Cui Y, Liang W, Li M, Zhao Z, Jiang X, Zhao B, Xu Z, Mang J. Better late than never: initial experience of intra-arterial pulsed-urokinase-injection as a salvage therapy for refractory sudden sensorineural hearing loss. Interv Neuroradiol 2022; 28:575-580. [PMID: 34726104 PMCID: PMC9511619 DOI: 10.1177/15910199211056819] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/06/2021] [Accepted: 10/11/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND PURPOSE Cochlear vascular micro-thrombosis has been hypothesized as one of the pathogenic mechanisms for sudden sensorineural hearing loss (SSNHL) refractory to regular management. This study aimed to evaluate the feasibility and safety of intra-arterial pulsed-injection urokinase (IAPU) as a salvage therapy for SSNHL after the failure of conventional therapy. METHODS We retrospectively reviewed our patient database to identify refractory SSNHL patients between November 2017 and July 2020. Study outcomes before and after the IAPU therapy were compared between IAPU and conventional therapy groups. RESULTS Sixty-seven moderate-profound SSNHL patients (29 in IAUP group, 38 in control group) were included in this study. Compared to the control group, patients in the IAPU group showed more significant improvement in pure tone average (PTA) (34.2 ± 23.5 vs. 10.7 ± 13.1, p < 0.001) and degree of hearing recovery (total: 20.7% vs. 5.3%, partial: 24.1% vs. 10.5%, mild: 27.6% vs. 13.2% and non: 27.6% vs. 71.1%) 2 weeks after admission. In the IAPU group, a significant improvement of PTA (86.6 ± 11.5 vs. 54.6 ± 20.1 dB, p < 0.005) was observed on the first day after IAPU treatment. CONCLUSION In carefully selected SSNHL cases with a highly suspected vascular origin, IAPU is a safe and effective therapy when conventional treatments have failed. Despite the encouraging findings of our work, large studies are needed to better investigate the strengths and limitations of this salvage therapy.
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Affiliation(s)
- Yang Cui
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Wenzhao Liang
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Mengxue Li
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Zhongyu Zhao
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Xinzhao Jiang
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Bingyang Zhao
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Zhongxin Xu
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Jing Mang
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
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Li G, Xia YF, Huang YX, Okat D, Qiu B, Doyen J, Bondiau PY, Benezery K, Gao J, Qian CN. Intensity-modulated proton radiation therapy as a radical treatment modality for nasopharyngeal carcinoma in China: A cost-effectiveness analysis. Head Neck 2021; 44:431-442. [PMID: 34837286 DOI: 10.1002/hed.26941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 09/11/2021] [Accepted: 11/10/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Compared to conventional intensity-modulated photon radiation therapy (IMRT), intensity-modulated proton radiation therapy (IMPT) has potential to reduce irradiation-induced late toxicities while maintaining excellent tumor control in patients with nasopharyngeal carcinoma (NPC). However, the relevant cost-effectiveness remains controversial. METHODS A Markov decision tree analysis was performed under the assumption that IMPT offered normal tissue complication probability reduction (NTCP reduction) in long-term dysphagia, xerostomia, and hearing loss, compared to IMRT. Base-case evaluation was performed on T2N2M0 NPC of median age (43 years old). A Chinese societal willingness-to-pay threshold (33558 US dollars [$])/quality-adjusted life-year [QALY]) was adopted. RESULTS For patients at median age and having NTCP reduction of 10%, 20%, 30%, 40%, 50%, and 60%, their incremental cost-effectiveness ratios were $102684.0/QALY, $43161.2/QALY, $24134.7/QALY, $13991.6/QALY, $8259.8/QALY, and $4436.1/QALY, respectively; IMPT should provide an NTCP reduction of ≥24% to be considered cost-effective. CONCLUSIONS IMPT has potential to be cost-effective for average Chinese NPC patients and should be validated clinically.
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Affiliation(s)
- Guo Li
- Department of Radiation Oncology, Guangzhou Concord Cancer Center, Guangzhou, China.,Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China
| | - Yun-Fei Xia
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yi-Xiang Huang
- Department of Health Management, Public Health Institute of Sun Yat-sen University, Guangzhou, China
| | - Deniz Okat
- Department of Finance, Hong Kong University of Science and Technology, Hong Kong, China
| | - Bo Qiu
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jerome Doyen
- Department of Radiation Oncology, Antoine Lacassagne Cancer Center, University of Nice-Sophia, Nice, France.,Mediterranean Institute of Proton Therapy, Antoine Lacassagne Cancer Center, University of Nice-Sophia, Nice, France
| | - Pierre-Yves Bondiau
- Department of Radiation Oncology, Antoine Lacassagne Cancer Center, University of Nice-Sophia, Nice, France.,Mediterranean Institute of Proton Therapy, Antoine Lacassagne Cancer Center, University of Nice-Sophia, Nice, France
| | - Karen Benezery
- Department of Radiation Oncology, Antoine Lacassagne Cancer Center, University of Nice-Sophia, Nice, France.,Mediterranean Institute of Proton Therapy, Antoine Lacassagne Cancer Center, University of Nice-Sophia, Nice, France
| | - Jin Gao
- Division of Life Sciences and Medicine, Department of Radiation Oncology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Chao-Nan Qian
- Department of Radiation Oncology, Guangzhou Concord Cancer Center, Guangzhou, China.,State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
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Radiologic Findings in Pediatric Sudden Sensorineural Hearing Loss. Otol Neurotol 2021; 42:1201-1207. [PMID: 33973955 DOI: 10.1097/mao.0000000000003188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Pediatric sudden sensorineural hearing loss (pSSNHL) is a rare phenomenon. There is currently no consensus on the role of imaging in the work-up for this patient population. We aim to evaluate the efficacy of magnetic resonance imaging (MRI) and high-resolution computed tomography (CT) studies in determining the etiology of pSSNHL. STUDY DESIGN Retrospective case review. SETTING Tertiary Hospital and Ambulatory Otolaryngology Clinic. PATIENTS Patients ≤18 years of age with sudden sensorineural hearing loss (SSNHL) and who had either MRI or CT imaging between January 2010 and May 2019 were included. INTERVENTION Diagnostic imaging. MAIN OUTCOME MEASURES Clinical characteristics and radiology impressions. RESULTS A total of 11 patients were identified, and 10 had unilateral SSNHL. MRI was performed on all patients, five patients had additional CT imaging. Abnormal imaging findings relevant to SSNHL were observed in five patients (45.5%), which included enlarged endolymphatic duct and sac, labyrinthine ossification, apical petrositis, hypoplastic cochlear nerve, and arachnoid cyst in the internal auditory canal; one patient had unrelated findings (enlarged pituitary gland), all remaining imaging studies were normal. CONCLUSION In our cohort, we found a higher imaging yield on pSSNHL than what has been reported for adult populations, indicating that the use of imaging in the diagnostic work-up is especially important in children.
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Sancaktar ME, Ağrı İ, Çeçen AB, Akgül G, Çelebi M. The Prognostic Value of Circulating Inflammatory Cell Counts in Sudden Sensorineural Hearing Loss and the Effect of Cardiovascular Risk Factors. EAR, NOSE & THROAT JOURNAL 2020; 99:464-469. [PMID: 32320296 DOI: 10.1177/0145561320920968] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Recent studies suggest that elevated neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are poor prognostic factors in sudden sensorineural hearing loss (SSNHL). We aimed to investigate the accuracy of this hypothesis by taking into account the effect of cardiovascular risk (CVR) factors. METHODS Medical records of 122 patients with SSNHL were reviewed retrospectively and grouped into 2 as; patients without CVR (group 1; n = 68) and patients having CVR (group 2; n = 54). Moreover, 60 control cases who did not have SSNHL were also included and grouped into 2 as; group 3 (n = 30) with CVR and group 4 (n = 30) healthy controls without having SSNHL or CVRs. Neutrophil (N), lymphocyte (L), platelet (Plt), NLR, and PLR between the groups and their relationship with the severity of hearing loss, recovery rates, and audiogram configurations were analyzed. RESULTS The highest N and NLR values were in group 1 and were significantly higher than the values of group 4 (P < .05, P < .01). There was no significant relationship between the groups in terms of L, Plt, or PLR values. The highest NLR and PLR values were determined in SSNHL patients with mild hearing loss, complete recovery, and up-sloping audiogram configuration (P > .05). CONCLUSIONS Elevated levels of N and NLR may be considered as strong laboratory findings showing an inflammatory response in the diagnosis of SSNHL, but the presence of CVR factors does not seem to increase the inflammatory response in SSNHL as expected. In patients with SSNHL, NLR and PLR elevation may indicate better prognosis.
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Affiliation(s)
- Mehmet Eser Sancaktar
- Department of Otorhinolaryngology-Head and Neck Surgery, Ministry of Health, University of Medical Sciences, Samsun Training and Research Hospital, Samsun/Turkey
| | - İbrahim Ağrı
- Department of Otorhinolaryngology-Head and Neck Surgery, Ministry of Health, University of Medical Sciences, Samsun Training and Research Hospital, Samsun/Turkey
| | - Ayşe Bel Çeçen
- Department of Otorhinolaryngology-Head and Neck Surgery, Ministry of Health, University of Medical Sciences, Samsun Training and Research Hospital, Samsun/Turkey
| | - Gökhan Akgül
- Department of Otorhinolaryngology-Head and Neck Surgery, Ministry of Health, University of Medical Sciences, Samsun Training and Research Hospital, Samsun/Turkey
| | - Mehmet Çelebi
- Department of Otorhinolaryngology-Head and Neck Surgery, Ministry of Health, University of Medical Sciences, Samsun Training and Research Hospital, Samsun/Turkey
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Exploring the association of Bone Alkaline Phosphatases And Hearing Loss. Sci Rep 2020; 10:4006. [PMID: 32132610 PMCID: PMC7055307 DOI: 10.1038/s41598-020-60979-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 02/19/2020] [Indexed: 11/16/2022] Open
Abstract
Hearing loss becomes increasingly common with age and affects quality of life. Recently, scientists have published articles about the relationship between metabolic disease and hearing loss. Metabolic disease was previously found to be highly related to an increase in alkaline phosphatase. Thus, there may be an indirect relationship between alkaline phosphatase (ALP) and hearing loss. In this paper, we will demonstrate the relationship between ALP and hearing loss. We included 3877 National Health and Nutrition Examination Survey (NHANES) participants, who represent the noninstitutionalized civilian population in the United States from age 20 to age 69, and examined the association between ALP and frequency distributions of pure-tone air-condition (PTAC) thresholds. After adjusting for pertinent variables, the subjects who belonged to the higher quartiles of ALP tended to have worse hearing thresholds (pure tone average at high and low frequencies) than the first quartile of ALP (p < 0.001). The results showed a positive correlation between ALP and hearing loss, in both males and females (p < 0.001) and in subjects whose body mass indices (BMI) were less than 30 (p < 0.001). In conclusion, ALP may play a role in detecting hearing loss.
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Force and Sound Pressure Sensors Used for Modeling the Impact of the Firearm with a Suppressor. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10030961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this paper, a mathematical model for projectiles shooting in any direction based on sensors distributed stereoscopically is put forward. It is based on the characteristics of a shock wave around a supersonic projectile and acoustical localization. Wave equations for an acoustic monopole point source of a directed effect used for physical interpretation of pressure as an acoustic phenomenon. Simulation and measurements of novel versatile mechanical and acoustical damping system (silencer), which has both a muzzle break and silencer properties studied in this paper. The use of the proposed damping system can have great influence on the acoustic pressure field intensity from the shooter. A silencer regarded as an acoustic transducer and multi-holes waveguide with a chamber. Wave equations for an acoustic monopole point source of a directed effect used for the physical interpretation of pressure as an acoustic phenomenon. The numerical simulation results of the silencer with different configurations presented allow trends to be established. A measurement chain was used to compare the simulation results with the experimental ones. The modeling and experimental results showed an increase in silencer chamber volume results in a reduction of recorded pressure within the silencer chamber.
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Cooper T, Dixit R, Hobson CE, Hirsch BE, McCall AA. Metachronous Sudden Sensorineural Hearing Loss: Patient Characteristics and Treatment Outcomes. Otolaryngol Head Neck Surg 2020; 162:337-342. [PMID: 31986973 DOI: 10.1177/0194599820902387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Idiopathic sudden sensorineural hearing loss (ISSNHL) is a distressing condition that can significantly affect quality of life. Unilateral ISSNHL, occurring first in 1 ear and then the contralateral ear at a separate and discrete time, is a rare presentation that we refer to as metachronous ISSNHL. Our objective was to characterize the presentation of metachronous ISSNHL and report on management and hearing outcomes. STUDY DESIGN Retrospective case series. SETTING Otology clinic at an academic tertiary referral center. SUBJECTS AND METHODS Patients ≥18 years old presenting with metachronous ISSNHL between April 2008 to November 2017 were identified through review of the clinic electronic medical record. Metachronous ISSNHL was defined as unilateral ISSNHL occurring in temporally discrete episodes (>6 months apart) affecting both ears. Patients with identifiable causes for sudden hearing loss were excluded. Patient demographics, comorbidities, management, and audiologic outcomes were recorded. RESULTS Eleven patients with metachronous ISSNHL were identified out of 558 patients with ISSNHL. In patients with metachronous ISSNHL, the mean ± standard deviation age at the time of ISSNHL in the second ear was 58.6 ± 15.2 years (range, 31-77 years). The mean interval between episodes was 9.6 ± 7.5 years (range, 1-22 years). Patients were treated with systemic and intratympanic steroids with variable hearing recovery; 5 patients with resultant bilateral severe to profound hearing loss underwent successful cochlear implantation. CONCLUSION Metachronous ISSNHL is uncommon. Treatment is similar to ISSNHL, and cochlear implantation can successfully restore hearing in individuals who do not experience recovery.
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Affiliation(s)
- Timothy Cooper
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Ronak Dixit
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Candace E Hobson
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Barry E Hirsch
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Andrew A McCall
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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Validation of the Hearing Handicap Inventory for Adults Scale for Spanish-Speaking Patients. Otol Neurotol 2019; 40:e947-e954. [PMID: 31725590 DOI: 10.1097/mao.0000000000002419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To perform translation, cross-cultural adaptation, and validation of the hearing handicap inventory for adults scale (HHIA) to the Spanish language. STUDY DESIGN Prospective study. SETTING Tertiary neurotologic referral center. PATIENTS The study included 104 hearing impaired persons. Inclusion criteria were adults with untreated hearing loss, diagnosed in the past 12 months. A control group of 30 normal hearing subjects was also recruited. INTERVENTION HHIA was translated and translated back, and a pretest trial was performed. Feasibility, internal consistency, test-retest reliability, construct validity, and ceiling and floor effects were assessed for the present study. MAIN OUTCOME MEASURES The mean overall score of the HHIA was 31.9 (0-100 scale, lowest to highest handicap). Cronbach's α was 0.95. Intraclass correlation coefficient was performed for each item, with an overall score of 0.95. The k coefficient scores ranged between moderate and almost perfect in all patients. The emotional score of the HHIA was correlated with the mental component of the SF-12. CONCLUSIONS Feasibility, internal consistency, reliability, and construct validity outcomes in the current study support the validity of the Spanish version of the HHIA.
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Mata-Castro N, Sanz-López L, Varillas-Delgado D, García-Fernández A. Intratympanic infliximab is a safe and effective rescue therapy for refractory immune-mediated hearing loss. Eur Arch Otorhinolaryngol 2019; 277:393-400. [PMID: 31691017 DOI: 10.1007/s00405-019-05716-x] [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: 07/17/2019] [Accepted: 10/28/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To determine the efficacy and safety of the intratympanic infiltration of infliximab at the hearing threshold of patients in follow-up for refractory immune-mediated hearing loss. METHODS 17 patients were collected with relapses, despite maintenance treatment with oral azathioprine associated or not with oral prednisone at low doses (between 5 and 7.5 ml/day) or refractory relapses to previous intratympanic corticoid treatment being 19 affected ears infiltrated. We measured the hearing threshold by Pure-Tone Average (PTA) 500-3000 Hz, 125-8000 Hz and 250-8000 Hz in pre-infiltration (baseline) and follow-up 3 weeks post-infiltration with auditory threshold at frequencies 125-8000 Hz. RESULTS The average age was 50.68 years (±15.23 years). After the administration of intratympanic infliximab, an improvement of the hearing threshold was showed in the Pure-Tone Average (PTA) calculated at 500-3000 Hz (p = 0.004), 125-8000 Hz (p = 0.001) and 250-8000 Hz (p = 0.006). An immediate improvement in low frequencies also was observed: 125, 250 and 500 Hz (p = 0.009, p = 0.002 and p < 0.001 respectively) also at 1000 Hz (p = 0.004) and a persistence of the effect at 3 months in the low frequencies: 125 Hz (p = 0.020), 250 Hz (p = 0.006) and 500 Hz (p = 0.002). CONCLUSIONS Infliximab intratympanic infiltration improves the hearing threshold in patients with immune-mediated hearing loss. The effect of improving the hearing threshold is higher in low frequencies and persists within 3 months of the infiltration. The administration of intratympanic infliximab is an effective and safe technique.
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Affiliation(s)
- Nieves Mata-Castro
- Department of Otolaryngology, Hospital Univeristario de Torrejón, Torrejón de Ardoz, Madrid, Spain. .,Universidad Francisco de Vitoria, Faculty of Medicine, Pozuelo de Alarcón, Madrid, Spain.
| | - Lorena Sanz-López
- Department of Otolaryngology, Hospital Univeristario de Torrejón, Torrejón de Ardoz, Madrid, Spain.,Universidad Francisco de Vitoria, Faculty of Medicine, Pozuelo de Alarcón, Madrid, Spain
| | - David Varillas-Delgado
- Universidad Francisco de Vitoria, Faculty of Medicine, Pozuelo de Alarcón, Madrid, Spain
| | - Alfredo García-Fernández
- Department of Otolaryngology, Hospital Universitario 12 de Octubre, Madrid, Spain.,Universidad Complutense, Faculty of Medicine, Madrid, Spain
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Padmanabhan A, Connelly-Smith L, Aqui N, Balogun RA, Klingel R, Meyer E, Pham HP, Schneiderman J, Witt V, Wu Y, Zantek ND, Dunbar NM, Schwartz GEJ. Guidelines on the Use of Therapeutic Apheresis in Clinical Practice - Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Eighth Special Issue. J Clin Apher 2019; 34:171-354. [PMID: 31180581 DOI: 10.1002/jca.21705] [Citation(s) in RCA: 760] [Impact Index Per Article: 152.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The American Society for Apheresis (ASFA) Journal of Clinical Apheresis (JCA) Special Issue Writing Committee is charged with reviewing, updating and categorizing indications for the evidence-based use of therapeutic apheresis (TA) in human disease. Since the 2007 JCA Special Issue (Fourth Edition), the committee has incorporated systematic review and evidence-based approaches in the grading and categorization of apheresis indications. This Eighth Edition of the JCA Special Issue continues to maintain this methodology and rigor in order to make recommendations on the use of apheresis in a wide variety of diseases/conditions. The JCA Eighth Edition, like its predecessor, continues to apply the category and grading system definitions in fact sheets. The general layout and concept of a fact sheet that was introduced in the Fourth Edition, has largely been maintained in this edition. Each fact sheet succinctly summarizes the evidence for the use of TA in a specific disease entity or medical condition. The Eighth Edition comprises 84 fact sheets for relevant diseases and medical conditions, with 157 graded and categorized indications and/or TA modalities. The Eighth Edition of the JCA Special Issue seeks to continue to serve as a key resource that guides the utilization of TA in the treatment of human disease.
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Affiliation(s)
- Anand Padmanabhan
- Medical Sciences Institute & Blood Research Institute, Versiti & Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Laura Connelly-Smith
- Department of Medicine, Seattle Cancer Care Alliance & University of Washington, Seattle, Washington
| | - Nicole Aqui
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Rasheed A Balogun
- Department of Medicine, University of Virginia, Charlottesville, Virginia
| | - Reinhard Klingel
- Apheresis Research Institute, Cologne, Germany & First Department of Internal Medicine, University of Mainz, Mainz, Germany
| | - Erin Meyer
- Department of Hematology/Oncology/BMT/Pathology, Nationwide Children's Hospital, Columbus, Ohio
| | - Huy P Pham
- Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Jennifer Schneiderman
- Department of Pediatric Hematology/Oncology/Neuro-oncology/Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago, Illinois
| | - Volker Witt
- Department for Pediatrics, St. Anna Kinderspital, Medical University of Vienna, Vienna, Austria
| | - Yanyun Wu
- Bloodworks NW & Department of Laboratory Medicine, University of Washington, Seattle, Washington, Yale University School of Medicine, New Haven, Connecticut
| | - Nicole D Zantek
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | - Nancy M Dunbar
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
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Lee CY, Chen HC, Wu PH, Chi JCY, Sun CC, Huang JY, Lin HY, Yang SF. Increased incidence of age-related macular degeneration in sensorineural hearing loss: A population-based cohort study. PLoS One 2019; 14:e0222919. [PMID: 31644539 PMCID: PMC6808445 DOI: 10.1371/journal.pone.0222919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 08/29/2019] [Indexed: 12/26/2022] Open
Abstract
Background To evaluate the incidence of age-related macular degeneration (AMD) in patients diagnosed with sensorineural hearing loss (SNHL) via the application of the National Health Insurance Research Database in Taiwan. Methodology/Principal findings A retrospective cohort study was conducted. Patients with a diagnosis of SNHL was enrolled in the study group after exclusion and a propensity score matched group without SNHL was served as the control group with a 1:2 ratio. The main outcome was regarded as the emergence of AMD diagnostic codes. Cox proportional hazard regression was applied to analyze the incidence and adjusted hazard ratio (aHR) of AMD in the multivariate model. A total of 15,686 patients with SNHL were included in the study group while another 31,372 non-SNHL patients served as the control group. After a follow-up interval up to 16 years, there were 484 AMD events occurred in the study group and 660 AMD cases in those non-SNHL patients with a significantly higher aHR compared to the control group after adjusting for multiple potential risk factors (aHR: 1.399, 95% CI: 1.244–1.574). Other prominent risk factors for AMD included older age, ischemic heart disease, hyperlipidemia, Alzheimer's disease, liver disease and kidney disease. Besides, a higher cumulative probability of AMD was observed in the study group (log-rank P <0.0001). Conclusion The patients with SNHL demonstrated a higher incidence of developing AMD.
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Affiliation(s)
- Chia-Yi Lee
- Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua, Taiwan
- Department of Optometry, College of Medicine and Life Science, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Hung-Chi Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan
- Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Pei-Hsuan Wu
- Department of Otolaryngology–Head and Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan
| | - Jessie Chao-Yun Chi
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Otorhinolaryngology Head and Neck Surgery, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Chi-Chin Sun
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan
- Department of Chinese Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Jing-Yang Huang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Hung-Yu Lin
- Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Optometry, Chung Shan Medical University, Taichung, Taiwan
- Department of Exercise and Health Promotion, Chung Chou University of Science and Technology, Changhua, Taiwan
- * E-mail: (S-FY); (H-YL)
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
- * E-mail: (S-FY); (H-YL)
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15
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Chien HW, Wu PH, Wang K, Sun CC, Huang JY, Yang SF, Chen HC, Lee CY. Increased Incidence of Glaucoma in Sensorineural Hearing Loss: A Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16162907. [PMID: 31416136 PMCID: PMC6720936 DOI: 10.3390/ijerph16162907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 08/11/2019] [Accepted: 08/12/2019] [Indexed: 01/08/2023]
Abstract
The purpose of the current study was to evaluate the incidence of glaucoma in patients diagnosed with sensorineural hearing loss (SNHL) via the application of the National Health Insurance Research Database in Taiwan. A retrospective cohort study was conducted. Patients with a diagnosis of SNHL were enrolled in the study group after an exclusion procedure and a propensity score matched group without SNHL was served as the control group with a 1:2 ratio. The main outcome was regarded as the emergence of glaucoma diagnostic codes. Cox proportional hazard regression was applied to analyze the incidence and adjusted hazard ratio (aHR) of glaucoma in the multivariate model. A total of 15,686 patients diagnosed with SNHL were enrolled in the study group while another 31,372 non-SNHL individuals served as the control group. There were 444 glaucoma events in the study group and 647 glaucoma events in those non-SNHL individuals after the follow-up interval of 16 years. The study group demonstrated a significantly higher aHR compared to the control group after adjusting for multiple possible risk factors. In the subgroup analysis, both the normal tension glaucoma and angle closure glaucoma subgroups revealed a higher aHR in the study group. In conclusion, the patients with SNHL demonstrated a higher incidence of developing glaucoma. Moreover, the incidence was more prominent for patients diagnosed with normal tension glaucoma and angle closure glaucoma.
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Affiliation(s)
- Hsiang-Wen Chien
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
- Departments of Ophthalmology, Sijhih Cathay General Hospital, New Taipei City 221, Taiwan
- Department of Ophthalmology, Cathay General Hospital, Taipei 106, Taiwan
| | - Pei-Hsuan Wu
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, Taipei 114, Taiwan
| | - Kai Wang
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
- Departments of Ophthalmology, Sijhih Cathay General Hospital, New Taipei City 221, Taiwan
- Department of Ophthalmology, Cathay General Hospital, Taipei 106, Taiwan
| | - Chi-Chin Sun
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 204, Taiwan
- Department of Chinese Medicine, Chang Gung University, Taoyuan City 333, Taiwan
| | - Jing-Yang Huang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Hung-Chi Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou 333, Taiwan.
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan 333, Taiwan.
- Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou 333, Taiwan.
| | - Chia-Yi Lee
- Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua 500, Taiwan.
- Department of Optometry, College of Medicine and Life Science, Chung Hwa University of Medical Technology, Tainan 717, Taiwan.
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Singh A, Kumar Irugu DV. Sudden sensorineural hearing loss - A contemporary review of management issues. J Otol 2019; 15:67-73. [PMID: 32440269 PMCID: PMC7231990 DOI: 10.1016/j.joto.2019.07.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 07/26/2019] [Indexed: 01/24/2023] Open
Abstract
Sudden sensorineural hearing loss (SSNHL) is an enigmatic entity, with obscure pathophysiology and debatable efficacy of the treatment agents used. An underlying cause is identified in only 10-15% of cases. The management of the remaining patients, classified as 'idiopathic', is empirical, and is conventionally with systemic steroids, vasodilator therapy, rheological agents, and antioxidants, to list a few amongst the host of the agents employed for the treatment. The availability of conflicting outcomes and lack of conclusive evidence has resulted in the propagation of consensus-based treatment protocols. In the present review, we discuss the various controversial issues and newer developments in the management of idiopathic SSNHL. The current review aims to present a narrative outlook of the updated evidence base available from PUBMED, augmented with relevant designated publications.
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Affiliation(s)
- Anup Singh
- Department of Otorhinolaryngology and Head and Neck Surgery, Medanta- the Medicity, Gurugram, Haryana, India
| | - David Victor Kumar Irugu
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
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Currie S, Saunders D, Macmullen-Price J, Verma S, Ayres P, Tait C, Harwood C, Scarsbrook A, Craven IJ. Should we be moving to a national standardized non-gadolinium MR imaging protocol for the surveillance of vestibular schwannomas? Br J Radiol 2019; 92:20180833. [PMID: 30633539 DOI: 10.1259/bjr.20180833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES: To examine whether the model of Getting It Right First Time (GIRFT) could be relevant to the surveillance of non-operated vestibular schwannomas (vs) by testing the following hypotheses: (1) in the UK there is a great variation in the imaging protocol for the follow-up of vs; (2) high-resolution, T 2 weighted MRI (HRT 2W-MRI) has an equivalent accuracy to gadolinium-enhanced T 1 weighted MRI (Gd-MRI) in the assessment of vs size and; (3) imaging with HRT 2W-MRI rather than Gd-MRI could offer financial savings. METHODS: Two neuroradiologists independently performed measurements of 50 vs imaged with HRT 2W-MRI and Gd-MRI. Differences in mean tumour measurements between HRT 2W-MRI and Gd-MRI were determined, as were intra- and interobserver concordance. Level of agreement was measured using Bland-Altman plots. Consultant neuroradiologists within 30 adult neurosurgical units in the UK were contacted via email and asked to provide the MRI protocol used for the surveillance of non-operated vs in their institution. The financial difference between scanning with HRT 2W-MRI and Gd-MRI was determined within Leeds Teaching Hospitals NHS Trust. RESULTS: There was no statistically significant difference in the mean diameter of vs size, measured on HRT 2W-MRI and Gd-MRI (p = 0.28 & p = 0.74 for observers 1 and 2 respectively). Inter- and intraobserver concordance were excellent (Interclass correlation coefficient = 0.99, Interclass correlation coefficient ≥ 0.98 respectively). Differences between the two sequences were within limits of agreement. 26 of 30 UK neuroscience centres (87 % response rate) provided imaging protocols. 16 of the 26 (62%) centres use Gd-MRI for the surveillance of vs. HRT 2-MRI is £36.91 cheaper per patient than Gd-MRI. CONCLUSION: Variation exits across UK centres in the imaging surveillance of non-operated vs. HRT 2W-MRI and Gd-MRI have equivalent accuracy when measuring vs. Imaging with HRT 2W-MRI rather than Gd-MRI offers potential financial savings. ADVANCES IN KNOWLEDGE: This study highlights the potential health and economic benefits of a national standardized imaging protocol for the surveillance of non-operated vs.
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Affiliation(s)
- Stuart Currie
- 1 Department of Neuroradiology, Leeds Teaching Hospitals NHS Trust , Leeds , UK
| | - David Saunders
- 1 Department of Neuroradiology, Leeds Teaching Hospitals NHS Trust , Leeds , UK
| | | | - Sanjay Verma
- 2 Department of Ear Nose and Throat Surgery, Leeds Teaching Hospitals NHS Trust , Leeds , UK
| | - Philip Ayres
- 3 Public Health, Leeds Teaching Hospitals NHS Trust , Leeds , UK
| | - Caroline Tait
- 3 Public Health, Leeds Teaching Hospitals NHS Trust , Leeds , UK
| | - Ceryl Harwood
- 3 Public Health, Leeds Teaching Hospitals NHS Trust , Leeds , UK
| | - Andrew Scarsbrook
- 4 Department of Radiology and Nuclear Medicine, Leeds Teaching Hospitals NHS Trust , Leeds , UK
| | - Ian J Craven
- 1 Department of Neuroradiology, Leeds Teaching Hospitals NHS Trust , Leeds , UK
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Khan HZ, Park CY, Lim MA, Beltran AJ, Farquhar D, Yencha M, Capra GG. Radiographic findings in young adults with asymmetric sensorineural hearing loss. Am J Otolaryngol 2019; 40:78-82. [PMID: 30472122 DOI: 10.1016/j.amjoto.2018.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 10/05/2018] [Accepted: 10/08/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To evaluate radiographic findings in US Navy recruits found to have asymmetric sensorineural hearing loss (ASNHL) during routine medical screening. MATERIALS AND METHODS Retrospective analysis of US Navy recruits receiving screening audiometry and medical suitability evaluation from January 2011 to October 2016. Single-institution, institutional review board-approved study of US Navy recruits screened for hearing loss over a six-year period. All recruits with ASNHL were evaluated by an otolaryngologist and received diagnostic radiographic evaluation. Audiometric and imaging results were retrospectively reviewed for this population and compared to common screening criteria. RESULTS ASNHL was identified in 674 of 228,504 total recruits screened. This population was 91% male and between 17 and 29 years old (mean age 21.1). Six-hundred fifty-three (97%) met criteria for further ASNHL evaluation. Subjective hearing loss was reported in only 6% of patients. Six-hundred sixty-one (99%) received magnetic resonance imaging of the internal auditory canals. Intracranial pathology was identified in 43 (6.3%) patients and 2 (0.3%) had a causative intracranial lesion corresponding to ASNHL. No patients were found to have a vestibular schwannoma. CONCLUSIONS In a population of healthy young adults with audiometric proven ASNHL, 0.3% had radiographic proven intracranial pathology explaining the hearing loss. Intracranial masses may be less likely to cause ASNHL in this population; further research is needed to determine appropriate MRI screening methods for young adults with ASNHL.
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Sharma A, Kirsch CF, Aulino JM, Chakraborty S, Choudhri AF, Germano IM, Kendi AT, Kim HJ, Lee RK, Liebeskind DS, Luttrull MD, Moritani T, Murad GJ, Shah LM, Shih RY, Symko SC, Bykowski J. ACR Appropriateness Criteria® Hearing Loss and/or Vertigo. J Am Coll Radiol 2018; 15:S321-S331. [DOI: 10.1016/j.jacr.2018.09.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 09/07/2018] [Indexed: 12/17/2022]
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Lai D, Zhong J, Lu T, Pu JM. Patient education in sudden sensorineural hearing loss: Knowledge, attitude/belief, and practice findings among otolaryngologists and otologists in China. PATIENT EDUCATION AND COUNSELING 2018; 102:93-98. [PMID: 30146406 DOI: 10.1016/j.pec.2018.08.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 08/13/2018] [Accepted: 08/16/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To examine patient education knowledge, attitude/belief, and practices (KABP) among specialists who manage sudden sensorineural hearing loss (SSNHL). METHODS A cross-sectional study design was employed wherein semi-structured interviews were conducted at a 2017 otorhinolaryngology meeting. In this survey, we asked the respondents about their perspectives regarding the imparting of SSNHL patient education. RESULTS The sample consisted of 84 physicians from 23 cities in Sichuan province. Three quarters of the respondents felt SSNHL patient education was necessary. Notably, 67.9% of the respondents believed that patient education could improve treatment. Half of the respondents provided culturally tailored education (based on US guidelines) inclusive of traditional Chinese medicine (TCM) notions of lifestyle adjustments. Internet platforms were an emerging preference for education delivery mode. Only 47.4% of participants reported being satisfied with their current patient education offerings, and these activities were regarded as needing improvement. CONCLUSION This study captured the perspectives of otorhinolaryngologists and otologists in China regarding the imparting of SSNHL patient education. The results of this survey should support Chinese physician's implementation of SSNHL patient education. PRACTICE IMPLICATIONS Findings obtained with the present survey may be employed to support the importance of SSNHL patient education in China.
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Affiliation(s)
- Dan Lai
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
| | - Juan Zhong
- Hearing Center/Hearing and Speech Science Laboratory, Department of Otolaryngology Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Tao Lu
- Hearing Center/Hearing and Speech Science Laboratory, Department of Otolaryngology Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Jun-Mei Pu
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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21
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Khaku A, Patel V, Zacharia T, Goldenberg D, McGinn J. Guidelines for radiographic imaging of cranial neuropathies. EAR, NOSE & THROAT JOURNAL 2018; 96:E23-E39. [PMID: 29121382 DOI: 10.1177/0145561317096010-1106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Disruption of the complex pathways of the 12 cranial nerves can occur at any site along their course, and many, varied pathologic processes may initially manifest as dysfunction and neuropathy. Radiographic imaging (computed topography or magnetic resonance imaging) is frequently used to evaluate cranial neuropathies; however, indications for imaging and imaging method of choice vary considerably between the cranial nerves. The purpose of this review is to provide an analysis of the diagnostic yield and the most clinically appropriate means to evaluate cranial neuropathies using radiographic imaging. Using the PubMed MEDLINE NCBI database, a total of 49,079 articles' results were retrieved on September 20, 2014. Scholarly articles that discuss the etiology, incidence, and use of imaging in the context of evaluation and diagnostic yield of the 12 cranial nerves were evaluated for the purposes of this review. We combined primary research, guidelines, and best practice recommendations to create a practical framework for the radiographic evaluation of cranial neuropathies.
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Affiliation(s)
- Aliasgher Khaku
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, The Pennsylvania State University College of Medicine, 500 University Dr., MC H091, Hershey, PA 17033-0850, USA
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Marx M, Younes E, Chandrasekhar S, Ito J, Plontke S, O’Leary S, Sterkers O. International consensus (ICON) on treatment of sudden sensorineural hearing loss. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:S23-S28. [DOI: 10.1016/j.anorl.2017.12.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 12/10/2017] [Accepted: 12/14/2017] [Indexed: 10/18/2022]
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Lai D, Zhao F, Jalal N, Zheng Y. Intratympanic glucocorticosteroid therapy for idiopathic sudden hearing loss: Meta-analysis of randomized controlled trials. Medicine (Baltimore) 2017; 96:e8955. [PMID: 29390288 PMCID: PMC5815700 DOI: 10.1097/md.0000000000008955] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Glucocorticoids are the standard treatment for idiopathic sudden sensorineural hearing loss (ISSNHL), but whether intratympanic or systemic therapy is superior remains controversial. Previous meta-analyses of this question have omitted key clinical trials or included observational studies. METHODS English-language randomized controlled trials in OvidSP, PubMed, Embase, CINAHL, and the Cochrane Library comparing intratympanic versus systemic glucocorticoid therapy for ISSNHL were meta-analyzed using RevMan 5.3. The primary outcome of interest was improvement in pure tone average (PTA) threshold. RESULTS Six trials involving 248 patients receiving intratympanic steroids and 236 receiving systemic steroids were meta-analyzed. PTA thresholds were similar between the 2 groups at 3 months after therapy initiation (mean difference, 0.24; 95% confidence interval [CI] -2.43 to 2.91, P = .86; I = 54%, P = .07, random-effects model). PTA thresholds were also similar at 6 months (mean difference, 4.69, 95% CI -5.84 to 15.22, P = .38), although the results showed extremely high heterogeneity (I = 98%). Sensitivity analysis indicated that a single trial containing 250 patients provided the strongest evidence for equivalence between the 2 types of therapy. Rates of recovery within 3 months (defined as PTA improvement >10 dB) were similar between the 2 types of therapy (odds ratio 0.92, 95% CI 0.59-1.43, P = .70), with no significant heterogeneity in the pooled data (I = 1%, P = .40). CONCLUSION Intratympanic and systemic steroids' therapies appear to show similar short-term efficacy for restoring hearing in patients with ISSNHL. Intratympanic therapy may reduce systemic side effects associated with steroid use.
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Affiliation(s)
- Dan Lai
- Hearing Center/Hearing and Speech Science Laboratory, Department of Otolaryngology Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Fei Zhao
- Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, England
- Department of Hearing and Speech Science, Xinhua College, Sun Yat-Sen University, Guangzhou, China
| | - Nasim Jalal
- Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, England
| | - Yun Zheng
- Hearing Center/Hearing and Speech Science Laboratory, Department of Otolaryngology Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu
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Abstract
This article discusses the physiology of normal hearing, the pathophysiology and differential diagnoses of sudden sensorineural hearing loss, and an approach for definitive diagnosis and treatment. A focus is placed on idiopathic sudden sensorineural hearing loss in the adult population in a primary care setting.
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Affiliation(s)
- Elizabeth Ann H Jensen
- Elizabeth Ann H. Jensen is a nursing instructor at the Medical University of South Carolina, Charleston, S.C. Elizabeth D. Harmon is an instructor at the Medical University of South Carolina, Charleston, S.C. Whitney Smith is an instructor at the Medical University of South Carolina, Charleston, S.C
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25
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Naples JG. Calcium-channel blockers as therapeutic agents for acquired sensorineural hearing loss. Med Hypotheses 2017; 104:121-125. [PMID: 28673569 DOI: 10.1016/j.mehy.2017.05.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 05/28/2017] [Accepted: 05/31/2017] [Indexed: 11/27/2022]
Abstract
Acquired sensorineural hearing loss represents a challenging clinical scenario. Currently, there are few approved therapies for treating this type of hearing loss, and diagnosis is often made after permanent damage has occurred. There are numerous etiologies for acquired hearing loss, with complex mechanisms underlying each cause. Despite these complexities, apoptosis of the structures within the inner ear, is a theme common to many forms of acquired hearing loss. Apoptosis is a calcium-dependent process, and within the inner ear, L- and T-type calcium channels are believed to contribute to calcium availability during this process. There are few studies limited to animal models evaluating the role of calcium-channel blockers (CCBs) as otoprotective agents in the setting of acquired hearing loss. Here, I hypothesize that CCBs will provide utility as a therapy against acquired forms of sensorineural hearing loss by preventing calcium influx that occurs during inner ear cellular apoptosis.
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Affiliation(s)
- James G Naples
- University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT 06030, United States.
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Abstract
Sudden sensorineural hearing loss is defined as sudden unilateral or bilateral sensorineural hearing loss with at least 30 dB decrease in threshold in 3 contiguous test frequencies occurring over 72 hours or less. It is rare among children. The mechanism of the process and prognosis of the disorder remains unclear. The current incidence of sudden sensorineural hearing loss among pediatric population is unknown. The authors carried out a retrospective chart analysis of patients under 15 years of age from 2004 to 2015, who consulted to the Otolaryngology Head and Neck Surgery Department of Inonu University Medical Faculty. Age, sex, number of affected ear and side, audiometric evaluations, medical follow-up, treatment method, duration of treatment recovery, associated complaints; tinnitus and/or vertigo, presence of mumps disease were recorded for each patient. A 4-frequency pure-tone average (500, 1000, 2000, and 4000 Hz) was calculated for each ear. Complete recovery, defined as some hearing level compared with the nonaffected ear, was observed in 3 patients (21.4 %) and there was no partial hearing recovery. The hearing loss of 11 patient remained unchanged after prednisolone treatment. Two of the 11 patients had bilaterally total sensorineural hearing loss and evaluated as appropriate for cochlear implantation. Sex of patient and laterality of hearing loss were not correlated with hearing recovery. Sensorineural hearing loss among pediatrics has been the issue of otolaryngologists. The incidence, etiology, and treatment methods should be more studied.
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Coelho DH, Tang Y, Suddarth B, Mamdani M. MRI surveillance of vestibular schwannomas without contrast enhancement: Clinical and economic evaluation. Laryngoscope 2017; 128:202-209. [DOI: 10.1002/lary.26589] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2017] [Indexed: 11/12/2022]
Affiliation(s)
- Daniel H. Coelho
- Department of Otolaryngology-Head and Neck Surgery; Virginia Commonwealth University School of Medicine; Richmond Virginia U.S.A
| | - Yang Tang
- Department of Radiology; Virginia Commonwealth University School of Medicine; Richmond Virginia U.S.A
| | - Brian Suddarth
- Department of Radiology; Virginia Commonwealth University School of Medicine; Richmond Virginia U.S.A
| | - Mohammed Mamdani
- Department of Otolaryngology-Head and Neck Surgery; Virginia Commonwealth University School of Medicine; Richmond Virginia U.S.A
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Schwartz J, Padmanabhan A, Aqui N, Balogun RA, Connelly-Smith L, Delaney M, Dunbar NM, Witt V, Wu Y, Shaz BH. Guidelines on the Use of Therapeutic Apheresis in Clinical Practice-Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Seventh Special Issue. J Clin Apher 2017; 31:149-62. [PMID: 27322218 DOI: 10.1002/jca.21470] [Citation(s) in RCA: 276] [Impact Index Per Article: 39.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The American Society for Apheresis (ASFA) Journal of Clinical Apheresis (JCA) Special Issue Writing Committee is charged with reviewing, updating, and categorizing indications for the evidence-based use of therapeutic apheresis in human disease. Since the 2007 JCA Special Issue (Fourth Edition), the Committee has incorporated systematic review and evidence-based approaches in the grading and categorization of apheresis indications. This Seventh Edition of the JCA Special Issue continues to maintain this methodology and rigor to make recommendations on the use of apheresis in a wide variety of diseases/conditions. The JCA Seventh Edition, like its predecessor, has consistently applied the category and grading system definitions in the fact sheets. The general layout and concept of a fact sheet that was used since the fourth edition has largely been maintained in this edition. Each fact sheet succinctly summarizes the evidence for the use of therapeutic apheresis in a specific disease entity. The Seventh Edition discusses 87 fact sheets (14 new fact sheets since the Sixth Edition) for therapeutic apheresis diseases and medical conditions, with 179 indications, which are separately graded and categorized within the listed fact sheets. Several diseases that are Category IV which have been described in detail in previous editions and do not have significant new evidence since the last publication are summarized in a separate table. The Seventh Edition of the JCA Special Issue serves as a key resource that guides the utilization of therapeutic apheresis in the treatment of human disease. J. Clin. Apheresis 31:149-162, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Joseph Schwartz
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York
| | - Anand Padmanabhan
- Blood Center of Wisconsin, Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Nicole Aqui
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Rasheed A Balogun
- Division of Nephrology, University of Virginia, Charlottesville, Virginia
| | - Laura Connelly-Smith
- Department of Medicine, Seattle Cancer Care Alliance and University of Washington, Seattle, Washington
| | - Meghan Delaney
- Bloodworks Northwest, Department of Laboratory Medicine, University of Washington, Seattle, Washington
| | - Nancy M Dunbar
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Volker Witt
- Department for Pediatrics, St. Anna Kinderspital, Medical University of Vienna, Vienna, Austria
| | - Yanyun Wu
- Bloodworks Northwest, Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Beth H Shaz
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York.,New York Blood Center, Department of Pathology.,Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
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Metabolomic analysis of urine with Nuclear Magnetic Resonance spectroscopy in patients with idiopathic sudden sensorineural hearing loss: A preliminary study. Auris Nasus Larynx 2016; 44:381-389. [PMID: 27817938 DOI: 10.1016/j.anl.2016.10.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 09/22/2016] [Accepted: 10/06/2016] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Idiopathic sudden sensorineural hearing loss is a frequent emergency, with unknown aetiology and usually treated with empiric therapy. Steroids represent the only validated treatment but prognosis is unpredictable and the possibility to select the patients who will not respond to steroids could avoid unnecessary treatments. Metabolomic profiling of the biofluids target the analysis of the final product of genic expression and enzymatic activity, defining the biochemical phenotype of a whole biologic system. METHODS We studied the metabolomics of the urine of a cohort of patients with idiopathic sudden sensorineural hearing loss, correlating the metabolic profiles with the clinical outcomes. Metabolomic profiling of urine samples was performed by 1H Nuclear Magnetic Resonance spectroscopy in combination with multivariate statistical approaches. RESULTS 26 patients were included in the study: 5 healthy controls, 13 patients who did not recover after treatment at 6 months while the remaining 8 patients recovered from the hearing loss. The orthogonal partial least square-discriminant analysis score plot showed a significant separation between the two groups, responders and non-responders after steroid therapy, R2Y of 0.83, Q2 of 0.38 and p value <0.05. The resulting metabolic profiles were characterized by higher levels of urinary B-Alanine, 3-hydroxybutyrate and Trimethylamine N-oxide, and lower levels of Citrate and Creatinine in patients with worst outcome. CONCLUSION Idiopathic sudden sensorineural hearing loss is a specific disease with unclear systemic changes, but our data suggest that there are different types of this disorder or patients predisposed to effective action of steroids allowing the recover after treatment.
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Acute Disseminated Encephalomyelitis. J Clin Apher 2016; 31:163-202. [PMID: 27322219 DOI: 10.1002/jca.21474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Lawrence R, Thevasagayam R. Controversies in the management of sudden sensorineural hearing loss: an evidence-based review. Clin Otolaryngol 2016; 40:176-82. [PMID: 25521864 DOI: 10.1111/coa.12363] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Sudden sensorineural hearing loss (SSNHL) is considered an otological emergency. It may present as an isolated condition or be the presenting feature of a systemic disease process. Idiopathic sudden sensorineural hearing loss (ISSNHL) is diagnosed when an underlying cause or condition cannot be identified. OBJECTIVE OF REVIEW To review the current literature on SSNHL and propose a treatment algorithm based on the highest quality evidence. SEARCH STRATEGY AND TYPE OF REVIEW An evidence-based literature review using medline (search terms 'sudden sensorineural hearing loss' and 'acute sensorineural hearing loss'). RESULTS (i) Baseline Investigations: All patients should be assessed with a thorough history and examination. This should include a pure tone audiogram (PTA) where possible. Baseline and targeted laboratory tests should be carried out to diagnose specific conditions. (ii) Imaging: MRI should be carried out in all cases of ISSNHL. If MRI imaging is contraindicated either CT or auditory brainstem response (ABR) testing should be performed. (iii) Medical Management: If a specific cause for a SSNHL is found, the patient should be managed accordingly. If idiopathic in nature, patients may be offered a course of oral steroid. If systemic steroids are contraindicated and/or there is no improvement with initial oral therapy, intratympanic steroids (IT) as either primary or salvage therapy may be considered. (iv) Further Management: There is no evidence to support the routine use of antiviral therapy. The cost, limited availability and lack of strong evidence for hyperbaric oxygen therapy (HBOT) make it impractical at present. Due to the variability in the vasodilator and vasoactive agents used, there is insufficient evidence to support the routine use of these agents. Consideration should be given to both temporary and permanent hearing amplification when required. CONCLUSIONS SSNHL is an important condition that can have a significant impact on quality of life. Some patients respond spontaneously without intervention; however, evidence tells us that certain interventions such as corticosteroid treatment may improve outcomes. Further high-quality research is required. Meanwhile, an interim indicative treatment algorithm for SSNHL based on the current best evidence available is outlined.
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Affiliation(s)
- R Lawrence
- Sheffield Children's Hospital, Western Bank, Sheffield, UK
| | - R Thevasagayam
- Sheffield Children's Hospital, Western Bank, Sheffield, UK
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Symptomatic sensorineural hearing loss in patients with ulcerative colitis. Tech Coloproctol 2015; 19:729-31. [PMID: 26280882 DOI: 10.1007/s10151-015-1349-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 05/15/2015] [Indexed: 10/23/2022]
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Zhang XC, Xu XP, Xu WT, Hou WZ, Cheng YY, Li CX, Ni GX. Acupuncture therapy for sudden sensorineural hearing loss: a systematic review and meta-analysis of randomized controlled trials. PLoS One 2015; 10:e0125240. [PMID: 25919000 PMCID: PMC4412536 DOI: 10.1371/journal.pone.0125240] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 03/22/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Acupuncture has commonly been used in China, either alone or in combination with Western medicine, to treat sudden sensorineural hearing loss (SSHL). The purpose of this systematic review is to assess the efficacy and safety of acupuncture therapy for patients with SSHL. METHODS We searched PubMed, the Cochrane Library, Embase, China National Knowledge Internet (CNKI), Database for Chinese Technical Periodicals (VIP), and Chinese Biomedical literature service system (SinoMed) to collect randomized controlled trials of acupuncture for SSHL published before July 2014. A meta-analysis was conducted according to the Cochrane systematic review method using RevMan 5.2 software. The evidence level for each outcome was assessed using the GRADE methodology. RESULTS Twelve trials involving 863 patients were included. A meta-analysis showed that the effect of manual acupuncture combined with Western medicine comprehensive treatment (WMCT) was better than WMCT alone (RR 1.33, 95%CI 1.19-1.49) and the same as the effect of electroacupuncture combined with WMCT (RR 1.33, 95%CI 1.19-1.50). One study showed a better effect of electroacupuncture than of WMCT (RR 1.34, 95%CI 1.24-1.45). For mean changes in hearing over all frequencies, the meta-analysis showed a better effect with the combination of acupuncture and WMCT than with WMCT alone (MD 10.85, 95%CI 6.84-14.86). However, the evidence levels for these interventions were low or very low due to a high risk of bias and small sample sizes in the included studies. CONCLUSION There was not sufficient evidence showing that acupuncture therapy alone was beneficial for treating SSHL. However, interventions combining acupuncture with WMCT had more efficacious results in the treatment of SSHL than WMCT alone. Electroacupuncture alone might be a viable alternative treatment besides WMCT for SSHL. However, given that there were fewer eligible RCTs and limitations in the included trials, such as methodological drawbacks and small sample sizes, large-scale RCTs are required to confirm the current findings regarding acupuncture therapy for SSHL.
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Affiliation(s)
- Xin-chang Zhang
- Department of Pain Management, Subei People’s Hospital of Jiangsu Province & Clinical Medical School, Yang Zhou University, Yangzhou 225001, P.R. China
- The Second School Medical College, Nanjing University of Chinese Medicine, Nanjing 210029, P.R. China
| | - Xiu-ping Xu
- Department of Critical Care Medicine, Nanjing Zhong-da Hospital, School of Medicine, Southeast University, Nanjing 210009, P.R. China
| | - Wen-tao Xu
- The Second School Medical College, Nanjing University of Chinese Medicine, Nanjing 210029, P.R. China
| | - Wen-zhen Hou
- The Second School Medical College, Nanjing University of Chinese Medicine, Nanjing 210029, P.R. China
| | - Ying-ying Cheng
- The Second School Medical College, Nanjing University of Chinese Medicine, Nanjing 210029, P.R. China
| | - Chang-xi Li
- Department of Pain Management, Subei People’s Hospital of Jiangsu Province & Clinical Medical School, Yang Zhou University, Yangzhou 225001, P.R. China
| | - Guang-xia Ni
- The Second School Medical College, Nanjing University of Chinese Medicine, Nanjing 210029, P.R. China
- The Second Chinese Medicine Hospital of Jiangsu Province, Nanjing 210017, P.R. China
- * E-mail:
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Terzi H, Kale A, Hasdemir PS, Selcuk A, Yavuz A, Genc S. Hearing loss: An unknown complication of pre-eclampsia? J Obstet Gynaecol Res 2014; 41:188-92. [DOI: 10.1111/jog.12505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 05/22/2014] [Indexed: 12/31/2022]
Affiliation(s)
- Hasan Terzi
- Obstetrics and Gynecology Clinic; Derince Education and Research Hospital; Kocaeli Turkey
| | - Ahmet Kale
- Obstetrics and Gynecology Clinic; Derince Education and Research Hospital; Kocaeli Turkey
| | - Pinar Solmaz Hasdemir
- Obstetrics and Gynecology Department; Celal Bayar University Hospital; Manisa Turkey
| | - Adin Selcuk
- Ear, Nose and Throat Clinic; Derince Education and Research Hospital; Kocaeli Turkey
| | - Arzu Yavuz
- Obstetrics and Gynecology Clinic; Derince Education and Research Hospital; Kocaeli Turkey
| | - Selahattin Genc
- Ear, Nose and Throat Clinic; Derince Education and Research Hospital; Kocaeli Turkey
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Weiss D, Neuner B, Gorzelniak K, Bremer A, Rudack C, Walter M. Platelet glycoproteins and fibrinogen in recovery from idiopathic sudden hearing loss. PLoS One 2014; 9:e86898. [PMID: 24466284 PMCID: PMC3900659 DOI: 10.1371/journal.pone.0086898] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 12/17/2013] [Indexed: 01/12/2023] Open
Abstract
Background The pathomechanism and location of idiopathic sudden sensorineural hearing loss (ISSHL) is unclear. In a previous case-control study, we found elevated fibrinogen concentrations and a higher prevalence of T allele carriers of the glycoprotein (Gp) Ia C807T polymorphism in ISSHL patients. Methodology 127 patients with ISSHL (mean age 53.3 years, 48.8% females), who underwent a standard therapy with high dose steroids, pentoxifyllin and sterofundine over 8 days were included. We examined the influence of GpIa genotype and fibrinogen (BclI-, A312-, HaeIII-) genotype and fibrinogen plasma levels on hearing recovery after 8 weeks (change from baseline: 0 dB = no recovery, >0 to 10 dB = moderate recovery, >10 dB = good recovery). In a subsample of 59 patients with ISSHL, we further studied the association of platelet glycoprotein GpIa, Ib and IIIa densities on hearing recovery as well as the possible effect-modification of platelet glycoproteins on hearing recovery by plasma fibrinogen. Results In univariate analysis, neither the GpIa genotype nor fibrinogen genotype (all p>0.1) but lower fibrinogen levels (p = 0.029), less vertigo (p = 0.002) and lower GpIIIa receptor density (p = 0.037, n = 59) were associated with hearing recovery. In multivariate analysis, fibrinogen significantly modified the effect of GPIa receptor density on good hearing recovery (effect-modification on multiplicative scale OR = 0.45 (95% confidence interval (0.21–0.94)), p = 0.03). GPIb receptor density below the mean was associated with a 2-fold increase in good hearing recovery both in patients with fibrinogen levels above (p = 0.04) as well as in patients with fibrinogen levels below the mean (p = 0.06). There was no indication for an effect-modification (p = 0.97). Conclusions The findings suggest a vascular/rheological origin of ISSHL with unique features of thrombosis in the inner ear artery that may include complex interrelationships among platelet glycoproteins and plasma fibrinogen.
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Affiliation(s)
- Daniel Weiss
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Münster, Münster, Germany
| | - Bruno Neuner
- Department of Anaesthesiology and Intensive Care Medicine, Campus Virchow-Klinikum and Campus Charité-Mitte, Charité – University Medicine, Berlin, Germany
| | - Kerstin Gorzelniak
- Institute of Laboratory Medicine, Unfallkrankenhaus Berlin, Berlin, Germany
| | - Alexis Bremer
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Münster, Münster, Germany
| | - Claudia Rudack
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Münster, Münster, Germany
| | - Michael Walter
- Institute of Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Campus Virchow-Klinikum, Charité – University Medicine & Labor Berlin – Charité Vivantes Services GmbH, Berlin, Germany
- * E-mail:
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Wu RX, Chen CC, Wang CH, Chen HC. Intratympanic steroid injection for sudden sensorineural hearing loss in a patient on hemodialysis. Hemodial Int 2013; 18:195-9. [DOI: 10.1111/hdi.12062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Rui-Xin Wu
- Department of Medicine; Division of Nephrology; Tri-Service General Hospital; National Defense Medical Center; Taipei Taiwan
| | - Chun-Chi Chen
- Department of Medicine; Division of Nephrology; Tri-Service General Hospital; National Defense Medical Center; Taipei Taiwan
| | - Chih-Hung Wang
- Department of Otolaryngology-Head and Neck Surgery; Tri-Service General Hospital; National Defense Medical Center; Taipei Taiwan
| | - Hsin-Chien Chen
- Department of Otolaryngology-Head and Neck Surgery; Tri-Service General Hospital; National Defense Medical Center; Taipei Taiwan
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Tarshish Y, Leschinski A, Kenna M. Pediatric sudden sensorineural hearing loss: diagnosed causes and response to intervention. Int J Pediatr Otorhinolaryngol 2013; 77:553-9. [PMID: 23369615 DOI: 10.1016/j.ijporl.2013.01.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 01/04/2013] [Accepted: 01/05/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Sudden sensorineural hearing loss (SSNHL) is an underappreciated issue in pediatric patient care. The goal of this study was to identify children who met the criteria for SSNHL and examine the etiologies, useful diagnostic studies, and treatment outcomes for these patients. METHODS A retrospective medical records review was performed in patients meeting the criteria for SSNHL seen at a tertiary care pediatric hospital from 2007 to 2012. Information collected included age, gender, audiometric evaluations, onset and duration of hearing loss, additional symptoms, diagnostic studies and response to any medical management. The Institutional Review Board approved this project. RESULTS 12/20 patients were male. Mean age was 11.41 years (3 months-24 years). Hearing loss was bilateral in 9/20 patients. Degree of hearing loss ranged from mild to profound across frequencies. Probable etiologies were viral of unknown type (n = 12), late presentation of congenital CMV (n = 1), noise-related (n = 1), non organic (n = 1), enlarged vestibular aqueduct (EVA) (n = 1), one with both acute Epstein-Barr virus (EBV) and significant ototoxic exposure (n = 1), one had significant ototoxic exposure and an inflammatory cerebrovascular incident (n = 1), and unknown (n = 2). Diagnostic studies included temporal bone computed tomography (CT) (n = 15) and/or magnetic resonance imaging (MRI) (n = 15), Lyme titers (n = 9), streptococcal throat culture (n = 1) and EBV (n = 1) and mumps titers (n = 1). Positive diagnostic studies included 1 MRI consistent with congenital CMV, and one CT that showed an EVA . 15/20 patients received systemic steroids, 3 received antivirals, and 4 got antibiotics. Response to steroids varied from complete resolution of SSNHL to worsening. Symptoms reported, in addition to the hearing loss included tinnitus (n = 9), vertigo (n = 9), sensation of a blocked ear (n = 6), and otalgia (n = 4). CONCLUSIONS The incidence of SSNHL in pediatric patients is unknown. Etiologies of SSNHL include viral, EVA, ototoxicity, noise, and non-organic. Most studies were non-diagnostic although 2/22 CT/MRI provided an etiology. Identification of other causes required careful history review. The incidence of SSNHL in the pediatric population needs to be studied, and the timing, dosage, route and efficacy of steroids further evaluated.
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Affiliation(s)
- Yael Tarshish
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, 300 Longwood Ave, LO-367, Boston, MA 02115, United States
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Suppression of tinnitus in a patient with unilateral sudden hearing loss: a case report. Case Rep Otolaryngol 2012; 2012:210707. [PMID: 23227400 PMCID: PMC3512246 DOI: 10.1155/2012/210707] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 10/31/2012] [Indexed: 11/17/2022] Open
Abstract
We describe a case of a 67-year-old woman with severe disabling right-sided tinnitus, mild hyperacusis, and headache. The tinnitus was associated with sudden right hearing loss and vertigo, which occurred about 18 months before. Magnetic resonance imaging (MRI) resulted in normal anatomical structures of the cochlea and of the cranial nerves showing a partial empty sella syndrome with suprasellar cistern hernia. Angio-MR revealed a bilateral contact between the anterior-inferior cerebellar artery (AICA) and the acoustic-facial nerve with a potential neurovascular conflict. Surgery was considered unnecessary after further evaluations. The right ear was successfully treated with a combination device (hearing aid plus sound generator). Shortly after a standard fitting procedure, the patient reported a reduction of tinnitus, hyperacusis, and headache which completely disappeared at the follow-up evaluation after 3, 6, and 12 months. This paper demonstrates that the combination device resulted in a complete tinnitus and hyperacusis suppression in a patient with unilateral sensorineural sudden hearing loss. Our paper further supports the restoration of peripheral sensory input for the treatment of tinnitus associated with hearing loss in selected patients.
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