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Zhou E, Xiao X, Liu B, Tan Z, Zhong J. Characteristics of ear fullness and synaptic loss in ear fullness revealed by SV2A positron emission tomographycortical. Front Mol Neurosci 2024; 17:1451226. [PMID: 39309273 PMCID: PMC11412955 DOI: 10.3389/fnmol.2024.1451226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 08/20/2024] [Indexed: 09/25/2024] Open
Abstract
Objective Studies on feeling of ear fullness (FEF) related to sudden sensorineural hearing loss(SSNHL) are limited. The mechanisms of FEF are unclear. This study aimed to explore the characteristics and related brain activation of SSNHL with FEF. Methods A total of 269 SSNHL patients were prospectively observed and divided into two groups, with FEF and without FEF. Fifteen SSNHL patients with FEF and 20 healthy controls (HCs) were recruited and underwent 18F-SynVesT-1 static PET. Standardized uptake values ratios (SUVr) of 18F-SynVesT-1 were computed between regions of interest. Results The occurrence of FEF was not related to the audiogram type or severity of hearing loss. There was a positive correlation between the degree of FEF and the degree of hearing loss. Recovery from FEF was not related to the audiogram shape, the degree of hearing loss or recovery. Fifteen SSNHL patients with FEF had relatively low 18F-SynVesT-1 uptake in the right middle frontal gyrus, right inferior frontal gyrus, right middle temporal gyrus, bilateral parietal lobe sub-gyral and left medial frontal gyrus, as compared with HCs. There was no relatively high 18F-SynVesT-1 uptake in the cerebral cortex. Conclusion The occurrence and recovery of FEF in SSNHL patients are not related to the classification, degree and recovery of hearing loss. The 18F-SynVesT-1 uptake in the cerebral cortex of patients experiencing SSNHL and FEF has shown alterations. This indicates that FEF may be related to cortical reorganization after the sudden impairment of unilateral auditory input.
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Affiliation(s)
- En Zhou
- Department of Otolaryngology Head and Neck Surgery, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Xuping Xiao
- Department of Otolaryngology Head and Neck Surgery, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Bin Liu
- Department of Otolaryngology Head and Neck Surgery, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Zhiqiang Tan
- Department of Otolaryngology Head and Neck Surgery, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - JiaYu Zhong
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, Changsha, China
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Li XB, Han YX, Fu ZY, Zhang YC, Fan M, Sang SJ, Chen XX, Liang BY, Liu YC, Lu PC, Li HW, Pan HF, Yang JM. Association of sudden sensorineural hearing loss with meteorological factors: a time series study in Hefei, China, and a literature review. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:42970-42990. [PMID: 38886269 PMCID: PMC11222232 DOI: 10.1007/s11356-024-33943-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 06/04/2024] [Indexed: 06/20/2024]
Abstract
Air pollution can cause disease and has become a major global environmental problem. It is currently believed that air pollution may be related to the progression of SSNHL. As a rapidly developing city in recent years, Hefei has serious air pollution. In order to explore the correlation between meteorological variables and SSNHL admissions, we conducted this study. This study investigated the short-term associations between SSNHL patients admitted to the hospital and Hefei climatic variables. The daily data on SSNHL-related hospital admissions and meteorological variables containing mean temperature (T-mean; °C), diurnal temperature range (DTR; °C), atmospheric pressure (AP; Hp), and relative humidity (RH; %), from 2014 to 2021 (2558 days), were collected. A time-series analysis integrating distributed lag non-linear models and generalized linear models was used. PubMed, Embase, Cochrane Library, and Web of Science databases were searched. Literature published up to August 2023 was reviewed to explore the potential impact mechanisms of meteorological factors on SSNHL. The mechanisms were determined in detail, focusing on wind speed, air pressure, temperature, humidity, and air pollutants. Using a median of 50.00% as a baseline, the effect of exceedingly low T-mean in the single-day hysteresis effect model began at a lag of 8 days (RR = 1.032, 95% CI: 1.001 ~ 1.064). High DTR affected the admission rate for SSNHL on lag 0 day. The significance of the effect was the greatest on that day (RR = 1.054, 95% CI: 1.007 ~ 1.104) and then gradually decreased. High and exceedingly high RH affected the admission rate SSNHL on lag 0 day, and these effects lasted for 8 and 7 days, respectively. There were significant associations between all grades of AP and SSNHL. This is the first study to assess the effect of meteorological variables on SSNHL-related admissions in China using a time-series approach. Long-term exposures to high DTR, RH values, low T-mean values, and all AP grades enhance the incidence of SSNHL in residents. Limiting exposure to extremes of ambient temperature and humidity may reduce the number of SSNHL-related hospital visits in the region. It is advisable to maintain a suitable living environment temperature and avoid extreme temperature fluctuations and high humidity. During periods of high air pollution, it is recommended to stay indoors and refrain from outdoor exercise.
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Affiliation(s)
- Xiao-Bo Li
- Department of Otolaryngology, Head and Neck Surgery, Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, Anhui, 230601, People's Republic of China
| | - Yan-Xun Han
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui, China
| | - Zi-Yue Fu
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui, China
- Department of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Yu-Chen Zhang
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui, China
| | - Min Fan
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui, China
| | - Shu-Jia Sang
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui, China
| | - Xi-Xi Chen
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui, China
| | - Bing-Yu Liang
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui, China
| | - Yu-Chen Liu
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui, China
| | - Peng-Cheng Lu
- Department of Otolaryngology, Head and Neck Surgery, Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, Anhui, 230601, People's Republic of China
| | - Hua-Wei Li
- Institute and Otorhinolaryngology, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology, NHC Key Laboratory of Hearing Medicine Research, Fudan University, Shanghai, 200032, People's Republic of China
| | - Hai-Feng Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jian-Ming Yang
- Department of Otolaryngology, Head and Neck Surgery, Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, Anhui, 230601, People's Republic of China.
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Zheng J, Zhan Y, Cheng Y, Liu C, Lu B, Yang W, Hu J. Correlation between right-to-left shunt and sudden sensorineural hearing loss: protocol for a case-control study. BMJ Open 2023; 13:e070771. [PMID: 37945293 PMCID: PMC10649378 DOI: 10.1136/bmjopen-2022-070771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 09/29/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND AND PURPOSE Sudden sensorineural hearing loss (SSNHL) is a neurological and otolaryngological emergency during which rapid diagnosis and early treatment are of great importance. Clinical experience indicates that a considerable number of patients with SSNHL have concurrent right-to-left shunt (RLS). With limited reports, the association between SSNHL and RLS is yet unclear and there is a need for large observational studies to explore their latent relationship. METHODS AND ANALYSIS This proposed study is a prospective, observational case-control study. A total of 194 eligible participants matched in age and sex will be divided equally into two groups: 97 patients with SSNHL included in the case group and 97 individuals without SSNHL in the control group. Medical evaluations, including clinical characteristics, laboratory examination, audiological examination and ultrasonography examination, will be performed in all subjects. The primary outcome of the study is the difference in RLS rates between the groups. Differences in patent foramen ovale rates and other measured variables will be further assessed. A conditional logistic regression as a correlation analysis will be used to evaluate the relationship between RLS and SSNHL. DISCUSSION This study may provide evidence on the correlation between RLS and SSNHL in order to enrich the aetiology of SSNHL. ETHICS AND DISSEMINATION The study protocol has been approved by the Ethics Committee of Peking University Shenzhen Hospital. A written informed consent form will be signed and dated by the participants and the researchers before the study begins. The results will be disseminated in peer-reviewed publications. TRIAL REGISTRATION NUMBER ChiCTR2200064067.
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Affiliation(s)
- Jianrong Zheng
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Department of Clinical Medicine, Shantou University Medical College, Shantou, Guangdong, China
| | - Ying Zhan
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Yajing Cheng
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Cong Liu
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Bihua Lu
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Weiqiang Yang
- Department of Otorhinolaryngology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Jun Hu
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
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Clinical Factors Associated With Prognosis of Tinnitus and Aural Fullness After Sudden Sensorineural Hearing Loss. Otol Neurotol 2023; 44:432-437. [PMID: 36922014 DOI: 10.1097/mao.0000000000003853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
OBJECTIVES We evaluated the long-term prognosis and risk factors associated with tinnitus and aural fullness, which occurred with sudden sensorineural hearing loss. STUDY DESIGN Retrospective cross-sectional review. SETTING Tertiary referral center. PATIENTS Those who visited our clinic for sudden hearing loss from January 2016 to May 2020, diagnosed with sudden sensorineural hearing loss based on pure-tone audiometry, and underwent magnetic resonance imaging to rule out other cause of hearing loss. In total, 106 patients were enrolled in this study. INTERVENTION All patients were treated with oral glucocorticoids. Salvage intratympanic dexamethasone injection therapy was performed for the patients whose hearing was not fully recovered. MAIN OUTCOME AND MEASURES We scored the loudness of tinnitus and the intensity of aural fullness using the numerical rating scale. We used a mixed-effects model for repeatedly measured tinnitus and aural fullness scores. RESULTS The time after the onset of sudden sensorineural hearing loss (SSNHL; β = -0.07; 95% confidence interval, -0.09 to -0.05; p < 0.001) and hearing outcome after treatment (overall p = 0.003) were significant factors associated with the prognosis of tinnitus. Concerning aural fullness, the time after the onset of SSNHL was a significant prognosis factor (β = -0.08; 95% confidence interval, -0.09 to -0.06; p < 0.001), unlike hearing outcome (overall p = 0.261). Pretreatment pure-tone audiometry average threshold and mainly affected frequencies were not significant factors for tinnitus and aural fullness recovery, respectively. CONCLUSION The persistence of tinnitus with SSNHL was significantly affected by hearing recovery after treatment, whereas aural fullness was not associated with hearing recovery. However, both symptoms were improved over time after SSNHL.
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Niu X, Chen Y, Zhong Y, Xiao X. The relationship between serum homocysteine levels and sudden sensorineural hearing loss: a meta-analysis. Eur Arch Otorhinolaryngol 2023; 280:2091-2097. [PMID: 36658368 DOI: 10.1007/s00405-023-07829-w] [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: 11/24/2022] [Accepted: 01/06/2023] [Indexed: 01/20/2023]
Abstract
OBJECTIVE There was disagreement over the association between serum/plasma homocysteine (HCY) levels and sudden sensorineural hearing loss (SSNHL). Through the use of a meta-analysis, this study aims to determine whether there is a significant difference in serum homocysteine levels between the SSNHL group and the control group. DESIGN The Cochrane Library, EMBASE, and PubMed databases were all thoroughly searched. The two independent reviewers thoroughly examined the initially searched articles. The data results were calculated by standard mean difference (SMD) or odds ratios (OR). Review Manager (version 5.3) was applied to statistical data. STUDY SAMPLE There were 766 participants in the 6 trials with continuous outcomes that were part of the meta-analysis A. In addition, meta-analysis B, which included 961 people, contained a total of 3 studies with dichotomous results. RESULTS Both meta-analyses revealed the same conclusion that serum/plasma HCY levels in the SSNHL patients are higher than those in the controls (SMD 0.41, 95 % confidence interval (CI) 0.11 to 0.72, P < 0.01; OR 3.27, 95 % CI 2.16 to 4.94, P < 0.01). CONCLUSION This study demonstrated that the SSNHL patients' serum/plasma HCY levels were greater than those of the control group.
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Affiliation(s)
- Xun Niu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuzhang Chen
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Zhong
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Xiyue Xiao
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Jeon SY, Kang DW, Kim SH, Byun JY, Yeo SG. Prognostic Factors Associated with Recovery from Recurrent Idiopathic Sudden Sensorineural Hearing Loss: Retrospective Analysis and Systematic Review. J Clin Med 2022; 11:jcm11051453. [PMID: 35268543 PMCID: PMC8910997 DOI: 10.3390/jcm11051453] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/28/2022] [Accepted: 03/05/2022] [Indexed: 02/06/2023] Open
Abstract
Although idiopathic sudden sensorineural hearing loss (ISSNHL) is uncommon, recurrent ISSNHL is even rarer. The knowledge about factors associated with patient recovery from recurrent episodes is needed to counsel and treat the patients. Medical records of patients admitted for high dose oral steroid therapy for recurrent ISSNHL between January 2009 and December 2021 were reviewed. Their demographic and clinical characteristics, co-morbid symptoms, and audiologic results were analyzed. The 38 patients admitted for treatment of recurrent ISSNHL included 14 men and 24 women. Recovery rates after the first and recurrent episodes of ISSNHL were 78.9% and 63.2%, respectively. Patients who recovered after recurrent episodes showed significantly higher rates of ear fullness symptoms and early treatment onset than those who did not recover (p < 0.05 each). Of the 30 patients who recovered after the first episode, those who had ear fullness symptoms (p < 0.05, odds ratio (OR) 0.1, 95% confidence interval (CI) 0.01−0.76) and who showed a lower initial hearing threshold (p < 0.05, OR 1.06, 95% CI 1.01−1.12) during the recurrent episode showed significantly better or similar recovery than after the first episode. Ear fullness symptoms and less initial hearing loss were associated with a more favorable prognosis after intial than after recurrent ISSNHL.
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Affiliation(s)
| | | | | | | | - Seung Geun Yeo
- Correspondence: ; Tel.: +82-2-958-8980; Fax: +82-2-958-8470
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Risbud A, Muhonen EG, Tsutsumi K, Martin EC, Abouzari M, Djalilian HR. Migraine Features in Patients With Isolated Aural Fullness and Proposal for a New Diagnosis. Otol Neurotol 2021; 42:1580-1584. [PMID: 34420023 PMCID: PMC8595802 DOI: 10.1097/mao.0000000000003324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the presence of migraine features between patients with isolated aural fullness (AF) who meet the diagnostic criteria for migraine headache and those who do not, and to propose diagnostic criteria for migraine-related AF based on our results. METHODS We performed a retrospective study of patients presenting to a tertiary-care neurotology clinic between 2014 and 2020 with migraine-related AF. This was defined as isolated, prolonged aural fullness concurrent with migraine features once other etiologies were ruled out via examination, audiometry, and imaging. Migraine features were compared between patients meeting the diagnostic criteria for migraine headache and those not meeting the criteria. RESULTS Seventy-seven patients with migraine-related AF were included. The mean age was 56 ± 15 years and 55 (71%) patients were female. Eleven (14%) patients fulfilled the criteria for migraine headache (migraine group). Of the 66 patients who did not meet the criteria (nonmigraine group), 17 (26%) met 4/5 criteria, and 32 (48%) met 3/5 criteria, for a total of 49 (74%) patients. The migraine and nonmigraine groups were only different in 5 of 20 features, including family history of migraine (p = 0.007), sound sensitivity (p < 0.001), mental fogginess (p = 0.008), visual motion sensitivity (p = 0.008), and light sensitivity (p < 0.001). CONCLUSION There are minimal differences in the overall prevalence of migraine features between patients with migraine-related AF who meet and do not meet the diagnostic criteria for migraine. Our findings suggest that the criteria may be too stringent and exclude many patients from potentially benefitting from treatment with migraine prophylaxis.
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Affiliation(s)
- Adwight Risbud
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, California
| | - Ethan G. Muhonen
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, California
| | - Kotaro Tsutsumi
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, California
| | - Elaine C. Martin
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, California
| | - Mehdi Abouzari
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, California
| | - Hamid R. Djalilian
- Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, California
- Department of Biomedical Engineering, University of California, Irvine, California
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Ear fullness characteristics and prognosis in patients with all-frequency sudden sensorineural hearing loss. The Journal of Laryngology & Otology 2021; 135:926-931. [PMID: 34404495 DOI: 10.1017/s0022215121002206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study investigated the characteristics and prognosis of the feeling of ear fullness in patients with unilateral all-frequency sudden sensorineural hearing loss. METHODS Our study included 56 patients with a diagnosis of unilateral all-frequency sudden sensorineural hearing loss accompanied by a feeling of ear fullness and 48 patients without a feeling of ear fullness. The condition of these patients was prospectively observed. RESULTS Positive correlations were observed between grading of feeling of ear fullness and hearing loss in patients with a feeling of ear fullness (r = 0.599, p < 0.001). No significant differences were observed in the total effective rate of hearing recovery between patients with and without a feeling of ear fullness after one month of treatment (Z = -0.641, p = 0.521). Eighty-six per cent of patients (48 out of 56) showed complete recovery from the feeling of ear fullness. There was no correlation between feeling of ear fullness recovery and hearing recovery (r = 0.040, p = 0.769). CONCLUSION The prognosis of feeling of ear fullness is good. There was no correlation between feeling of ear fullness recovery and hearing recovery for all-frequency sudden sensorineural hearing loss patients.
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Serum Bilirubin Level as a Potential Marker for the Hearing Outcome in Severe-Profound Bilateral Sudden Deafness. Otol Neurotol 2020; 40:728-735. [PMID: 31135669 PMCID: PMC6594721 DOI: 10.1097/mao.0000000000002287] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Supplemental Digital Content is available in the text Objective: To investigate the association of serum bilirubin level with hearing outcomes in bilateral sudden sensorineural hearing loss (BSSHL) patients. Participants: One hundred thirteen in-patient BSSHL patients were consecutively enrolled between July 2008 and December 2015 in a tertiary center. Main Outcome Measures: Multivariable linear regression, generalized estimating equations (GEE), and stratified analyses were applied to examine the association between serum bilirubin level and hearing outcome measures such as final hearing threshold and absolute and relative hearing gains in BSSHL. Results: After full adjustment for potential confounders, total bilirubin levels (TBIL) were observed to be positively and independently associated with hearing outcomes as measured by final hearing (β [95% confidence interval {CI}]: −1.5 [−2.7, −0.2] dB HL per 1 μmol/L increase in TBIL) and absolute and relative hearing gains (β [95% CI]: 1.4 [0.2, 2.7] dB and 1.6 [0.2, 3.1] dB, respectively) in the severe to profound hearing loss subpopulation. Conclusions: Higher TBIL levels, within the normal or mildly elevated ranges, were independently and significantly associated with better hearing outcome in BSSHL patients with severe to profound hearing loss. Given bilirubin elevation treatments exist, our finding suggests a novel pharmacological strategy for this specific subpopulation.
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DELGADO-GIL JE, KRSTULOVIC C, PÉREZ-GUILLÉN V, GARCÍA-ZAMORA E, PÉREZ-GARRIGUES H. Sordera súbita idiopática. Revisión de 58 casos. REVISTA ORL 2019. [DOI: 10.14201/orl.20151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Fasano T, Pertinhez TA, Tribi L, Lasagni D, Pilia A, Vecchia L, Baricchi R, Bianchin G. Laboratory assessment of sudden sensorineural hearing loss: A case-control study. Laryngoscope 2017; 127:2375-2381. [DOI: 10.1002/lary.26514] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 11/17/2016] [Accepted: 12/02/2016] [Indexed: 11/12/2022]
Affiliation(s)
- Tommaso Fasano
- Clinical Chemistry and Endocrinology Laboratory; Arcispedale Santa Maria Nuova-Scientific Institute for Research, Hospitalization and Health Care; Reggio Emilia Italy
| | - Thelma A. Pertinhez
- Transfusion Medicine Unit; Arcispedale Santa Maria Nuova- Scientific Institute for Research, Hospitalization and Health Care; Reggio Emilia Italy
- Department of Biomedical, Biotechnological, and Translational Sciences; University of Parma; Parma Italy
| | - Lorenzo Tribi
- Department of Otolaryngology and Audiology; Arcispedale Santa Maria Nuova-Scientific Institute for Research, Hospitalization and Health Care; Reggio Emilia Italy
| | - Daniela Lasagni
- Transfusion Medicine Unit; Arcispedale Santa Maria Nuova- Scientific Institute for Research, Hospitalization and Health Care; Reggio Emilia Italy
| | - Annalisa Pilia
- Clinical Chemistry and Endocrinology Laboratory; Arcispedale Santa Maria Nuova-Scientific Institute for Research, Hospitalization and Health Care; Reggio Emilia Italy
| | - Luigi Vecchia
- Clinical Chemistry and Endocrinology Laboratory; Arcispedale Santa Maria Nuova-Scientific Institute for Research, Hospitalization and Health Care; Reggio Emilia Italy
| | - Roberto Baricchi
- Transfusion Medicine Unit; Arcispedale Santa Maria Nuova- Scientific Institute for Research, Hospitalization and Health Care; Reggio Emilia Italy
| | - Giovanni Bianchin
- Department of Otolaryngology and Audiology; Arcispedale Santa Maria Nuova-Scientific Institute for Research, Hospitalization and Health Care; Reggio Emilia Italy
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Abstract
Meniere's disease (MD) is a disorder of the inner ear that causes vertigo attacks, fluctuating hearing loss, tinnitus and aural fullness. The aetiology of MD is multifactorial. A characteristic sign of MD is endolymphatic hydrops (EH), a disorder in which excessive endolymph accumulates in the inner ear and causes damage to the ganglion cells. In most patients, the clinical symptoms of MD present after considerable accumulation of endolymph has occurred. However, some patients develop symptoms in the early stages of EH. The reason for the variability in the symptomatology is unknown and the relationship between EH and the clinical symptoms of MD requires further study. The diagnosis of MD is based on clinical symptoms but can be complemented with functional inner ear tests, including audiometry, vestibular-evoked myogenic potential testing, caloric testing, electrocochleography or head impulse tests. MRI has been optimized to directly visualize EH in the cochlea, vestibule and semicircular canals, and its use is shifting from the research setting to the clinic. The management of MD is mainly aimed at the relief of acute attacks of vertigo and the prevention of recurrent attacks. Therapeutic options are based on empirical evidence and include the management of risk factors and a conservative approach as the first line of treatment. When medical treatment is unable to suppress vertigo attacks, intratympanic gentamicin therapy or endolymphatic sac decompression surgery is usually considered. This Primer covers the pathophysiology, symptomatology, diagnosis, management, quality of life and prevention of MD.
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Muñoz-Proto F, Carnevale C, Bejarano-Panadés N, Ferrán-de la Cierva L, Mas-Mercant S, Sarría-Echegaray P. [Management of sudden neurosensory hearing loss in a Primary Care Centre]. Semergen 2013; 40:149-54. [PMID: 24071487 DOI: 10.1016/j.semerg.2013.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 07/29/2013] [Accepted: 08/01/2013] [Indexed: 11/26/2022]
Abstract
Sudden hearing loss is a rapid loss of neurosensory hearing that may occur within hours or days in an apparently healthy patient. Its origins are variable and multifactorial. Most patients do not recover hearing if not treated, and some even develop cophosis (deafness) in the affected ear. It is an otological emergency, as early therapeutic management offers a better hearing prognosis. As there is limited knowledge on this condition, it may be underdiagnosed in Primary Health Care Centers. It should be suspected in patients with abrupt hearing loss or tinnitus. Sophisticated instruments are not required for its diagnosis, just a detailed history, basic otoscopy, and proper interpretation of the hearing test. In this way, an accurate diagnosis is achieved in most cases, which is confirmed by audiometry.
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Affiliation(s)
- F Muñoz-Proto
- Servicio de Otorrinolaringología, Hospital Universitario Son Espases, Palma de Mallorca, España.
| | - C Carnevale
- Servicio de Otorrinolaringología, Hospital Universitario Son Espases, Palma de Mallorca, España
| | - N Bejarano-Panadés
- Servicio de Otorrinolaringología, Hospital Universitario Son Espases, Palma de Mallorca, España
| | - L Ferrán-de la Cierva
- Servicio de Otorrinolaringología, Hospital Universitario Son Espases, Palma de Mallorca, España
| | - S Mas-Mercant
- Servicio de Otorrinolaringología, Hospital Universitario Son Espases, Palma de Mallorca, España
| | - P Sarría-Echegaray
- Servicio de Otorrinolaringología, Hospital Universitario Son Espases, Palma de Mallorca, España
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Prognostic factors of profound idiopathic sudden sensorineural hearing loss. Eur Arch Otorhinolaryngol 2013; 271:1423-9. [DOI: 10.1007/s00405-013-2593-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2013] [Accepted: 06/05/2013] [Indexed: 11/24/2022]
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Ballesteros F, Tassies D, Reverter JC, Alobid I, Bernal-Sprekelsen M. Idiopathic sudden sensorineural hearing loss: classic cardiovascular and new genetic risk factors. Audiol Neurootol 2012; 17:400-8. [PMID: 22948415 DOI: 10.1159/000341989] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 07/19/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The main causative process in idiopathic sudden sensorineural hearing loss (iSSNHL) has yet to be explained or demonstrated. The clinical picture supports vascular involvement, but obvious limitations of inner ear study make this difficult to corroborate. OBJECTIVES To determine the role of thrombophilic genetic variants that may affect platelet function and to assess the cardiovascular risk profile in a cohort of patients with iSSNHL. PATIENTS AND METHODS 118 Caucasian patients with iSSNHL were recruited from the same geographical area and enrolled prospectively in this study. Clinical data were obtained for each patient. Polymorphisms of the platelet glycoprotein subunit IIIa gene, ITGB3 (PLA1/A2, rs5918), and of the platelet glycoprotein subunit Ia gene, ITGA2 (C807T, rs1126643) were analyzed. A control group of 161 age- and gender-matched healthy individuals from the same geographical area was recruited for genetic comparisons. In order to determine the cardiovascular risk profile of each patient and of our cohort, a cross-sectional assessment was performed by means of a calibrated Framingham coronary heart disease risk scale. Risk factor proportions were compared to those recommended in European guidelines for coronary prevention, which are also based on the Framingham function. RESULTS A significantly high prevalence of the 807T allele of platelet glycoprotein subunit Ia was found in patients compared to controls. There was a significant correlation between the 807TT homozygous genotype and a low probability of recovery. The PLA1/A2 polymorphism of platelet glycoprotein subunit IIIa was not associated with recovery, with a similar genotype prevalence being found in patients and controls. In terms of cardiovascular risk profile, patients did not present an excess of baseline coronary risk factors compared to the general population in the same geographical area. CONCLUSIONS Patients with iSSNHL had a higher prevalence of the 807T thrombophilic polymorphism of platelet glycoprotein Ia/IIa. Patients homozygous for this polymorphism are less likely to recover from iSSNHL. Classical cardiovascular risk factors were not related to iSSNHL.
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Affiliation(s)
- F Ballesteros
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Clínic, Barcelona, Spain.
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Affiliation(s)
- BT Stew
- the Department of Ear, Nose and Throat Surgery, Royal Glamorgan Hospital, Llantrisant, Pontyclun CF72 8XR
| | - SJC Fishpool
- the Department of Ear, Nose and Throat Surgery, Princess of Wales Hospital, Bridgend, and
| | - H Williams
- the Department of Ear, Nose and Throat Surgery, Royal Glamorgan Hospital, Llantrisant
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Huang N, Li C. Recurrent sudden sensorineural hearing loss in a 58-year-old woman with severe dizziness: a case report. Acupunct Med 2011; 30:56-9. [PMID: 22169707 DOI: 10.1136/aim.2010.010003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A case of recurrent sudden sensorineural hearing loss in the right ear is presented. The patient was a 58-year-old Chinese woman with profound hearing loss, a feeling of fullness in the ear, vomiting and severe dizziness for 2 months. A head scan and MRI of the brain and neck showed no cause for the symptoms. The ear, nose and throat specialist diagnosed a microcirculatory dysfunction, rejecting the diagnosis of Meniere's disease. The patient did not respond to medical treatment and after 2 months attended for acupuncture. It was suspected that the severe dizziness was associated with her neck and back pain. Daily electroacupuncture treatments to her ear, back and neck were given. After 1 month the dizziness was significantly reduced and the hearing loss recovered to a good level. The patient's symptoms recurred after exposure to cold and strong wind and again recovered with acupuncture. She later suffered a third recurrence of severe dizziness which again responded to acupuncture.
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Affiliation(s)
- Nanbin Huang
- Department of Acupuncture, Beijing Shijitan Hospital, 10 Tie Yi Road, Yang Fang Dian, Haidian District, Beijing 100083, PR China.
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Greco A, Fusconi M, Gallo A, Marinelli C, Macri G, De Vincentiis M. Sudden sensorineural hearing loss: An autoimmune disease? Autoimmun Rev 2011; 10:756-61. [DOI: 10.1016/j.autrev.2011.05.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2011] [Accepted: 05/05/2011] [Indexed: 10/18/2022]
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Sakata T, Higuchi H, Ueno T, Nakagawa T. Modulation of somatosensory abilities and the feeling of ear fullness in patients with acute sensorineural hearing loss. Auris Nasus Larynx 2011; 39:265-9. [PMID: 21862262 DOI: 10.1016/j.anl.2011.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Revised: 05/08/2011] [Accepted: 05/31/2011] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Patients with acute sensorineural hearing loss (ASNHL) often complain of a feeling of ear fullness (FEF) that is similar to the sensation experienced during barometric pressure changes. This suggests that modulation of somatosensory abilities may relate to the manifestation of FEF, whereas it cannot simply be assumed that somatosensory abilities would be directly affected by ASNHL. To examine this possible relationship, we estimated somatosensory abilities of the tympanic membrane, and investigated the relationship between them and the manifestation of FEF. METHODS To estimate somatosensory abilities of the tympanic membrane, 83 new patients demonstrating unilateral sudden deafness were studied. The air pressure was loaded through an exclusive device on the external auditory canals in order to measure the minimum change in air pressure sensed by the subjects. The minimum pressure was defined as the minimum sensory threshold for air pressure loading (MSTAP; daPa). We estimated patient's somatosensory abilities and inquired about their experiences with FEF at the first medical examination (point 1) and at the time a steady audiogram was obtained (point 2). We also estimated MSTAP in 65 volunteers (130 ears) with no history of ear diseases and compared their MSTAP with that of sudden deafness patients. RESULTS MSTAP values (-64.0±32.2daPa, 60.5±26.0daPa) on the affected side with both negative pressure and positive pressure measured at point 1 were significantly higher than those (-40.7±15.0daPa, 40.0±12.7daPa) obtained at point 2 in all sudden deafness patients (p=0.0001, p=0.0001). There was no difference between MSTAP values (-39.6±10.7daPa, 39.9±11.4daPa) in normal subjects and those obtained at point 2 in all sudden deafness patients. On the other hand, significant differences of MSTAP with negative pressures between the affected and unaffected sides at point 1 were seen in 32 patients, and manifestation of FEF showed an insignificant association in these 32 patients (p<0.05). CONCLUSION Modulation of somatosensory abilities in ASNHL seemed to be the best possible explanation for results, suggesting that a rise in MSTAP may somehow be associated with FEF. Although it cannot be verified by result of the current study, consideration of the previous literature suggests that the phenomenon may be caused by cross-modality of hearing and somatosensory abilities.
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Affiliation(s)
- Toshifumi Sakata
- Department of Otorhinolaryngology, Fukuoka University Chikushi Hospital, Zokumyoin 1-1-1, Chikushino city, Fukuoka 818-8502, Japan.
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Abstract
Sudden sensorineural hearing loss is usually unilateral and can be associated with tinnitus and vertigo. In most cases the cause is not identified, although various infective, vascular, and immune causes have been proposed. A careful examination is needed to exclude life threatening or treatable causes such as vascular events and malignant diseases, and patients should be referred urgently for further assessment. About half of patients completely recover, usually in about 2 weeks. Many treatments are used, including corticosteroids, antiviral drugs, and vasoactive and oxygen-based treatments. Although no treatment is proven, we recommend a short course of oral high-dose corticosteroids. There is much to learn about pathogenesis of sudden sensorineural hearing loss, and more clinical trials are needed to establish evidence-based management.
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Ishida IM, Sugiura M, Teranishi M, Katayama N, Nakashima T. Otoacoustic emissions, ear fullness and tinnitus in the recovery course of sudden deafness. Auris Nasus Larynx 2007; 35:41-6. [PMID: 17904320 DOI: 10.1016/j.anl.2007.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2006] [Revised: 01/19/2007] [Accepted: 04/24/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This study aimed to investigate how the symptoms of ear fullness, tinnitus and otoacoustic emissions (OAE) change in relation to the recovery course of pure tone audiometry thresholds (PTA) in sudden deafness (SD). METHODS This study analyzed follow-up data on ear fullness, tinnitus and otoacoustic emissions of eight SD patients with good hearing improvement (Group A) and eight SD patients with poor hearing improvement (Group B) in an attempt to elucidate the behavior of these symptoms in their recovery course. This study was done until there was no change in the PTA for more than 1 week and hearing recovery was no longer expected. RESULTS All patients from both groups had ear fullness and tinnitus in association with the onset of SD. However, these symptoms improved only in Group A. showing a significant relationship between PTA recovery and the improvement of ear fullness annoyance (P<0.05), presence of tinnitus (P<0.01), improvement in tinnitus loudness (P<0.01) and in tinnitus annoyance (P<0.01). No patients (Group A or B) had OAE responses at their first examination. In Group A, OAE responses appeared simultaneously with improvement of hearing levels in five patients (63%) and it appeared later than hearing levels improvement in the other three patients (37%) from Group A. No patient from Group B showed OAE response on follow-up. CONCLUSION SD patients with good hearing improvement (Group A) tended to have OAE responses and the sensations of the ear fullness and tinnitus improved almost simultaneously with hearing level improvement. Their PTA improvement occurred primarily in the low to mid frequencies, with high frequencies showing less recovery. When hearing recovery was not full, OAEs did not reappear for these frequencies. Patients with poor hearing improvement tended to have absent OAEs and persistent ear fullness and tinnitus.
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Affiliation(s)
- Ieda M Ishida
- Nagoya University Graduate School of Medicine, Department of Otorhinolaryngology, 65, Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
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