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Aldè M, Ambrosetti U, Piatti G, Romanini C, Filipponi E, Di Berardino F, Zanetti D, Pignataro L, Cantarella G, Barozzi S. Sudden Sensorineural Hearing Loss in Patients Aged from 15 to 40 Years. J Clin Med 2024; 13:3303. [PMID: 38893014 PMCID: PMC11172854 DOI: 10.3390/jcm13113303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 05/30/2024] [Accepted: 06/01/2024] [Indexed: 06/21/2024] Open
Abstract
Objectives: The purpose of this study was to investigate the hearing characteristics and causes of sudden sensorineural hearing loss (SSNHL) in patients aged from 15 to 40 years, focusing on audiological outcomes one year after the diagnosis. Methods: The medical records of individuals with SSNHL who were referred to our tertiary-level audiologic center were reviewed. All patients had undergone comprehensive diagnostic evaluations, including high-resolution 3D-FLAIR delayed magnetic resonance imaging (MRI), cone beam computed tomography (CBCT), and screening for coagulation, infectious, and autoimmune diseases. Results: Overall, 56 patients (mean age 28.1 ± 7.6 years) were included in the study. The hearing threshold in the affected ear improved significantly from 56.0 ± 18.0 dB at the diagnosis to 46.9 ± 22.3 dB after one year (p = 0.02). The degree of hearing loss, audiometric configurations, hearing improvements, and adherence to hearing treatments showed considerable variability among patients. Aural fullness, tinnitus, and hyperacusis were the predominant symptoms associated with SSNHL, and their prevalence decreased significantly over time. The diagnostic protocol led to the identification of the specific cause of SSNHL in 75% (42/56) of patients. The known etiology was found to be otological (39.3%), infectious (21.4%), autoimmune (7.1%), vascular (5.4%), or neoplastic (1.8%). In particular, Menière's disease (n = 12), isolated cochlear endolymphatic hydrops (n = 6), HSV-1 (n = 5), and EBV (n = 4) infections were the most frequent causes of SSNHL. Conclusions: The identification of the specific etiology of SSNHL may facilitate a more personalized approach to management and treatment.
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Affiliation(s)
- Mirko Aldè
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (U.A.); (C.R.); (E.F.); (F.D.B.); (D.Z.); (L.P.); (G.C.); (S.B.)
- Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Umberto Ambrosetti
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (U.A.); (C.R.); (E.F.); (F.D.B.); (D.Z.); (L.P.); (G.C.); (S.B.)
| | - Gioia Piatti
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
- Unit of Bronchopneumology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Camilla Romanini
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (U.A.); (C.R.); (E.F.); (F.D.B.); (D.Z.); (L.P.); (G.C.); (S.B.)
| | - Eliana Filipponi
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (U.A.); (C.R.); (E.F.); (F.D.B.); (D.Z.); (L.P.); (G.C.); (S.B.)
- Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Federica Di Berardino
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (U.A.); (C.R.); (E.F.); (F.D.B.); (D.Z.); (L.P.); (G.C.); (S.B.)
- Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Diego Zanetti
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (U.A.); (C.R.); (E.F.); (F.D.B.); (D.Z.); (L.P.); (G.C.); (S.B.)
- Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Lorenzo Pignataro
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (U.A.); (C.R.); (E.F.); (F.D.B.); (D.Z.); (L.P.); (G.C.); (S.B.)
- Otolaryngology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Giovanna Cantarella
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (U.A.); (C.R.); (E.F.); (F.D.B.); (D.Z.); (L.P.); (G.C.); (S.B.)
- Otolaryngology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Stefania Barozzi
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (U.A.); (C.R.); (E.F.); (F.D.B.); (D.Z.); (L.P.); (G.C.); (S.B.)
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Park M, Jang SI, Hurh K, Park EC, Kim SH. Association between Sudden Sensorineural Hearing Loss and the Risk of Cardio Cerebrovascular Disease. Laryngoscope 2024; 134:2372-2376. [PMID: 37987243 DOI: 10.1002/lary.31186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/18/2023] [Accepted: 11/02/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVES This study investigated the association between sudden sensorineural hearing loss (SSNHL) and the risk of cardio-cerebrovascular disease (CCVD) among older adults in South Korea. METHODS Data from 38,426 patients in the Korean National Health Insurance Service-Senior Cohort from 2002 to 2019 were collected. The risk of CCVD includes both stroke and acute myocardial infarction. Propensity score matching (1:1) was used to identify pairs of individuals with and without SSNHL (n = 19,213 for cases and controls). Cox proportional hazards regression models were used to analyze the associations between variables. RESULTS Patients with SSNHL had a higher risk of CCVD (hazard ratio [HR] = 1.17, 95% confidence interval [CI] = 1.11-1.24) compared to those without. The risk of CCVD was higher among those who experienced a stroke than those who did not (HR = 1.17 95% CI = 1.10-1.25). Compared to their matched controls, patients with SSNHL were 1.69 times (HR = 1.69 CI = 1.46-1.94) more likely to have CCVD during the first 12 months of the follow-up period. CONCLUSION Older patients with SSNHL are at an increased risk of CCVD. Hence, a more attentive approach featuring aggressive monitoring of patients with SSNHL is required to lessen their risk of CCVD. LEVEL OF EVIDENCE 3 Laryngoscope, 134:2372-2376, 2024.
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Affiliation(s)
- Minah Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Eulji University College of Medicine, Daejun, Republic of Korea
| | - Sung-In Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyungduk Hurh
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Hoon Kim
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Eulji University College of Medicine, Daejun, Republic of Korea
- Department of Ophthalmology, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
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Zhang Z, Yu C, Wang X, Ge S, Zhai G, Si S, Ma T, Li F, Cui Z, Jin X, Jin Y. The construction and validation of prognostic prediction model for sudden sensorineural hearing loss in middle-aged and elderly people. Auris Nasus Larynx 2024; 51:276-285. [PMID: 37872076 DOI: 10.1016/j.anl.2023.10.001] [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: 07/05/2023] [Revised: 09/27/2023] [Accepted: 10/13/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVE Idiopathic sudden sensorineural hearing loss (ISSNHL), as an otologic emergency, is commonly encountered and its prevalence has been climbing every year recently. To our knowledge, the prognosis of middle-aged and elderly patients is worse than that of young patients. Previous researches mainly focused on the adult population, which was considered as prognostic models who performed hearing recovery in ISSNHL. However, few studies regarding the middle-aged and elderly population who are regarded as prognostic models have been reported. Therefore, we aim to construct and validate a nomogram-based prognostic prediction model, which can provide a reference for the prognostic assessment in the middle-aged and elderly patients with ISSNHL. METHOD A total of 371 middle-aged and elderly ISSNHL patients who were admitted to the Department of Otolaryngology-Head and Neck Surgery, Yanbian Hospital, Yanbian University, from April 2018 to April 2023 were enrolled in the study. All subjects were randomly divided into two groups including training group (n = 263) and validation group (n = 108). Lasso regression and multi-factor logistic regression were jointly utilized to screen out prognosis-related independent risk factors and establish a nomogram-based risk prediction model. The accuracy and clinical application value of the model were evaluated by combining the Bootstrapping method and k-fold cross-validation, plotting the receiver operating characteristic (ROC) curve, calculating the area under the ROC curve (AUC), plotting the decision curve analysis (DCA), and the calibrating curve. RESULT We used the method of lasso regression combined with multivariate logistic regression and finally screened out eight predictors (including age, number of affected ears, degree of hearing loss, type of hearing curve, duration of disease, presence of vertigo, diabetes, and lacunar cerebral infarction) that were included into the nomogram. The C-index were 0.823 [95% CI (0.725, 0.921)] and 0.851 [95% CI (0.701, 1.000)], and the AUC values were 0.812 and 0.823 for the training and validation groups, respectively. The calibration curve for the validation group was approximately conformed to that for the modeling group, indicating favorable model calibration. The DCA results revealed the modeling group (3%-86%) and the validation group (2%-92%) showed significant net clinical benefit under the majority of thresholds. CONCLUSION This study developed and validated a nomogram-based prognostic prediction model which based on the eight independent risk factors mentioned above. The predictors are conveniently accessible and may assist clinicians in formulating individualized treatment strategies.
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Affiliation(s)
- Zhiqiang Zhang
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Changxu Yu
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Xueyan Wang
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Sitong Ge
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Guanhong Zhai
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Shurui Si
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Tianyi Ma
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Fuyao Li
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Zhezhu Cui
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Xianghua Jin
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China.
| | - Yulian Jin
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China; Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
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Lee HA, Chung JH. Contemporary Review of Idiopathic Sudden Sensorineural Hearing Loss: Management and Prognosis. J Audiol Otol 2024; 28:10-17. [PMID: 38254304 PMCID: PMC10808390 DOI: 10.7874/jao.2024.00024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 01/07/2024] [Indexed: 01/24/2024] Open
Abstract
Sudden sensorineural hearing loss (SSNHL) is a rapid decline in auditory function that needs urgent medical management. Although etiologic factors, including viral infections, autoimmune diseases, and vascular issues, contribute to the understanding of SSNHL, the condition remains unclear in most cases. Systemic steroids are often used as the first-line treatment because they reduce inner ear inflammation; however, there remains numerous discussions about the effectiveness of alternative treatments. To predict hearing recovery is crucial in patients' counseling with factors, including delayed treatment, vertigo, and other health conditions, which indicate poor prognosis. Herein, we review contemporary research on the treatment approaches and outcome predictions of SSNHL to establish important guidelines for physicians in evaluating and treating patients with SSNHL.
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Affiliation(s)
- Hyeon A Lee
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Korea
| | - Jae Ho Chung
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Korea
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Kovács M, Uzsaly J, Bodzai G, Pap I, Lippai B, Dergez T, Németh A, Gerlinger I, Szanyi I, Bakó P. Efficacy of high dose systemic versus combined (systemic and intratympanic) corticosteroid therapy in idiopathic sudden sensorineural hearing loss: A prospective randomized trial and risk factor analysis. Am J Otolaryngol 2024; 45:104099. [PMID: 37948820 DOI: 10.1016/j.amjoto.2023.104099] [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: 07/26/2023] [Accepted: 10/29/2023] [Indexed: 11/12/2023]
Abstract
The pathophysiology and the proper treatment of idiopathic sudden sensorineural hearing loss (ISSNHL) are an ongoing subject of debate. Locally or systemic administered corticosteroids are the most accepted drugs of treatment in reference to ISSNHL (idiopathic sudden sensorineural hearing loss), however, no strong evidence nor guidelines regarding their effectiveness yet exists. In our prospective, randomized, controlled trial 78 participants were enrolled. Patients were randomly assigned based on the day of admission to two groups according to treatment: group SS (n = 43) received intravenous systemic methylprednisolone alone, and group CT (n = 35) received intratympanic dexamethasone + systemic methylprednisolone. The primary outcome was to compare the hearing outcomes between the treatment groups based on different, widely accepted categories (Siegel, Kanzaki, modified Siegel and PTA4 gain). In consideration of the secondary outcome, we examined the effect of the various risk factors on the hearing improvement. No differences were detected regarding hearing improvement between the two groups, based on any criteria [Siegel's criteria (p = 0.604); Kanzaki's criteria (p = 0.720); modified Siegel's criteria (p = 0.524) and PTA 4 gain (p = 0.569)]. However, several clinical factors such as vertigo (p = 0.039), or cardiovascular comorbidity (p = 0.02) and the severity of initial hearing loss (p = 0.033) were found to bear a significant impact upon the hearing outcome. To the best of our knowledge, this is the first randomized controlled trial comparing high dose systemic and combination corticosteroid therapy in ISSNHL patients. Our findings suggest coexisting cardiovascular comorbidity, vertigo and severity of the initial hearing loss may bear a significantly higher impact upon hearing improvement, than the additional intratympanic steroid administration. The presented trial was registered in the European Union Drug Regulating Authorities Clinical Trials Database (name: Combinated systemic and intratympanic steroid therapy in idiopathic sudden sensorineural hearing loss, No.: 2017-000658-20) and with the ethical approval of The National Institute of Pharmacy and Nutrition (OGYÉI) (protocol No.: 7621, on 2017.02.16.).
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Affiliation(s)
- M Kovács
- University of Pécs, Medical School, Department of Otorhinolaryngology, Munkácsy M St 2, H-7621 Pécs, Hungary
| | - J Uzsaly
- University of Pécs, Medical School, Department of Otorhinolaryngology, Munkácsy M St 2, H-7621 Pécs, Hungary
| | - G Bodzai
- University of Pécs, Medical School, Department of Otorhinolaryngology, Munkácsy M St 2, H-7621 Pécs, Hungary
| | - I Pap
- University of Pécs, Medical School, Department of Otorhinolaryngology, Munkácsy M St 2, H-7621 Pécs, Hungary
| | - B Lippai
- University of Pécs, Szentagothai Research Centre, Ifjuság Str 20, H-7624 Pécs, Hungary
| | - T Dergez
- University of Pécs, Medical School, Institute of Bioanalysis, Honvéd St 1, H-7624 Pécs, Hungary
| | - A Németh
- University of Pécs, Medical School, Department of Otorhinolaryngology, Munkácsy M St 2, H-7621 Pécs, Hungary
| | - I Gerlinger
- University of Pécs, Medical School, Department of Otorhinolaryngology, Munkácsy M St 2, H-7621 Pécs, Hungary
| | - I Szanyi
- University of Pécs, Medical School, Department of Otorhinolaryngology, Munkácsy M St 2, H-7621 Pécs, Hungary.
| | - P Bakó
- University of Pécs, Medical School, Department of Otorhinolaryngology, Munkácsy M St 2, H-7621 Pécs, Hungary; University of Pécs, Szentagothai Research Centre, Ifjuság Str 20, H-7624 Pécs, Hungary
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Nitta Y, Kurioka T, Furuki S, Sano H, Yamashita T. Effect of statins on hearing outcome in patients with idiopathic sudden sensorineural hearing loss. Laryngoscope Investig Otolaryngol 2023; 8:1631-1636. [PMID: 38130250 PMCID: PMC10731490 DOI: 10.1002/lio2.1170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/05/2023] [Accepted: 10/06/2023] [Indexed: 12/23/2023] Open
Abstract
Objective Statins have been reported to improve vascular endothelial function and microcirculation, reduce oxidative stress, and exert anti-inflammatory and protective effects against inner ear damage. Therefore, this study aimed to investigate the effect of statins on hearing prognosis in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). Methods We reviewed the medical records of 149 patients diagnosed with ISSNHL. Clinical characteristics, hearing thresholds, statin medications, and hematological findings were investigated. First, patients with ISSNHL were assigned to the good and poor outcome groups, and factors influencing their prognosis were analyzed. Furthermore, patients with dyslipidemia were investigated to determine whether statins have therapeutic effects on ISSNHL. Results Significant differences in age (p = .011), days from the onset of ISSNHL to the initiation of treatment (p = .04), and hematological total cholesterol (TC; p = .015) between the good and poor outcome groups were observed. Furthermore, when hearing outcomes were investigated in patients with dyslipidemia, TC was significantly lower in the good outcome group (p = .03). Although no significant therapeutic effects of statins were observed in participants with dyslipidemia, patients in the statin-treated group were significantly older and experienced more diabetic complications than those in the non-statin-treated group. Conclusion Although our study showed that dyslipidemia is a poor prognostic factor for ISSNHL, statins had no significant therapeutic effects on hearing recovery in ISSNHL patients with dyslipidemia. The patients that received statin medications were significantly older and experienced more diabetic complications, which may have affected their hearing prognosis. Level of Evidence Level 4.
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Affiliation(s)
- Yoshihiro Nitta
- Department of Otorhinolaryngology, Head and Neck SurgeryKitasato University School of MedicineKanagawaJapan
| | - Takaomi Kurioka
- Department of OtorhinolaryngologyNational Defense Medical CollegeSaitamaJapan
| | - Shogo Furuki
- Department of Otorhinolaryngology, Head and Neck SurgeryKitasato University School of MedicineKanagawaJapan
| | - Hajime Sano
- School of Allied Health SciencesKitasato UniversityKanagawaJapan
| | - Taku Yamashita
- Department of Otorhinolaryngology, Head and Neck SurgeryKitasato University School of MedicineKanagawaJapan
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Melo RS, Cardeira CSF, Rezende DSA, Guimarães-do-Carmo VJ, Lemos A, de Moura-Filho AG. Effectiveness of the aquatic physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in healthy community-dwelling older adults: A systematic review and meta-analysis. PLoS One 2023; 18:e0291193. [PMID: 37683025 PMCID: PMC10490910 DOI: 10.1371/journal.pone.0291193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Opting to use aquatic or land-based physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in community-dwelling older adults (CDOAs) is still a questionable clinical decision for physiotherapists. OBJECTIVE Assess the quality of evidence from randomized or quasi-randomized controlled trials that used aquatic physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in CDOAs. METHODS Articles were surveyed in the following databases: MEDLINE/PubMed, EMBASE, SCOPUS, LILACS, Web of Science, CENTRAL (Cochrane Central Register of Controlled Trials), PEDro, CINAHL, SciELO and Google Scholar, published in any language, up to July 31, 2023. Two independent reviewers extracted the data and assessed evidence quality. The risk of bias of the trials was evaluated by the Cochrane tool and evidence quality by GRADE approach. Review Manager software was used to conduct the meta-analyses. RESULTS 3007 articles were identified in the searches, remaining 33 studies to be read in full, with 11 trials being eligible for this systematic review. The trials included presented low evidence quality for the balance, gait, quality of life and fear of falling. Land-based and aquatic physical therapy exercises improved the outcomes analyzed; however, aquatic physical therapy exercises were more effective in improving balance, gait, quality of life and reducing fear of falling in CDOAs. The meta-analysis showed that engaging in aquatic physical therapy exercises increases the functional reach, through of the anterior displacement of the center of pressure of CDOAs by 6.36cm, compared to land-based physical therapy exercises, assessed by the Functional Reach test: [CI:5.22 to 7.50], (p<0.00001), presenting low quality evidence. CONCLUSIONS Aquatic physical therapy exercises are more effective than their land-based counterparts in enhancing balance, gait, quality of life and reducing the fear of falling in CDOAs. However, due to methodological limitations of the trials, this clinical decision remains inconclusive. It is suggested that new trials be conducted with greater methodological rigor, in order to provide high-quality evidence on the use of the aquatic physical therapy exercises to improve the outcomes analyzed in CDOAs.
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Affiliation(s)
- Renato S. Melo
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | | | | | | | - Andrea Lemos
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Alberto Galvão de Moura-Filho
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
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Uhm TW, Yi S, Choi SW, Oh SJ, Kong SK, Lee IW, Lee HM. Hearing recovery prediction and prognostic factors of idiopathic sudden sensorineural hearing loss: a retrospective analysis with a deep neural network model. Braz J Otorhinolaryngol 2023; 89:101273. [PMID: 37307713 PMCID: PMC10391245 DOI: 10.1016/j.bjorl.2023.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 04/08/2023] [Indexed: 06/14/2023] Open
Abstract
OBJECTIVE Idiopathic Sudden Sensorineural Hearing Loss (ISSHL) is an otologic emergency, and an early prediction of prognosis may facilitate proper treatment. Therefore, we investigated the prognostic factors for predicting the recovery in patients with ISSHL treated with combined treatment method using machine learning models. METHODS We retrospectively reviewed the medical records of 298 patients with ISSHL at a tertiary medical institution between January 2015 and September 2020. Fifty-two variables were analyzed to predict hearing recovery. Recovery was defined using Siegel's criteria, and the patients were categorized into recovery and non-recovery groups. Recovery was predicted by various machine learning models. In addition, the prognostic factors were analyzed using the difference in the loss function. RESULTS There were significant differences in variables including age, hypertension, previous hearing loss, ear fullness, duration of hospital admission, initial hearing level of the affected and unaffected ears, and post-treatment hearing level between recovery and non-recovery groups. The deep neural network model showed the highest predictive performance (accuracy, 88.81%; area under the receiver operating characteristic curve, 0.9448). In addition, initial hearing level of affected and non-affected ear, post-treatment (2-weeks) hearing level of affected ear were significant factors for predicting the prognosis. CONCLUSION The deep neural network model showed the highest predictive performance for recovery in patients with ISSHL. Some factors with prognostic value were identified. Further studies using a larger patient population are warranted. LEVEL OF EVIDENCE Level 4.
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Affiliation(s)
- Tae Woong Uhm
- Department of Statistics, Pukyong National University, Busan, Republic of Korea
| | - Seongbaek Yi
- Department of Statistics, Pukyong National University, Busan, Republic of Korea
| | - Sung Won Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University College of Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Se Joon Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University College of Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Soo Keun Kong
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University College of Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Il Woo Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University College of Medicine, Pusan National University Yangsan Hospital, Yangsan, Gyeongnam, Republic of Korea
| | - Hyun Min Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University College of Medicine, Pusan National University Yangsan Hospital, Yangsan, Gyeongnam, Republic of Korea.
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Zhu Y, He S, Liao K, Li M, Zhao Z, Jiang H. Clinical Profiles and Prognoses of Adult Patients with Full-Frequency Sudden Sensorineural Hearing Loss in Combination Therapy. J Clin Med 2023; 12:jcm12041478. [PMID: 36836013 PMCID: PMC9966669 DOI: 10.3390/jcm12041478] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/31/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023] Open
Abstract
We aimed to characterize the clinical profiles and short-term outcomes of adult patients with full-frequency idiopathic sudden sensorineural hearing loss (ISSNHL) treated uniformly with combination therapy, and to determine the prognostic predictors for the combination therapy. A total of 131 eligible cases hospitalized in our department from January 2018 to June 2021 were retrospectively reviewed. All enrolled cases received a standardized combination therapy employing intravenous methylprednisolone, batroxobin, and Ginkgo biloba extract during the 12 days of hospitalization. The clinical and audiometric profiles were compared between recovered patients and their unrecovered counterparts. The overall recovery rate was 57.3% in the study. Accompanying vertigo (odds ratio = 0.360, p = 0.006) and body mass index (BMI, odds ratio = 1.158, p = 0.016) were two independent predictors of hearing outcomes of the therapy. The male gender and cigarette-smoking history were marginally associated with good hearing prognosis (p = 0.051 and 0.070, respectively). Patients with BMI ≥ 22.4 kg/m2 had a better chance of hearing recovery (p = 0.02). Conclusions: Accompanying vertigo and low BMI (<22.4 kg/m2) were independently associated with poor prognosis for full-frequency ISSNHL in combination therapy. Male gender and cigarette-smoking history might be considered positive effects on hearing prognosis.
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Tsuzuki N, Wasano K, Oishi N, Hentona K, Shimanuki M, Nishiyama T, Hiraga Y, Ueno M, Suzuki N, Shinden S, Ogawa K, Ozawa H. Association between atherosclerosis, hearing recovery, and hearing in the healthy ear in idiopathic sudden sensorineural hearing loss: a retrospective chart analysis. Sci Rep 2022; 12:21571. [PMID: 36513737 PMCID: PMC9747959 DOI: 10.1038/s41598-022-25593-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022] Open
Abstract
Atherosclerosis is reported to be a risk factor for the severity of idiopathic sudden sensorineural hearing loss (ISSNHL). We evaluated the hypothesis that atherosclerosis affects the hearing thresholds of both the affected and healthy sides of ISSNHL patients. We conducted multivariate analyses on retrospectively collected data of patients with ISSNHL (N = 762) to evaluate the relationship between known factors linked to atherosclerosis and hearing thresholds on affected and healthy sides and whether these factors are prognostic for hearing recovery. Older ages, vertigo or dizziness, diabetes mellitus, and congestive heart failure were significantly related to higher hearing thresholds on the affected side. Older ages, male, and vascular disease were significantly related to higher hearing thresholds on the healthy side. Vertigo or dizziness, severe hearing loss and hearing loss at high frequencies on the affected side, higher hearing thresholds on the healthy side, regular anticoagulant medication, and delayed steroid treatment were significantly related to lack of recovery. Since several atherosclerosis-related factors are associated with higher hearing thresholds on both affected and healthy sides in ISSNHL and higher hearing thresholds on the healthy side predict poorer prognosis, diagnosis, and predicting prognosis of ISSNHL may benefit from rigorous evaluation of patients' cardiovascular comorbidities and hearing levels on both the healthy and affected sides.
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Affiliation(s)
- Nobuyoshi Tsuzuki
- grid.26091.3c0000 0004 1936 9959Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjuku, Tokyo 160-8582 Japan ,grid.414147.30000 0004 0569 1007Department of Otolaryngology, Hiratsuka City Hospital, 1-19-1 Minamihara, Hiratsuka-City, Kanagawa 254-0065 Japan
| | - Koichiro Wasano
- grid.265061.60000 0001 1516 6626Department of Otolaryngology, Head and Neck Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara-City, Kanagawa 259-1193 Japan ,grid.416239.bNational Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro, Tokyo 152-8902 Japan
| | - Naoki Oishi
- grid.26091.3c0000 0004 1936 9959Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjuku, Tokyo 160-8582 Japan
| | - Ko Hentona
- grid.416239.bDepartment of Otolaryngology, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro, Tokyo 152-8902 Japan
| | - Marie Shimanuki
- grid.26091.3c0000 0004 1936 9959Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjuku, Tokyo 160-8582 Japan ,grid.416684.90000 0004 0378 7419Department of Otolaryngology, Saiseikai Utsunomiya Hospital, 911-1 Takebayashimachi, Utsunomiya-City, Tochigi 321-0974 Japan
| | - Takanori Nishiyama
- grid.26091.3c0000 0004 1936 9959Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjuku, Tokyo 160-8582 Japan ,grid.415107.60000 0004 1772 6908Department of Otolaryngology, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki, Kawasaki-City, Kanagawa 210-0013 Japan
| | - Yoshihiko Hiraga
- grid.410790.b0000 0004 0604 5883Department of Otolaryngology, Japanese Red Cross Shizuoka Hospital, 8-2 Outemachi, Aoi, Shizuoka-City, Shizuoka 420-0853 Japan
| | - Masafumi Ueno
- grid.416684.90000 0004 0378 7419Department of Otolaryngology, Saiseikai Utsunomiya Hospital, 911-1 Takebayashimachi, Utsunomiya-City, Tochigi 321-0974 Japan
| | - Narihisa Suzuki
- grid.414147.30000 0004 0569 1007Department of Otolaryngology, Hiratsuka City Hospital, 1-19-1 Minamihara, Hiratsuka-City, Kanagawa 254-0065 Japan
| | - Seiichi Shinden
- grid.416684.90000 0004 0378 7419Department of Otolaryngology, Saiseikai Utsunomiya Hospital, 911-1 Takebayashimachi, Utsunomiya-City, Tochigi 321-0974 Japan
| | - Kaoru Ogawa
- grid.26091.3c0000 0004 1936 9959Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjuku, Tokyo 160-8582 Japan
| | - Hiroyuki Ozawa
- grid.26091.3c0000 0004 1936 9959Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, 35, Shinanomachi, Shinjuku, Tokyo 160-8582 Japan
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Zhang BY, Young YH. Geriatric sudden deafness. Am J Otolaryngol 2021; 42:102985. [PMID: 33610920 DOI: 10.1016/j.amjoto.2021.102985] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 02/14/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE Sudden sensorineural hearing loss, briefly sudden deafness (SD), in the elderly remains less investigated despite rapidly aging population in most countries around the world. This study investigated whether aging process affects the treatment outcome of SD in the elderly. PATIENTS AND METHODS Eighty patients with SD, comprising 40 geriatric patients aged >65 years and 40 non-geriatric patients aged 55-64 years, were enrolled in this study. All patients underwent an inner ear test battery including audiometry, and cervical vestibular-evoked myogenic potential (cVEMP), ocular VEMP (oVEMP), and caloric tests. RESULTS Pre-treatment mean hearing level in the geriatric group (94 ± 16 dB) did not significantly differ from non-geriatric group (89 ± 20 dB). After treatment for 3 months, mean hearing gain in the geriatric group (22 ± 18 dB) with an improvement rate of 65%, did not significantly differ from non-geriatric group (21 ± 28 dB) with 58% improvement rate. Both inter-subject and intra-subject analyses revealed that the aging process greatly influenced the cVEMP and oVEMP responses, while less influenced the caloric responses. CONCLUSION The treatment outcome of SD in geriatric patients aged >65 years did not significantly differ from that in non-geriatric patients aged 55-64 years, indicating that aging process did not affect treatment outcome of SD. Unlike treatment outcome for the presbycusis is unsatisfactory, treatment outcome for the elderly with SD could be favorable.
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Comparison of Sudden Sensorineural Hearing Loss with Tinnitus and Short-Term Tinnitus. Neural Plast 2021; 2021:6654932. [PMID: 33986795 PMCID: PMC8079215 DOI: 10.1155/2021/6654932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 03/18/2021] [Accepted: 04/15/2021] [Indexed: 01/28/2023] Open
Abstract
Objective As one of the common symptoms of sudden sensorineural hearing loss (SSH), tinnitus seriously affects the life and work of SSH patients. The present study is aimed at exploring whether SSH can receive acoustic therapy and the factors that affect the efficacy of SSH acoustic therapy. Methods A total of 162 patients were outpatients and inpatients, 86 were SSH, and 76 were short-term tinnitus (STT). Both groups received pure tone audiometry, tinnitus matching, and residual inhibition test (RI). The Tinnitus Handicap Inventory (THI), visual analog scale with respect to tinnitus loudness (VAS), and RI in each group were evaluated. The effects of age, degree of hearing loss, and tinnitus course on the efficacy of SSH acoustic therapy were also evaluated. Results In the comparison of RI, THI, and VAS, there was no difference between SSH and STT (P > 0.05). SSH patients with mild hearing loss showed better acoustic therapy efficacy compared with SSH patients with severe hearing loss (P < 0.05), but there is no statistical difference in age and the course of tinnitus (P > 0.05). Conclusion The present study showed that SSH may improve tinnitus symptom through receiving acoustic therapy and SSH patients with mild hearing loss can get better acoustic therapy effects.
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Zhang Y, Zhang Z, Jia X, Guan X, Lyu Y, Yang J, Jiang T. Imaging Parameters of the Ipsilateral Medial Geniculate Body May Predict Prognosis of Patients with Idiopathic Unilateral Sudden Sensorineural Hearing Loss on the Basis of Diffusion Spectrum Imaging. AJNR Am J Neuroradiol 2021; 42:152-159. [PMID: 33214182 DOI: 10.3174/ajnr.a6874] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 08/29/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND PURPOSE Idiopathic sudden sensorineural hearing loss is an acute unexplained onset of hearing loss. We examined the central auditory pathway abnormalities in patients with unilateral idiopathic sudden sensorineural hearing loss using diffusion spectrum imaging and the relationships between hearing recovery and diffusion spectrum imaging parameters. MATERIALS AND METHODS Forty-eight patients with unilateral idiopathic sudden sensorineural hearing loss with a duration of ≤2 weeks (range, 8.9 ± 4.3 days) and 20 healthy subjects underwent diffusion spectrum imaging tractography. Hearing levels were evaluated using a pure-tone average at initial presentation and 3-month follow-up. Clinical characteristics and MR imaging findings were assessed. RESULTS Compared with healthy control subjects, the generalized fractional anisotropy values of patients decreased significantly in the bilateral posterior limbs of the internal capsule, with no differences between the ipsilateral and contralateral sides. The quantitative anisotropy values decreased in the Brodmann area 41, contralateral medial geniculate body, bilateral lateral lemniscus, anterior limb of internal capsule, middle temporal gyrus, and anterior corona radiata. Furthermore, at 3-month follow-up, 14 patients had <15 dB of hearing gain. Receiver operating characteristic curve analysis demonstrated that generalized fractional anisotropy in the ipsilateral medial geniculate body was related to prognosis (sensitivity = 64.7%; specificity = 85.7%; area under the curve = 0.796, 95% CI, 0.661-0.931; P < .01). CONCLUSIONS Diffusion spectrum imaging can detect abnormalities of white matter microstructure along the central auditory pathway in patients with unilateral idiopathic sudden sensorineural hearing loss. The generalized fractional anisotropy value of the ipsilateral medial geniculate body may help to predict recovery outcomes.
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Affiliation(s)
- Y Zhang
- From the Departments of Hyperbaric Oxygen (Y.Z., J.Y.)
| | - Z Zhang
- Radiology (Z.Z., X.J., Y.L., T.J.), Beijing Chaoyang Hospital
| | - X Jia
- Radiology (Z.Z., X.J., Y.L., T.J.), Beijing Chaoyang Hospital
| | - X Guan
- Department of Radiology (X.G.), Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Y Lyu
- Radiology (Z.Z., X.J., Y.L., T.J.), Beijing Chaoyang Hospital
| | - J Yang
- From the Departments of Hyperbaric Oxygen (Y.Z., J.Y.)
| | - T Jiang
- Radiology (Z.Z., X.J., Y.L., T.J.), Beijing Chaoyang Hospital
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