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Tan X, Pan J, Cai J, Jiang S, Shu F, Xu M, Peng H, Tang J, Zhang H. Relevant Research of Inflammatory Cytokines Spectrum in Peripheral Blood of Sudden Hearing Loss. Laryngoscope 2024; 134:3293-3301. [PMID: 38193513 DOI: 10.1002/lary.31276] [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: 09/19/2023] [Revised: 12/24/2023] [Accepted: 12/27/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVE To investigate whether there is a correlation between the inflammatory state and the pathogenesis and clinical features of sudden hearing loss (SHL) by studying the expression of inflammation-related cytokines in the peripheral blood of patients with SHL. METHODS In this work, we analyzed the cytokine profiles of 48 analytes in 38 patients with SHL compared to 38 healthy donors using a multiplex immunoassay. This study used appropriate statistical methods to screen for inflammatory cytokines associated with the pathogenesis of SHL, to analyze their network correlation, and to analyze the relationship between clinical features of SHL and inflammatory cytokines. RESULTS Several cytokines, including CTACK, Eotaxin, HGF, INF-α2, IFN-β, IL-1β, IL-1ra, IL-2Rα, IL-4, IL-7, IL-8, IL-9, IL-10, IL-12(p40), IL-13, MIG, β-NGF, SCF, and TNF-α, exhibited significantly higher levels in the peripheral blood of the SHL group compared to the control group. An inflammatory network composed of multiple cytokines, including IL-1β, is a risk factor for the development of SHL. CONCLUSION This study identified several inflammatory cytokines with elevated expression, which may be linked with the onset of SHL. The results of this study also provide a basis for the theoretical hypothesis of inflammation in SHL. LEVEL OF EVIDENCE 3 Laryngoscope, 134:3293-3301, 2024.
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Affiliation(s)
- Xinyuan Tan
- Department of Otolaryngology Head and Neck Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Ear Research Institute, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jing Pan
- Department of Otolaryngology Head and Neck Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Ear Research Institute, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jieqing Cai
- Department of Otolaryngology Head and Neck Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Ear Research Institute, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Shanshan Jiang
- Department of Otolaryngology Head and Neck Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Ear Research Institute, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Fan Shu
- Department of Otolaryngology Head and Neck Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Ear Research Institute, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Muqing Xu
- Department of Otolaryngology Head and Neck Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Ear Research Institute, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Hua Peng
- Department of Otolaryngology Head and Neck Surgery, General Hospital of Southern Theatre Command of PLA, Guangzhou, China
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Jie Tang
- Ear Research Institute, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Department of Physiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Hongzheng Zhang
- Department of Otolaryngology Head and Neck Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Ear Research Institute, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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Monzani D, Liberale C, Segato E, De Cecco F, Arietti V, Palma S, Sacchetto L, Nocini R. The Role of Fibrinogen, Homocysteine and Metabolic Syndrome's Alterations in Sudden Sensorineural Hearing Loss (SSHL): A Narrative Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1977. [PMID: 38004026 PMCID: PMC10673203 DOI: 10.3390/medicina59111977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/05/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023]
Abstract
Fibrinogen and homocysteine (HCY) are molecules known to play a role in vascular homeostasis, and their blood levels are often elevated in patients with metabolic syndrome. Recent evidence suggests that sudden sensorineural hearing loss (SSHL) may have a vascular origin. This has led many authors to advocate that fibrinogen, homocysteine, and metabolic syndrome (MetS) may play a direct role in SSHL. The aim of this brief review is to examine the role and influence of these molecules and MetS on the mechanisms of SSHL. Elevated fibrinogen levels have been associated with a worse prognosis in SSHL, possibly due to increased blood viscosity and decreased blood flow. Similarly, HCY has been associated with vascular damage, particularly in hyperhomocysteinemia, although the exact association with SSHL remains controversial. MetS has been demonstrated to function both as a causative factor and as a contributor to poorer recovery in cases of SSHL. However, although some studies suggest a possible role for these biomarkers and MetS in the prognosis and treatment of SSHL, specific therapeutic and preventive strategies based solely on these factors have yet to be developed. Given their potential role in prognosis and treatment and the global epidemic of metabolic syndrome, this issue needs to be analyzed comprehensively. Thus, further quality studies need to be conducted, even though it is difficult to determine the actual impact of MetS on the development of SSHL, as it is a multifactorial disease affecting multiple organs.
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Affiliation(s)
- Daniele Monzani
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (D.M.); (C.L.); (F.D.C.); (V.A.)
| | - Carlotta Liberale
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (D.M.); (C.L.); (F.D.C.); (V.A.)
| | - Erika Segato
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (D.M.); (C.L.); (F.D.C.); (V.A.)
| | - Francesca De Cecco
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (D.M.); (C.L.); (F.D.C.); (V.A.)
| | - Valerio Arietti
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (D.M.); (C.L.); (F.D.C.); (V.A.)
| | - Silvia Palma
- Otolaryngology and Audiology Unit, University of Modena and Reggio Emilia, 41100 Modena, Italy;
| | - Luca Sacchetto
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (D.M.); (C.L.); (F.D.C.); (V.A.)
| | - Riccardo Nocini
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (D.M.); (C.L.); (F.D.C.); (V.A.)
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Sun H, Jiang W, Wang J. The prognostic value of peripheral blood parameters on all-frequency sudden sensorineural hearing loss. Braz J Otorhinolaryngol 2023; 89:101302. [PMID: 37634408 PMCID: PMC10472238 DOI: 10.1016/j.bjorl.2023.101302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 05/10/2023] [Accepted: 08/06/2023] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVE To determine whether peripheral blood parameters have any predictive value for all-frequency Sudden Sensorineural Hearing Loss (SSNHL). METHODS We chose 78 individuals with all-frequency SSNHL who had been admitted to our department. They were divided into two groups: the effective group and the ineffective group. In patients with all-frequency SSNHL, the prognostic variables, including peripheral blood tests and clinical traits, were examined by a logistic regression analysis. In addition, the predictive value was carried out. RESULTS The effective rate of all-frequency SSNHL was 61.5%. Pre-treatment hearing level and the proportion of patients with diabetes were both significantly lower in the effective group than in the ineffective group (p = 0.024 and 0.000, respectively). The levels of fibrinogen and C-reactive protein were also significantly different between the two groups (p = 0.001 and 0.025, respectively). Pre-treatment hearing level and fibrinogen level both significantly impacted the prognosis of all-frequency SSNHL (p = 0.032 and 0.002, respectively), according to a logistic regression analysis. Furthermore, the prognosis was significantly predicted by both fibrinogen level and pre-treatment hearing level (p = 0.001 and 0.0002, respectively). The receiver operating characteristic curve showed that the fibrinogen level had a sensitivity of 85.4% and a specificity of 60.0% for predicting the prognosis of all-frequency SSNHL. CONCLUSION For the prognosis of all-frequency SSNHL, the fibrinogen level can be regarded as a useful predictor. The level of C-reactive protein, however, does not have a significant prognostic effect on predicting all-frequency SSNHL. Therefore, more attention should be devoted to the level of fibrinogen in the acute period of all-frequency SSNHL. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Hongcun Sun
- The Affiliated People's Hospital of Ningbo University, Department of Otorhinolaryngology-Head and Neck Surgery, Ningbo, China.
| | - Wenbo Jiang
- The Affiliated People's Hospital of Ningbo University, Department of Otorhinolaryngology-Head and Neck Surgery, Ningbo, China
| | - Jian Wang
- The Affiliated People's Hospital of Ningbo University, Department of Otorhinolaryngology-Head and Neck Surgery, Ningbo, China
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Al-Azzawi A, Stapleton E. Blood tests as biomarkers for the diagnosis and prognosis of sudden sensorineural hearing loss in adults: a systematic review. J Laryngol Otol 2023; 137:977-984. [PMID: 36794400 DOI: 10.1017/s0022215123000282] [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] [Indexed: 02/17/2023]
Abstract
OBJECTIVE Sudden sensorineural hearing loss is considered idiopathic in up to 90 per cent of cases. This study explored the role of blood tests as biomarkers for the diagnosis and prognosis of sudden sensorineural hearing loss. METHOD Two researchers filtered 34 papers into the final review. This review was pre-registered on the Prospero database and conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. RESULTS Raised inflammatory markers are almost universal in sudden sensorineural hearing loss, suggesting an inflammatory or autoimmune process. The most useful biomarkers are neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and fibrinogen level. Focused investigations should be deployed on a case-by-case basis to identify underlying metabolic, infective and autoimmune conditions. CONCLUSION A full blood count and coagulation screen (fibrinogen) is recommended in all cases of sudden sensorineural hearing loss. These are inexpensive, accessible and offer as much diagnostic and prognostic information as any other biomarker. There is emerging evidence regarding specific biomarkers for sudden sensorineural hearing loss prognosis, with heat shock protein-70, anti-endothelial cell antibody and prestin demonstrating potential; investigation of their validity through prospective, controlled research is recommended.
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Affiliation(s)
- A Al-Azzawi
- Medical School, University of Manchester, Manchester, UK
| | - E Stapleton
- Department of Otolaryngology, Manchester Royal Infirmary, Manchester, UK
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Fan X, Zhu Q, Hou H, Hou L, Wang Z, Zhang H, Xu A. Analysis of the vestibular aqueduct development on the risk for suffering from idiopathic sudden sensorineural hearing loss. Auris Nasus Larynx 2023:S0385-8146(23)00032-9. [PMID: 36797195 DOI: 10.1016/j.anl.2023.01.013] [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: 10/19/2022] [Revised: 01/25/2023] [Accepted: 01/31/2023] [Indexed: 02/16/2023]
Abstract
OBJECTIVE Large vestibular aqueduct syndrome (LVAS) is one of the etiology of hearing loss. Clinically, we observed that the VA size of patients with idiopathic sudden sensorineural hearing loss (ISSNHL) did not meet the diagnostic criteria of VA enlargement, but there were individual variations. Through this study, we want to understand the VA development and explore its risk for suffering from ISSNHL. METHODS 74 patients with ISSNHL were retrospectively reviewed in our department from June 2018 to September 2021. Meanwhile, 57 people with no ear diseases were randomly selected as the control group. All their clinical information were systematically collected. The axial thin-slice CT images of temporal bone were used to observe and measure the VA in ISSNHL and controls. ISSNHL were classified as different types and grades according to pure tone audiometry and the degree of hearing loss, respectively. Logistic regression analysis was adopted to evaluate the risk factors of different types and grades of ISSNHL. RESULTS The operculum morphology could be funnel-shaped, tubular and invisible, but they had no statistical difference in the morbidity of ISSNHL. The operculum width of the affected sides in the case group was significantly wider than that of the matched sides in the control group (0.84±0.35mm vs 0.68±0.34mm, p=0.009), but the midpoint width had no statistical difference (p=0.447). The operculum width was an independent risk factor for the total hearing loss type (p=0.036, OR=4.49, 95% CI=1.10-18.29), moderate (p=0.013, OR=17.62, 95% CI=1.82-170.95) and profound (p=0.031, OR=4.50, 95% CI=1.14-17.67) grade of ISSNHL. Hypertension was an independent risk factor for the severe grade (p=0.004, OR=12.44, 95% CI=2.19-70.64) of ISSNHL. Both the operculum width (p=0.048, OR=7.14, 95% CI=1.02-50.26) and hypertension (p=0.014, OR=6.73, 95% CI=1.46-30.97) were the risk factors for the flat type of ISSNHL. The midpoint width of the VA, gender, age, diabetes mellitus, hyperlipidemia, and plasma fibrinogen concentration had no significant effect on the risk for suffering from ISSNHL. CONCLUSION The development of the VA operculum is a risk factor for some types and grades of ISSNHL. Hypertension remained a risk factor for ISSNHL.
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Affiliation(s)
- Xintai Fan
- Department of Otolaryngology, The Second Hospital of Shandong University, Shandong University, No.274 Beiyuan Avenue, Jinan, Shandong Province, China
| | - Qingping Zhu
- Department of Otolaryngology, Chengwu People's Hospital (Chengwu Branch of the Second Hospital of Shandong University), No.66 Bole Avenue, Chengwu, Heze, Shandong Province, China
| | - Hongling Hou
- Department of Otolaryngology, Chengwu People's Hospital (Chengwu Branch of the Second Hospital of Shandong University), No.66 Bole Avenue, Chengwu, Heze, Shandong Province, China
| | - Lingxiao Hou
- Department of Otolaryngology, The Second Hospital of Shandong University, Shandong University, No.274 Beiyuan Avenue, Jinan, Shandong Province, China
| | - Zhe Wang
- Department of Otolaryngology, The Second Hospital of Shandong University, Shandong University, No.274 Beiyuan Avenue, Jinan, Shandong Province, China
| | - Hui Zhang
- Department of Otolaryngology, The Second Hospital of Shandong University, Shandong University, No.274 Beiyuan Avenue, Jinan, Shandong Province, China
| | - Anting Xu
- Department of Otolaryngology, The Second Hospital of Shandong University, Shandong University, No.274 Beiyuan Avenue, Jinan, Shandong Province, China.
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Zhou T, Chen M, Yuan Z, Xia Z, Zhang S, Zhang Z, Chen H, Lin R. Inflammatory markers and the risk of idiopathic sudden sensorineural hearing loss: A Mendelian randomization study. Front Neurol 2023; 14:1111255. [PMID: 36908593 PMCID: PMC9992207 DOI: 10.3389/fneur.2023.1111255] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/03/2023] [Indexed: 02/25/2023] Open
Abstract
Background Observational studies suggest that inflammatory markers may increase the risk of idiopathic sudden sensorineural hearing loss (ISSHL). However, the causal relationship between the two has not been established. We sought to assess the possible causal effect between several genetically predicted inflammatory markers and ISSHL by Mendelian random (MR) analysis. Methods We extracted single nucleotide polymorphisms (SNPs) associated with C-reactive protein (CRP), Tumor necrosis factor-α (TNF-α), and fibrinogen from abstract data from the European Individual Large genome-wide association studies (GWAS). Genetic data for ISSHL were obtained from the FinnGen study (n = 196,592). Effect estimates were assessed using inverse variance weighting (IVW) as the primary method. Sensitivity analyses were performed using weighted median, MR-Egger, and MR-PRESSO to evaluate heterogeneity and pleiotropy. Results In the random-effects IVW approach, there was a significant causal relationship between genetic susceptibility to CRP levels and ISSHL (OR = 1.23, 95% CI = 1.02-1.49, P = 0.03). In contrast, genetic TNF-α and fibrinogen were not risked factors for ISSHL (OR = 1.14, 95% CI = 0.88-1.49, P = 0.30; OR = 0.74, 95% CI = 0.07-7.96, P = 0.30; OR = 1.05, 95% CI = 0.88-1.25, P = 0.59). All the above results were consistent after validation by different Mendelian randomization methods and sensitivity analyses. Conclusion This Mendelian randomization study provides causal evidence that CRP is a risk factor for ISSHL, while TNF-α and fibrinogen do not increase the risk for ISSHL Introduction.
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Affiliation(s)
- Tingfeng Zhou
- Department of Otolaryngology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Mengjiao Chen
- Department of Otolaryngology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ziyi Yuan
- Wenzhou Medical University, Wenzhou, China
| | - Zhigang Xia
- Department of Otolaryngology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shurou Zhang
- Department of Otolaryngology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ziheng Zhang
- Department of Otolaryngology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Huanqi Chen
- Department of Otolaryngology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Renyu Lin
- Department of Otolaryngology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Frosolini A, Franz L, Daloiso A, Lovato A, de Filippis C, Marioni G. Digging into the Role of Inflammatory Biomarkers in Sudden Sensorineural Hearing Loss Diagnosis and Prognosis: A Systematic Review and Meta-Analysis. Medicina (B Aires) 2022; 58:medicina58070963. [PMID: 35888682 PMCID: PMC9324865 DOI: 10.3390/medicina58070963] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/14/2022] [Accepted: 07/18/2022] [Indexed: 11/25/2022] Open
Abstract
Background and Objectives: Sudden Sensorineural Hearing Loss (SSNHL) is a quite common clinical finding in otolaryngology. Most cases are classified as idiopathic and there is a dearth of information on factors able to predict the response to treatment and hearing recovery. The main aim of this systematic review and meta-analysis was to assess and critically discuss the role of circulating inflammatory biomarkers in SSNHL. Materials and Methods: A search was conducted of the English literature published between 1 January 2009 and 7 July 2022 on Pubmed, Scopus, Web of Science, ScienceDirect, and Cochrane following PRISMA guidelines. Results: A total of 256 titles were retrieved from the search. After full-text screening and application of inclusion/exclusion criteria, 13 articles were included. Twelve out of thirteen studies reported significant differences in biomarkers values in SSNHL patients, of which Tumor Necrosis Factor alpha (TNF-α) and C-reactive Protein (CRP) were the most analyzed. Our meta-analysis for CRP’s mean values in SSNHL groups vs. controls showed significantly higher CRP levels with a pooled overall difference of 1.07; confidence interval (CI) at 95%: 0.03; 2.11. For TNF-α, discordant results were found: three studies showed significantly higher levels in SSNHL patients vs. controls, whereas other three investigations showed lower levels in the SSNHL groups (overall pooled difference 1.97; 95% CI: −0.90; 4.84). A high between-study heterogeneity was found. Conclusions: This systematic review pointed out that, although there exists a growing literature in the field of circulatory biomarkers identification in SSNHL, there is a high heterogeneity of results and low quality of evidence. CRP resulted to be higher in SSNHL patients than in controls, while TNF-α showed more heterogeneous behavior. The data reported herein needs to be confirmed in well-designed prospective multicenter randomized studies, with the objective of improving SSNHL treatment and outcome and thereby reducing the social burden of hearing loss.
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Affiliation(s)
- Andrea Frosolini
- Department of Neuroscience DNS, Audiology Unit, University of Padova, 31100 Treviso, Italy; (A.F.); (C.d.F.)
| | - Leonardo Franz
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, 35100 Padova, Italy; (L.F.); (A.D.)
- Guided Therapeutics (GTx) International Scholarship Program, Techna Institute, University Health Network (UHN), Toronto, ON M5G2C4, Canada
| | - Antonio Daloiso
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, 35100 Padova, Italy; (L.F.); (A.D.)
| | - Andrea Lovato
- Otolaryngology Unit, Vicenza Hospital, 36100 Vicenza, Italy;
| | - Cosimo de Filippis
- Department of Neuroscience DNS, Audiology Unit, University of Padova, 31100 Treviso, Italy; (A.F.); (C.d.F.)
| | - Gino Marioni
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, 35100 Padova, Italy; (L.F.); (A.D.)
- Correspondence: ; Tel.: +39-049-8212-029
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Chen L, Wang Y, Gao X, Xiong W, Duan F, Zhang N, Wang H, Wang M. Thromboelastography Predicting the Prognosis of Sudden Sensorineural Hearing Loss. Clin Otolaryngol 2022; 47:724-731. [PMID: 35818895 DOI: 10.1111/coa.13959] [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: 02/17/2022] [Revised: 05/24/2022] [Accepted: 06/12/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To explore the association between thromboelastography and the clinical features as well as the prognosis of sudden sensorineural hearing loss (SSNHL). DESIGN Single-centre, retrospective study. SETTING A hospital in China PARTICIPANTS: In total, 133 patients presenting with SSNHL within 2 weeks before the study, who did not receive treatment. MAIN OUTCOME MEASURES The patients' medical history was collected. Audiological, imaging, and haematological examinations were performed before treatment. Patients with abnormal thromboelastography were re-examined 1 week after treatment, and efficacy was evaluated 1 month after treatment. The chi-squared test and binary logistic regression analysis were used to analyse the association between factors, such as vertigo, degree and type of hearing loss, vestibular function, inner ear MRI results, thromboelastography, and efficacy of treatment. RESULTS Thromboelastography was correlated with prognosis (P=0.049) and degree (P=0.030) and type of hearing loss (P=0.013) in patients with SSNHL. The R (P=0.002) and angle values (P=0.010) correlated with prognosis. The MA (P=0.022) and G values (P=0.020) correlated with the degree of hearing loss. The R (P=0.033) value correlated with inner ear MRI results, and the ΔG (P=0.010) value correlated with fibrinogen levels. ΔThromboelastography (P=0.032) was correlated with the prognosis of patients with abnormal thromboelastography results. Logistic regression analysis showed that thromboelastography correlated with prognosis (P=0.013), and Δthromboelastography correlated with the prognosis of patients with abnormal thromboelastography results (P=0.013) and vertigo (P=0.016). CONCLUSION Thromboelastography is an independent risk factor affecting the prognosis of SSNHL with the R and angle values playing a major role.
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Affiliation(s)
- Lei Chen
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan250022, P.R. China.,Department of Otology Medicine, Shandong Provincial ENT Hospital, Jinan, China
| | - Yingjun Wang
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan250022, P.R. China.,Department of Otology Medicine, Shandong Provincial ENT Hospital, Jinan, China
| | - Xin Gao
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan250022, P.R. China.,Department of Otology Medicine, Shandong Provincial ENT Hospital, Jinan, China
| | - Wenping Xiong
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan250022, P.R. China.,Department of Otology Medicine, Shandong Provincial ENT Hospital, Jinan, China
| | - Fujia Duan
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan250022, P.R. China.,Department of Otology Medicine, Shandong Provincial ENT Hospital, Jinan, China
| | - Na Zhang
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan250022, P.R. China
| | - Haibo Wang
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan250022, P.R. China
| | - Mingming Wang
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan250022, P.R. China.,Department of Otology Medicine, Shandong Provincial ENT Hospital, Jinan, China
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Cho Y, Kim J, Oh SJ, Kong SK, Choi SW. Clinical features and prognosis of severe-to-profound sudden sensorineural hearing loss. Am J Otolaryngol 2022; 43:103455. [PMID: 35398740 DOI: 10.1016/j.amjoto.2022.103455] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/04/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Sudden sensorineural hearing loss (SSNHL) is an otologic emergency. Despite multiple efforts to clarify the factors affecting the prognosis of severe-to-profound SSNHL, various studies showed inconsistent results and lack of clinical significance. Therefore, we examined the clinical features and outcomes of severe-to-profound SSNHL. MATERIALS AND METHODS We included patients who experienced SSNHL between 2018 and 2021 and were diagnosed according to the American Academy of Otolaryngology-Head and Neck Surgery criteria; hearing loss over 70 dB on initial pure tone audiometry (PTA) was used to define severe-to-profound SSNHL. We retrospectively examine the demographic, laboratory, radiologic, and audiometric data of SSNHL patients. We also evaluated the final hearing gain of these patients by assessing their PTA findings and word-recognition scores. RESULTS Of the 178 patients, 94 (52.81%) and 84 (47.19%) showed profound (>90 dB) and severe (>70 to 90 dB) hearing loss, respectively. The presence of vertigo and hypertension differed significantly between the severe and profound groups (p < 0.001 and p = 0.012, respectively), as did the initial serum creatinine level (p = 0.043). Recovery in PTA showed a reliable correlation with the interval between onset and treatment in the severe group and periventricular white-matter findings in the profound group (p < 0.001 and p = 0.011, respectively). The presence of hypertension was related to recovery of low tone (p = 0.023 for 250 Hz; p = 0.034 for 500 Hz), while glycated hemoglobin level was related to recovery of high tone in the severe group (p = 0.049 for 4000 Hz; p = 0.047 for 8000 Hz). CONCLUSIONS Severe-to-profound SSNHL showed poor prognosis for hearing gain. The interval from onset to treatment was a significant prognostic factor for severe SSNHL, while the presence of vertigo, estimated glomerular filtration rate, and periventricular white-matter findings were significant prognostic factors for profound SSNHL.
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郭 文, 屈 永, 郭 明, 许 夏. [Analysis of coagulation state in sudden deafness patients with total deafness and vertigo]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2022; 36:172-176. [PMID: 35193336 PMCID: PMC10128292 DOI: 10.13201/j.issn.2096-7993.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/10/2021] [Indexed: 06/14/2023]
Abstract
Objective:To analyze the coagulation status and prognosis of sudden deafness patients with total deafness accompanied by vertigo, and to provide basis for improving the treatment of this disease. Methods:From January 2017 to December 2020, 33 patients with total deafness and vertigo sudden deafness who were hospitalized in the Department of Otolaryngology Head and Neck Surgery, Hebei Provincial People's Hospital were selected as the research group. During the same period, 33 cases of low frequency type, full frequency type, total deafness and 26 cases of high frequency type were treated as control group.Thirty-three cases of inpatients without history of middle ear and inner ear diseases were treated as normal control group. The levels of fibrinogen(FIB), D-Dimer(D-D), Prothrombin Time(PT), Activated Partial Thrombin Time(APTT) between the research group and the control group were analyzed, and the therapeutic effects of different types of sudden deafness patients were analyzed. Results:FIB and D-D of total deafness with vertigo were 2.50(2.11, 2.95)and 0.27(0.16, 0.51) respectively, which were higher than 2.31(1.92, 2.50) and 0.17(0.12, 0.21) of normal group. APTT was 25.2(23.1, 28.1), lower than 27.3(26.4, 29.7) in the normal group, the differences were statistically significant(P<0.01). ② FIB of total deafness with vertigo was 2.50(2.11, 2.95), which was higher than that of low frequency group 2.37(1.81, 2.68). D-D was 0.27(0.16, 0.51), higher than low frequency group 0.16(0.12, 0.25), high frequency group of 0.13(0.11, 0.23), the whole frequency group 0.16(0.11, 0.28), total of 0.18(1.45, 0.30). APTT was 25.75±3.18/25.2(23.1, 28.1), lower than 27.72±2.22 in low frequency group and 26.7(25.8, 28.7) in full frequency group, with statistical significance(P<0.05). ③ The total deafness with vertigo group had the worst curative effect(ineffective rate was 63.6%), and the low frequency group had the best curative effect(recovery rate was 75.8%). The difference of curative effect among different types of sudden deafness groups was statistically significant(P<0.05). Conclusion:Hypercoagulability and thrombosis may be one of the influencing factors of total sudden deafness. The hypercoagulable state of sudden deafness patients with total deafness and vertigo is more serious than that of total deafness and other types of sudden deafness, and the prognosis is the worst.
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Affiliation(s)
- 文苹 郭
- 石家庄市人民医院耳鼻咽喉头颈外科(石家庄,050057)Department of Otolaryngology Head and Neck Surgery, Shijiazhuang People's Hospital, Shijiazhuang, 050057, China
| | - 永涛 屈
- 河北省人民医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, Hebei General Hospital
| | - 明丽 郭
- 河北省人民医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, Hebei General Hospital
| | - 夏 许
- 河北省人民医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, Hebei General Hospital
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García-Callejo FJ, Balaguer-García R, Lis-Sancerni MD, Ruescas L, Murcia-López M. Blood viscosity in COVID-19 patients with sudden deafness. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2022; 73:104-112. [PMID: 35397819 PMCID: PMC8864080 DOI: 10.1016/j.otoeng.2022.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 07/07/2021] [Indexed: 11/24/2022]
Abstract
Background Changes in blood viscoelastic properties have been proposed previosuly as etiopathogenesis for severe complications in COVID-19 and some cases of Sudden Deafness (SD). This is an attempt to verify if SD cases in patients admitted for SARS-Cov-2 infection can be correlated. Patients and methods A prospective follow-up was carried out with COVID-19 patients, monitoring their blood viscosity (BV) at high shear rate (300 s−1) and inquiring them periodically for eventual hearing loss. This measurement was extended to cases bearing of SD in 2019 and 2020 without infection and a control group of healthy normoacoustic subjects. Results The normality range was 4,16 ± 0,62 cps. 330 cases admitted for COVID-19 were evaluated from February 24th, 2020 to March 24th, 2021, 85 of them attended in ICU. After anamnesis and Audiometric Tone Thresholds developed as soon as possible, 9 SD were detected, all belonging to ICU group. The mean BV was 4,38 ± 0,43 cps in the ward group, 4,53 ± 0,39 cps in the ICU patients without SD, and 4,85 ± 0,52 cps in the cases with SD, with statistically significant differences. Highest BV elevations in the SD cases were detected between days 6 and 10 of hospital admission. In 2019 four cases consulted with SD, and another two did it in 2020 without a diagnosis of COVID-19, with normal BV values. Conclusions During SARS-Cov-2 infection, patients may show high BV and SS, although an inpatients control group and a larger sample volume are necessary to confirm the predisposition to hyperviscosity. The incidence of hearing damage is considerable if its possible appearance is taken into account, within the limitations of critical patients with COVID-19.
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12
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García-Callejo FJ, Balaguer-García R, Lis-Sancerni MD, Ruescas-Gómez L, Murcia-López M. [Blood viscosity in Covid-19 patients with sudden deafness]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2021; 73:104-112. [PMID: 34305143 PMCID: PMC8279948 DOI: 10.1016/j.otorri.2021.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 07/07/2021] [Indexed: 12/12/2022]
Abstract
Antecedentes La alteración en las propiedades viscoelásticas de la sangre ha sido anteriormente propuesta como etiopatogenia de complicaciones severas por COVID-19 y algunos casos de sordera súbita (SS). Pretendemos verificar si la aparición de casos de SS en pacientes ingresados por infección por SARS-CoV-2 puede correlacionarse de este modo. Pacientes y métodos Estudio longitudinal prospectivo de pacientes ingresados en nuestro Centro por COVID-19, efectuando monitorización de la viscosidad sanguínea (VS) a alta velocidad de cizallamiento (300 seg-1) y un requerimiento periódico personal sobre hipoacusia. Esta determinación se extendió a casos atendidos por SS sin infección en 2019 y 2020 y un grupo control de sujetos sanos normoacúsicos. Resultados El rango de normalidad se situó en 4,16±0,62 cps. Entre el 24 de febrero de 2020 y el 24 de marzo de 2021 se evaluaron 330 casos ingresados por COVID-19, 85 asistidos en la Unidad de Cuidados Intensivos (UCI). Fueron identificadas tras anamnesis y Audiometría Tonal Liminar (ATL) todo lo inmediata que el status clínico lo permitió hasta nueve casos con SS, todos pertenecientes al grupo de UCI. La VS media fue 4,38±0,43 cps en el grupo de sala, 4,53±0,39 cps en los pacientes en UCI sin SS, y 4,85±0,52 cps en los casos con SS, con diferencias estadísticamente significativas. Las mayores elevaciones de la VS en los casos con SS se detectaron entre los días seis y 10 del ingreso hospitalario. En 2019 consultaron cuatro casos y otros 2 en 2020 sin diagnóstico de COVID-19, con valores normales de VS. Conclusiones Durante la infección por SARS-CoV-2 los pacientes pueden presentar elevación en la VS y SS, si bien se hacen necesarios un grupo control hospitalario y un volumen muestral mayor para confirmar la predisposición a la hiperviscosidad. La incidencia del daño auditivo resulta considerable si se tiene en cuenta su posible aparición en pacientes críticos con COVID-19.
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Affiliation(s)
| | | | | | | | - Marta Murcia-López
- Medicina Familiar y Comunitaria, Hospital General de Requena, Valencia, España
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13
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Reading JCS, Hall A, Nash R. Paediatric Sudden Sensorineural Hearing Loss: Pooled Analysis and Systematic Review. J Int Adv Otol 2021; 17:64-71. [PMID: 33605224 DOI: 10.5152/iao.2020.8902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Sudden sensorineural hearing loss (SSNHL) is defined as hearing loss of ≥30 dB in one or both ears, developing within 3 days, affecting ≥3 contiguous frequencies. It is rare in children, but if untreated can cause significant morbidity. During the critical developmental period, it may cause lifelong social, behavioral, and mental sequelae. Currently, little guidance exists on prognosis and management within a pediatric population. A systematic literature review of pediatric SSNHL on PubMed, EMBASE, and the Cochrane CENTRAL database was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. A total of 620 papers met the Medical Subject Headings criteria, of which 14 met analysis criteria-13 were level 4 and 1 was level 2b evidence. A population of 732 individuals was analyzed. Most reported cases of pediatric SSNHL were idiopathic. Other etiologies included viral infection, trauma, ototoxic drugs, and structural abnormalities. Recovery was defined as any improvement in hearing after the initial loss, from "slight" to "complete." Recovery ranged from 20% to 100%, with a pooled rate of 56%. Systemic steroids were the mainstay of treatment, although salvage intratympanic steroid therapy had a role after the failure of systemic steroids. Children with bilateral SSNHL had poorer outcomes than those with unilateral loss, with 29% showing improvement. Two studies reported outcomes with no treatment, for which recovery rate was 7%. This analysis of SSNHL shows that 61% of children with unilateral and 29% of children with bilateral SSNHL demonstrate some recovery, a worse prognosis than adults. Multiple treatment regimens exist, although comparison is challenging owing to inconsistently reported improvement parameters.
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Affiliation(s)
| | - Andrew Hall
- Great Ormond Street Hospital NHS Foundation Trust
| | - Robert Nash
- Great Ormond Street Hospital NHS Foundation Trust
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Li C, Zhou H, Feng Y, Zhao Y, Wang J, Chen Z, Yin S. Coagulation States in Patients With Sudden Sensorineural Hearing Loss Evaluated by Thromboelastography. Otolaryngol Head Neck Surg 2020; 164:1280-1286. [PMID: 33138704 DOI: 10.1177/0194599820965240] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE The state of coagulation is controversial in patients with sudden sensorineural hearing loss (SSNHL). We used thromboelastography (TEG) to explore the relationships between blood coagulation parameters and SSNHL pathogenesis and recovery. STUDY DESIGN Prospective study. SETTING Affiliated Sixth People's Hospital, Shanghai Jiao Tong University. METHODS A total of 104 newly diagnosed patients with SSNHL and 29 matched healthy controls were recruited. Hearing assessments, TEG, and conventional coagulation tests (CCTs) were performed, followed by standard treatments and follow-up. RESULTS The TEG parameters of patients with SSNHL were in the normal range, but the group exhibited a significantly prolonged kinetic time (K; P = .004) and a smaller angle (P = .003) as compared with the controls. After grouping the patients with SSNHL according to audiograms and comparing them in pairs, we found that the differences were significant only when controls were compared with patients with low-frequency SSNHL (K, P = .023; angle, P = .04) and flat-type SSNHL (K, P = .017; angle, P = .014). Logistic regression analysis showed that neither TEG nor CCT parameters significantly affected hearing improvement after SSNHL treatment. CONCLUSIONS Although the K value and angle were significantly increased and significantly reduced, respectively, in the test group as compared with the control group, the state of coagulation in patients with SSNHL was still within the normal range. No CCT or TEG coagulation parameters (except the angle) differed significantly among patients in each group according to hearing recovery status, which suggested that the coagulation status does not determine the prognosis of patients with SSNHL.
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Affiliation(s)
- Chunyan Li
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Xuhui District, Shanghai, China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Huiqun Zhou
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Xuhui District, Shanghai, China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Yanmei Feng
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Xuhui District, Shanghai, China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Yan Zhao
- Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, China.,Shanghai Jinshan District Central Hospital, Shanghai, China.,Shanghai Jinshan Hospital of Traditional Chinese Medicine, Shanghai, China
| | - Jingjing Wang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Xuhui District, Shanghai, China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Zhengnong Chen
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Xuhui District, Shanghai, China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Shankai Yin
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Xuhui District, Shanghai, China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
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Doo JG, Kim D, Kim Y, Yoo MC, Kim SS, Ryu J, Yeo SG. Biomarkers Suggesting Favorable Prognostic Outcomes in Sudden Sensorineural Hearing Loss. Int J Mol Sci 2020; 21:ijms21197248. [PMID: 33008090 PMCID: PMC7583026 DOI: 10.3390/ijms21197248] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/27/2020] [Accepted: 09/28/2020] [Indexed: 02/07/2023] Open
Abstract
Sudden sensorineural hearing loss (SSNHL) is a medical emergency, making detailed examination to determine possible causes and early treatment important. However, etiological examinations in SSNHL do not always reveal a cause, and several factors have been found to affect treatment outcomes. Various studies are being performed to determine the prognosis and effects of treatment in patients who experience sudden hearing loss, and to identify biomarkers associated with this condition. Embase, PubMed, and the Cochrane database were searched using the key words SSNHL, prognostic, and biomarker. This search identified 4 articles in Embase, 28 articles in PubMed, and 36 in the Cochrane database. Of these 68 articles, 3 were duplicates and 37 were unrelated to the research topic. After excluding these articles, the remaining 28 articles were reviewed. Factors associated with SSNHL were divided into six categories: metabolic, hemostatic, inflammatory, immunologic, oxidative, and other factors. The associations between these factors with the occurrence of SSNHL and with patient prognosis were analyzed. Low monocyte counts, low neutrophil/lymphocyte ratio (NLR) and monocyte/high-density lipoproteins (HDL) cholesterol ratio (MHR), and low concentrations of fibrinogen, platelet glycoprotein (GP) IIIa, and TNF-α were found to be associated with good prognosis. However, these factors alone could not completely determine the onset of and recovery from SSNHL, suggesting the need for future basic and clinical studies.
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Affiliation(s)
- Jeon Gang Doo
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea; (J.G.D.); (J.R.)
| | - Dokyoung Kim
- Department of Anatomy and Neurobiology, College of Medicine, Kyung Hee University, Seoul 02447, Korea;
| | - Yong Kim
- Department of Physical Medicine & Rehabilitation, School of Medicine, Kyung Hee University, Seoul 02447, Korea; (Y.K.); (M.C.Y.)
| | - Myung Chul Yoo
- Department of Physical Medicine & Rehabilitation, School of Medicine, Kyung Hee University, Seoul 02447, Korea; (Y.K.); (M.C.Y.)
| | - Sung Su Kim
- Medical Research Center for Bioreaction to Reactive Oxygen Species and Biomedical Science Institute, School of Medicine, Graduate School, Kyung Hee University, Seoul 02447, Korea;
| | - Jeewon Ryu
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea; (J.G.D.); (J.R.)
| | - Seung Geun Yeo
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea; (J.G.D.); (J.R.)
- Medical Research Center for Bioreaction to Reactive Oxygen Species and Biomedical Science Institute, School of Medicine, Graduate School, Kyung Hee University, Seoul 02447, Korea;
- Correspondence: ; Tel.: +82-2-958-8980; Fax: +82-2-958-8470
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Nimodipine and Steroid Combination Therapy for Idiopathic Sudden Sensorineural Hearing Loss. Otol Neurotol 2020; 41:e783-e789. [PMID: 32558748 DOI: 10.1097/mao.0000000000002695] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the treatment outcomes of nimodipine and steroid combination therapy for idiopathic sudden sensorineural hearing loss (ISSNHL). STUDY DESIGN Retrospective case review. SETTING Tertiary referral center. PATIENTS Seventy-eight patients who were diagnosed with ISSNHL were divided into two group based on the treatment strategies used: steroid+nimodipine (SN, n = 36) and steroid only (SO, n = 42) groups. Based on the level of hearing loss before treatment, subgroup analysis (<90 dB HL, SN-S versus SO-S groups; ≥90 dB HL, SN-P versus SO-P groups) was performed. INTERVENTIONS Nimodipine+dexamethasone versus dexamethasone alone. MAIN OUTCOME MEASURES Hearing thresholds and complete/partial recovery rate after treatment. RESULTS Hearing thresholds after treatment were not significantly different between the SN and SO groups (46.8 ± 29.4 versus 54.8 ± 27.6 dB HL, p = 0.218). However, the complete recovery rate was significantly higher in the SN group than in the SO group (41.7% versus 16.8%, p = 0.014). In subgroup analysis, the complete recovery rate was significantly higher in the SN-S group than in the SO-S group (60.9% versus 19.2%, p = 0.003), whereas the difference between the SN-P and SO-P groups was not significant (7.7% versus 12.5%, p = 0.672). The cumulative incidence of complete recovery was significantly higher in SN-S group than in the SO-S group (p = 0.005); the mean recovery time was 4.4 weeks (95% confidence interval [CI], 2.8-6.1) in the SN-S group and 8.8 weeks (95% CI, 7.0-10.5) in the SO-S group. CONCLUSIONS The results of this study suggest that nimodipine and steroid combination therapy for ISSNHL results in a higher complete recovery rate than steroid alone in patients with moderate to severe hearing loss.
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