1
|
Grajczyk A, Sobczyk K, Zarzecka J, Barcz E, Dżaman K. Objective Measurements of Nasal Obstruction and Eustachian Tube Function in Pregnant Women. J Clin Med 2024; 13:2671. [PMID: 38731199 PMCID: PMC11084222 DOI: 10.3390/jcm13092671] [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: 03/15/2024] [Revised: 04/25/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024] Open
Abstract
Background: Hormonal changes during pregnancy have a substantial effect on the swelling of the mucous membrane in the nasal cavity, resulting in rhinitis and Eustachian tube dysfunction. The aim of the study was to assess subjective and objective changes in nasal cavity and Eustachian tube patency in the third trimester of pregnancy. Materials and Methods: The study group included fifty 18-41 year-old women in the third trimester of pregnancy. The control group consisted of 25 females aged 25 to 31 who were not pregnant. The Eustachian tube and nasal cavity patency examination was carried out using a rhinomanometer, a tympanometer and a SNOT-22 Questionnaire. Results: The SNOT-22 showed that subjective nasal obstruction was assessed as strong or worse by 42% of the study group, which was significantly higher than in the control group and confirmed with rhinomanometry. A total of 68% of the study group reported a subjective ear fullness which correlated with the week of pregnancy. The tympanometry showed that all pregnant women exhibited a type A tympanogram, but tympanometry values decreased at higher weeks of pregnancy, and statistical analysis confirmed a significant difference between the study group and the control group in tympanometry for both ears. Conclusions: The results highlight the substantial impact on both subjective and objective measurements of nasal and Eustachian tube patency. Almost every woman in the third trimester of pregnancy experiences nasal obstruction, and nearly 70% struggle with ear fullness. Recognizing and addressing these challenges are pivotal for ensuring the well-being of pregnant individuals and enhancing the quality of antenatal care.
Collapse
Affiliation(s)
- Alicja Grajczyk
- Department of Otolaryngology, Collegium Medicum, Faculty of Medicine, Cardinal Stefan Wyszyński University, Międzylesie Specialist Hospital, 01-938 Warsaw, Poland;
| | - Krystyna Sobczyk
- Department of Otolaryngology, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland;
| | - Justyna Zarzecka
- Department of Gynecology and Obsetrics, Collegium Medicum, Faculty of Medicine, Cardinal Stefan Wyszyński University, Międzylesie Specialist Hospital, 01-938 Warsaw, Poland; (J.Z.); (E.B.)
| | - Ewa Barcz
- Department of Gynecology and Obsetrics, Collegium Medicum, Faculty of Medicine, Cardinal Stefan Wyszyński University, Międzylesie Specialist Hospital, 01-938 Warsaw, Poland; (J.Z.); (E.B.)
| | - Karolina Dżaman
- Department of Otolaryngology, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland;
| |
Collapse
|
2
|
Qian H, Yang H. Risk Factors, Complications, and Treatment Modalities for Sudden Sensorineural Hearing Loss in Pregnant Women: A Systematic Review and Meta-analysis. Noise Health 2024; 26:205-213. [PMID: 38904824 DOI: 10.4103/nah.nah_62_23] [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: 08/03/2023] [Accepted: 02/21/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Sudden sensorineural hearing loss (SSNHL) during pregnancy is a rare condition and has not been much studied. The study aimed to perform a systematic review and meta-analysis of the risk factors, complications, and treatment modalities for SSNHL in pregnant women. MATERIALS AND METHODS PubMed, Web of Science, Scopus, ProQuest, and Google Scholar were used for the literature search. The Cochrane technique for assessing risk of bias was used for the article quality appraisal, and RevMan 5.4 was used for conducting the meta-analysis. Standard mean difference (SMD) and odds ratios with a 95% confidence interval (95% CI) were utilized. Heterogeneity and publication bias were assessed using the I-square (I2) test statistic and the Egger's test, respectively. RESULTS AND DISCUSSION The seven primary studies employed prospective and retrospective study designs. The meta-analysis showed that there were fewer risk variables for SSNHL in the experimental group compared with those in the control group (SMD = -0.45 to 3.24, 95% CI = -3.063.63 to 2.16-2.85), indicating that the analysis revealed an insignificant difference. However, the treated patients presented hearing improvement, suggesting a significant analysis (SMD = -0.6710.20, 95% CI = -1.2713.51 to -0.066.88). Furthermore, after therapy, substantial differences were observed in SMD between the two groups (SMD = -0.7415.18, 95% CI = -1.2423.85 to -0.256.40) in favor of the experimental group patients, based on the analysis results of four included studies. However, the I2-value of 0% showed that the heterogeneity was low. CONCLUSION SSNHL during pregnancy is a notably rare condition with an unknown cause. However, hormonal fluctuations, particularly increased levels of estrogen and progesterone during pregnancy, have been frequently implicated as potential triggers for SSNHL.
Collapse
Affiliation(s)
- Haibin Qian
- Department of Obstetrics and Gynecology, Wenzhou Center Hospital, Wenzhou, Zhejiang 325000, China
| | - Huaqin Yang
- Department of Obstetrics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang 318000, China
| |
Collapse
|
3
|
Bao M, He Y, Tao Y, Liu L, Li Y, Zhu Y, Huang Q, Zhang M, Wu B, Wang H. Large vestibular schwannomas presenting in the late state of pregnancy: a case report and literature review. Front Neurol 2023; 14:1270989. [PMID: 38107637 PMCID: PMC10722247 DOI: 10.3389/fneur.2023.1270989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/07/2023] [Indexed: 12/19/2023] Open
Abstract
Vestibular schwannomas in pregnancy have rarely been reported, and there is a lack of in-depth discussion on the experience of management of massive acoustic neuromas in pregnancy. Herein, we present a pregnant woman with a giant vestibular schwannoma and obstructive hydrocephalus who presented at 30 weeks of gestation. She was initially misdiagnosed as having a pregnancy-related reaction of headache, dizziness, and vomiting that had occurred 2 months earlier. After observation at home, her symptoms progressed at 30 weeks of gestation, and imaging findings revealed a brain tumor in the CPA region with secondary cerebella tonsil herniation and obstructive hydrocephalus, and she was transferred to our center for treatment. Consequently, we relieved her hydrocephalus with a ventriculoperitoneal shunt (V-P shunt) and used corticosteroids to simulate fetal maturation. After 10 days, her mental condition deteriorated, and her right limb muscle strength gradually decreased until grade 0 (MMT Grading). Finally, under a joint consultation with the Department of Neurosurgery, Obstetrics, and Anesthesiology, she underwent a cesarean section under general anesthesia and first-stage tumor removal at 31 weeks of gestation. Upon discharge, the previously observed neurological deficits, which were reversible and had manifested during her gestational period, had been successfully resolved, and the fetus had been conserved. The neuroimaging confirmed the complete tumor removal, while the neuropathologic examination revealed a vestibular schwannoma. Therefore, we recommend early diagnosis and treatment for these patients, especially people with headaches, vomiting, and sudden hearing loss during pregnancy. Herein, we concluded that our cases provide a valuable experience in the latest acceptable time frame for the operation to prevent irreversible neurological impairment and premature delivery in late pregnancy.
Collapse
Affiliation(s)
- Mingbin Bao
- Department of Neurosurgery, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yunsen He
- Department of Neurosurgery, Sichuan Lansheng Brain Hospital & Shanghai Lansheng Brain Hospital Investment Co., Ltd, Chengdu, China
| | - Ye Tao
- Department of Neurosurgery, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Li Liu
- Department of Imaging, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yuheng Li
- Department of Neurosurgery, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yongjun Zhu
- Department of Neurosurgery, Suining Municipal Hospital of TCM, Suining, China
| | - Qinjiang Huang
- Department of Neurosurgery, Wenjiang District People’s Hospital of Chengdu, Chengdu, China
| | - Mengjun Zhang
- Department of Psychiatry, Sichuan Provincial Center for Mental Health, University of Electronic Science and Technology of China, Chengdu, China
| | - Bo Wu
- Department of Neurosurgery, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Hao Wang
- Department of Neurosurgery, Jianyang Chinese Medicine Hospital, Chengdu, China
| |
Collapse
|
4
|
Yang S, Liu C, Zhao C, Zuo W. Pregnant Patients with Sudden Sensorineural Hearing Loss: Treatments and Efficacy. J Int Adv Otol 2023; 19:472-277. [PMID: 38088319 PMCID: PMC10765178 DOI: 10.5152/iao.2023.22981] [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: 11/11/2022] [Accepted: 07/28/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The aim of this study was to study the safety and effectiveness of oral and tympanic hormone injection in the treatment of sudden sensorineural hearing loss during pregnancy. METHODS Data were collected via prospective method. A total of 102 pregnant women with sensorineural hearing loss as experimental group and another 102 patients of sensorineural hearing loss without pregnancy as control group were simultaneously included in the study. Pure tone audiometry test was examined at pre- and posttreatment in 1 week, 2 weeks, and 12 weeks. The experimental group received oral and tympanic hormones, while the control group was treated with the Clinical Practice Guideline: Sudden Hearing Loss (2019) of USA. Recovery rate and hearing gain were assessed by the Clinical Practice Guidelines. RESULTS After treatment, the effects of the experimental group and the control group were compared at the 1st, 2nd, and 12th week after treatment. It was found that at the 12th week after treatment, the curative effect of the experimental group was significantly different from that of the control group, and the difference was statistically significant. CONCLUSION The pregnant women with sensorineural hearing loss were more serious than nonpregnant women, and the treatment efficacies were worse than control group. For pregnancy patients with sudden deafness, oral steroids and tympanic cavity injection is an effective, safe first-line treatment options.
Collapse
Affiliation(s)
- Sen Yang
- Department of Otolaryngology, Suining Central Hospital, Suining, China
| | - Chonghua Liu
- Department of Otolaryngology, Suining Central Hospital, Suining, China
| | - Churong Zhao
- Department of Otolaryngology, Suining Central Hospital, Suining, China
| | - Wenqi Zuo
- Department of Otolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| |
Collapse
|
5
|
Muacevic A, Adler JR. A Systematic Review of Vertigo: Negligence in Pregnancy. Cureus 2022; 14:e29814. [PMID: 36337796 PMCID: PMC9622035 DOI: 10.7759/cureus.29814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/01/2022] [Indexed: 11/24/2022] Open
Abstract
From conception to childbirth, there are many physical, hormonal, and psychological changes that a woman undergoes during pregnancy. During this time, balance is also affected, resulting in symptoms like vertigo and unsteadiness. These symptoms can lead to physical impairment and disability and can develop at any time. Vertigo in pregnancy has not been extensively written about. The subject of a narrative review is vertigo in pregnant patients. In pregnant women, hormonal alterations in the peripheral tissues and inner ear organs may contribute to vertigo. Meniere's disease, mild convulsive positional dizziness, and oculomotor migraines are all commonly exacerbated by pregnancy. Between the second and third trimesters of pregnancy, specific modifications to proprioception and hearing are also detected during physical examination. Patients who are pregnant typically experience these symptoms throughout this time. Some vertigo conditions can worsen during pregnancy, while others can appear at any time. Understanding audio-vestibular symptoms' pathological and clinical relationship during pregnancy requires more study.
Collapse
|
6
|
Serna-Hoyos LC, Herrón Arango AF, Ortiz-Mesa S, Vieira-Rios SM, Arbelaez-Lelion D, Vanegas-Munera JM, Castillo-Bustamante M. Vertigo in Pregnancy: A Narrative Review. Cureus 2022; 14:e25386. [PMID: 35765386 PMCID: PMC9233861 DOI: 10.7759/cureus.25386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2022] [Indexed: 11/18/2022] Open
Abstract
During pregnancy, physical, hormonal, and psychological changes may occur from conception to labor. Balance is also impacted throughout this time, leading to symptoms such as vertigo and unsteadiness. These symptoms may appear at any time and can cause disability and physical impairment. Little has been published about vertigo in pregnancy. We performed a narrative review of vertigo in pregnant patients. Vertigo in pregnant females may be associated with hormonal changes in peripheral structures and inner ear organs. Meniere’s disease, vestibular migraine, and benign paroxysmal positional vertigo are usually exacerbated during pregnancy. Specific changes to hearing and proprioception in the physical examination are also noted between the second and third trimester of pregnancy. These symptoms are usually seen in pregnant patients throughout this time. Some types of vertigo may be exacerbated and others may present at any time of pregnancy. Further research is needed to understand the clinical and pathological association of audiovestibular symptoms during pregnancy.
Collapse
|
7
|
Kim HS, Lee KM, Han SW, Cho GJ, Hwang HS. Risk factors associated with idiopathic sudden sensorineural hearing loss in pregnant South Korean women: a nationwide population-based study. J Matern Fetal Neonatal Med 2021; 35:7389-7394. [PMID: 34256656 DOI: 10.1080/14767058.2021.1949443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Sudden sensorineural hearing loss (SSNHL) is rare in pregnancy and can be attributed to pregnancy-induced changes in hormone levels that increase thrombogenic risk and alter cochlear microcirculation with consequent development of sudden deafness. The study aimed to analyze the risk factors associated with SSNHL in pregnant South Korean. METHODS A retrospective study of the incidence and risk factors associated with SSNHL before pregnancy enrolled 401,470 Korean women who delivered between January 2010 and December 2014. All participants underwent a pre-pregnancy national health screening examination through the National Health Insurance Corporation. We investigated the risk factors in 459 pregnant women with sudden sensorineural hearing loss and in 401,011 pregnant women without SSNHL through the pre-pregnancy national health screening examination and adverse perinatal outcome. RESULTS No statistically significant intergroup differences were observed in the maternal age, parity, method of delivery, gestational age at delivery, body mass index, blood pressure, as well as fasting blood glucose and cholesterol levels. After adjusting for maternal age, the pre-pregnancy body mass index was associated with an increased risk of sensorineural hearing loss in pregnancy (adjusted odds ratio 1.52, 95% confidence interval 1.04-2.22). The sensorineural hearing loss did not increase the risk for gestational hypertension, preterm birth (<37 weeks' gestation), small- and large-for-gestational-age infants, postpartum hemorrhage, placenta previa, and placental abruption. CONCLUSION SSNHL can occur throughout pregnancy and is associated with maternal pre-pregnancy obesity. Notably, it does not increase risks during delivery or cause adverse perinatal outcomes.
Collapse
Affiliation(s)
- Hee-Sun Kim
- Department of Obstetrics and Gynecology, Dongguk University Ilsan Hospital, Goyang, South Korea
| | - Kyu-Min Lee
- School of Industrial Management Engineering, Korea University, Seoul, South Korea
| | - Sung Won Han
- School of Industrial Management Engineering, Korea University, Seoul, South Korea
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, South Korea
| | - Han-Sung Hwang
- Department of Obstetrics and Gynecology, Konkuk University School of Medicine, Seoul, South Korea
| |
Collapse
|
8
|
Lyu YL, Zeng FQ, Zhou Z, Yan M, Zhang W, Liu M, Ke ZY. Intratympanic dexamethasone injection for sudden sensorineural hearing loss in pregnancy. World J Clin Cases 2020; 8:4051-4058. [PMID: 33024762 PMCID: PMC7520784 DOI: 10.12998/wjcc.v8.i18.4051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/23/2020] [Accepted: 08/12/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND As sudden sensorineural hearing loss (SSNHL) rarely occurs in pregnant women, there is a lack of knowledge and relevant research on its management.
AIM To investigate the effect of intratympanic dexamethasone injection in the treatment of pregnant patients with SSNHL.
METHODS A retrospective chart review was made for the period between June 2017 and August 2019 at our Department of Otorhinolaryngology-Head and Neck Surgery. Pregnant women who met the criteria for SSNHL were included and grouped based on the therapeutic modalities. The treatment group received intratympanic dexamethasone (2.5 mg) q.o.d. for a total of four times, while the control group received no medication other than bed rest and medical observations. All the patients were under close care of obstetricians. Pure-tone audiograms were performed before and after treatment.
RESULTS Eleven patients who met the inclusion criteria were assigned to the treatment group (n = 7) and the control group (n = 4). The mean age of patients was 31.2 ± 3.8 years; the right ear was affected in seven (63.64%) cases. Two patients (18.2%) suffered from vertigo, 10 (90.9%) suffered from tinnitus and 6 (54.5%) suffered from aural fullness. The time from onset to clinic visit was relatively short, with a mean time of 1.3 ± 0.9 d. All the women were within the second or third trimester; the average gestation period was 26.0 ± 6.2 wk. The pure-tone averages at onset between the two groups were similar. After one wk of therapy, the treatment group had a curative rate of 57.1% and a significantly better hearing threshold and greater improvement compared to the control group (all P < 0.05). Some patients experienced transient discomfort from intratympanic injections that disappeared after getting rest, while none had permanent complications. All patients delivered healthy full-term neonates with an average Apgar score of 9.7 ± 0.5.
CONCLUSION Intratympanic dexamethasone injections can be used as a first-line therapy in pregnant women with SSNHL.
Collapse
Affiliation(s)
- Yan-Lu Lyu
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Fan-Qian Zeng
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Zhou Zhou
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Min Yan
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Wei Zhang
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Ming Liu
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Zhao-Yang Ke
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| |
Collapse
|
9
|
Khamvongsa P, Patel N, Ali AA, Bodoukhin N, Carreno O. Using corticosteroids to treat sudden sensorineural hearing loss in pregnancy: A case report and literature review. Case Rep Womens Health 2020; 27:e00201. [PMID: 32346519 PMCID: PMC7178325 DOI: 10.1016/j.crwh.2020.e00201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 03/26/2020] [Accepted: 04/02/2020] [Indexed: 11/25/2022] Open
Abstract
Sudden sensorineural hearing loss (SSNHL) can manifest in pregnancy, but very few cases of SSNHL in pregnancy have been reported and none has been reported in the United States. Additionally, there are no established guidelines for how to treat SSNHL in pregnancy. The purpose of this report is to describe how SSNHL presents in pregnancy, to evaluate other etiologies and discuss current treatment options. A 35-year-old parous woman at 22 weeks of gestation, with a 2-week history of left-sided hearing loss, was shown to have a speech recognition threshold of 70 dB in her left ear. Otolaryngology confirmed the diagnosis of SSNHL. The patient was prescribed an oral prednisone taper that helped alleviate the hearing loss. She had an uncomplicated delivery and treatment with corticosteroids had no adverse consequences for the patient. After ruling out etiologies of SSNHL, corticosteroids may be used safely and efficaciously to treat SSNHL during the second trimester of pregnancy.
Collapse
Affiliation(s)
- Peter Khamvongsa
- Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8 St, Miami, FL, USA
| | - Naiya Patel
- Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8 St, Miami, FL, USA
| | - Ayesha Aziz Ali
- Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8 St, Miami, FL, USA
| | - Nikita Bodoukhin
- Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8 St, Miami, FL, USA
| | - Octavio Carreno
- Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8 St, Miami, FL, USA
| |
Collapse
|