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Li X, Cao Z, Chen F, Yang D, Zhao F. Sensorineural Hearing Loss in Autoimmune Diseases: A Systematic Review and Meta-analysis. J Int Adv Otol 2023; 19:277-282. [PMID: 37528591 PMCID: PMC10544475 DOI: 10.5152/iao.2023.22991] [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: 12/02/2022] [Accepted: 02/12/2023] [Indexed: 08/03/2023] Open
Abstract
Autoimmune diseases may cause various kinds of conflicts in and outside the target organ, and some evidence brings forward the suggestion that autoimmune diseases may damage the auditory nerve and cause sensorineural hearing loss. However, this relationship is not clearly defined yet. Therefore, the aim of this study was to assess sensorineural hearing loss in autoimmune diseases through systematic review and metaanalysis. The literature databases of PubMed, Google Scholar, Scopus, Web of knowledge, and Cochrane library were thoroughly searched, and a meta-analysis study was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Eighteen articles were included, involving 27 859 cases affected by autoimmune diseases. The prevalence of sensorineural hearing loss in systemic lupus erythematosus cases was 21.26 [3.80, 38.71]%, which was significant, and pooled analysis of odds ratio observed in individual studies showed that the odds of sensorineural hearing loss prevalence was 12.11 [7.4, 24.12] (P < .001). The prevalence of sensorineural hearing loss in rheumatoid arthritis cases was 16.14 [-9.03, 41.31]%, which was significant, and pooled analysis of odds ratio observed in individual studies showed that the odds of sensorineural hearing loss prevalence was 2.23 [1.84, 2.32] (P < .001). In vitiligo cases, the prevalence of sensorineural hearing loss was 38.80 [22.36, 55.25]%, which was significant, and pooled analysis of odds ratio observed in individual studies showed that the odds of sensorineural hearing loss prevalence was 5.82 [3.74, 9.68] (P < .001). The present study showed that sensorineural hearing loss is significantly related to the autoimmune diseases of systemic lupus erythematosus, rheumatoid arthritis, and vitiligo. Therefore, these cases need a routine evaluation of sensorineural hearing loss.
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Affiliation(s)
- Xin Li
- Beijing Tsinghua Changgung Hospital School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Zuwei Cao
- Center for Rehabilitative Auditory Research, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, China
| | - Feifan Chen
- Centre for Speech and Language Therapy and Hearing Science, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Wales, UK
| | - Dong Yang
- Tianjin Medical University General Hospital, Tianjin, China
| | - Fei Zhao
- Centre for Speech and Language Therapy and Hearing Science, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Wales, UK
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Han SM, Lee HS, Chae HS, Seo YJ. Usefulness of vertebrobasilar artery radiological finding as a predictive and prognostic factor for sudden sensorineural hearing loss. Auris Nasus Larynx 2021; 48:823-829. [PMID: 33451886 DOI: 10.1016/j.anl.2021.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 12/24/2020] [Accepted: 01/04/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The association between sudden sensorineural hearing loss (SSNHL) and radiological findings of the vertebrobasilar artery is not well-known and little research has been done. We hypothesized that the radiological features of the vertebrobasilar artery contribute to the incidence and prognosis of SSNHL. METHODS We retrospectively enrolled patients diagnosed with unilateral SSNHL (SSNHL group) and those with acute vestibular neuritis (AVN; control group) in our hospital. All patients underwent magnetic resonance imaging and computed tomography. We measured the following parameters on the radiological images: basilar artery diameter, direction and distance of basilar artery deviation, direction and distance of vertebral artery deviation, and incidence of vertebral artery obstruction. Pure tone audiometry (PTA) was performed in all patients. Follow up PTA between 1 week and 1 month after treatment was performed in the SSNHL group. RESULTS A total of 244 SSNHL patients and 62 AVN patients were included in the analysis. Age, body mass index, and basilar artery diameter were found to be significantly associated with SSNHL. In the SSNHL group, patients were divided into three subgroups based on the consistency between the basilar artery deviation site and disease site. No significant difference was noted in initial PTA, final PTA, PTA recovery, and symptom improvement among the three groups. In case of the basilar artery, when the deviation and disease sites were in the opposite direction and the basilar artery diameter was >3.5 mm, diameter of basilar artery was positively correlated with PTA recovery. CONCLUSIONS The strength of this study is that radiological evaluation of the vertebrobasilar artery was performed. Further research on the association between SSNHL and radiological features of the vertebrobasilar artery should be conducted to emphasize the importance of vascular assessment in SSNHL.
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Affiliation(s)
- Sung Min Han
- Department of Otorhinolaryngology, Yonsei University Wonju College of Medicine, 20, Ilsan-ro, Wonju, Gangwon-do, Wonju 26426, South Korea
| | - Hyun Su Lee
- Department of Otorhinolaryngology, Yonsei University Wonju College of Medicine, 20, Ilsan-ro, Wonju, Gangwon-do, Wonju 26426, South Korea
| | - Hee Sung Chae
- Department of Otorhinolaryngology, Yonsei University Wonju College of Medicine, 20, Ilsan-ro, Wonju, Gangwon-do, Wonju 26426, South Korea
| | - Young-Joon Seo
- Research Institute of Hearing Enhancement, Yonsei University Wonju College of Medicine, Wonju, South Korea.
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Early hearing improvement predicts the prognosis of idiopathic sudden sensorineural hearing loss. Eur Arch Otorhinolaryngol 2021; 278:4251-4258. [PMID: 33389010 DOI: 10.1007/s00405-020-06532-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 11/27/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To determine pre- and post-treatment factors that are useful for predicting the prognosis of hearing improvement in idiopathic sudden sensorineural hearing loss (ISSHL). METHODS This retrospective study included 332 patients with ISSHL. Patients received intravenous steroid treatment (prednisolone sodium succinate; 120 mg/day followed by dose tapering). Complete recovery of hearing levels was defined as a final pure-tone audiometry of ≤ 20 dB HL or the same level as the contralateral ear. Patients' age; sex; side of hearing loss; initial hearing level; days from onset to treatment; presence of vertigo, diabetes, and hypertension; and hearing improvement on days 3-4 and 6-7 after treatment initiation were analyzed as potential prognostic factors. RESULTS Overall, 109 patients (32%) had complete recovery. Results of the multivariate logistic regression model identified age (odds ratio [OR] = 0.974), initial hearing level (OR = 0.949), vertigo (OR = 0.409), and hearing improvement on days 6-7 after treatment initiation (OR = 1.11) as significant independent predictors of complete recovery. Age ≥ 60 years, initial hearing level ≥ 72.5 dB HL, and vertigo contributed to poor prognosis. Patients without these three factors and a hearing improvement of ≥ 10 dB HL on days 6-7 post-treatment had a complete recovery rate of 80%. Only 1.5% of the patients with 2-3 of these factors and a hearing improvement of < 10 dB HL on days 6-7 after treatment initiation achieved complete recovery. CONCLUSION Age, initial hearing level, vertigo, and hearing improvement on days 6-7 after treatment initiation were independent predictors of hearing recovery in ISSHL.
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Herrera M, Berrocal JRG, Arumí AG, Lavilla MJ, Plaza G. Update on consensus on diagnosis and treatment of idiopathic sudden sensorineural hearing loss. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2019. [DOI: 10.1016/j.otoeng.2018.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Herrera M, García Berrocal JR, García Arumí A, Lavilla MJ, Plaza G. Update on consensus on diagnosis and treatment of idiopathic sudden sensorineural hearing loss. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2018; 70:290-300. [PMID: 30093087 DOI: 10.1016/j.otorri.2018.04.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 04/18/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Idiopathic sudden sensorineural hearing loss (ISSNHL) is a sudden, unexplained unilateral hearing loss. OBJECTIVES To update the Spanish Consensus on the diagnosis, treatment and follow-up of ISSNHL. MATERIAL AND METHODS After a systematic review of the literature from 1966 to March 2018, on MESH terms «(acute or sudden) hearing loss or deafness», a third update was performed, including 1508 relevant papers. RESULTS Regarding diagnosis, 11ISSNHL is clinically suspected, the following diagnostic tests are mandatory: otoscopy, acumetry, tonal audiometry, speech audiometry, and tympanometry, to discount conductive causes. After clinical diagnosis has been established, and before treatment is started, a full analysis should be performed. An MRI should then be requested, ideally performed during the first 15 days after diagnosis, to discount specific causes and to help to understand the physiopathological mechanisms in each case. Although treatment is very controversial, due to its effect on quality of life after ISSNHL and the few rare adverse effects associated with short-term steroid treatment, this consensus recommends that all patients should be treated with steroids, orally and/or intratympanically, depending on each patient. In the event of failure of systemic steroids, intratympanic rescue is also recommended. Follow-up should be at day 7, and after 12 months. CONCLUSION By consensus, results after treatment should be reported as absolute decibels recovered in pure tonal audiometry and as improvement in speech audiometry.
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Affiliation(s)
- Mayte Herrera
- Servicio de Otorrinolaringología, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, Madrid, España.
| | - José Ramón García Berrocal
- Servicio de Otorrinolaringología, Hospital Universitario Puerta de Hierro Majadahonda, Universidad Autónoma, Madrid, España
| | - Ana García Arumí
- Servicio de Otorrinolaringología, Hospital Vall d'Hebron, Universidad Autónoma, Barcelona, España
| | - María José Lavilla
- Servicio de Otorrinolaringología, Hospital Clínico, Universidad de Zaragoza, España
| | - Guillermo Plaza
- Servicio de Otorrinolaringología, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, Madrid, España
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Kostal M, Drsata J, Bláha M, Lánská M, Chrobok V. Rheopheresis in treatment of idiopathic sensorineural sudden hearing loss. J Otolaryngol Head Neck Surg 2017; 46:50. [PMID: 28662721 PMCID: PMC5492286 DOI: 10.1186/s40463-017-0228-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 06/21/2017] [Indexed: 12/18/2022] Open
Abstract
Backround Only few therapeutic options exist for patients with refractory sudden idiopathic sensorineural hearing loss (SISHL). Little is known about the efficacy of second-line therapies. Rheopheresis seems to be an effective therapeutic possibility. Methods Between 2012 and 2015, 106 patients with SISHL were enrolled in the study, of whom 52 were refractory to initial treatment. As salvage therapy, these patients were offered either 3 sessions of rheopheresis (33 pts) or intratympanic steroid treatment through MicroWick application (19 pts). Pure tone audiometry was performed at diagnosis, at the 1st month and the 1st year during the follow-up. Results Patients in the rheopheretic arm had higher hearing loss than in the MicroWick arm (81% vs. 52%, p = 0.04). In spite of this, there was a significant improvement for patients in the rheopheretic arm (27% of hearing loss reduction, p < 0.001) after the 1st month and this remained unchanged during the 1st year, while no improvement was seen in the MicroWick arm (0% of hearing loss reduction, p = 0.424). We found no predictive factor for steroid-failure in first-line therapy. Older age (p = 0.003), presence of vertigo (p = 0.006) and more profound initial hearing loss (p < 0.001) were identified as negative prognostic markers. Conclusion Rheopheresis can be used as a potentially effective and safe salvage therapy for patients with cortico-refractory SISHL.
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Affiliation(s)
- Milan Kostal
- 4th Department of Internal Medicine, University Hospital Hradec Kralove Charles University, Faculty of Medicine in Hradec Kralove, Hradec Králové, Czech Republic.
| | - Jakub Drsata
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove Charles University, Faculty of Medicine in Hradec Kralove, Hradec Králové, Czech Republic
| | - Milan Bláha
- 4th Department of Internal Medicine, University Hospital Hradec Kralove Charles University, Faculty of Medicine in Hradec Kralove, Hradec Králové, Czech Republic
| | - Miriam Lánská
- 4th Department of Internal Medicine, University Hospital Hradec Kralove Charles University, Faculty of Medicine in Hradec Kralove, Hradec Králové, Czech Republic
| | - Viktor Chrobok
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove Charles University, Faculty of Medicine in Hradec Kralove, Hradec Králové, Czech Republic
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Kosyakov SY, Kirdeeva AI. [The etiopathogenetic aspects of idiopathic sensorineural impairment of hearing]. Vestn Otorinolaringol 2017; 82:95-101. [PMID: 28514375 DOI: 10.17116/otorino201681695-101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The objectives of the present work were the overview of the results of the modern investigations concerning etiology of idiopathic sensorineural impairment of hearing as well as the analysis of the theory of microthrombus formation and its role in pathogenesis of hearing impairment.
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Affiliation(s)
- S Ya Kosyakov
- Russian Medical Academy for Post-Graduate Education, Moscow, Russia, 125993
| | - A I Kirdeeva
- Russian Medical Academy for Post-Graduate Education, Moscow, Russia, 125993
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Ganesan P, Kothandaraman PP, Swapna S, Manchaiah V. A Retrospective Study of the Clinical Characteristics and Post-treatment Hearing Outcome in Idiopathic Sudden Sensorineural Hearing Loss. Audiol Res 2017; 7:168. [PMID: 28286637 PMCID: PMC5337819 DOI: 10.4081/audiores.2017.168] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 01/02/2017] [Indexed: 01/01/2023] Open
Abstract
The purpose of this retrospective study was to analyze the clinical characteristics and document hearing recovery in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). 122 patients diagnosed with unilateral ISSNHL, from March 2009 to December 2014, were treated with oral steroids and pentoxifylline. Hearing change was evaluated by comparing pre-treatment and post-treatment pure-tone average (PTA) (500, 1K, and 2K Hz), and categorized into complete, partial, and no recovery of hearing. T-test, Wilcoxon Signed Rank test and Regression analysis were employed to analyze the statistical significance. Of the 122 patients, seventy-one (58%) had complete recovery and 34 (28%) had partial recovery. The average pre-treatment PTA was 78.3±16.9 dB whereas post-treatment average was 47.0±20.8 dB, showing statistically significant improvement (t=24.89, P≤0.001). The factors such as presence of tinnitus (P=0.005) and initial milder hearing loss (P=0.005) were found to be significant predictors for hearing recovery. Conventional steroid regimes produced a recovery rate in ISSNHL, which exceeds the spontaneous recovery rate. The current study results highlight the importance of medical treatment in the management of ISSNHL.
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Affiliation(s)
- Purushothaman Ganesan
- Expert Hearing Solutions, Wall Street Audiology Inc. , Saskatoon, Saskatchewan, Canada
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Salvago P, Rizzo S, Bianco A, Martines F. Sudden sensorineural hearing loss: is there a relationship between routine haematological parameters and audiogram shapes? Int J Audiol 2016; 56:148-153. [DOI: 10.1080/14992027.2016.1236418] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Pietro Salvago
- BioNeC Department, Universitù degli Studi di Palermo, ENT Section, Via del Vespro, Palermo, Italy and
| | - Serena Rizzo
- BioNeC Department, Universitù degli Studi di Palermo, ENT Section, Via del Vespro, Palermo, Italy and
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Università degli Studi di Palermo, Via Giovanni Pascoli, 6, Palermo, Italy
| | - Francesco Martines
- BioNeC Department, Universitù degli Studi di Palermo, ENT Section, Via del Vespro, Palermo, Italy and
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Assessment of Hematological Factors Involved in Development and Prognosis of Idiopathic Sudden Sensorineural Hearing Loss. J Craniofac Surg 2016; 27:e85-91. [DOI: 10.1097/scs.0000000000002241] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Nakagawa T, Yamamoto M, Kumakawa K, Usami SI, Hato N, Tabuchi K, Takahashi M, Fujiwara K, Sasaki A, Komune S, Yamamoto N, Hiraumi H, Sakamoto T, Shimizu A, Ito J. Prognostic impact of salvage treatment on hearing recovery in patients with sudden sensorineural hearing loss refractory to systemic corticosteroids: A retrospective observational study. Auris Nasus Larynx 2015; 43:489-94. [PMID: 26739948 DOI: 10.1016/j.anl.2015.12.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 11/02/2015] [Accepted: 12/07/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To determine the prognostic factors for hearing recovery in patients with sudden sensorineural hearing loss (SSHL) refractory to systemic corticosteroids following salvage treatment. METHODS This is a retrospective observational study at nine tertiary referral hospitals. A total of 120 patients with sudden deafness refractory to systemic corticosteroids were enrolled. The patients were randomly assigned to receive topical application of recombinant human IGF-1 or intratympanic injection of dexamethasone as salvage treatment. Multiple regression analysis was performed to identify determinants of hearing recovery using pure tone audiometry results at 8 weeks after treatment. Clinical predictors that were evaluated included age, sex, pretreatment hearing level, presence of vertiginous symptoms, days to study entry from symptom onset and salvage treatment assignment (IGF-1 vs. dexamethasone). RESULTS The linear regression model identified age (P=0.001), pretreatment hearing level (P<0.001), days to study entry from symptom onset (P=0.011) and treatment assignment (P=0.033) at 8 weeks after treatment as significant variables influencing the recovery of pure tone audiometry average thresholds. Younger age (<60 years), early initiation of salvage treatment and treatment with topical IGF-1 therapy had significant effects on hearing recovery. CONCLUSION The results indicate that early initiation and choice of treatment modalities for salvage treatment may be important for the prognosis of patients with refractory SSHL. The positive effect of topical IGF-1 therapy on hearing recovery indicates its utility as salvage treatment.
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Affiliation(s)
- Takayuki Nakagawa
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan.
| | - Michio Yamamoto
- Department of Data Science, Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto 606-8507, Japan
| | - Kozo Kumakawa
- Department of Otolaryngology, Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo 105-8470, Japan
| | - Shin-Ichi Usami
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto 390-8621, Japan
| | - Naohito Hato
- Department of Otolaryngology, Ehime University Graduate School of Medicine, Ehime 791-0295, Japan
| | - Keiji Tabuchi
- Department of Otolaryngology, Graduate School of Comprehensive Human Science, University of Tsukuba, 305-8575 Tsukuba, Japan
| | - Mariko Takahashi
- Department of Otolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya 467-8601, Japan
| | - Keizo Fujiwara
- Department of Otolaryngology, Kobe City Medical Center General Hospital, Kobe 650-0047, Japan
| | - Akira Sasaki
- Department of Otorhinolaryngology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan
| | - Shizuo Komune
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Norio Yamamoto
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
| | - Harukazu Hiraumi
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
| | - Tatsunori Sakamoto
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
| | - Akira Shimizu
- Department of Experimental Therapeutics, Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto 606-8507, Japan
| | - Juichi Ito
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
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Abstract
OBJECTIVE Sudden hearing loss (SHL) is a disease, isolated or associated with vertigo, of unknown etiology. The aim of this study was to identify the prognostic factors for hearing recovery. METHODS In this retrospective study, we analyzed 287 cases of SHL (mean age 42). Tonal threshold audiometry, BAEP, and RM were the diagnostic procedures for clinical balance of the patient. The therapy used the following: corticosteroids, osmotic diuretic infusion, and vasoactives. All the factors were evaluated through statistical tests, Spearman test, and linear logistic regression. RESULTS In our study, we observed that 39.3% of patients improved, 27.9% remained unchanged, 29% had complete recovery, and 3.8% worsened. Therapy was not related to the degree of recovery from hearing loss, whereas young age, delayed diagnosis, and audiometric curve type were the three factors related to the degree of hearing recovery. CONCLUSIONS In our study, we report a better overall recovery rate compared with spontaneous recovery. In particular, early treated patients as well as patients with upsloping hearing loss frequently recovered after treatment. Age, time between onset and treatment, and audiogram type were shown to be significantly related to outcome.
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Oya R, Horii A, Akazawa H, Osaki Y, Inohara H. Prognostic predictors of sudden sensorineural hearing loss in defibrinogenation therapy. Acta Otolaryngol 2015; 136:271-6. [PMID: 26573379 DOI: 10.3109/00016489.2015.1104723] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSIONS Defibrinogenation therapy rather than corticosteroids therapy should be chosen for patients specifically with profound hearing loss and with initial high fibrinogen. OBJECTIVES Corticosteroids therapy is the standard treatment for sudden sensorineural hearing loss (SSNHL) and prognostic factors by this therapy were reported. Defibrinogenation therapy is one of the treatment options for SSNHL. Aims of this study were to identify prognostic factors and correlative markers with hearing improvement in treating SSNHL by defibrinogenation therapy. METHODS During the early phase of the study, consecutive 61 patients were treated by defibrinogenation therapy with batroxobin (50 units), whereas corticosteroids (500 mg/day of hydrocortisone tapered by 9 days) were used for consecutive 64 patients during the late phase. Blood data that could predict a complete recovery were identified. Coagulation/fibrinolysis markers correlated with hearing improvement by defibrinogenation therapy were investigated. RESULTS Although there were no overall differences in hearing improvement between the two therapies, recovery rate in profound hearing loss patients was better in defibrinogenation therapy. In patients who showed complete recovery, serum fibrinogen level before treatment was significantly higher in the defibrinogenation group than the corticosteroid group. Responses of several fibrinolysis markers to defibrinogenation therapy evaluated by post-/pre-values were negatively correlated with hearing improvement.
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Affiliation(s)
- Ryohei Oya
- a Department of Otorhinolaryngology Head and Neck Surgery , Osaka University Graduate School of Medicine , Osaka , Japan
| | - Arata Horii
- b Department of Otolaryngology Head and Neck Surgery , Niigata University Graduate School of Medical and Dental Sciences , Niigata , Japan
| | - Hitoshi Akazawa
- c Department of Otolaryngology , Higashiosaka City General Hospital , Higashiosaka , Japan
| | - Yasuhiro Osaki
- d Department of Otolaryngology , Suita Municipal Hospital , Suita , Japan
| | - Hidenori Inohara
- a Department of Otorhinolaryngology Head and Neck Surgery , Osaka University Graduate School of Medicine , Osaka , Japan
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