Acute Low-tone Sensorineural Hearing Loss Research Articles

Findings of Intravenous Gadolinium Inner Ear Magnetic Resonance Imaging in Patients With Acute Low-Tone Sensorineural Hearing Loss.

Acute low-tone sensorineural hearing loss (ALHL) is thought to have a different etiology from that of idiopathic sudden sensorineural hearing loss. We hypothesized that endolymphatic hydrops (EH) in the inner ear organ contributes to ALHL, even in patients without vertigo. This study investigated the presence of EH in ALHL and compared the clinical characteristics of patients with or without EH. We retrospectively reviewed 38 patients diagnosed with ALHL without vertigo from January 2017 to March 2022. EH was measured in all patients using inner ear magnetic resonance imaging (MRI). In addition, we selected patients who showed only mid- or high-frequency hearing loss and had available MRI data as a control group and compared the ALHL and control groups. After treatment, the pure-tone average at low frequencies significantly improved compared to the initial hearing (P<0.001). Hearing recovery was observed in 63.1% of patients; however, the recovery rate did not differ based on the treatment method. During the follow-up period, six patients (15.8%) progressed to Meniere's disease, and 18 (47.4%) experienced recurrence. In the ALHL group, the cochlear hydrops ratio on the affected side (0.34±0.09) was significantly higher than on the contralateral side (0.29±0.12) (P=0.005), and most patients showed hydrops in the apex area of the cochlea. Compared with the control group (0.25±0.15), the ALHL group showed a significantly higher cochlear hydrops ratio (P=0.043). The correlation analysis showed a tendency for hearing thresholds at low frequencies to increase as the hydrops ratio increased, albeit without statistical significance. The cochlear hydrops ratio, especially in the apex area on the affected side, was significantly higher in patients with ALHL, suggesting that EH in the cochlea contributes to the pathogenesis of ALHL.

Retracted: The Relationship between Meniere's Disease and Acute Low-Tone Sensorineural Hearing Loss.

[This retracts the article DOI: 10.1155/2022/4217131.].

The Relationship between Meniere's Disease and Acute Low-Tone Sensorineural Hearing Loss.

Objective To analyse the vestibular function characteristics of patients with Meniere's disease and acute hypophonic sensorineural hearing loss in order to find more reliable and objective ancillary tests that will reduce misdiagnosis and missed diagnoses. Methods From January 2021 to December 2021, 60 healthy adults who underwent physical examination in our hospital were included in the control group, 60 patients with Meniere's disease were included in Study Group A, and 60 patients with acute low-tone sensorineural hearing loss were recruited in Study Group B. All participants underwent the caloric test (CT), video-head impulse test (vHIT), headshaking test (HST), and vestibular-evoked myogenic potential (VEMP) testing, which includes ocular vestibular-evoked myogenic potential (oVEMP) and cervical vestibular-evoked myogenic potential (cVEMP). Results Statistical analyses of unilateral weakness and directional preponderance (DP) in the two groups of patients found no significant differences between the two groups (P > 0.05). There was no statistically significant difference in the abnormal rate of vHIT and HST results between the two study groups (P > 0.05). There was no significant difference in the wave latencies, interwave intervals, and amplitudes of cVEMP and oVEMP, among the three groups (P > 0.05). Conclusion This study found that factors affecting CT, vHIT, HST, and VEMP results included age, head posture and position during testing, stimulus type, manipulation method, and control of muscle tone, and also those that are related to the testing instrument, statistical software, and manipulation procedures, resulting in different excitation rates and testing parameters. The small sample size prevented a comprehensive assessment of the differences in vestibular function between patients with Meniere's disease and acute hypotonic sensorineural hearing loss, and a larger sample size will be investigated in the future to provide useful insight into the diagnosis, treatment and differentiation of Meniere's disease, and acute hypotonic sensorineural hearing loss.

Optimal First-Line Therapy for Acute Low-Tone Sensorineural Hearing Loss

Background and ObjectivesWe aimed to analyze treatment outcomes following different initial management approaches and confirm treatment regimens for acute low-tone sensorineural hearing loss (ALHL) that would yield the best results.Subjects and MethodsWe retrospectively analyzed the medical records of 106 patients with ALHL who visited a university hospital’s otology clinic from March 2013 to June 2019. Pure-tone averages at the initial visit and at 2 and 4 weeks after the initial visit were evaluated.ResultsForty-nine patients were enrolled in this study; of them, 41 (83.7%) exhibited complete recovery (CR) at 2 weeks and 43 (87.8%) exhibited CR at 1 month after the initial visit. Regression analysis revealed that CR at 2 weeks after the initial visit was associated with diuretic use [Exp(B): 10.309, 95% confidence interval (CI): 1.007-100]. An initial daily low-dose steroid use was marginally significant [Exp(B): 1.042, 95% CI: 0.997-1.092; p=0.066]. Isolated diuretic use [Exp(B): 25.641, 95% CI: 1.121-90.909; p=0.039] was an independent, good prognostic factor at 1 month after the initial visit. However, other treatment regimens did not affect the final results.ConclusionsA combination of initial daily administration of ≤30 mg prednisolone plus diuretics was sufficient as the first-line treatment for ALHL. High-dose steroids and salvage intratympanic steroid injections can be applied as a second choice; however, the predicted outcome would not be good in that case.

High level of IgE in acute low-tone sensorineural hearing loss: A predictor for recurrence and Meniere Disease transformation

BackgroundAutoimmunity may play an important role in sudden onset sensorineural hearing loss. However, little is known about the relationship between immunoglobulin E (IgE) and acute low-tone sensorinerual hearing loss (ALHL). ObjectivesTo investigate the relationship between IgE level and endolymphatic hydrops and outcomes of ALHL. MethodsA total of 242 subjects with sudden onset hearing loss, including 115 with ALHL and 127 with idiopathic sudden sensorineural hearing loss (ISSHL), were included in this study. Peripheral venous blood samples of 242 subjects were collected for detection. Clinical data, IgE level, and distribution of allergens were compared between the ALHL and ISSHL groups. The ALHL group received an electrocochleogram (ECochG) test and a follow-up in the outpatient unit or by telephone to evaluate outcomes. ResultsCompared to the values in the ISSHL group, a significantly younger onset age (42.30±14.33 years old), higher female onset proportion (72/115, 62.61%), increased total IgE level (median: 66.47, interquartile range: 24.56, 180.96, IU/mL) and specific IgE level (median: 9.42, interquartile range: 1.42, 22.23 IU/mL) were noted in the ALHL group. A clear difference in allergen distribution was noted between the ALHL and ISSHL groups (p=.001). Total IgE and specific IgE levels were factors that contributed to the SP/AP ratio in the electrocochleogram (ECochG) (R2=0.413) in ALHL group. Finally, during the follow-up (17.61±3.46 months) for the ALHL group, 37 subjects recurred, and 17 subjects developed Meniere Disease. In the ROC curve for ALHL recurrence, the area under the curve (AUC) of total IgE was 0.709 and that of specific IgE was 0.679. For MD transformation, the AUC of total IgE was 0.736 and that of specific IgE was 0.716. ConclusionsHigh IgE levels correlated with an enhanced SP/AP ratio in ALHL. High IgE levels could be used as a predictor of ALHL recurrence and MD transformation.

Comparative Study of Acute Low-Tone Sensorineural Hearing Loss and Ménière’s Disease

Involvement of endolymphatic hydrops has been reported in both Ménière’s disease (MD) and acute low-tone sensorineural hearing loss (ALHL). However, only a few studies have been conducted to compare the two conditions in respect of the involvement of endolymphatic hydrops. For this research, I extracted the medical records of patients who fulfilled the diagnostic criteria for MD and ALHL among patients who visited my clinic for dizziness or hearing loss over the past seven years. I then conducted a retrospective analysis of the patient data, including the age at the time of the initial visit, gender, affected side, hearing level, subjective symptoms, presence/absence of nystagmus, tendency to develop MD, etc. There were 108 cases with 110 ears diagnosed as having MD (definite), including 29 cases in men (26.9%) and 79 cases in women (73.1%), 163 cases with ALHL, including 41 cases in men (25.2%) and 122 cases in women (74.8%), and 31 cases with cochlear MD, including 5 cases in men (16.1%) and 26 cases in women (83.9%). The male-female ratio was 1:5.2 for patients with cochlear MD, 1:3.0 for patients with ALHL, and 1:2.7 for patients with MD (definite). The average ages of the above patient groups were as follows: MD (definite), 45.1±14.1 years; cochlear MD, 38.8±14.2 years; ALHL, 46.9±15.5 years. There was no significant age difference between the patients with MD (definite) and those with ALHL. There were 31 cases (15.3%) in which the diagnosis changed from ALHL to cochlear MD and 8 cases (4.0%) in which the diagnosis changed from ALHL to MD (definite). The diagnosis changed from ALHL to cochlear MD or MD (definite) more frequently in women than in men; in particular, all of the patients in whom the diagnosis changed from ALHL to MD (definite) were woman. There were no significant differences among the three patient groups in the total hearing levels for three low frequencies (125 Hz, 250 Hz, 500 Hz) at the initial visit. The average age of the patients in whom the diagnosis changed from ALHL to MD (definite) tended to be higher (53.7±18.3), whereas those of the patients in whom the diagnosis changed to cochlear MD tended to be lower (38.8±14.2). Of the patients with MD (definite), 77.8% already had hearing loss at the time of their clinic visit. On the other hand, only 20.4% of patients had nystagmus or dizziness at the first visit. The results of this study revealed that most patients with ALHL and MD were already aware of hearing loss or the sensation of clogged ears.

The Significance of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Acute Low Tone Sensorineural Hearing Loss

Background and Objectives Acute low tone sensorineural hearing loss (ALHL), an acuteonset hearing loss limited to low tone, was thought to be a subtype of sudden sensorineural hearing loss (SSNHL) but also considered as new disease entity because it shows quite different symptoms, progress, and prognosis. More recently, however, it is thought that SSNHL results from chronic inflammation and thrombosis. Some studies have reported that neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were high in SSNHL patients, and that they were significant as prognostic factors. The aim of this study was to evaluate the significance of NLR and PLR in ALHL.Subjects and Method From January 2009 to June 2019, we retrospectively studied 58 patients who were diagnosed with ALHL. Characteristics of patients such as sex, age, symptoms and signs, the results of serologic test and pure tone audiometry were evaluated for recovery and for recurrence. Also, we selected 58 people with the same age as control group.Results A total of 167 patients were identified, of whom a half was diagnosed with ALHL and the other half with were the control group. Among the 58 patients, the mean age was 38.0±14.5 years old, and 10 (17.2%) patients were male and 48 (82.8%) patients were female. Among the patients, 35 (60.3%) were hospitalized and 23 (39.7%) were outpatients. For recovery, 38 (65.5%) patients fully recovered while 11 (19.0%) partially recovered, and 9 (15.5%) did not recover. Additionally, 16 (27.6%) patients recurred later with similar symptoms. Between the patient group and control group, there were significant differences in the total white blood cell count, neutrophil count, NLR and PLR (&lt;i&gt;p&lt;/i&gt;=0.015, 0.001, 0.002, and 0.025), but there was no significant differences between the recovery group and non-recovery group in any laboratory findings. Also, NLR and PLR showed no significant differences between the recurred group and non-recurred group.Conclusion NLR and PLR in ALHL patients were relatively high compared to the control group, but there were no significant differences between the recovery group and non-recovery group. Furthermore, there was no correlation between NLR and PLR with recurrence. High NLR and PLR values in ALHL patients might reflect its inflammatory etiology, but there is lack evidence for them to serve as prognostic factors.

Clinical study of cases with acute low-tone sensorineural hearing loss (ALHL) and cases of transition of ALHL to Meniere's disease

Clinical study of cases with acute low-tone sensorineural hearing loss (ALHL) and cases of transition of ALHL to Meniere's disease

A Study on Suspected Acute Low-Tone Sensorineural Hearing Loss

In the present study, the records of patients diagnosed as having suspected acute low-tone sensorineural hearing loss (ALHL) from among all the patients with hearing loss who visited a single clinic over a recent 6-year period were extracted, and a retrospective analysis of the recovery rate, recurrence, and tendency to progress to Ménière’s disease was performed. A total of 35 cases (6 men, 29 women) were diagnosed as having suspected ALHL. The 16 cases that were given isosorbide, Wu-Ling-San (Goreisan), and ATP as an initial treatment all recovered. The 19 patients who did not respond to this initial treatment were given steroids and vitamin preparations, and 7 of these cases recovered. The overall recovery rate was 65.7%. No improvement (no change) was seen in 12 cases (34.2%). Out of the 35 cases, a one-year follow-up examination was performed in 14 cases (40%). Out of the cases who underwent a one-year follow-up, recurrences had occurred in 3 (8.6%) cases. Out of the patients with recurrences, 1 case (2.9%) had progressed to Ménière’s disease.

Subjective symptoms of acute low-tone sensorineural hearing loss: An attempted analysis using symptom scores

Subjective symptoms of acute low-tone sensorineural hearing loss: An attempted analysis using symptom scores

Wide-Band Tympanometry Results during an Acute Episode of Ménière’s Disease

Background: Wide-band tympanometry (WBT) was introduced as a beneficial diagnostic test for Ménière’s disease (MD) almost 15 years ago. However, an acute episode of MD has not been evaluated by using WBT yet. Objective: To investigate WBT findings in patients with MD during acute attacks. Method: Thirty definite MD patients with unilateral acute low-tone sensorineural hearing loss and aural fullness, and thirty age- and sex-matched control subjects were enrolled prospectively in a tertiary referral center. Ears were divided into three groups as follows: (1) affected ears of MD patients, (2) contralateral ears of MD patients, (3) control ears. Individuals underwent WBT. The resonance frequency (RF), mean absorbance value, mean low- and high-frequency absorbance values (LF-A and HF-A), and double peak width at 2 kHz of conductance tympanometry (2-kHz PW) were assessed. Results: Seventy percent in group 1, 66.7% in group 2, and 78.3% in group 3 demonstrated double peaks at 2 kHz. The mean 2-kHz PW values were 157.52 ± 79.19, 177.40 ± 79.14, and 139.64 ± 87.501 daPa for groups 1, 2, and 3, respectively. There were no significant differences between groups with respect to 2-kHz PW, RF, absorbance, LF-A, and HF-A. Conclusion: This was the first study that evaluated the effects of acute Ménière attacks on WBT findings. An acute Ménière attack was found to have no significant effect on the 2-kHz PW and other variables measured using WBT.

Magnetic resonance imaging of the endolymphatic space in patients with acute low-tone sensorineural hearing loss

ObjectiveThe aim of this study was to measure the volume of the endolymphatic space (ELS) and to investigate prognosis in patients with acute low-tone sensorineural hearing loss (ALHL). MethodsA total of 61 ALHL patients participated; 47 were definite while 14 were probable ALHL cases. The definite ALHL patients were classified into three groups: A, “Cure”; B, “No cure”; and C, “Recurrence.” Also, nine patients for whom diagnosis changed from ALHL to cochlear Meniere’s disease (cMD) without vertigo (ALHL-cMD group). Images of the inner ear fluid space, positive perilymph, and positive endolymph were acquired using a 3T magnetic resonance scanner. Three-dimensional (3D) images were semi-automatically reconstructed using anatomical and tissue information to fuse the 3D images of the inner ear fluid space with the 3D ELS images. ResultsPatients in the no cure group showed a significantly higher ELS/total fluid space (TFS) volume ratio in the affected cochlear region than the patients of the other groups. Additionally, the affected vestibular ELS/TFS volume ratio in the cure group was significantly lower than that in the recurrence group. There were significantly higher cochlear and vestibular ELS/TFS ratios in ALHL-cMD patients than in control subjects. ConclusionsThese results indicate that the cochlear ELS/TFS volume ratio should be considered when investigating the extent of recovery, while the extended ELS in the vestibule should be considered when investigating cases of recurrence. Thus, our study suggests that the severe extended ELS appeared likely to change to cMD and that the prognostic determination of ALHL is possible.

Penatalaksanaan Acute Low-tone Sensorineural Hearing Loss

Acute Low-tone Sensorineural Hearing Loss (ALHL) merupakan ketulian mendadak sensorineural pada nada rendah dengan penyebab yang tidak diketahui secara jelas (idiopatik) dan tidak disertai dengan keluhan vertigo. Tujuan: Melaporkan ALHL sebagai salah satu kegawatdaruratan di bagian telinga hidung tenggorok bedah kepala dan leher (THT-KL) yang memerlukan tindakan penanganan yang cepat. Diagnosis dini dan penatalaksanaan segera pada kasus ALHL dapat meningkatkan angka kesembuhan dan menurunkan risiko ketulian permanen pada pasien. Kasus: Dilaporkan seorang pasien perempuan 22 tahun dengan diagnosis Acute Low-tone Sensorineural Hearing Loss telinga kanan. Pasien datang dengan keluhan telinga berdengung, telinga terasa penuh, penurunan pendengaran tanpa disertai dengan pusing berputar. Pasien diberikan terapi kombinasi kortikosteroid dengan terapi tambahan lainnya dan menunjukkan perbaikan komplit dalam 2 minggu terapi. Simpulan: Pemberian terapi yang cepat dan tepat (terapi inisial) dapat memberikan perbaikan yang maksimal pada pasien dengan ALHL. Evaluasi terapi awal sangat berpengaruh terhadap prognosis jangka panjang pasien ALHL, terutama evaluasi pada satu bulan pertama.

A Study on 146 Cases of Acute Low-Tone Sensorineural Hearing Loss

Acute low-tone sensorineural hearing loss (ALHL) is an ailment presenting with a sudden sensorineural hearing loss in which the hearing impairment is confined to the lower frequencies. In the present study, the records of patients diagnosed with ALHL from among the patients of hearing loss who visited my clinic in the last 6 years were extracted, and a retrospective analysis of the subjective symptoms, recovery rate, recurrence, and a tendency of progression to Meniere’s disease were recorded. A total of 146 cases were diagnosed as having ALHL, of which 34 were male and 112 were female. The most common subjective symptom was aural fullness, reported by 131 patients (89.7%). The 116 cases who were given isosorbide, Wu-Ling-San (Goreisan), and ATP as initial treatment recovered. Out of the 30 patients who did not respond to the initial treatment and were given steroids and vitamin preparations, 20 cases showed recovery. The overall recovery rate was 93.2%. There was no improvement in 10 cases (6.8%). Based on the severity, Grades 1, 2, and 3 showed a recovery rate of 90% or more. Grade 4 showed a low recovery rate of 68.8%. The cases who showed no improvement were either elderly patients or patients diagnosed as having a high severity at the first visit. Out of the 146 cases, the post-one year follow-up was performed for 82 cases (56.2%). Out of the cases who underwent the post-one year follow-up, there was recurrence in 31 cases (21.2%). Out of the patients with recurrence, 22 cases progressed to cochlear Meniere’s disease. 6 cases progressed to Meniere’s disease, all of which were females. The severity grade of all the 6 cases who progressed to Meniere’s disease was Grade 3 or Grade 4. Patients progressing to Meniere’s disease had a higher severity of the disease.

Magnetic resonance-based volumetric measurement of the endolymphatic space in patients with Meniere’s disease and other endolymphatic hydrops-related diseases

ObjectiveTo employ magnetic resonance imaging (MRI) to measure the volume of the inner ear endolymphatic space (ELS) in patients with acute low-tone sensorineural hearing loss (ALHL), sudden deafness (SD), cochlear Meniere’s disease (cMD), and unilateral MD (uMD) compared with control subjects (CS) with chronic rhinosinusitis. MethodsForty-one patients with ALHL, 82 with SD, 48 with cMD, 72 with uMD, and 47 CS participated in the study. With the exception of all uMD patients, none of the subjects had vertigo. Images of the inner ear fluid space, positive perilymph signal, and positive endolymph signal were acquired using a 3-T MRI scanner. Three-dimensional images were reconstructed semi-automatically by using anatomical and tissue information to fuse the inner ear fluid space images and the ELS images. ResultsThe cochlear ELS/total fluid space (TFS) volume ratio was 10.2±6.7% (mean±standard deviation) in the CS group, 12.1±5.7% in ALHL patients, 15.2±8.7% in SD patients, 18.1±8.2% in cMD patients, and 21.9±16.4% in uMD patients. The vestibular ELS/TFS volume ratio was 17.7±10.2% in the CS group, 18.9±8.3% in ALHL patients, 19.9±11.3% in SD patients, 22.5±13.7% in cMD patients, and 35.7±24.1% in uMD patients. The cochlear ELS/TFS volume ratio in patients with uMD was similar to that in the cMD group and significantly higher than that in the CS, ALHL, and SD groups (CS=ALHL<SD<cMD=uMD: p<0.05 for CS vs. SD and p<0.01 for CS vs. cMD). The vestibular ELS/TFS volume ratio in patients with uMD was significantly higher than that in the CS and all other patient groups (CS=ALHL=SD=cMD<uMD: p<0.01 for uMD vs. all other groups). ConclusionThe cochlear ELS volume of patients with MD and other endolymphatic hydrops-related diseases differed from that of CS. Our results suggest that ALHL may not be caused by endolymphatic hydrops. We confirmed the presence of extended ELS in patients with SD.

Comorbid Symptoms Occurring During Acute Low-Tone Hearing Loss (AHLH) as Potential Predictors of Menière's Disease.

Acute low-tone sensorineural hearing loss (ALHL) is a type of idiopathic sudden sensorineural hearing loss. ALHL is rarely a solitary condition but rather co-occurs with vertigo and tinnitus, being an element of contemporary diagnostic criteria for Menière's disease (MD). The goal of our present study was to determine the value of ALHL for the early diagnosis of MD in patients presenting in the emergency room with ALHL as a main complaint. The files of 106 patients with ALHL who were admitted to the emergency room over the period of 7 years and 104 patients with acute high- tone sensorineural hearing loss (AHHL) from the same period were included in this retrospective study. Forty ALHL patients presented with recurrent episode of hearing loss and 66 remaining patients presented with ALHL for the first time. Of the latter group, 25 patients gave consent for the follow-up. First, we analyzed the difference in the occurrence of tinnitus and vertigo between the ALHL and AHHL groups. In patients with ALHL, the incidence of vertigo with tinnitus and the number of recurrent episodes were statistically higher than in patients with AHHL. Next, we focused on the ALHL follow-up group (25 patients). In that group, two patients had all MD symptoms at presentation, 18 had ALHL and tinnitus and five ALHL only. Of 18 patients with ALHL and tinnitus at admission, five developed vertigo and thus the triad of Menière's disease. None of the five patients with AHLH as a sole symptom developed MD during the follow-up time but four of them have developed tinnitus. Patients with recurrent ALHL had significantly higher incidence of MD than the patients with first episode. We conclude that some patients who present with ALHL and concomitant tinnitus or have recurrent episodes of ALHL are more likely to develop Menière's disease than these patients, who present with ALHL as a sole symptom. Nonetheless, we recommend otological follow-up for all patients presenting with ALHL.

Acute low-tone sensorineural hearing loss vs. Meniere's disease:their similarities and differences From the point of view of Meniere's disease

Meniere’s disease is diagnosed by the clinical triad of episodic vertigo, fluctuating hearing loss and tinnitus. Meniere’s disease sometimes develops initially as acute low-tone sensorineural hearing loss, which is characterized by hearing loss limited to low-tone frequencies, in the absence of vertigo. Acute low-tone sensorineural hearing loss, with its favorable prognosis, is a distinct clinical entity from idiopathic sudden sensorineural hearing loss. However, it frequently relapses, with fluctuating hearing loss, in the absence of vertigo. Finally, Meniere’s disease is diagnosed when these patients with acute low-tone sensorineural hearing loss develop episodic vertigo. According to epidemiological studies, about 10% of patients with acute low-tone sensorineural hearing loss suffer from Meniere’s disease. It is assumed that endolymphatic hydrops is the common pathophysiology of both Meniere’s disease and acute low-tone sensorineural hearing loss. In this review, the similarities and differences between acute low-tone sensorineural hearing loss and Meniere’s disease are discussed.

Acute low-tone sensorineural hearing loss and Meniere's disease:similarities and differences From the standpoint of acute low-tone sensorineural hearing loss

Acute low-tone sensorineural hearing loss and Meniere's disease:similarities and differences From the standpoint of acute low-tone sensorineural hearing loss

The Comparison of Short-Term Therapeutic Effects of Acute Low-Tone Sensorineural Hearing Loss according to Steroid Capacity

Background and Objectives Acute low-tone sensorineural hearing loss refers to a condition wherein thresholds increase only at low frequencies in pure-tone audiometry. Systemic steroid treatment is commonly used for acute low-tone sensorineural hearing loss without vertigo, but there has been no established treatment in most clinical researches. The purpose of this study is to compare and analyze the short-term effects of high- and half-dose oral steroid therapy on patients suffering from acute low-tone sensorineural hearing loss without vertigo. Subjects and Method Forty-six patients diagnosed with acute low-tone sensorineural hearing loss were divided into two groups and treated with high-dose (24 patients) and half-dose (22 patients) steroids, respectively. A retrospective analysis was conducted on their medical records. Results There were no significant differences between the two groups in any of the following: age, sex ratio, duration of symptoms before treatment, pure-tone hearing thresholds, low frequency hearing thresholds and speech intelligibility. However, both groups showed significant differences in hearing thresholds before and after treatment. In addition, no significant difference was noted in the recovery and recurrence rate between the two groups. Conclusion According to the results of this study, there is no difference in treatment effect between the high- and half-dose groups. Therefore, half-dose steroids may be used as a treatment option for acute low tone sensorineural hearing loss. Key words: Low-tone ㆍ Sensorineural hearing loss ㆍ Steroid

Diagnostic criteria for Patulous Eustachian Tube: A proposal by the Japan Otological Society

Patulous Eustachian Tube (PET) is of increasing importance in otology. However, despite the abundance of diseases requiring a differential diagnosis from PET, such as superior semicircular canal dehiscence syndrome, perilymphatic fistula, acute low-tone sensorineural hearing loss, etc., there are currently no established diagnostic criteria for PET.In view of these circumstances, the Japan Otological Society (JOS) Eustachian Tube Committee proposed the diagnostic criteria for Patulous Eustachian Tube in 2012, in order to promote clinical research on PET. A revision was made in 2016, maintaining the original concept that the criteria should be very simple, avoid any contamination of “Definite PET” with uncertain cases. Moreover, it was also intended to minimize the number of cases that could be accidentally excluded even in the presence of some suspected findings (“Possible PET”).The criteria can be used by all otolaryngologists even without using the Eustachian tube function test apparatus. However, the use of such an apparatus may increase the chances of detecting “Definite PET”. The algorithm for the diagnosis of PET using the criteria has also been described.The JOS diagnostic criteria for Patulous Eustachian Tube will further promote international scientific communication on PET.