Improvement In Hearing Threshold Research Articles

Comparison of the efficacy between Ginkgo Biloba and Caroverine in the management of Idiopathic Tinnitus.

Aim: This Study of Tinnitus management conducted to compare the efficacy of two drugs namelycaroverine and gingko Biloba in Mahavir institute of medical sciences, Vikarabad over one year.Objective: To describe the results found in a group of people who have undergone treatment withcarvoverine, gingko Biloba,placebo. Method: Using Tchqs Score 90 adult subjects with the complaintof tinnitus and associated symptoms were analyzed with Proper History, Clinical Examination andPure Tone Audiometry and Thcq’s to determine the Degree of Annoyance of the Tinnitus and toAssess Tinnitus Impact on the Quality of Life before and after Treatment. Results: There was asignificant reduction in the degree of annoyance caused by Tinnitus, there was a significantreduction of tinnitus and there was a significant improvement in hearing thresholds, consequently,on the Quality of Life of the respondents after using the caroverine, gingko Biloba. Conclusion: Thisstudy allowed the Verification that the use of Caroverine, gingko bilobaand placebo for the Treatmentof Tinnitus and their Effect.

Implantation of the Bonebridge BCI 602 after Mastoid Obliteration with S53P4 Bioactive Glass: A Safe Method of Treating Difficult Anatomical Conditions-Preliminary Results.

This study presents the preliminary results of a new otosurgical method in patients after canal wall down (CWD) surgery; it involves the implantation of the Bonebridge BCI 602 implant after obliteration of the mastoid cavity with S53P4 bioactive glass. The study involved eight adult patients who had a history of chronic otitis media with cholesteatoma in one or both ears and who had had prior radical surgery. The mean follow-up period was 12 months, with routine follow-up visits according to the schedule. The analysis had two aspects: a surgical aspect in terms of healing, development of bacterial flora, the impact on the inner ear or labyrinth, recurrence of cholesteatoma, and possible postoperative complications (firstly, after obliteration of the mastoid cavity with S53P4 bioactive glass, then after implantation). The second was an audiological aspect which assessed audiometric results and the patient’s satisfaction based on questionnaires. During the follow-up period, we did not notice any serious postoperative complications. Studies demonstrated significantly improved hearing thresholds and speech recognition in quiet and noise using the Bonebridge BCI 602. Data collected after six months of use showed improved audiological thresholds and patient satisfaction. Based on the preliminary results, we believe that the proposed two-stage surgical method using bioactive glass S53P4 is a safe and effective way of implanting the Bonebridge BCI 602 in difficult anatomical conditions. This makes it possible to treat a larger group of patients with the device.

Middle Ear Implant for Sensorineural and Conductive Hearing Loss: Indications and Audiological Results

Background and Objectives Middle ear implants (MEI) have been reported to be an effective and safe alternative for the treatment of sensorineural hearing loss (SNHL) and conductive hearing loss (CHL). This study aimed to compare the functional outcomes between SNHL and CHL in terms of audiological gains.Subjects and Method The medical records of 14 consecutive SNHL and CHL patients who underwent MEI surgeries from 2015 to 2019 by a single surgeon were retrospectively reviewed. Audiological changes using hearing aids (HA) and MEI were compared.Results In SNHL, the mean unaided air-conduction pure tone audiometry (PTA), (57.7 dB HL) decreased significantly using HA and MEI (44.7 and 41.4 dB HL), but with no significant difference from each other. Unaided word recognition score (WRS) at 65 dB HL (45.1%) was significantly improved using HA and MEI (72.6% and 76.6%), with no significant difference. In CHL, the mean unaided air-conduction and bone-conduction PTA were 77.1 (57.5-93.8) and 44.1 (26.3-57.5) dB HL. Three patients could not use conventional HAs due to otorrhea and deformity of the external auditory canal by previous surgeries and 4 patients had used conventional HAs before MEI. Though both HA and vibrant soundbridge (VSB) showed improvement of hearing thresholds (32.0 and 48.8 dB HL) and WRS (80.0% and 94.9%), it was significant only when using VSB. There was no significant difference between HA and VSB.Conclusion MEI can be an effective treatment option for both SNHL and CHL patients, especially for those who suffered from problems using conventional HA.

Hearing and Language Outcomes of Cochlear Implant Users in Zagazig University Program

Introduction: The most common congenital sensory deficit is sensory neural hearing loss (SNHL), with a 1:3 occurrences per 1000 live births, this incidence increases to 4-5% in neonates with risk factors for SNHL. For severe to profound deaf persons, cochlear implantation has been used as a successful method to regain partial hearing. Children with CIs are now able to communicate and understand speech, learn spoken language, and attend regular schools. Objectives: The aim of this study was to assess auditory perception threshold of cochlear implant users in Zagazig University Hospitals and evaluate their speech and language outcomes.Patients and methods: This study included 62 participants operated in zagazig university hospital and follow the candidacy criteria for cochlear implantation of Zagazig University CI program. All patients were subjected to postoperative audiological and phonological assessment including Warble tone response thresholds in sound field, aided speech discrimination, language test and speech analysis.Results: The results of this study revealed a statistically significant improvement in hearing thresholds and increase in speech intelligibility in the studied group. By comparing total language age with CI age there was 56.5% of cases have total language age less than CI age and 43.3% of cases have total language age equal and more than CI age.

Over-Underlay technique of myringoplasty.

Objective: To observe the success rate of Over-underlay technique of myringoplasty in patients with inactive tubo-tympanic type of CSOM. Study Design: Descriptive, Observational study. Setting: ENT Department Fauji Foundation Hospital Rawalpindi. Period: December 2018 to December 2019. Material & Methods: A total of 80 patients with inactive tubo-tympanic type of CSOM, from both genders, within age range of 15-45 years, having pure conductive hearing loss with an Air-Bone gap of not less than 15 dB were selected by convenient sampling technique. Patients having an active ear disease or previous history of ear surgery, an active sinus or URT disease, or any comorbidity were excluded from the study. Complete general and head-neck examination was done after taking history. Patients’ affected ears were examined under surgical microscope to see the drum perforation, condition of middle ear mucosa and the status of the ossicles. Hearing assessment was done by Pure Tone Audiometry through both air and bone conduction. Temporalis fascia graft myringoplasty was done in all these patients by over-underlay technique, and they were discharged on 5th post-operative day, and were followed up in ENT OPD after 3 weeks. Status of graft was seen under surgical microscope after removing the BIPP. After three months the patients were reviewed for graft status and hearing assessment. Successful outcome was taken as those patients in whom graft uptake was successful with complete closure of perforation, and secondly, closure of the Air-Bone gap by at least 10 dB. Data was analyzed by SPSS 19. Results: Mean age of the patients (n = 80) was found to be 30.8 Years. Gender distribution showed 57 (71.25%) Males and 23 (28.75%) Females with a M:F ratio of 2.5:1. Success rate was found significantly better among younger aged males. Graft uptake was successful in 74 (92.5%) of the patients. With respect to closure of A-B gap, post-operative mean difference in Air-Bone gap was found to be 9.6 dB ± 3.9 SD as compared to preoperative mean A-B gap of 28.5 dB ± 4.2 SD, thus a closure of A-B gap by 18.9 dB ± 2.4 SD. Conclusion: Over-underlay technique is found to be a successful technique for myringoplasty in terms of graft uptake and improvement in hearing thresholds in the patients with inactive tubo-tympanic type of CSOM.

Explaining better hearing in Norway: a comparison of two cohorts 20 years apart - the HUNT study

BackgroundThe hearing function at a given age seems to have improved in more recent born cohorts in industrialized countries. But the reasons for the improvement have not yet been explained.MethodsWe investigated the extent to which better hearing in Norway is attributed to modifiable risk factors by using representative demographic and audiometric data from two cohorts of the Trøndelag Health Study, HUNT2 (1996–1998) and HUNT4 (2017–2019). We estimated natural indirect effects using causal inference methods in order to assess whether cohort improvement in hearing thresholds (HTs) was mediated by occupational noise exposure, recurrent ear infections, smoking and education.ResultsThe improvement in HTs from HUNT2 to HUNT4 was 2.8 and 3.0 dB at low respectively high frequencies. Together all risk factors mediated this improvement by 0.8 dB (95% CI 0.7–0.9) and 0.8 dB (95% CI 0.7–0.9) respectively, corresponding to mediated proportions of 27 and 28%. Substantial mediation was specifically found for occupational noise in men and recurrent ear infections in women (mediated proportions of 11 and 17% at high frequencies, respectively).ConclusionsIncreased education, less occupational noise exposure, ear infections and smoking contributed considerably to better hearing in Norway the last two decades.

A Comparative Prospective Study to Evaluate Outcomes of Ossiculoplasty using Autograft Versus Synthetic Graft.

Chronic Otitis Media is the most common cause of hearing impairment with ear discharge with which patients report to any otologist. The aim of management in such cases is to provide a safe ear and restore the hearing by Tympanoplasty. Many materials have been used for ossicular reconstruction, including both biological and synthetic materials. Minimally destroyed ossicle can be utilized for Ossiculoplasty while in case of complete destruction of ossicles, synthetic materials may be used such as teflon, titanium, hydroxyapatite etc. To evaluate the outcome of Ossiculoplasty using autograft versus synthetic graft. A prospective study done using non-probability convenience method of sampling involving a group of 50 patients were subjected to Tympanoplasty with Ossiculoplasty. Intra operative decision was taken on the type of graft to be used for Ossiculoplasty and the patients were divided into two equal groups, A (autograft) and B (synthetic graft) of 25 each. The patients were thereafter evaluated post surgery at periodic intervals of 3, 6 and 12months. The improvement in hearing following surgery was significant (AB gap < 20dB) in the range of 72% in Group A to 84% in Group B of patients 12months after surgery. Also there was a 37% change in AC in Group A as compared to 40% in Group B, demonstrating marginally better improvement in hearing with synthetic graft as compared to autograft. The patients have significant improvement in hearing thresholds after ossiculoplasty with both autograft and synthetic graft. Teflon is an excellent alternative for ossiculoplasty when autologous incus is not available for use due to disease.

The stochastic resonance model of auditory perception: A unified explanation of tinnitus development, Zwicker tone illusion, and residual inhibition.

Stochastic resonance (SR) has been proposed to play a major role in auditory perception, and to maintain optimal information transmission from the cochlea to the auditory system. By this, the auditory system could adapt to changes of the auditory input at second or even sub-second timescales. In case of reduced auditory input, somatosensory projections to the dorsal cochlear nucleus would be disinhibited in order to improve hearing thresholds by means of SR. As a side effect, the increased somatosensory input corresponding to the observed tinnitus-associated neuronal hyperactivity is then perceived as tinnitus. In addition, the model can also explain transient phantom tone perceptions occurring after ear plugging, or the Zwicker tone illusion. Vice versa, the model predicts that via stimulation with acoustic noise, SR would not be needed to optimize information transmission, and hence somatosensory noise would be tuned down, resulting in a transient vanishing of tinnitus, an effect referred to as residual inhibition.

Characteristics of Chronic Suppurative Otitis Media (CSOM) patients who underwent tympanoplasty surgery at Sanglah General Hospital for the period 2017 - 2019

Background: One way to deal with deafness from Chronic Suppurative Otitis Media (CSOM) is middle ear reconstruction surgery known as tympanoplasty. The success of surgery is when complete eradication of the disease is possible as well as hearing improvement. This study aims to evaluate the characteristics of chronic suppurative otitis media patients who underwent tympanoplasty surgery at Sanglah General Hospital for the period 2017 – 2019.Methods: A retrospective descriptive study was conducted through secondary data from the medical records of CSOM patients who had undergone tympanoplasty surgery at Sanglah General Hospital in Denpasar during the January 2017 - December 2019 period. Variables assessed in this study were age, sex, address of residence, infected side, perforation surface area, CT-scan, culture, surgical findings, graft type and antibiotic therapy, post tympanoplasty tympanic membrane perforation condition, audiometry results before and after undergoing tympanoplasty. Data were analyzed using SPSS version 20 for Windows.Results: Most of the respondents were male (53.3%), aged 46 - 55 years (26.7%), and living in Denpasar (30.0%). Based on the ear side, the most infected were unilateral (53.3%) and the subtotal perforation surface area (78.3%). No visible abnormalities (40.0%) were the most cases on the CT-Scan, following by the Pseudomonas aeruginosa (21.7%) infection and surgical findings in the form of tympanic membrane perforation only (55.0%). Based on the 3 months post tympanoplasty condition, it was found that the perforation had closed (83.3%), normal audiometric results (38.3%), and a degree of improvement in the hearing threshold after undergoing tympanoplasty was found to be mostly 5-10 dB (48.3%).Conclusion: CSOM patients who underwent tympanoplasty surgery were mostly men, aged 46-55 years, unilateral, subtotal perforation, and no CT scan abnormalities. In comparison, the membrane perforation condition 3 months post tympanoplasty was closed, mild deafness before tympanoplasty, normal degree of deafness after tympanoplasty, and the average mean hearing threshold improvement was 5 - 10 dB.

Clinical and audiological evaluation of post traumatic hearing loss

&lt;p&gt;&lt;strong&gt;Background&lt;/strong&gt;: Post traumatic hearing loss is one of the most common problems encountered among trauma victims. It can manifest as conductive, sensorineural or mixed hearing loss. It is against this background that the study evaluated the clinical and audiological outcome of 47 patients of trauma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods&lt;/strong&gt;: A descriptive longitudinal study was conducted over a period January 2017 to March 2018. Follow up was done after 3 months of discharge. Study consisted of 47 patients presenting with features of trauma related injuries. After carrying out systematic clinical, audiometric and radiological evaluation, patients were managed conservatively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results&lt;/strong&gt;: Of the 47 patients studied, 89.98% were related to road traffic accidents (RTAs); and 76.60% were under the influence of alcohol at the time of trauma. Among the 32 cases of the RTAs involving two wheelers, 29 patients (90.62%) were not using protective devices like helmet. Nearly 90% of patients had temporal bone fracture. Audiological evaluation confirmed hearing loss in 77% of patients at presentation. There was significant improvement of hearing thresholds with 51% attaining normal hearing at follow up with conservative management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions&lt;/strong&gt;: Post traumatic hearing loss was very common, conductive hearing loss being the most common type. It resolved over a few days to few weeks post injury. Timely diagnosis and management with early steroid therapy showed encouraging results for patients with traumatic sensorineural hearing loss or mixed hearing loss.&lt;/p&gt;

Cochlear Implantation Outcomes in Post Synaptic Auditory Neuropathies: A Systematic Review and Narrative Synthesis.

To establish outcomes following cochlear implantation (CI) in patients with postsynaptic auditory neuropathy (AN). Systematic review and narrative synthesis. Databases searched: MEDLINE, PubMed, EMBASE, Web of Science, Cochrane Collection and ClinicalTrials.gov. No limits placed on language or year of publication. Review conducted in accordance with the PRISMA statement. Searches identified 98 studies in total, of which 14 met the inclusion criteria reporting outcomes in 25 patients with at least 28 CIs. Of these, 4 studies focused on Charcot-Marie-Tooth disease (CMT), 3 on Brown-Vialetto-Van-Laere syndrome (BVVL), 2 on Friedreich Ataxia (FRDA), 2 on Syndromic dominant optic atrophy (DOA+), 2 on Cerebellar ataxia - areflexia - pes cavus - optic atrophy - sensorineural hearing loss (CAPOS) syndrome, and 1 on Deafness-dystonia-optic neuronopathy (DDON) syndrome. All studies were Oxford Centre for Evidence Based Medicine (OCEBM) grade IV. Overall trend was towards good post-CI outcomes with 22 of the total 25 patients displaying modest to significant benefit. Hearing outcomes following CI in postsynaptic ANs are variable but generally good with patients showing improvements in hearing thresholds and speech perception. In the future, development of a clearer stratification system into pre, post, and central AN would have clinical and academic benefits. Further research is required to understand AN pathophysiology and develop better diagnostic tools for more accurate identification of lesion sites. Multicenter longitudinal studies with standardized comprehensive outcome measures including health-related quality of life data will be key in establishing a better understanding of short and long-term post-CI outcomes.

The effect of using a PORP to reconstruct the ossicular chain under otoendoscopy with and without a malleus handle

Background There are many reports on the role of the malleus handle in ossicular chain reconstruction (OCR). However, the effect of the presence of the malleus handle is not clear. Aim/objectives To compare the hearing outcomes of using a partial ossicular replacement prosthesis (PORP) to reconstruct the ossicular chain under otoendoscopy with and without a malleus handle. Methods Records of 57 patients requiring OCR were retrospectively analyzed. They were divided into the malleus handle-present group (group 1) and the malleus handle-absent group (group 2). The audiometric results were analyzed pre- and postoperatively. A postoperative air-bone gap (ABG)≤20 dB was considered successful. Results The mean improvement in air conduction hearing thresholds was 19.80 dB in group 1 and 16.70 dB in group 2. The mean ABG improvement was 18.09 ± 12.79 dB for group 1 and 17.20 ± 16.44 dB for group 2. The malleus handle-present group achieved higher success (65.63%) than the malleus handle-absent group (52%; p> .05). Conclusions and significance Improvements in hearing outcomes were similar for the two groups. However, the malleus handle-present group showed a better reconstruction success rate. Our results suggest that if there is no lesion in the malleus handle, it is recommended to be retained.

Intratympanic dexamethasone injection for sudden sensorineural hearing loss in pregnancy.

BACKGROUNDAs sudden sensorineural hearing loss (SSNHL) rarely occurs in pregnant women, there is a lack of knowledge and relevant research on its management.AIMTo investigate the effect of intratympanic dexamethasone injection in the treatment of pregnant patients with SSNHL.METHODSA 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.RESULTSEleven 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.CONCLUSIONIntratympanic dexamethasone injections can be used as a first-line therapy in pregnant women with SSNHL.

Hearing Outcomes of Treatment for Acute Noise-induced Hearing Loss: A Systematic Review and Meta-analysis.

To determine the efficacy of various treatment modalities used for acute noise-induced hearing loss (aNIHL) from acute acoustic trauma (AAT) via a systematic review and meta-analysis. PubMed, Cochrane, and Scopus databases. The scientific literature was searched up to October 2018 for articles evaluating hearing outcomes after treatment of aNIHL. The following were extracted: Oxford level of evidence, number of patients, mean age, time to presentation, source of noise exposure, method of treatment/intervention, baseline hearing threshold, posttreatment hearing threshold, hearing gain, proportion of patients with no recovery, partial recovery, or complete recovery, and treatment complications. Sixteen studies with 932 patients met inclusion criteria for systematic review and four studies with 187 patients were included in the meta-analysis. Treatment modalities identified were steroids, vascular agents, nootropics, antioxidants, vitamins, cell apoptosis inhibitors, and hyperbaric oxygen therapy. Meta-analysis demonstrated significant improvement in mean hearing threshold for patients with high-frequency hearing loss, those treated within 48 hours, and those receiving treatment with a nootropic agent. Significant heterogeneity was present in experimental design among included studies and many were of lower levels of evidence. More prospective, large scale, randomized, double-blinded, placebo-controlled clinical trials are required to determine optimal treatment regimens for patients suffering from aNIHL caused by AAT.

Prevalence of cerumen impaction and associated factors among primary school children in Mwanza city, Tanzania

Background: Cerumen impaction is a worldwide problem constituting a significant proportion of health problems in many settings and its prevalence varies. There is a paucity of published data regarding this condition in Tanzania with none from Mwanza region. The aim of this study was to determine the prevalence of cerumen impaction and associated factors among primary school children in Mwanza City and to assess the effect of cerumen impaction and its removal on hearing ability&#x0D; Methods and Patients: This was a cross-sectional, community-based study of primary school children with cerumen impaction that was carried out in randomly selected primary schools in Mwanza City between December 2016 and May 2017. Multistage cluster sampling technique was employed to obtain a required number of the study population.&#x0D; Results: Out of the 406 participants, ninety-five (23.4%) had cerumen impacted in their ears. Of these, 56 (58.9%) were males and 39(41.1%) were females. The mean age at presentation was 11.24±8.86 years. Ear bud abuse (83.7%) was the most common predisposing factor for cerumen impaction. Cerumen impaction was found in the right ear of 9 (9.5%) patients and in the left ear in 31 (32.6%) patients and bilateral in 55 (57.9%) of patients. The major presenting symptoms were ear itching, otalgia, hearing loss and tinnitus. Ear syringing was used to remove cerumen impaction and caused significant improvement in hearing thresholds. There were no recorded complications.&#x0D; Conclusion: Cerumen impaction is a common otologic presentation in our sub-region. Ignorance with the profound abuse of cotton buds is the major predisposing factor. Health education is of the essence as treatment is simple and effective.

Comparison of middle ear function and hearing thresholds in children with adenoid hypertrophy after microdebrider and conventional adenoidectomy: a randomised controlled trial.

Microdebrider has superior efficacy in clearing the adenoids, compared to curettage. We compared the improvement in middle ear function and hearing thresholds after adenoidectomy, by both methods. 126 patients (median age-9years) were randomized into groups A and B, where adenoidectomy was done by microdebrider and curettage, respectively. Middle ear function parameters and hearing thresholds were measured serially. The mean improvement in middle ear pressure, compliance and hearing thresholds were 92.5 ± 67.6 and 84.2 ± 71.4 daPa; (p = 0.40), 0.19 ± 0.34 and 0.27 ± 0.27mL; (p = 0.07) and 3.20 ± 4.95 and 2.54 ± 3.98dB; (p = 0.27), in groups A and B, respectively. Reversal of type B tympanograms was noted in both groups. Middle ear function and hearing thresholds improved in both groups after adenoidectomy. More improvement was noted in the microdebrider group, which, however, was not significant.

“EFFECT OF ANTERIOR NASAL PACKING ON MIDDLE EAR FUNCTION AND HEARING: A PROSPECTIVE STUDY”

Introduction- The Eustachian tube provides an anatomic communication between the middle ear and nasopharynx, and maintains pressure equality across the tympanic membrane. Objective- To see the effect of anterior nasal packing on Otological symptoms, middle ear pressure and hearing Materials and method- This prospective study was carried out during period of September 2018 till August 2019. 100 ears were taken in the study. Middle ear pressure and hearing threshold were evaluated by Tympanometry and Audiometry respectively. Results- Postoperatively two days after anterior nasal packing, there was increase in no. of patient ears with ear fullness, ear ache, tinnitus, hearing threshold and abnormal negative middle ear pressure. After removal of nasal packing up to twelve weeks, improvement in middle ear pressure and hearing threshold was seen. Conclusion- Anterior nasal packing causes decrease in middle ear pressure and increase in hearing threshold. Key words- Eustachian tube, Middle ear pressure, Hearing threshold

Long-term Outcomes of Clip Coupler Implantation in Patients with Unilateral Congenital Aural Atresia.

To evaluate the long-term safety and efficacy of the Clip coupler attached to the stapes head in patients with unilateral congenital aural atresia (CAA). This single-center retrospective study included 16 Mandarin-speaking patients who had unilateral microtia accompanied by CAA. All patients were divided into two groups: the short-term follow-up group (n = 9) and the long-term follow-up group (n = 7). The floating mass transducer of the Vibrant Soundbridge (VSB) was positioned in the stapes head by the Clip coupler. The safety of the VSB was investigated by comparing preoperative and postoperative bone-conduction (BC) thresholds as well as by complications. The effectiveness was evaluated by functional gain (FG), word recognition score (WRS), speech reception threshold (SRT) and signal-to-noise ratio (SNR). Pre- and post-operative BC thresholds were no different in all patients. And no complications developed. VSB-aided thresholds in the free-field had improved significantly in both short- and long-term follow-up groups. The improvements of WRS were observed in two groups. The monosyllabic VSB-aided WRS in the long-term follow-up group was significantly higher than that in the short-term follow-up group. When speech was from the impaired ear and noise presented to the side of normal ear (SVSBNCL), lower SNRs were found in two groups after VSB implantation. However, there was no statistical difference in aided SNR between the two groups at SVSBNCL status. Our results show that the FMT connected to the stapes head is a secure and useful device for patients with unilateral CHL/MHL, not only in terms of improved hearing thresholds, but also improved speech intelligibility in quiet and noisy environments.

The efficacy of hyperbaric oxygen in the treatment of sudden sensorineural hearing loss

Objective:To investigate the therapeutic effect of hyperbaric oxygen on sudden sensorineural hearing loss（SSNHL）. Method:One hundred and seven patients with SSNHL were selected, and were randomly divided into 3 groups according to admission order. Therapeutic schedule in group A （38 cases） consisted of hyperbaric oxygen treatment once a day for 10 consecutive days, then 1 day off treatment, and on treatment for another 10 consecutive days （20 treatments in total）. Twenty-seven patients in group B were treated with hyperbaric oxygen twice per day for a total of 10 days. Forty-two patients in group C didn't receive hyperbaric oxygen therapy. Meanwhile, all patients were given conventional treatment for 14 days in accordance with the recommendations of the otolaryngology, head and neck branch of the Chinese medical association for the diagnosis and treatment of sudden sensorineural hearing loss. Patients in group A underwent pure tone audiometry after the end of treatment, and patients in group B and C were reexamined 20 days after the start of treatment, and the treatment efficacy of the three groups was compared. Result:The overall effective rate of group A was 78.9%, and the improvement of hearing threshold was（27.2±17.5） dB HL. In group B, the overall effective rate was 81.5%, and the improvement of threshold value was（26.9±16.7） dB HL. The overall effective rate of group C was 61.9%, and the improvement of threshold value o was（17.6±18.5） dB HL. The effective rate of group C was significantly higher than that of group A or B, while there was no significant difference in efficacy between group A and group B. Conclusion:The efficacy of hyperbaric oxygen combined with drug therapy for SSNHL is better than that of drug therapy alone. Programs of different hyperbaric oxygen combined with drug therapy can be selected on an individual basis.

Adjuvant Migraine Medications in the Treatment of Sudden Sensorineural Hearing Loss.

To examine the hearing outcomes of patients with sudden sensorineural hearing loss (SSNHL) treated with oral and intratympanic (IT) steroid only or a combination of steroid and migraine treatment. Our hypothesis was that adjuvant migraine medications may improve outcomes in SSNHL. A retrospective chart review at a tertiary otology center was conducted to identify patients with SSNHL who received oral steroid and IT dexamethasone injection(s) with or without migraine medications (a combination of nortriptyline and topiramate). A total of 47 patients received oral steroid and IT dexamethasone injection(s) only, and 46 patients received oral steroid and IT dexamethasone injection(s) as well as migraine lifestyle changes plus a combination of nortriptyline and topiramate. There were no significant differences in demographics and baseline audiometric data between the two groups. Both groups demonstrated improvements in pure tone average (PTA) and hearing thresholds at 250 Hz and 8000 Hz posttreatment. However, compared to steroid-only group, the adjuvant migraine medications group had significantly greater improvements in hearing thresholds at the lower frequencies (250 Hz, 500 Hz, 1000 Hz). Patients in the latter cohort also had greater improvement in PTA (P = .01) and received fewer IT injections (P = .04) PTA improvement of ≥ 10 dB was observed in 36 patients (78%) in the adjuvant migraine medications group and 22 patients (46%) in the control group (P < .001). In multimodal treatment of SSNHL, supplementing oral and IT steroid with migraine medications may result in greater improvements in lower frequency hearing thresholds and PTA. Furthermore, adjuvant migraine treatment can lead to decrease in number of IT injections, thus reducing procedure-related risks and complications. 3 Laryngoscope, 131:E283-E288, 2021.