Intermittent Tinnitus Research Articles

Treatment of neural deafness with prednisone

1. (1) Nineteen patients with neural deafness due to congenital syphilis and twenty patients with neural deafness of other origin have been treated with prednisone in gradually tapering dosage. Dosage was in general regulated according to the results of standard pure-tone air and bone-conduction audiometry, speech hearing threshold, and discrimination score, measured before, and at short intervals following the commencement of therapy. 2. (2) The neural deafness of congenital syphilis occurs late, often not until adult life. It is usually an isolated neurological finding without abnormalities in the cerebrospinal fluid. Its development and progression are not prevented by treponemicidal therapy, even with penicillin. It is almost always bilateral and usually of gradual onset, although there may be either sudden onset or sudden dramatic worsening. Episodes of vertigo and continuous or intermittent tinnitus are common. Hearing impairment is often fluctuant but, in the absence of effective treatment, inexorably progressive at a highly variable rate. The major difficulty is in discriminating speech. 3. (3) Objective improvement, often marked, occurred during the first month of prednisone therapy in ten of the nineteen congenital syphilitics, and was subsequently maintained. In three therapy was deliberately stopped, with no retrogression over periods of 40 months, 1 month, and 2 months respectively. In the nine without definite improvement progression may in some instances have been prevented. These results show that the neural deafness of congenital syphilis is not usually a purely degenerative process. 4. (4) In long-standing neural deafness of undetermined etiology prednisone therapy was in general unsuccessful. 5. (5) In sudden non-syphilitic deafness of neural type which is often unilateral and occurs with or without an apparent concomitant upper respiratory infection, prednisone therapy sometimes results in dramatic improvement and may be urgently indicated.

Tuberculosis of the middle ear and nasal passages; report of an unusual case.

TUBERCULOSIS of the middle ear is not common. It is, however, the second most frequent disease of tuberculous etiology seen by the otolaryngologist and should be suspected in any tuberculous person who develops painless otitis media.¹Tuberculous infection of the nose and nasal fossae has been said to be the rarest form of localized tuberculosis.²The finding of both of these conditions in a healthy, young adult appears to be extremely rare and prompted us to report this case. <h3>REPORT OF CASE</h3> A 28-year-old Negro woman, in her ninth month of pregnancy, was admitted to Letterman Army Hospital, on Nov. 24, 1953, because of facial palsy associated with otitis media. One month prior to admission, a sensation of fullness, without pain, accompanied by deafness and intermittent tinnitus, developed in the left ear. Penicillin was prescribed initially. Later the treatment was changed to oxytetracycline (Terramycin) and finally to