Profound Sudden Hearing Loss Research Articles

Efficacy of multimodality approach to sudden hearing loss.

This study aims to investigate whether addition of intratympanic steroid (ITS) to systemic steroid and hyperbaric oxygen (HBO) is effective in the treatment of sudden hearing loss (SHL). Between January 2008 and October 2011, 58 patients diagnosed with SHL were enrolled in the study. Twenty patients (11 males, 9 females; mean age 45.3±21 years; range 24 to 66 years) who received systemic steroid and HBO composed group 1, while 38 patients (19 males, 19 females; mean age 41.6±16 years; range 25 to 61 years) who received ITS in addition to systemic steroid and HBO composed group 2. Post-treatment hearing improvement was statistically significant in both groups in terms of the mean pure tone according to the Siegel's criteria (p<0.05). Treatment was successful at 55% of patients in group 1 and 63% in group 2. Despite increased success rate with the addition of ITS, it did not indicate statistical significance (p>0.05). However, there was a strong statistically significant difference in terms of profound hearing loss over 90 dB (p<0.05). None of six patients (0%) with profound hearing loss in group 1 benefited treatment, while addition of ITS to the treatment yielded success in six of 12 patients with profound hearing loss (50%) in group 2 (p<0.05). Addition of ITS to systemic steroid and HBO treatment may yield better results in patients with SHL. However, ITS injection seems beneficial for patients with profound SHL.

Magnetic resonance imaging-detected inner ear hemorrhage as a potential cause of sudden sensorineural hearing loss

PurposeThe aim of this study is to assess the value of magnetic resonance imaging in identifying the etiology of sudden sensorineural hearing loss, and to correlate the high signals in the labyrinth with clinical features to identify if inner ear hemorrhage could be implicated. Materials and methodsIn this retrospective study, inner ear magnetic resonance imaging was given to 112 patients with sudden sensorineural hearing loss in the First Affiliated Hospital of Sun Yat-sen University from 2011 to 2012. The clinical features of patients with high signals in the labyrinth on magnetic resonance imaging were analyzed. ResultsAbnormal magnetic resonance images were identified in 13 (11.6%) patients. Retrocochlear pathology was found in six patients, including two cases of lacunar infarction, one case of multiple ischemias in the brainstem and bilateral centrum semiovale, two cases of acoustic neuroma, and one case of inner ear hemangioma. There were seven cases showing high signals in the labyrinth on unenhanced T1-weighted and fluid-attenuated inversion recovery images. Clinical features of these seven patients were characterized by irreversible profound hearing impairment and vestibular dysfunction. These findings were consistent with the hypothesis that their symptoms were caused by an inner ear hemorrhage. ConclusionThe results indicate the importance of magnetic resonance imaging in sudden sensorineural hearing loss in patients. Moreover, patients with vestibular dysfunction and sudden profound hearing loss may have an inner ear hemorrhage evident by interpreting clinical and magnetic resonance imaging results.

Efficacy of Multimodality Approach at Sudden Hearing Loss

Objective: The etiological spectrum of sudden hearing loss is ample and ambiguous. The combined form of different treatment modalities geared toward the hypothetical etiologies given at once must work better theoretically . This study is a trial to see whether addition of intratympanic steroid to systemic steroid and hyperbaric oyygen treatment works better or not. Method: Prospective randomized study in a tertiary referral hospital. Fifty-eight patients who presented with sudden hearing loss between 2008 and 2011 were enrolled into the study. Twenty patients who had received systemic steroid and hyperbaric oxygen composed group I while 38 patients who had received intratympanic steroid in addition to systemic steroid and hyperbaric oxygen composed group II. Results: Posttreatment hearing improvement was statistically significant in both groups in terms of pure tone average according to Siegel’s criteria ( P &lt; .05). Treatment was successful for 55% of patients in group I and 63% in group II. Although there is an increase in success rate with the addition of intratympanic steroid, this was not statistically significant ( P &gt; .05). Regarding profound hearing loss over 90 dB, there seems a strong statistically significant difference. Treatment didn’t work in group I for a total of 6 patients (0%) while addition of intratympanic steroid to the protocol yielded success for 6 patients over 12 (50%) in group II ( P &lt; .05). Conclusion: Addition of intratympanic steroids to systemic steroid and hyperbaric oxygen yielded better results, but this was not statistically significant in general. However, intratympanic steroid injection seems beneficial for patients with profound sudden hearing loss.

Non-organic hearing loss in Chinese teenagers

Objective To heighten the physician's awareness of non-organic hearing loss in teenagers in China. Methods Retrospective cases review of seven patients (six girls and one boy) with sudden hearing loss was conducted. Results Five patients presented with hearing loss bilaterally and two patients unilaterally. All patients suffered from severe to profound hearing loss. However, the acoustic reflex test indicated direct and indirect responses were present bilaterally at 1000 Hz 100 dB SPL. The results of ABR test revealed hearing threshold within 20–30 dB nHL. Further investigations indicated non-organic hearing loss was associated with school stress or environment conflict. Satisfactory outcomes were achieved in all patients. Conclusion Non-organic hearing loss should be considered when teenagers present with severe to profound sudden hearing loss if the acoustic reflex is present. School and home stresses are associated with the occurrence of non-organic hearing loss in the present study.

メニエール病における偽ろう孔症状について 外耳道圧負荷平衡機能検査による検討

It is well known that pressure changes applied to the external auditory canal produce eye movements in some cases of Meniere, s disease (Hennebert's sign or pseudofistula sign). Theire influence on posture was studied by measuring the change in lateral body sway when a quantitatively regulated pressure load was applied to the external ear canal (PLT). A total of 82 subjects were sutudied by this method. Of these 47 suffered from Meniere's disease and 15 from sud-den profound sensorineural hearing loss; 20 normal subjects were served as controls. Our test results showed that 26 (55%) of the 47 patients with Meniere's disease showed a difference in PLT thres-hold between the right and left ears and only 3 (20%) of the 15 patients suffering from sudden profound hearing loss and 1 (5%) of the normal subjects exibited such a differece. In the patients with Meniere's disease, a statistically significant correlation was found between the PLT and low tone hearing level and also between the PLT and the flluctuation of hearing in the low tone range. The presence of a positive PLT provides usefull information not only about the site of the lesion but also about the stage of Meniere's disease.

Five Patients with Recurrent Vertigenous Attacks Subsequent to Profound Sudden Hearing Loss

Five patients with long term recurrent vertigenous attacks subsequent to profound sudden hearing loss were observed neurotologically and the related pathology was investigated.Characteristic findings were as follows;1) subjective; positional vertigo2) objective; direction changing positional nystagmus and marked canal paresis in the bithermal caloric test3) no fluctuating tinnitus or hearing loss; the cerebellopontine angle cystic arachnitis and broad vascular disorder including those in the central nervous system were assumed to be the etiology. Concerning the arachnitis, physiomechanical, inflammatory, and/or a hydrodynamic influence on the labyrinth via the perilymphatic system were seemed likely to occur.