Siegel's Criteria Research Articles

Coenzyme Q10 in combination with steroid therapy for treatment of sudden sensorineural hearing loss: a controlled prospective study

To evaluate the therapeutic efficacy of coenzyme Q10 added to systemic steroid in patients with idiopathic sudden sensorineural hearing loss. A controlled prospective study. Asan medical center, University of Ulsan College of Medicine. Between August 2007 and October 2008, the first 60 patients diagnosed with sudden sensorineural hearing loss were managed with systemic steroid treatment for 2 weeks including 5-day hospitalisation. And the second 60 patients were managed with coenzyme Q10 for 2 weeks added to previous management. We evaluated auditory function by pure tone audiometry and speech discrimination score. Auditory evaluations were performed before and 3 months after treatment using Siegel's criteria. The degree of improvement in four-tone average hearing and speech discrimination score was calculated from the results before and after treatment. The total hearing improvement rate after the treatment was 75.0% (90/120 patients) in this study. Although 47 patients (78.3%) of coenzyme Q10 group showed better hearing improvement than 43 patients (71.7%) of control group, there was no significant difference. However, the coenzyme Q10 group showed significantly higher improvement in speech discrimination score. From this study, we suggest that coenzyme Q10 may have beneficial effects in the treatment of sudden sensorineural hearing loss.

Effect of steroid, carbogen inhalation, and lipoprostaglandin E 1 combination therapy for sudden sensorineural hearing loss

Purpose The purpose of this study was to evaluate the efficacy of combined therapy with steroid, carbogen inhalation, and lipoprostaglandin E 1 (lipo-PGE 1) treatment and compare the results with other treatment modalities in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). Subjects and methods The study group consisted of 670 patients diagnosed with unilateral ISSNHL. Two hundred patients (DCP group) were treated with steroid, lipo-PGE 1 and carbogen inhalation combination therapy, 194 patients (DC group) with steroid and carbogen inhalation, and 276 patients (D group) with steroid medication only. The therapeutic effects of the treatment groups were evaluated 2 months after treatment, using pure tone averages. Siegel's criteria for hearing improvement were used for the assessments. Results The overall recovery rate after treatment was 57.5%. For each group, the recovery rate was as follows: 67.0% in the DCP group, 52.6% in the DC group, and 53.9% in the D group. The DCP group had a significantly better improvement rate than the other 2 groups. In addition, the DCP treatment was better than the other 2 groups for patients: less than 50 years of age, with an initial hearing loss less than 90 dB HL, had treatment started within 1 week from the onset of hearing loss, had tinnitus or an ascending type audiogram, and/or had no vertigo. Conclusion Steroid, lipo-PGE 1, and carbogen inhalation therapy was more effective than the other treatment modalities studied for patients with ISSNHL.

How long should the sudden hearing loss patients be followed after early steroid combination therapy?

To evaluate the beginning time and the completion time of hearing improvement in patients with sudden hearing loss who were treated with combination therapy including oral steroid. From September 2006 to December 2007, 102 idiopathic sudden hearing loss patients who showed any 'recovery' in hearing according to the Siegel's criteria after treatment were analyzed. Pure tone audiometries were performed on the pretreatment day and on the third, seventh, fourteenth post-treatment day, and on the first, second, third, sixth post-treatment month. The time of initial hearing improvement and the completion time of hearing improvement were analyzed. Of 102 patients who showed any improvement, cumulatively, 93.1% showed beginning of hearing improvement within 14 days after treatment. Complete recovery or an end of change was achieved in cumulatively 80.4% of the patients within 1 month after treatment and in 92.2% of the patients within 2 months after treatment. Prognosis can be predicted approximately 2 weeks after start of treatment because time of commencement shows plateau after 2 weeks in improved cases. Hearing should be followed-up for at least 2 months after treatment in patients who show incomplete or delayed hearing improvement.

The Clinical Correlation between Anterior Inferior Cerebellar Artery and Sudden Sensorineural Hearing Loss

Background and Objectives The influence of anterior inferior cerebellar artery (AICA) loop on sudden sensorineural hearing loss (SSHL) remains controversial. The objective of this study was to evaluate the correlation between the anatomical type of AICA loop and SSHL. Subjects and Method We reviewed the medical records of 69 ears from 60 patients with SSHL between January 2005 and April 2008, retrospectively. AICA loops were classified according to the Chavda classification method by magnetic resonance imaging. According to the extension depth of the loop in the internal auditory canal, it was classified as type I, II and III. The loop was classified as S (small diameter) and L (large diameter) by comparing the thickness of the loop with adjacent facial nerves. Results The predominant type of AICA loop was type I (68.1%) and type S (78.3%). There was no significant correlation between the pretreatment hearing level, extension depth and diameter. There was also no significant correlation between the rate of hearing recovery by Siegel's criteria and diameter. However, there was significant correlation between the rate of hearing recovery by Siegel's criteria and the types of the extension depth (p

The Effect of Stellate Ganglion Block on the Treatment of Idiopathic Sudden Sensorineural Hearing Loss

Background: Idiopathic sudden sensorineural hearing loss (ISSNHL) is defined as a sensorineural hearing loss which develops abruptly without definitive causes. Stellate ganglion block (SGB) has been used as one of the treatment modalities in ISSNHL. However, published data establishing the effect of SGB has been slim. We conducted this study to evaluate the effect of SGB according to the factors that may influence the prognosis of the disease. Methods: We reviewed the records of 343 patients. The control group was managed with medications, and the SGB group was managed with SGB and the same medications. SGB was performed with 5 ml of 1.0% mepivacaine. The pure-tone audiogram was performed after the therapy and Siegel's criteria was used to define the recovery of hearing. Results: The recovery rate of the SGB group was higher than that of the control group (58.1% vs. 42.1%, P ＜ 0.05). The SGB group had a higher recovery rate than the control group in patients treated within 7 days from the onset of symptoms (66.9% vs. 44.1%, P ＜ 0.05), without diabetes mellitus (58.5% vs. 44.9%, P ＜ 0.05), without dizziness (61.6% vs. 44.6%, P ＜ 0.05), or whose initial hearing loss was between 71 and 90 dB (69.4% vs. 38.9%, P ＜ 0.05). Conclusions: SGB is thought to be a useful therapy for ISSNHL, especially in the patients treated within 7 days, without diabetes mellitus, dizziness, or whose initial hearing loss was severe.

Critical Thinking, Epistemic Virtue, and the Significance of Inclusion: Reflections on Harvey Siegel's Theory of Rationality

Among proponents of critical thinking, Harvey Siegel stands out in his attempt to address fundamental epistemological issues. Siegel argues that discursive inclusion of diverse groups should not be confused with rational justification of the outcome of inquiry. He maintains that epistemic virtues such as inclusion are neither necessary nor sufficient for rational judgment, and that if we are to avoid falling prey to relativism, criteria are needed to distinguish which of these virtues are indeed rational. However, the author argues that at least some of Siegel's own rational criteria cannot pass the “necessary or sufficient” standard by which he measures epistemic virtues. Moreover, reliance upon criteria fails to settle conflict in cases of disagreement over what constitutes authoritative evidence. Jürgen Habermas's theory of communicative rationality can help us to overcome this impasse, because it provides a nonrelativistic basis for justifying inclusion and giving it a place of priority in practical reasoning.

Rational Suicide and AIDS

One of the issues arising out of the increasing incidence of acquired immunodeficiency syndrome (AIDS) is whether or not suicide may be considered to be a rational choice for a person with AIDS. In an effort to address this dilemma, this article begins by reviewing the literature pertaining to suicide and persons with terminal illnesses. Then, after recounting the suicide rate for persons with AIDS, it explores some of the physical and psychosocial factors that may be a part of a decision by a person with AIDS to commit suicide. Siegel's criteria for a rational suicide are applied to the case of a person with AIDS. In addition, the role of the psychotherapist in the decision-making process is critically examined, as are some arguments against allowing suicide. Finally, suggestions for future directions by counseling psychologists are offered.