Sudden Deafness Patients Research Articles

Prognostic changes after sudden deafness in patients with inner ear malformations characterized by LSCC: a retrospective study.

This study aimed to investigate the clinical features and prognosis of sudden sensorineural hearing loss in patients with lateral semicircular canal (LSCC) malformation. This study enrolled patients with LSCC malformation and sudden sensorineural hearing loss (SSNHL) who were admitted to Shandong ENT Hospital between 2020 and 2022. We collected and analyzed data on examinations of audiology, vestibular function, and imaging records of patients and summarized the clinical characteristics and prognosis of these patients. Fourteen patients were enrolled. Patients with LSCC malformation was noted in 0.42% of all SSNHL cases during the same period. One patients had bilateral SSNHL and the rest had unilateral SSNHL. Of them, eight and six patients had unilateral and bilateral LSCC malformations, respectively. Flat hearing loss was noted in 12 ears (80.0%) and severe or profound hearing loss was noted in 10 ears (66.7%). After treatment, the total efficacy rate of SSNHL with LSCC malformation was 40.0%. Vestibular function was abnormal in all patients, but only five patients (35.7%) had dizziness. There were statistically significant differences in the vestibular functions between patients with LSCC malformation and matched patients without the malformation hospitalized during the same period (p < 0.05). Patients with SSNHL and LSCC malformation had flat-type and severe hearing loss and worse disease prognosis compared to those with SSNHL without LSCC malformation. Vestibular function is more likely to be abnormal; however, there was no significant difference in vestibular symptoms between patients with and without LSCC malformation. LSCC is a risk factor for the prognosis of SSNHL.

Local vs Systemic Use of Steroids for Sudden Deafness with Diabetes: A Systematic Review and Meta-Analysis.

Diabetes is associated with a risk of idiopathic sudden deafness. The main treatment of diabetic sudden deafness is systemic and topical application of steroids. Topical steroid therapy reduces systemic adverse reactions compared with systemic therapy. The aim of this study was to conduct a meta-analysis design on the improvement value and recovery rate of pure tone mean hearing threshold (PTA).To investigate whether there is difference between local and systemic steroid treatment as the initial treatment for sudden deafness patients with diabetes. We searched databases from publication date to October 1, 2022 including PubMed, EMBASE, Cochrane Library, web of science, CNKI, Wan fang Database, China Biomedical Literature Database (CBM), and VIP information resource system. A systematic literature review was conducted on the efficacy and safety of local and systemic steroid therapy for diabetic sudden deafness. RevMan5.4 and stata14 software were used for Meta-analysis. A total of 23 studies were included in this study, covering 1777 patients, including 885 cases in the observation group (local steroid group) and 894 cases in the control group (systemic steroid group). Meta-analysis showed that there was a significant difference in the total effective rate of local and systemic steroid treatment for diabetic sudden deafness between groups (RR = 1.17, 95% CI = 1.11-1.22, P < 0.05). The effective rate in the observation group was higher than that in the control group. For the improvement of PTA, the difference between groups was statistically significant (RR = 6.60, 95% CI = 3.07-10.14, P < 0.05). The improvement of PTA in the local steroid group was higher than that in the systemic steroid group. Subgroup analysis showed that there were significant differences between groups in hormones, drug administration, follow-up time and course of disease. Topical steroid therapy is effective in the treatment of diabetic sudden deafness. Hormone methylprednisolone has high effective rate; the shorter the course of disease and the longer the follow-up time are, the higher the total effective rate will be. Tympanic injection is more effective than post-aural injection. Topical steroid injections are safer for hormonal side effect.

Analysis of coagulation state in sudden deafness patients with total deafness and vertigo

Objective:To analyze the coagulation status and prognosis of sudden deafness patients with total deafness accompanied by vertigo, and to provide basis for improving the treatment of this disease. Methods:From January 2017 to December 2020, 33 patients with total deafness and vertigo sudden deafness who were hospitalized in the Department of Otolaryngology Head and Neck Surgery, Hebei Provincial People's Hospital were selected as the research group. During the same period, 33 cases of low frequency type, full frequency type, total deafness and 26 cases of high frequency type were treated as control group.Thirty-three cases of inpatients without history of middle ear and inner ear diseases were treated as normal control group. The levels of fibrinogen（FIB）, D-Dimer（D-D）, Prothrombin Time（PT）, Activated Partial Thrombin Time（APTT） between the research group and the control group were analyzed, and the therapeutic effects of different types of sudden deafness patients were analyzed. Results:FIB and D-D of total deafness with vertigo were 2.50（2.11, 2.95）and 0.27（0.16, 0.51） respectively, which were higher than 2.31（1.92, 2.50） and 0.17（0.12, 0.21） of normal group. APTT was 25.2（23.1, 28.1）, lower than 27.3（26.4, 29.7） in the normal group, the differences were statistically significant（P<0.01）. ② FIB of total deafness with vertigo was 2.50（2.11, 2.95）, which was higher than that of low frequency group 2.37（1.81, 2.68）. D-D was 0.27（0.16, 0.51）, higher than low frequency group 0.16（0.12, 0.25）, high frequency group of 0.13（0.11, 0.23）, the whole frequency group 0.16（0.11, 0.28）, total of 0.18（1.45, 0.30）. APTT was 25.75±3.18/25.2（23.1, 28.1）, lower than 27.72±2.22 in low frequency group and 26.7（25.8, 28.7） in full frequency group, with statistical significance（P<0.05）. ③ The total deafness with vertigo group had the worst curative effect（ineffective rate was 63.6%）, and the low frequency group had the best curative effect（recovery rate was 75.8%）. The difference of curative effect among different types of sudden deafness groups was statistically significant（P<0.05）. Conclusion:Hypercoagulability and thrombosis may be one of the influencing factors of total sudden deafness. The hypercoagulable state of sudden deafness patients with total deafness and vertigo is more serious than that of total deafness and other types of sudden deafness, and the prognosis is the worst.

The association between the levels of autoimmune related indicators and clinical condition in sudden deafness patients

This study aimed to analyze the abnormal rates of immune related factors in serum of sudden deafness (SD) patients, and to discuss the correlation between these indicators and the degree of pathological changes of SD patients. From March 2018 to January 2021, 90 patients with SD who were hospitalized in Beijing Tsinghua Changgeng Hospital were enrolled as participants, and 60 healthy examinees served as the control group. Antinuclear antibody (ANA), anticardiolipin antibody immunoglobulin G (ACA-IgG), anticardiolipin antibody immunoglobulin M (ACA-IgM), and anti-β-glucoprotein (anti-β-GP) antibody were detected by enzyme-linked immunosorbent assay (ELISA). In the SD group, 43 participants were positive for ANA, while in the control group, only 9 participants were positive for ANA. The titer of antibodies was significantly higher in the SD group than in the control group. The differences in abnormal rates of ACA-IgG, ACA-IgM, and anti-β-GP antibodies between the SD group and control group were not statistically significant (P>0.05). The pathogenesis of SD is correlated with autoimmune factors to a certain extent. In the course of clinical treatment, in addition to vasodilation, neurotrophic therapy, and thrombolytic therapy, patients can also be approached from the perspective of autoimmunity, which may achieve more ideal treatment effects.

Genetic Susceptibility Study of Chinese Sudden Sensorineural Hearing Loss Patients with Vertigo.

To investigate the genetic causes of sudden sensorineural hearing loss (SSNHL) patients in China. This study focused on analyzing variations of coding sequence of common genes related to deafness, revealing the molecular pathogenesis of sudden deafness from a genomics perspective, discovering molecular markers associated with the onset of deafness, and then supplying prevention to high-risk populations, classifying disease according to accurate etiology, and choosing a much more precision therapy. We retrospectively analyzed the clinical characteristics of 51 patients diagnosed as SSNHL with vertigo treated in the Chinese PLA General Hospital. In this study, mutation screening of 307 nuclear genes and mitochondrial genome responsible for human or mouse deafness was performed on the 51 cases of unilateral sudden deafness patients with vertigo. We identified 51 cases of unilateral sudden deafness, including 2 cases of low-mid frequency hearing impairment, 18 cases of mid-high frequency hearing loss, 11 cases of flat-type hearing loss, and 20 cases of all frequency hearing loss. Among the 51 cases, 8 (15.69%) cases of GJB2 heterozygous variations, 1 (1.96%) case of GJB3 heterozygous variations, 5 (9.8%) cases of SLC26A4 heterozygous variations, 2 (3.92%) cases of COCH heterozygous variations, 14 (27.45%) cases of CDH23 heterozygous variations, 14 (27.45%) cases of OTOF heterozygous variations, 1 (1.96%) case of SLC17A8 heterozygous variations and 2 (3.92%) cases of KCNE1 heterozygous variations. No mtDNA gene variations were identified. SSNHL has some relationship with hereditary in Chinese population, but its complex genetic pathogenic mechanisms need further study.

Factors Affecting Intratympanic Corticosteroids Injection Therapy Results in Sudden Deafness Patients at Dr Mohammad Hoesin Hospital Palembang

Background. Sudden deafness is an emergency in the Ear Nose Throat Department, a subset of sensorineural hearing loss within a 72-hour window period and consists of a decrease in hearing of 30 decibels affecting at least three consecutive frequencies. The therapy given is corticosteroids, systemic corticosteroids or intratympanic corticosteroids injection, or both. The prognosis of sudden deafness depends on several factors. Patient with sudden hearing loss does not always have the same result in hearing improvement. This study was aimed to determine the factors that affect the results of intratympanic corticosteroid injection therapy in patients with sudden deafness.Methods. This study is an observational study with a cross-sectional design. The data were collected using medical records on 96 ears given intratympanic corticosteroid injection therapy at Dr. Mohammad Hoesin Hospital Palembang from July 2018 to February 2021.Results. From 96 ears conducted in the study, the improvement of therapeutic results on intratympanic corticosteroid injection in patients with sudden deafness was 72.9%. The study found factors that influenced the outcome of therapy, namely age (p=0.002), the onset of therapy (p = 0.003), and the use of a combination of systemic steroids (p=0.010). From the logistic regression test, it was found that the factors that most influenced the results of intratympanic corticosteroid injection therapy were young age 18-40 years (p=0.016) with (OR) 6.654 (CI95% 1.418-31.222) and therapy onset less than two weeks (p=0.027) with (OR) 3.108 (95% CI 1.134-8.515).Conclusions. The factors associated with the improvement in the outcome of intratympanic corticosteroid injection therapy in patients with sudden hearing loss were patient age and early onset of therapy.

Factors Affecting Intratympanic Corticosteroids Injection Therapy Results in Sudden Deafness Patients at Dr Mohammad Hoesin Hospital Palembang

Background. Sudden deafness is an emergency in the Ear Nose Throat Department, a subset of sensorineural hearing loss within a 72-hour window period and consists of a decrease in hearing of 30 decibels affecting at least three consecutive frequencies. The therapy given is corticosteroids, systemic corticosteroids or intratympanic corticosteroids injection, or both. The prognosis of sudden deafness depends on several factors. Patient with sudden hearing loss does not always have the same result in hearing improvement. This study was aimed to determine the factors that affect the results of intratympanic corticosteroid injection therapy in patients with sudden deafness.Methods. This study is an observational study with a cross-sectional design. The data were collected using medical records on 96 ears given intratympanic corticosteroid injection therapy at Dr. Mohammad Hoesin Hospital Palembang from July 2018 to February 2021.Results. From 96 ears conducted in the study, the improvement of therapeutic results on intratympanic corticosteroid injection in patients with sudden deafness was 72.9%. The study found factors that influenced the outcome of therapy, namely age (p=0.002), the onset of therapy (p = 0.003), and the use of a combination of systemic steroids (p=0.010). From the logistic regression test, it was found that the factors that most influenced the results of intratympanic corticosteroid injection therapy were young age 18-40 years (p=0.016) with (OR) 6.654 (CI95% 1.418-31.222) and therapy onset less than two weeks (p=0.027) with (OR) 3.108 (95% CI 1.134-8.515).Conclusions. The factors associated with the improvement in the outcome of intratympanic corticosteroid injection therapy in patients with sudden hearing loss were patient age and early onset of therapy.

Sudden deafness: a comparison between age groups

Objectives This study compared sudden deafness (SD) cases in 20-year age bands to investigate their causes and treatment outcome. Design Retrospective study. Study Samples 178 unilateral SD patients were divided into four 20-year age-groups, namely Groups I (aged 0–19 years, n = 6), II (aged 20–39 years, n = 33), III (aged 40–59 years, n = 63), and IV (aged 60–79 years, n = 76). Methods An inner ear test battery and/or serology assay were performed. Results Incidence of SD in relation to overall neurotological cases did not significantly differ among the four groups. Groups I and II showed two or three audiographic patterns, while Groups III and IV had six audiographic patterns indicating that the aetiology of Groups I and II may be of the same origin, while Groups III and IV had multiple aetiologies. The hearing improvement rate was significantly higher in Groups III (62%) and IV (62%) than in Groups I (16%) and II (33%). Conclusion SD inevitably affects individuals of all ages. Significant differences in the audiographic patterns and speculative causes may account for various outcomes of treatment in each 20-year age band. Those SD patients aged 40–59 and 60–79 years showed significantly better treatment outcomes than those aged 0–19 and 20–39 years.

Risks of tinnitus, sensorineural hearing impairment, and sudden deafness in patients with non-migraine headache.

Tinnitus and hearing impairment are prevalent among headache patients. This study aims to investigate the risk of tinnitus, sensorineural hearing impairment, and sudden deafness in patients with non-migraine headache. Participants included 43 294 patients with non-migraine headache (non-migraine headache cohort) and 173 176 patients with no headache of any type (control cohort) frequency-matched with respect to 10-year age interval and sex from the Longitudinal Health Insurance Database 2005 of the Taiwan National Health Insurance Research Database. The mean age of the non-migraine headache cohort was 28.4 ± 14.9 years, and 58.5% of this cohort was male. The incidence rates of tinnitus, sensorineural hearing impairment, and sudden deafness were compared between cohorts using the Kaplan–Meier method with the log-rank test. A Cox proportional hazard model was used to examine the association of tinnitus, sensorineural hearing impairment, and sudden deafness with non-migraine headache, with adjustment for all covariates. The combined risk of either tinnitus, sensorineural hearing impairment, or sudden deafness was higher in the non-migraine headache cohort than in the control cohort (adjusted odds ratio [aHR], 2.73; 95% confidence interval [95% CI], 2.62–2.84; p < 0.0001). Subgroup analysis showed that patients in the non-migraine headache cohort were at significantly higher risk of developing tinnitus (aHR, 3.05; 95% CI, 2.91–3.19; p < 0.0001), sensorineural hearing impairment (aHR, 1.89; 95% CI, 1.74–2.05; p < 0.0001), and sudden deafness (aHR, 2.14; 95% CI, 1.77–2.59; p < 0.0001) than were controls. In this population-based study, the risks of tinnitus, sensorineural hearing impairment, and sudden deafness were found to be significantly higher in patients with non-migraine headache than in those without headache.

Correlation study of peripheral blood inflammatory factors in patients with sudden deafness

Objective:The aim of this study is to compare the difference of inflammatory factors in peripheral blood between sudden deafness patients and normal people, and to evaluate the predictive value of inflammatory factors in hearing recovery of sudden deafness patients. Method:Seventy-two inpatients with sudden deafness and 19 healthy persons were included. At the beginning of treatment in our hospital, audiometry was performed and peripheral blood was collected. The levels of IL-1β, IL-6, IL-17α, TGF-β1 and TNF-α in peripheral blood were detected by ELISA. The treatment was intravenous steroid（not applied if patients with contraindication of systemic steroid application）+ intratympanic steroid injection+ microcirculation improvement or neurotrophic therapy+ hyperbaric oxygen. At the end of the treatment, audiometry was performed again. A total of 26 patients were collected to test the levels of inflammatory factors in peripheral blood again at the end of the treatment. Result:The mean levels of inflammatory factors IL-1β, IL-6, IL-17α, TGF-β1 and TNF-α in peripheral blood of patients were （2.66±9.57） pg/ml, （4.71±6.91） pg/ml, （19.33±32.27） pg/ml, （50 018.37±14 660.72） pg/ml, （1.52±2.40） pg/ml, respectively. And the level of these five inflammatory factors in normal persons were （3.61±9.82） pg/ml, （3.58±4.49） pg/ml, （11.64±13.29） pg/ml, （45 199.98±11 956.09） pg/ml，（1.09±1.08） pg/ml respectively. Statistical analysis showed no significant difference between these two groups. A total of 45 cases were effective（hearing threshold increased ≥15 dB） and 27 cases were ineffective（hearing threshold increased<15 dB）. There was no significant difference in the levels of inflammatory factors between the two groups. Among 26 patients with blood samples before and after treatment, the level of TGF-β1 after treatment was significantly lower than that before treatment. Conclusion:The levels of these five inflammatory factors including IL-1β, IL-6, IL-17α, TGF-β1 and TNF-αin peripheral blood could not predict the recovery of sudden hearing loss. The role of inflammation in the development of sudden deafness needs further confirmation. TGF-β1 may be involved in the development of sudden deafness.

Clinical characteristics and etiological analysis of sudden deafness patients with vertigo

Objective: To explore the possible causes and mechanisms of sudden deafness with vertigo. Methods: Between August 2016 and December 2017, 74 patients with sudden deafness and vertigo were hospitalized in the Department of Otolaryngology, First Affiliated Hospital of Sun Yat-sen University. Among them, 36 were male and 38 were female, aged 18-75 (40.5±6.5) years. According to the results of magnetic resonance imaging (MRI), the patients were divided into two groups: internal ear hemorrhage (IEH) and non-IEH (NIEH). The characteristics of deafness, vertigo, laboratory examination and follow-up results were compared between the two groups. Results: In IEH group, deafness and vertigo occurred simultaneously in 22 cases (84.6%), abnormalities of semicircular canal function, cervical vestibular evoked myogenic potential (C-VEMP), ocular vestibular evoked myogenic potential (O-VEMP) in 26 cases (100%) and benign paroxysmal positional vertigo (BPPV) in 10 cases (38.5%). The total effective rate was 19.2% (5/26) after 14 days of treatment, and 11 cases (42.3%) appeared disturbance after 180 days of treatment. The abnormal rate of lateral vestibular function, C-VEMP and O-VEMP was 69.2% (18/26), 53.8% (14/26) and 57.7% (15/26) respectively. The improvement of hearing threshold was (28.6±9.7) dB. In NIEH group, deafness and vertigo occurred simultaneously in 25 cases (52.1%). The abnormalities of semicircular canal function, C-VEMP and O-VEMP happened in 37 cases (77.1%), 34 cases (70.8%), 26 cases (54.2%), respectively, and 6 cases (12.5%) were of BPPV. The total effective rate was 52.1% (25/48) after 14 days of treatment. After 180 days of treatment, 8 cases (16.7%) were out of balance, and the abnormal rate of lateral vestibular function, C-VEMP and O-VEMP were 31.2% (15/48), 25.0% (12/48) and 20.8% (10/48) respectively. The improvement of hearing threshold was (42.5±10.3) dB. The incidence of stimulantous deafness and vertigo, vestibular dysfunction rate, BPPV incidence rate and the total effective rate after 14 days of treatment were significantly different between the two groups (all P<0.05). The vestibular and cochlear dysfunction in IEH group was more serious than that in NIEH group. After 180 days of treatment, the vestibular dysfunction rate, imbalance rate and improvement of hearing threshold in NIEH group were significantly higher than that in IEH group (all P<0.05). The recovery of vestibular and cochlear function in NIEH group was better than that in IEH group. Conclusions: Sudden deafness with vertigo can cause vestibular and cochlear dysfunction. Different etiologies may lead to different clinical features and prognosis. The vestibular and cochlear function damage caused by inner ear hemorrhage was more serious and the recovery effect was poor.

Brain network analysis for auditory disease: A twofold study

Tinnitus is the phantom perception of sound and can have negative effect on the quality of life. Sudden deafness is generally defined as sensorineural hearing loss of 30 dB or greater over at least three contiguous audiometric frequencies and within a three-day period, which is usually unilateral and can be associated with tinnitus. The exact pathogenesis of such auditory diseases is still unknown, and alterations in the functional connectivity of the brain network are suspected to involve one possible pathogenesis. Scalp electroencephalogram (EEG) analysis is a common approach to capture brain neural activity. This paper conducts a twofold study in terms of brain network analysis for auditory diseases based on EEG data. Specifically, the brain network is constructed in view of the phase lag index (PLI) between signals. The unsupervised study is first conducted via the unsupervised network community detection algorithm. The goal is to reveal the underlying characteristics of functional connectivity concerning subjects with and without auditory diseases from the brain network perspective. The second study is the supervised learning. A new strategy termed FBA (Features from Brain Areas) is proposed to abstract each brain network as a feature vector and the supervised classification method, i.e., Support Vector Machine (SVM) is utilized to perform the three-class classification concerning the regular control group, tinnitus patient group and sudden deafness patient group. Extensive experiments have been conducted on totally 146 subjects including 41 regular controls, 51 sudden deafness patients and 54 tinnitus patients. The results show the necessary of the unsupervised study that may shed light on the pathogenesis and the classification performed in the supervised study may serve as a portable detection method for auditory diseases.

Declining prevalence of pediatric sudden deafness during the past two decades

ObjectiveThis study compared the prevalence of sudden deafness (SD) in children to investigate the evolution of pediatric SD during the past two decades. MethodsFrom 1996 to 2005, totaling 358 SD patients were experienced. Of them, 25 patients (7%) aged <15 years were assigned to Group A. In contrast, 5 patients (2%) aged <15 years of 242 SD patients encountered during the period 2006–2015 were assigned to Group B. All patients underwent audiovestibular function testing. ResultsThe measles-mumps-rubella (MMR) vaccination reached to 95% vaccination rate in Taiwan after 1994. As 1994 (MMR vaccination years) + 11 (mean age of pediatric SD) equals 2005, this study found that declining prevalence of pediatric SD was from 7% (1996–2005) to 2% (2006–2015) at our hospital, consistent with declining annual cases of SD in Taiwan during the past decades. A significantly higher abnormality rate of mean hearing level (93%) than abnormal caloric responses (20%) was identified indicating that pediatric SD predominately affected the cochlear partition. ConclusionThe prevalence of pediatric SD cases has significantly declined during the past 20 years, probably due to global vaccination policy. Other causal factors such as growing numbers of hospital and advancement in radiological diagnostic technique may also contribute to the declining prevalence.

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.

Observation of Flupentixol and melitracen on curative effect of sudden deafness patients with anxiety and depression in different stages

Objective:To investigate the efficacy of flupentixol melitracen on different stages of sudden deafness patients with anxiety and depression.Method:Totally one hundred and sixty-three sudden deafness patients with anxiety and depression were randomly divided into two groups: experimental group(81 cases) and control group (82 cases). All patients were given routine treatment for 2 weeks. The experimental group was given oral flupentixol melitracen (1 tablet/day)for a period of 3 months. The hearing, tinnitus effect and vertigo treatment course were observed and compared. Curing rate of tinnitus at 2 weeks, 3 months and 6 months after treatment, self-rating anxiety scale (SAS) and depressive state scale (self-rating depression scale, SDS) score were collected and compared.Result:Total efficiency of hearing and tinnitus of experimental group(86.42%,84.21%)were higher than that of the control group(67.07%,61.29%);the vertigo cured the average treatment time of experimental group days was less than that of the control groupdays,all the differences were statistically significant.After treatment,the average hearing threshold value of the two groups of patients were lower than that before treatment,the low frequency descent type, high-frequency descent type,flat down type and total deafness type thresholds of the experimental group were lower than of the control group,all the differences were statistically significant.The tinnitus cure rate of experiment group were higher than the control group at 3months and 6 months after treatment,the differences were statistically significant;and after 3months and 6 months treatment tinnitus cure rate higher of the experimental group than that of after 2 weeks the treatment,the difference was statistically significant.After 2 weeks,3 months and 6 months treatment,the SAS and SDS scores of two groups were lower than that before treatment.The SAS and SDS scores of the experimental group decreased after 2 weeks,3 months and 6 months treatment, and the difference was statistically significant at different time points,the SAS,SDS scores of experimental group after treatment were lower than the control group at the same time,the differences were statistically significant.Conclusion:For the sudden deafness patients with anxiety and depression , the combination of flupentixol melitracen on the basis of conventional therapy can improve the clinical efficacy, the patient's mental status and long-term therapeutic effect of tinnitus..

The correlation between normal or abnormal vestibule function and prognosis of the low frequency sudden deafness

Objective:To study the correlation between prognosis and status of the vestibule functions with the patients of the low frequency sudden deafness (SD). Method:Eighty-eight patients with low frequency SD were enrolled in this study, the cervical vestibular evoked myogenic potential (cVEMP), the ocular VEMP (oVEMP) and caloric test were evaluated. Based upon the results of the test, patients were divided into 4 groups. A group has no abnormal test results, B group has one abnormal test results, C group has two abnormal test results,and D group has three abnormal test results. Calculating and comparing the effective rate and uneffective rate were conducted in every group after treatment. Result:In A group, the effective rate is 27.27%, the uneffective rate is 2.27%. In B group, the effective rate is 36.36%, the uneffective rate is 4.55%.In C group, the effective rate is 9.09%, the uneffective rate is 6.82%. In D group, the effective rate is 0%, the uneffective rate is 13.64%. The difference between effective and uneffective rate was significant in group A, B, and D, while, there was no significant difference in group C. Conclusion:The prognosis of low frenquency SD patients without abnormal test results or only with one abnormal test results is good. While, the prognosis of patients with three abnormal test is bad. The prognosis of patients with two abnormal test is not sure. The vestibule functions test can be used to determine the prognosis of low frequency SD in clinical treatment.

Intratympanic dexamethasone vesus post-auricular subperiosteal injection of methylprednisolone treatment for sudden hearing loss

Objective:To compare the efficacy and side effect between intratympanic dexamethasone and subperiosteal injection of methylprednisolone treatment for sudden hearing loss.Method:One hundred and eight unilateral sudden hearing loss patients were enrolled in this study, randomly divided into A group, which was accepted intratympanic dexamethasone (10 mg/ml) , and B group, which was accepted post-auricular subperiosteal injection of methylprednisolone (40 mg/ml) by every 3 days intotal 5 times. After 3 months follow-up, analysis of the differences of pure tone threshold, tinnitus handicap inventory (THI), dizziness handicap inventory (DHI), blood glucose between pretreatment and postreatment was made. Side effect such as perforation of tympanic membrane, infection of post-auricular skin was also observed.Result:①Both in A and B group, there was no statistical changes in total efficiency and pure tone threshold decrease (P> 0.05), whereas the pure tone threshold statistical change was observed in the low frequency sudden deafness between A and B group (P< 0.05). ②Both in A and B group, there was no statistical changes in THI (P> 0.05), whereas the THI statistical decrease was observed in the high frequency sudden deafness between A and B group (P< 0.05). ③There was no statistical change in THI both in A and B group (P> 0.05). ④Both in A and B group, there was no statistical changes in fasting plasma glucose between pretreatment and postreatment (P> 0.05). ⑤There was no patient who had gotten tympanitis or postauricular infection, although in A group, there were 2 patients had gotten perforation of tympanic membrane, but they all healed after the follow-up.Conclusion:Both topical injection of glucocorticoid can improve pure tone threshold and reduce the score of THI and DHI for sudden hearing loss patients. Intratympanic dexamethasone can reduce more score of THI for high frequency sudden deafness patients whereas subperiosteal injection of methylprednisolone can improve pure tone threshold more for low frequency sudden deafness patients. None of the two administrations elevate blood glucose, but intratympanic dexamethasone have the risk of perforation of tympanic membrane.

The analysis of systemic concomitant disease in sudden deafness patients

Objective:To investigate the clinical characteristics of patients with underlying disease in sudden deafness.Method:One hundred and seventy-three inpatients suffered from sudden deafness were included in this study. We analyzed the underlying disease of these patients retrospectively.Result:The underlying disease of sudden deafness patients mainly include atherosclerosis risk factors (hypertension, diabetes, hyperlipemia, hyperhomocystinemia, hyperuricemia) 79.8%, cervical vertebra disease 26.6%, ear disease 19.1%, thyroid disease 13.9%.Conclusion:The characteristics of underlying disease may plays a crucial role in pathogenesis and treatment in sudden deafness patients.

The influence of vestibular evoked myogenic potential and vestibular caloric test on the prognosis of sudden deafness

Objective: To explore the effect of vestibular evoked myogenic potential and vestibular caloric test on the prognosis of sudden deafness. Method:One hundred and seven patients with sudden deafness were enrolled in this study, the vestibular evoked myogenic potential(cVEMP ) and vestibular caloric test were evaluated(113 ears). Based upon the results of the tests, patients were divided into cVEMP normal and abnormal groups, vestibular caloric test normal and abnormal groups. The treatment effects were then compared between groups.Result: In seventytwo ears with normal cVEMP, the treatment of 42 ears is effective(58.33%); in fortyone ears with abnormal cVEMP the treatment of 12 ears is effective(29.27%); the difference in the treatment efficiency was significant between the two groups. In sixtyseven ears with normal caloric test, the treatment of 40 ears was effective(59.70%); and in fortysix ears with abnormal caloric test, the treatment of 14 ears is effective(30.43%); the difference in the treatment efficiency between the two groups was significant. Additionally, the treatment of 21 ears with both abnormal cVEMP and caloric test showed ineffective, while the treatment of 28 ears with normal cVEMP and caloric test was effective, which showed significant differences. Conclusion:The prognosis of sudden deafness in patients with normal cVEMP and caloric test is better than the patients with abnormal cVEMP and caloric test, indicating that the results of cVEMP and caloric test can be used to help determine the prognosis of sudden deafness in clinical treatment.

N-acetylcysteine as a single therapy for sudden deafness

Conclusion: Like NAC ameliorates hearing loss from acoustic trauma in the inner ear, NAC may also rescue hearing loss from sudden deafness confined to the inner ear.Objective: This study assesses the effect of N-acetyl-L-cysteine (NAC) as a single therapy for sudden deafness.Methods: Thirty-five sudden deafness patients with neither systemic disorders nor central signs in electronystagmography were treated with NAC alone and assigned to Group A. For comparison, another 35 sudden deafness patients treated by corticosteroids and plasma expander were assigned to Group B. There were no significant differences between the two groups in terms of age, sex, laterality, and pre-treatment mean hearing level. All patients underwent an inner ear test battery comprising audiometry, and ocular vestibular-evoked myogenic potential (oVEMP), cervical VEMP (cVEMP), and caloric tests.Results: Groups A and B did not significantly differ in the pre-treatment mean hearing level, and percentages of abnormal oVEMP, cVEMP, and caloric tests, indicating that the involvement severity of sudden deafness between the two groups was similar. However, Group A (43 ± 27 dB) showed significantly greater mean hearing gain than Group B (21 ± 28 dB), and Group A (91%) revealed better improved rate of hearing than Group B (57%).