Outcomes of Severe to Profound Idiopathic Sudden Sensorineural Hearing Loss

OBJECTIVES: While a severe to profound sudden sensorineural hearing loss (SSNHL) may cause serious disability in verbal communication, there have been little studies focusing on this high degree SSNHL. The present study was aimed to investigate the characteristics of hearing recovery in a high degree SSNHL (>70 dB). METHODS: Three hundred and two SSNHL patients were enrolled. For a long-term follow-up, 46 patients were evaluated. Hearing level was examined by pure tone audiometry on day 1, week 3, month 3, month 6, and year 1 or after. According to the degree of the initial hearing loss, the patients were divided into 4 groups from 70 to > or =100 dB. RESULTS: After 3 weeks, the recovery rate and mean hearing gain was 61%, 23.85 dB in the 70 dB group, whereas 10%, 6.61 dB in the > or =100 dB group. There was a significant correlation between 3-week recovery and final hearing outcome. However, there was almost no recovery after 3 months. CONCLUSION: An early recovery can be a prognostic factor for the final recovery in severe to profound SSNHL. Since recovery after 3 months is rare, an early hearing intervention like hearing aid or cochlear implantation should be considered in the high degree SSNHL to restore the patient's verbal communication.

A Case of Cochlear Implantation in Bromate-Induced Bilateral Sudden Deafness

Despite the well-established nature of bromate-induced ototoxicity, cochlear implantation after bromate intoxication has been rarely documented. We hereby present a case of a 51-year-old female deafened completely after bromate ingestion. Her hearing was not restored by systemic steroid treatment and hearing aids were of no use. A cochlear implantation was performed on her right ear 3 months after the bromate ingestion. In bromate intoxication cases, early monitoring of hearing level is necessary and other drugs with potential ototoxicity should be avoided. The outcome of cochlear implantation was excellent in this case of bromate-induced deafness.

The Diagnostic Value of Auditory Steady State Response in Patients of Idiopathic Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Sudden sensorineural hearing loss (SSNHL) is a medical emergency when an individual experiences at least 30 dB (decibels) of sudden SSNHL, occurring over a time period of three days or less. Pure tone audiometry (PTA) is by far the most widely used to diagnose SSNHL. Besides PTA, auditory steady-state response (ASSR) is also generally accepted to predict the hearing of SSNHL patients objectively and effectively. We analyzed correlation between ASSR and PTA in SSNHL patients, compared that with the corresponding data in non-SSNHL patients, and studied the usefulness of correlation between ASSR and PTA to forecast prognosis of SSNHL in clinical applications. SUBJECTS AND METHOD: We retrospectively analyzed the charts of SSNHL patients. We analyzed the correlation between the thresholds of PTA, ASSR, and audiotory brainstem response (ABR) in SSNHL, compared that with corresponding data in non-SSNHL patients. RESULTS: There was a very strong positive linear correlation between the average hearing threshold of ASSR and PTA among the non-SSNHL patients. Furthermore, there was relatively strong positive linear correlation between the average hearing threshold of ASSR and PTA among SSNHL patients. Also there was a normal positive linear correlation between the average hearing threshold of ABR and PTA among SSNHL patients. The average hearing threshold difference between ASSR and PTA among SSNHL patients was smaller compared with non-SSNHL patients, and this was statistically significant. CONCLUSION: There was a strong correlation between the average hearing threshold of ASSR and PTA among non-SSNHL & SSNHL patients. Compared to ABR, ASSR showed greater correlation with PTA in the SSNHL patients. We concluded that ASSR could be a useful diagnostic tool in SSNHL.

Osteoma of the Promontory Mimicking a Congenital Cholesteatoma

Osteoma of the temporal bone most commonly occurs in the external ear. Osteomas in the middle ear are not common, and only 25 relevant cases (18 papers) have been reported in the English literature. With only 5 cases reported to date, osteoma of the promontory in the middle ear is rare. This study reports a case of asymptomatic osteoma of the promontory in the middle ear mimicking a congenital cholesteatoma in a 4-year-old girl.