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<p><b>OBJECTIVE</b>To investigate the clinical characteristics and the effect of drug treatment for sudden hearing loss with vertigo or dizziness.</p><p><b>METHODS</b>In a prospective, randomized, single blinded randomized multicenter clinical study, patients with sudden deafness, ranging in age from 18 to 65 years old, with a duration less than 2 weeks, and with no any medical treatments were collected. In accordance with the hearing curve, those patients were divided into four types, i.e., low and intermediate frequency descent type; high frequency descent type; fall flat type; and total deafness type. Each type was treated by four different treatment options, according to the unified design of the random table, and randomly selected one of the options for treatment. The efficacy of the patients with sudden deafness with vertigo and dizziness was analyzed statistically after the follow-up for 4 weeks. SPSS 13.0 software was used to analyze the data.</p><p><b>RESULTS</b>In August 2007 to October 2011, 33 hospitals in the country included 1 024 patients with sudden deafness in line with the inclusion criteria, of whom 296 (28.91%) were accompanied by vertigo/dizziness symptoms, 126 were males and 170 were females, with an average age of (41.2 ± 13.5) years old. types of the different audiometric curves of sudden deafness, the occurrence of complete deafness with vertigo/dizziness was the highest (44.93%), followed by flat down type (25.87%), high frequency descent type (21.28%) and low intermediate frequency descent type (18.54%). After the standard treatment, the vertigo and dizziness symptoms of the sudden deafness patients could disappear, and the hearing in each group was obviously improved. The hearing curative effect on patients accompanied by vertigo/dizziness of low frequency and intermediate frequency descent type was the best, and the total efficiency can reach up to 94.74%, with the cure rate of 68.42%; followed by flat type, in which the total effective rate was 80.76%, with the recovery rate of 22.12%; and the effects on patients in high frequency descent type and total deafness type effect were relatively poor, in which the total effective rates were 70.00% (recovery rate of 10.00%) and 65.32% (recovery rate of 5.65%), respectively. The total effective rate of patients with sudden deafness associated with halo had no statistical significance (P > 0.05), in comparison to that of patients without halo; but, the cure rate of patients with no vertigo/dizziness of total deafness and the high frequency decreased patients with sudden deafness was significantly higher than that of vertigo/dizziness patients, with a statistical difference (P < 0.05).</p><p><b>CONCLUSIONS</b>The patients with sudden deafness in each type have a certain proportion of vertigo/dizziness, especially the deaf type. The possibility of hearing complete recovery in patients with vertigo/dizziness was significantly lower than that without vertigo/dizziness.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Audiometry , Dizziness , Therapeutics , Hearing Loss, Sudden , Therapeutics , Hearing Tests , Prospective Studies , Single-Blind Method , Software , Vertigo , TherapeuticsABSTRACT
OBJECTIVE To study the causes and mechanism of auditory neuropathy. METHODS Auditory neuropathy is characterized by the DPOAE being normal, the shape of the pure tone loss being mostly in low frequencies, but the ABR being absent or the threshold elevated disproportionally to the pure tone threshold. Patients were screened from the deaf patients through asking the ill history and taking the exams of pure tone audiometry, auditory brain stem response, distortion product of otoaccoustic emissions (DPOAE). Thirty six patients were met the above standard. Deparaffined sections of cochlea of the guinea pigs were used as antigens to test whether the sera of patients had the autoantibodies with immunofluorescence method. RESULTS In the total of 36 patients with this type of hearing loss, autoantibodies were positive in 31 patients(86.1%). Twenty of the 31 patients had autoantibodiesto connective tissue of osseous spiral lamina where the nerve fiber connecting the hair cells and spiral ganglion cells go through. The autoantibodies to capsula surrounding the spiral ganglion and inner ear nerve fiber was also seen in these patients. In additional 7 patients, the autoantibodies to spiral ganglion cell nucleus and inner ear nerve fiber was detected. In the 44 control persons, 9.1% of them have the autoantibodies to inner ear tissues(P
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75dB SPL or no response. RESULTS The individual differences of CM absolute amplitudes among the normal hearing ones at different frequencies are distinct, but bilateral CM amplitudes in same person are almost uniform and stable. Enlargedand prolongated CM was found in ears with loudness recruitment .Of 104 cases with unilateral hearing loss, CM were enlarged and prolongated at corresponding frequencies with loudness recruitment in 95 cases(91.3 %).The prognosis of cases with CM type Ⅰ was better than those with types Ⅱ and Ⅲ. The effective rates of treatment were 78.19 % in type Ⅰ , 2.5 % in type Ⅱ, and none in type Ⅲ. There were significant differences among them. CM was slightly enlarged during sleep, and the detected threshold of CM is less than that of the awake condition. CONCLUSION CM offers the reliable information for the mechanism of loudness recruitment and is also useful for understanding the relationship among loudness recruitment, cochlear microphonics and prognosis. CM may be taken as a valuable parameter for evaluating prognosis.
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OBJECTIVE To analyze for mutations of the PDS gene in patients with sensorineural hearing loss associated with enlarged vestibular aqueduct and analyze the molecular pathogenesis of enlarged vestibular aqueducts. METHODS Eighteen sporadic cases of large vestibular aqueduct syndrome and twelve control individuals with normal hearing were included in this study. Exons 6 and 9 of the PDS gene in all subjects were amplified by polymerase chain reaction and analyzed by direct DNA sequencing. RESULTS Analysis revealed 2 single base changes in exon 6 of one patient with large vestibular aqueduct syndrome. One was a G→C transversion at nucleotide position 611, and the other was a T→G transversion at nucleotide position 612, resulting in a predicted Gly→Ala substitution at position 204. No mutation in exons 6 and 9 of the PDS gene was found in the PDS gene of the control individuals. CONCLUSION Mutations of the PDS gene are responsible for the large vestibular aqueduct syndrome. Analysis of the PDS leftover sequence in patients with large vestibular aqueduct syndrome is the next step in elucidating the complicated causes of this disease.
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Objective To investigate the data of outpatient children,survey on the clinical characteristics of vertigo and provide baseline information for clinical diagnosis and treatment.Methods The questionnaires and clinical tests data of 553 children with vertigo were retrospectively analyzed.Results All the children and their parents received interviews,otological examinations and clinical audiological tests. Their ages were between 4 and 15,with the average at 9.51?2.83. ①The males were 341(61.66%) and female 212 (38.34%),with the gender ratio of male to female as 1.61:1. ②The peak of the age curves of treatment and the first onset of vertigo was 9.51 and 8.62-year-old,respectively. ③20.98% of children with vertigo had normal results with peripheral vertigo more common in the rest.④The semicircular canals were more likely to dysfunction if their relatives had vertigo or car sickness.Conclusion The age of children mostly with vertigo is between 6 and 11 years with more males than females. Vertigo itself can be a symptom but on the other hand,some show no positive signs even with vertigo.
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Objective:To investigate the relationship between hearing loss and acoustic neuroma(AN),the tests of pure tone audiometry,acoustic emissions impedance audiometry,audiometry brainstem response(ABR)and evoked otoacoustic emissions(EOAE)wee measured in 14 patients (16 ears)from March 1999 to December 2000.Methods:Fourteen patients (16 ears)with acoustic neuroma (8 males and 6 females,ranging in age from 21 to 72 years old)were diagnosed by CT or MRI scaning,and final confirmed by surgery and pathology.In the auditory tests ,efferent suppression test was curried out only in 4 ears with recordable emissions,promontory stimulation test (PST)was examined only in 5 ears with severe or profound deafness (hearing loss≥80dB SPL)who have no both measurable ABR and recordable EOAE.Results:It was found that 2 ears (12.5%,2/16)of the AN ears showed neural impairment,6 ears (37.5%,6/16)were cochlear impairment and 8 ears (50.0%,8/16)were cochlear-retrocochlear impairment.All of 4 tumors ears with EOAE emission have a disorders of efferent function.Conclusion:EOAE test had significant value for evaluation of the status of cochlear function (at the level of outer hair cells)in AN patients.The retrocochlear auditory nerve function of AN patients were evaluated by the tests of ABR combined PST which showed significant value.Results showed that the hearing impairment of AN have different levels of the peripheral auditory system according to auditory tests,including cochlear,eighth cranial nerve and efferent nerve level at the same or independently.