Intravenous dexamethasone for idiopathic sudden sensorineural hearing loss:clinical evaluation / 中国基层医药

Objective To investigate clinic efficacy of intravenous dexamethasone for idiopathic sudden sensorineural hearing loss.Methods Subjects received a 10-day dexamethasone(10mg/d) course.4-frequency(500,1000,2000,4000Hz) pure-tone averages(PTA) calculated using air conduction thresholds pre-treatment and post-treatment were compared.A clinically significant chanage in PTA was considered to be greater than 10dB HL.Results PTA of pre-treatment and post-treatment were(66.32?23.66)dB HL and(45.61?25.24)dB HL,respectively,in 40 patients with idiopathic sudden sensorineural hearing loss.There was significant improvement in PTA,P=0.000756.90% of patients showed improvement in hearing.Promising results were found with intravenous dexamethasone in cases with shorter time to treatment or/and without vertigo.Conclusion Intravenous dexamethasone can be beneficial in treating patient with idiopathic sudden sensorineural hearing loss.Prognostic indicators include time to treatment and vertigo.

Evaluation of Puretone Threshold Using Periodic Health Examination Data on Noise-exposed Workers in Korea / 예방의학회지

OBJECTIVES: This study was carried out to evaluate hearing impairment judgement and to investigate the differences in various diagnostic criteria for noise-induced hearing loss (NIHL) among workers who required for close observation (C). METHODS: Out of 731,029 workers who had taken the specific periodic health examination in 1994, we used the audiometric data on 37,999 workers (C) eliminating the employees who had previous otologic problems. Many investigators have being using different criteria for the evaluation of hearing impairment. In this study, we used the criteria of early (1989-1994), current, compensation for NIHL in Korea, 2-, 3-, 4-divided classification and hearing loss at 4,000 Hz and compared the evaluation results. RESULTS: The prevalences of C and workers who had occupational disease (D1) diagnosed for NIHL were 11.1 % and 0.44 %. There were significant difference in the prevalences of C and D1 depending on different province of Korea. Pure tone averages (PTAs) were not appropriately applied in their evaluation. 97% of workers whom we studied on were below the level of mild hearing loss judged by ISO standard. However, there were wide variations in the prevalence rate of mild hearing loss by diagnostic criteria. Thus, there were different judgements in determining the degree of NIHL depending on which diagnostic criteria were utilized. PTAs were found 20.54 (Rt) and 20.74 (Lt) when the method of 3-divided classification was applied for audiometric data. The degree of hearing impairment of the left ear was more severe than that of right ear. The prevalence of normal hearing threshold below 20 dB was 75.4% and the range of difference in both ear was below 10 dB. Right sided hearing threshold levels were 21.08 dB (500 Hz), 18.44 dB (1,000 Hz), 22.09 (2,000 Hz) and 52.36 dB (4,000 Hz). There was typical high frequency loss (C5-dip at 4,000 Hz) above 30 - 40 dB in normal hearing level. The increasing trend in hearing threshold level was gradually decreased by the increase of PTAs. The difference between PTAs and threshold at 4,000 Hz was about 10 dB. CONCLUSIONS: We could found that PTAs in the previous examination were not appropriately evaluated. This study revealed that they did not use unique criteria for managing the workers of NIHL. For the prevention of NIHL, it was found that the quality control on diagnosis and comprehensive management program were required, especially for those of hearing loss (C).

Effect of cigareet smoking on air-conduction hearing threshold level in adult men / 예방의학회지

To investigate the effect of smoking on the hearing threshold, l,887 adult male workers who visited health care center during the period l January 1996 - 31 July 1997 were selected. Air-conduction hearing threshold level, diastolic blood pressure(DBP), total cholesterol, fasting blood sugar(FBS), hematocrit and obesity, were measured. The data on age, occupation, and smoking were collected. Air-conduction hearing threshold in smoker was significantly higher than non-smoker in categories of 250, 500, 1000 and 4000 Hz(p<0.05). Mean values of PTA-low, PTA-mid, and PTA-high in smoker were also significantly higher than non-smoker(p<0.05). In multiple regression analysis, smoking is likely to play a significant role after controlling age, occupation, DBP, FBS, total cholesterol, hematocrit, and obesity,(p<0.05). The hearing threshold was significantly increased with increasing age(p<0.05), the manufacturing worker may have higher hearing threshold(p<0.05). The higher hematocrit and the more obese, the higher hearing threshold(p<0.05). However, DBP, total cholesterol and FBS were not significantly related with hearing threshold level. In conclusion, smoking was significantly related with the hearing threshold level in adult men.

Audiometric Changes after Ventilating Tube Insertion in Middle Ear Effusion / 대한이비인후과학회지

Audiometric and clinical findings of 90 patients(146 ears) who were suffered from otitis media with effusion and were treated by tympanostomy tube placement at KangNam General Hospital from Apr. 1994 to Jun. 1996 were analyzed. The results were follows; 1) Sex distribution shows 52 males and 38 females. Age distribution is 4 to 81, and fifty-one percent of them are younger than 9-year-old. 2) Pre-operative pure tone average was 27.1dB in air conduction and 20.6dB in air-bone gap. Post-operative pure tone average of air conduction and air-bone gap was average 12.6dB and 7.5dB at 13th day and 9.3dB and 5.6dB at 44th day after v-tube insertion, respectively. 3) For patients younger than 9-year-old, pre-operative average air conduction threshold was lower and air-bone gap was smaller than that of older age groups. But there are no significant difference of post-operative changes between younger than age of 9 and age between 10-19. 4) There are no significant differences among the groups with different nature of effusion in pre-operative hearing threshold. However the hearing threshold changes in air conduction and air-bone gap were larger in mucoid group than serous one. 5) There are no differences in the pre-operative hearing among the groups with different amount of effusion, but changes of post-operative hearing threshold was bigger in large amount group. 6) The incidence of post-operative otorrhea was 15%(22 ears) and its incidence was higher in mucoid group than serous one.

Association between air conduction hearing threshold and blood viscosity in normal adult males / 예방의학회지

This is cross-sectional study a potential relationship between air conduction hearing threshold and blood viscosity in normal adult males(n=1677). We measure hearing threshold in frequency level at 500, 1000, 2000, 4000Hz by pure-tone audiometry and RBC profiles contains red cell number, hemoglobin, hematocrit. Blood viscosity replaced by hematocrit that are one major factor of influencing blood viscosity. PTAs(pure-tone averages) measured by hearing threshold averages level at 500Hz, 1000Hz, 2000Hz by pure-tone audiometry. Grades of PTAs(pure-tone averages) are less then 10.0dB group, between 10.0-19.9dB group and excess 20.0dB. The results are significantly association among hematocrit, red cell number and hearing loss(age adjust by ANACOVA).