The effect of hemodialysis on hearing in chronic kidney disease patients – A systematic review

Hemodialysis as a treatment modality for Stage V chronic kidney disease (CKD) has significantly decreased mortality. However, there have been several studies reporting sensorineural hearing loss (SNHL) in these patients which affects their quality of life. The role of hemodialysis in its etiology has been widely debated and the strength of available evidence has not yet been evaluated. A systematic literature review was conducted to identify a possible association of hemodialysis to hearing loss and guide in making informed decisions in the management of CKD patients. Relevant articles from PubMed, ScienceDirect, EBSCO Medline, SCOPUS, Google Scholar, and Clinical Key were identified using Preferred Reporting Items for Systematic Review and Meta-Analyses framework. Studies that were published since the inception of the database to May 2020 and written in the English language were analyzed. A total of 36 articles on hemodialysis and sudden or SNHL were retrieved. Many were observational (13 cohorts, 10 case-control, seven case series, and six cross-sectional) studies involving 99,020 participants with ages ranging from 1 to 80 years. This review elucidates the occurrence of SNHL in CKD patients on hemodialysis. Yet, the available literature fails to provide conclusive evidence on hemodialysis as a causative agent for SNHL. Audiological assessment of all CKD patients before hemodialysis and regular follow-up may help in early diagnosis and better management of hearing loss

Intractable sudden deafness treated with acupuncture on the base of "heart housing the mind" / 中国针灸

Intractable sudden deafness is a kind of primary sudden deafness that is insensitive to the comprehensive treatment in modern medicine. Due to the close relationship between the ear and the "heart", combined with the characteristics of intractable sudden deafness, in the theoretic guidance of "the heart housing the mind", the acupuncture therapy for regulating the mind and nourishing the heart was introduced in treatment of intractable sudden deafness, the relevant theoretic evidences were explored and elaborated with the typical case.

Caloric Test as a Possible Prognostic Indicator in Sudden Deafness / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Dizziness has been known as a prognostic factor in sudden sensorineural hearing loss (SSHL), but it is difficult to describe and quantify its subjective symptoms. Also, dizziness itself cannot imply vestibular dysfunction in SSHL. Comprehensive evaluation of vestibular function may help us understand the extent of lesions in sudden deafness. The purpose of this study is to determine whether an impaired caloric response is associated with disease severity and hearing outcome. SUBJECTS AND METHOD: A retrospective chart review was conducted of 488 patients diagnosed as unilateral SSHL. The patients were divided into two, an abnormal caloric group (canal paresis >20%) and normal caloric group (canal paresis ≤20%). Initial demographic and audiologic findings and final hearing outcomes were compared between the two groups. RESULTS: The initial pure tone averages of SSHL patients of abnormal caloric group and normal caloric group were 75.4±28.4 dB HL and 68.2±25.4 dB HL (p=0.004), respectively. Patients of abnormal caloric test group showed worse hearing outcome across all frequencies compared to those of the normal caloric group. Also, a significant correlation was noted between the magnitude of hearing recovery and canal paresis (r=-0.223, p < 0.001). CONCLUSION: SSHL patients of abnormal caloric test showed worse initial hearing level and poorer hearing outcome. Evaluation of vestibular function in SSHL patients is important because subjective symptoms alone cannot account for vestibular hypofunction patients, and the caloric test can help in the counseling of patients and prediction of hearing outcome in SSHL patients.

Clinical study of dexamethasone acupoint Injection combined with conventional therapy for sudden deafness / 国际中医中药杂志

Objective To evaluate the efficacy of dexamethasone acupoint injection combined with conventional therapy for the paitents with sudden deafness. Methods A total of 72 patients with sudden deafness who met the inclusion criteria were randomly divided into 2 groups with 36 in each group. On the basis of conventional therapy, the observation group injected dexamethasone at acupoints; control group intravenous drip combined with oral dexamethasone. The average hearing threshold and the efficacy of symptoms between the 2 groups were compared. Results After treatment, the average hearing threshold of the observation group (49.64 ± 20.10 dB vs. 70.44 ± 21.60 dB, t=4.231), and the control group (49.25 ± 20.80 dB vs. 65.64 ± 22.30 dB, t=3.225) were both significantly lower than those before treatment (P<0.05), but there was no significant difference between the two groups after treatment (P>0.05). The effective rate of tinnitus was 85.3％ (29/34) in the observation group and 73.5％ (25/34) in the control group, and there was significant difference between 2 groups (Z=-2.109, P=0.035). The effective rate of ear fullness was 92.6％ (25/27) in the observation group and 82.8％ (24/29) in the control group, and the difference between the two groups was statistically significant (Z=-2.109, P=0.035). The effective rate of dizziness in the observation group was 92.9％ (13/14), whild the control group was 69.2％ (9/13), and the difference between the two groups was statistically significant (Z=-2.136, P=0.033). After treatment, the effective rates of the patients in the observation group of ≤7 days and >7 days were 90.5％ (19/21) and 66.7％ (10/15) respectively (Z=-2.162, P=0.031), while in the control group they were 73.9％ (17/23) and 46.2％ (6/13) respectively (Z=1.991, P=0.046). Conclusions The Dexamethasone acupoint injection combined with conventional therapy can effectively improve the accompanying symptoms such as tinnitus, ear fullness and vertigo in sudden deafness.

The curative effect and related influencing factors of hyperbaric oxygen combined with dexamethasone in the treatment of sudden deafness / 天津医药

Objective To analyze the curative effect and related influencing factors of hyperbaric oxygen combined with dexamethasone in the treatment of sudden deafness (SD). Methods The clinical data of 200 patients with SD, who were treated with hyperbaric oxygen combined with dexamethasone in our hospital from January 2014 to December 2016, were retrospectively analyzed.According to the curative effect,patients were divided into the effective group(n=182)and the ineffective group(n=18).Data of gender,age,time from onset to treatment,ears,hearing loss,the type of audiometric curve, dizziness, tinnitus, complications (hypertension or diabetes), plasma viscosity and serum C reactive protein (CRP) were compared between the two groups.Logistic regression analysis was used to screen risk factors influencing the curative effect of SD.Results The total response rate was 91.00%(182/200),and the ineffective rate was 9.00%(18/200).In the effective group patients aged > 50 years old, the time from onset to treatment was > 7 d, and the hearing loss was ≥ 60 dB. The proportions of high-frequency or stone-deaf audiometric curves, combined with dizziness, hypertension, diabetes, plasma viscosity ≥ 2 mPa·s and serum CRP level ≥ 20 μmol/L were significantly lower in the effective group than those in the ineffective group(P<0.05).Logistic regression analysis showed that age(>50 years old),time from onset to treatment(>7 d), hearing loss(≥60 dB), high-frequency or stone-deaf audiometric curves, combined with dizziness, hypertension, diabetes, plasma viscosity(≥2 mPa·s)and plasma CRP(≥20 μmol/L)were high risk factors for the curative effect of SD(P<0.05). Conclusion Hyperbaric oxygen combined with dexamethasone is an effective treatment for SD,but there are many factors affecting the curative effect. It is necessary to consider the clinical and pathological characteristics of patients in clinical treatment.

Comparison of the Short-Term Effect of Steroid Dosage Regimens in Patients with Idiopathic Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: For idiopathic sudden sensorineural hearing loss (ISSHL) patients, steroids are one of the most important therapies which are used to reduce inflammation in the inner ear. However, dosage regimens of oral steroid therapy have not been well established. This study aims to investigate the progression in recovery from ISSHL, and the optimal dosage regimen with steroids. SUBJECTS AND METHOD: We undertook a retrospective study of 149 patients diagnosed with ISSHL at our institution. We compared various clinical parameters such as age, gender, vertigo, tinnitus, the interval between disease onset and initial treatment, and severity of hearing loss. The 149 patients were divided based on their steroid regimens into two groups: group 1 (which received 40 mg of prednisolone in the morning and 20 mg at night) and group 2 (which received 20 mg of prednisolone three times daily). We then compared the results of group 1 with that of group 2. RESULTS: Recovery rates in group 1 (58/90, 64.4%) were significantly higher in ISSHL than those in group 2 (27/59, 45.8%). In particular, the complete recovery rates of Siegel's criteria in group 1 (35/90, 38.9%) were higher than those in group 2 (12/59, 20.3%). Therapeutic results were affected by the presence of tinnitus. Of the patients with tinnitus, 64.3% in group 1, and 43.9% in group 2 recovered. CONCLUSION: In the group treated with twice-daily regimens, greater hearing improvements were observed compared with the group treated with three times-daily regimens. These findings suggest that higher dose for a single administration may be an important prognostic factor.

Clinical Observation of Batroxobin in the Treatment of Senile Sudden Deafness / 中国药房

OBJECTIVE:To observe therapeutic efficacy and safety of batroxobin in the treatment of senile sudden deafness. METHODS:Totally 102 senile patients with sudden deafness were randomly divided into control group(51 cases)and observation group (51 cases). Control group was given routine treatment as Ginkgo biloba extract injection 105 mg+Dexamethasone sodium phosphate injection 30 mg+Methotrexate tablets 6 mg orally. Based on control group,observation group was additionally given Ba-troxobin injection 10 BU added into 0.9% Sodium chloride injection 100 mL intravenously,running out within 1 h,every 2 days, and then given 5 BU added into 0.9% Sodium chloride injection 100 mL intravenously,running out within 1 h. Both groups were treated for 10 d. Clinical efficacy,hearing recovery time,ear drowsiness disappearance time,dizziness disappearance time and tin-nitus disappearance time of 2 groups were observed. The levels of pure tone threshold,plasma specific viscosity(ns),high shear rate of whole blood viscosity(nbh),low shear rate of whole blood viscosity(nbl),hematocrit(HCT),erythrocyte sedimentation rate (ESR),Fb,endothelin (ET) and nitric oxide (NO) were observed before and after treatment as well as the occurrence of ADR. RESULTS:The total response rate of observation group was significantly higher than that of control group;hearing recovery time,ear drowsiness disappearance time,dizziness disappearance time and tinnitus disappearance time were significantly shorter than control group,with statistical significance(P0.05). After treatment,the levels of pure tone threshold,ns,nbh,nbl,HCT,ESR,Fb and ET in 2 groups were significantly lower than before;the observation group was significantly lower than the control group. The levels of NO in 2 groups were significantly higher than before;the obser-vation group was significantly higher than the control group,with statistical significance(P<0.01). During treatment,no obvious ADR was found in 2 groups. CONCLUSIONS:Based on routine treatment,batroxobin is effective in the treatment of sudden deaf-ness in the elderly,can effectively relieve the symptoms,improve the recovery of local blood flow and inner ear microcirculation disturbance with good safety.

Analysis of clinical effects of intratympanic injection of dexamethasone in treatment of sudden deafness in different time windows / 中国基层医药

Objective To investigate the clinical effect of intratympanic injection of dexamethasone in treatment of sudden deafness in different time windows.Methods 60 patients (60 ears) with sudden deafness were selected.Sixty patients were divided into control group and observation group according to the random number table method,30 cases (30 ears) in the control group and 30 cases (30 ears) in the observation group.The two groups were given systemic basic therapy, intravenous vinpocetine, alprostadil improve microcirculation, while hyperbaric oxygen therapy,12 days for a course of treatment, treatment for 2 courses.In the control group, dexamethasone was intravenously administered for 12 days.From the 7th day, dexamethasone was injected into the tympanic cavity and injected once every other day.The observation group was treated with dexamethasone at the same time.Injection of dexamethasone, treatment method and time were the same as the control group.At the end of the treatment, the clinical curative effect of the two groups was compared.The average hearing thresholds of the two groups were observed before and after treatment.The dizziness, tinnitus and hearing recovery time of the two groups were observed.Results The total effective rate was 96.67% in the observation group and 93.33% in the control group, the difference was not statistically significant (x2 =0.97,P> 0.05).After treatment, the average hearing threshold of the two groups was significantly improved (t=7.69,8.23,all P<0.05),the average hearing threshold of the observation group was higher than that of the control group, the average hearing threshold before and after treatment had statistically significant differences (t=2.34,2.67,all P<0.05).In the observation group, dizziness, tinnitus and hearing recovery time were shorter than those in the control group (t=3.32,3.14,3.67,all P<0.05).Conclusion The effect of dexamethasone combined with systemic treatment of sudden deafness in patients compared with intratympanic injection of dexamethasone after intravenous administration of dexamethasone is not significantly different, but the improvement of hearing threshold after treatment compared with the latter is obvious, and the average time to disappear symptoms is shorter than the latter, and therefore worthy of clinical promotion.

Curative efficacy of batroxobin combine with ginkgo injection in treatment of Sudden deafness and its effects on Serum ET、NO、SOD、sVCAM-1 / 中国生化药物杂志

Objective To study the effect of batroxobin combined with Yinxingdamo injection on serum endothelin(ET),nitric oxide(NO),superoxide dismutase(SOD),vascular cell adhesion molecule-1(VEGF-1)in patients with sudden deafness(SVCAM-1),to explore the best treatment for patients with sudden deafness.Methods Ninety patients with sudden deafness from June 2014 to June 2015 were recruited as the subjects of this study.The patients in control group were treated with batroxobin and batroxobin and ginkgo dipyridol.The levels of serum ET,NO,SOD,sVCAM-1,time of symptom recovery and the curative effect were observed.Results After treatment,the levels of ET,NO and sVCAM-1 in the observation group were significantly lower than those in the control group [(64.28±5.72)pg/mL vs(67.36±6.31)pg/mL,(43.08±9.53)μmol/(93.24±11.25)NU/mL](P<0.05).The results showed that there was no significant difference between the two groups.The recovery time of tinnitus,auria and vertigo in the observation group were less than those in the control group [(3.86±1.02)d vs(5.97±1.34),(5.03±1.24)d vs(7.37±2.01)d,(8.09±2.10)d vs 9.07±2.37)d](P<0.05).The total effective rate in the observation group was better than that in the control group(93.33％vs 75.55％,P<0.05).Conclusion Batroxobin combined with ginkgo dipyridolum injection can decrease the level of ET,NO and sVCAM-1,improve the level of SOD,and improve the microcirculation of the inner ear.Compared with the single effect of Batroxobin More desirable,worthy of promotion.

Evaluation on clinical efficacy of hyperbaric oxygenation in treatment of sudden deafness :A Meta-analysis / 吉林大学学报(医学版)

Objective:To evaluate the clinical efficacy of treatment of sudden deafness using hyperbaric oxygenation, and to provide guidance for its treatment. Methods:The studies about sudden deafness treated with hyperbaric oxygenation combined with drug were retrieved in Cochrane Library, PubMed , MEDLINE, Wanfang Database and CNKI up to July 2016.RavMan 5.3 provided by Cochrane was used for Meta-analysis.Results:Thirty-nine studies which were randomized controlled trials (RCTs)were included, a total of 4 599 cases,of which 2 418 cases received hyperbaric oxygenation therapy combined with drug treatment as treatment group and 2 181 cases received drug treatment alone as control group.A total of 36 studies about the comparison of clinical efficacy between treatment group and control group were included in the Meta-analysis, the result showed that treatment group had a significant clinical efficacy than control group(RR:1.26,95%CI:1.22-1.30,P<0.0001).A total of 6 studies about the improvement of the pure tone average(PTA)in the two groups were included in the Meta-analysis, the PTA gain was significant better in hyperbaric oxygenation group(WMD:11.8,95%CI:4.77-18.83,P<0.000 1).A total of 11 studies about the stage of using hyperbaric oxygenation therapy were included in the Meta-analysis, the result suggested that the early use of hyperbaric oxygenation therapy had better effect than the late use of hyperbaric oxygenation (RR:1.42,95%CI:1.31-1.53,P<0.000 01).Conclusion:The clinical efficacy of hyperbaric oxygenation combined with drug therapy is better than drug therapy alone, the PTA gain is significantly improved and the introduction of hyperbaric oxygenation therapy at the earlier stage shows better results.

Retrospective Observation of the Clinical Efficacy of Mouse Nerve Growth Factor in the Treatment of Unilateral Sudden Deafness / 听力学及言语疾病杂志

Objective To investigate the clinical efficacy of nerve growth factors in the treatment of sudden deafness.Methods A retrospective analysis was performed on 124 cases of hospitalized patients who suffered from unilateral sudden deafness from November 2013 to February 2015.The patients were divided into two groups: 59 in the treatment group and 65 in the control group.Each group was further divided into four subgroups according to different audiometric curves: the low-frequency declining type, the high-frequency declining type, the flat type, the completely deafness type.The control group: the patients were treated with the conventional therapy according to different audiometric curves.The treatment group: intramuscular mouse nerve growth factor treatment was added on the basis of conventional therapy mentioned above.The both treatments lasted 10 days.The total efficiency of two groups was compared ,and the efficiency of the subgroups was also compared.Results The total efficiency of the treatment group was 64.40% and 44.62% for the control group.The total efficiency of the treatment group was significantly higher than the control group.The analysis revealed as having statistically significant differences (x2=4.877,P=0.0320.05).Conclusion The mouse nerve growth factor has a positive effect on the treatment of sudden deafness, and has shown the acceptable clinical efficacy without side-effect.Thus the mouse nerve growth factor is a safe and effective drug for treating sudden deafness.

Clinical curative effect of sulfotanshinone sodium injection for treatment of patients with sudden deafness / 中国中西医结合急救杂志

Objective To explore the mechanism of sulfotanshinone sodium injection in treatment of patients with sudden deafness (SD).Methods Sixty patients with SD admitted to the Department of Otorhinolaryngology of Wuxi Traditional Chinese and Western Medicine Hospital from January to December 2016 were enrolled, and they were randomly divided into a study group and a control group (each 30 cases). The same basic treatment was given in the two groups, the patients in the study group were treated with sulfotanshinone sodium 40 mg intravenous (IV) drip, while the patients in the control group were treated with vinpocetine sodium chloride 20 mg IV drip, once a day for consecutive 14 days to complete a therapeutic course, and two courses were carried out in bothgroups. Before and after treatment, the changes of hearing threshold, indexes of hemorheology and immune function were compared between the patients in the two groups, and the clinical efficacy and adverse reactions in the two groups were observed.Results After treatment, the hearing threshold, hemorheology indexes, immune function index of CD8+ were significantly lower than those before treatment, while the CD3+, CD4+, CD4+/CD8+ ratio were significantly higher than those before treatment in the two groups, and the above changes of indexes were more obvious in the study group than those in the control group hearing [threshold (dB): 16.63±2.04 vs. 17.15±1.88, plasma viscosity (PV, mPa·s): 1.27±0.14 vs. 1.31±0.11, whole blood middle shearing viscosity (mPa·s): 4.77±0.33 vs. 4.95±0.28, whole blood high shearing viscosity (mPa·s): 3.86±0.25 vs. 4.00±0.31, erythrocyte aggregation index (EAI): 1.57±0.29 vs. 1.72±0.34, CD3+: 0.70±0.05 vs. 0.64±0.05, CD4+: 0.43±0.04 vs 0.37±0.03, CD8+: 0.32±0.04 vs. 0.34±0.03, CD4+/CD8+: 1.36±0.32 vs. 1.18±0.27]; the degree of whole blood low shearing viscosity (mPa·s: 6.72±0.80 vs. 7.01±1.13) and hematocrit (HCT: 0.38±0.04 vs. 0.40±0.03) decreasing weremore significant in the control group than those in the study group. The total effective rate was higher in study group than that in the control group [86.67% (26/30) vs. 83.33% (25/30)], but the difference between the two groups was not statistically significant (P > 0.05); the incidence of adverse reactions in the study group was markedly lower than that in the control group [3.33% (1/30) vs. 20.00% (6/30),P < 0.05].Conclusions Sulfot anshinone sodium injection can effectively enhance the SD patients' hearing, and improve their hemorheology indexes and immune function; the therapeutic results of sulfotanshinone sodium injection in safety and improvement in immune function are superior to those of vinpocetine sodium chloride injection.

Sordera aguda y ataxia de origen vestibular en paciente con meningitis por Meningococo Serogrupo C

La meningitis bacteriana aguda es una emergencia infectológica ya que puede ocasionar secuelas graves o incluso la muerte. Es rara la presentación de este cuadro con sordera súbita y ataxia. Se presenta el caso de una adolescente del sexo femenino de 14 años, que presentó meningitis bacteriana por meningococo serogrupo C con ataxia vestibular y sordera súbita, que fue tratada con corticoides y pentoxifilina, además de antibióticos para la infección de base. La recuperación de la audición no fue adecuada y persistió con sordera e hipoacusia severa unilateral y ataxia vestibular persistente e inhabilitante.

Acute bacterial meningitis is an infectious emergency as it can lead to serious sequelae or even death. The presentation of this condition with sudden deafness and ataxia is rare. We present the case of a 14-year old female adolescent, who presented with vestibular ataxia and sudden deafness and was subsequently diagnosed with bacterial meningitis due to serogroup C meningococcus. She was treated with corticosteroids and pentoxifylline, in addition to antibiotics, for the baseline infection. Hearing recovery was not adequate; she persisted with severe deafness, unilateral hearing loss and persistent and disabling vestibular ataxia.

Intratympanic corticosteroid for sudden hearing loss: does it really work? / Corticosteroide intratimpânico para perda súbita da audição: isso realmente funciona?

ABSTRACT INTRODUCTION: Sudden deafness is characterized by an abrupt hearing loss of at least 30 dB in three sequential frequencies in the standard pure tone audiogram over three days or less. Treatment is based on its etiology, and oral corticosteroids are widely used. Intratympanic corticosteroids are included as primary or secondary treatment when there is no improvement with the use of oral corticosteroids. OBJECTIVE: To determine the effectiveness of therapy with intratympanic steroids in sudden deafness. METHODS: A systematic review was performed of publications on the topic in the databases of PubMed/MEDLINE, with the keywords: sudden deafness, sudden hearing loss, and corticosteroids. RESULTS: Thirty scientific studies were analyzed. As to the objectives of the study analyzed, 76.7% sought to evaluate the use of intratympanic therapy salvage after failure to conventional treatment, and intratympanic therapy was used as the primary treatment 23.3% of the studies. CONCLUSION: Intratympanic corticosteroid therapy is prescribed primarily when there is failure of conventional therapy and when it is limited to use systemic corticosteroids, such as the diabetic patient.

Resumo Introdução: A surdez súbita é caracterizada por uma perda abrupta da audição de pelo menos 30 dB em três frequências sequenciadas no audiograma tonal de rotina ao longo de três dias, oumenos. O tratamento é fundamentado em sua etiologia e corticosteroides orais são amplamenteutilizados. A terapia com corticosteroide intratimpânico foi incluída como tratamento primárioou secundário nos casos em que não houve melhora com o uso de corticosteroides orais. Objetivo: Determinar a eficácia da terapia intratimpânica com esteroides em casos de surdez súbita. Método: Foi realizada uma revisão sistemática das publicações sobre o tópico no banco dedados Pubmed/Medline, com as palavras-chave: surdez súbita, perda súbita da audição e corticosteroides. Resultados: Foram analisados 30 estudos científicos. Com relação aos objetivos dos estudos analisados, 76,7% procuravam avaliar o uso da terapia intratimpânica em seguida ao insucesso com o tratamento convencional; a terapia intratimpânica foi empregada como tratamento primário em 23,3% dos estudos. Conclusão: A terapia com corticosteroide intratimpânico é prescrita primariamente nos casos de insucesso com a terapia convencional e quando há limitação para o uso de corticosteroides sistêmicos, como ocorre com o paciente diabético.

Clinical Characteristics and Hearing Results of Sudden Sensorineural Hearing Loss in Child / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Sudden sensorineural hearing loss (SSNHL) in children can occur just as can in adults; in fact, it may last throughout the entire life of a child, affecting the individual much more than when it does to an adult. As there are only a few studies that have focused on SSNHL in childhood, we investigated the clinical characteristics and hearing outcomes of pediatric SSNHL. SUBJECTS AND METHOD: A retrospective review of patients from November 2005 to May 2014 was carried out. Thirty nine patients under the age 15, who were hospitalized due to SSNHL were enrolled. Of these patients, 226 patients over the age of 15 were collected as a comparison group. Age, sex, underlying disease, site of hearing loss and duration from the onset to treatment were analyzed. We evaluated the overall recovery rate as well as the recovery rate according to accompanying diseases. RESULTS: Recovery rates were comparable between the pediatric and the adult group. Overall recovery rate was 60% in the pediatric group. Unlike for the adult group, dizziness and tinnitus were not a prognostic factor in the pediatric group. Pediatric patients showed similar overall recovery, whether the treatment initiation was under 7 days or more. Recurrence was seen in 3 patients, of which 2 showed complete recovery. CONCLUSION: The recovery rate for SSNHL was similar for the pediatric and the adult groups. A higher recurrence rate may alert clinicians to be aware of hearing changes after the recovery in pediatric patients.

Clinical Application of Hyperbaric Oxygen in Treatment of Idiopathic Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

Sudden sensorineural hearing loss is relatively common disease with unknown etiology. Although its etiology is unknown, it is thought to be a common pathway that leads to cochlear ischemia which leads to cochlear damage and hearing loss. Hyperbaric oxygen therapy is one of options for the treatment of sudden hearing loss which exposes patient with 1.5-3 fold sea level pressure of 100% oxygen which may reverse the ischemic condition of cochlea. According to previous studies, hyperbaric oxygen therapy is beneficial for restoring hearing level in sudden hearing loss patients especially when it is applied at early stage of onset, young age patient and profound hearing loss. Data from Asan medical center with 29 patients with idiopathic sudden sensorineural hearing loss shows 51.7% of good recovery rate after hyperbaric oxygen treatment. This treatment method however, also has minor complications and is very costly, practitioner should consider the cost-benefit before using this method.

Effect of ginkgo biloba injection combined with alprostadil on hearing recovery, immunoglobulin level and hemorheology indexes of patients with sudden deafness / 中国生化药物杂志

Objective To explore the effect of ginkgo biloba injection combined with alprostadil to hearing recovery,immunoglobulin level and hemorheology indexes of patients with sudden deafness.Methods 82 cases of sudden deafness patients collected in the first affiliated hospital of Wenzhou medical university from September 2015 to July 2014 were divided into control group(n=41) and experimental group(n=41) according to the random number table method.Control group were treated with 10μg alprostadil injection, added to 100 mL 0.9% saline infusion, intravenous drip, one time per day.Experimental group was given ginkgo biloba injection 20 mL, added to 500 mL 5% glucose intravenous drip on the basis of control group, one time per day.The clinical curative effect and hearing degree of recovery of two groups were observed after two weeks.Serum immunoglobulin A ( IgA ) , immunoglobulin G( IgG) , immunoglobulin M( IgM) levels were tested by automatic biochemical analyzer.The whole blood viscosity, plasma viscosity, red cell pressure product and red cell aggregation index were tested by blood viscosity analyzer.Results Two weeks after treatment, the total effective rate of experimental group was 92.68%, higher than 70.73% of the control group(χ2 =6.609,P=0.010).The tinnitus, aural fullness, vertigo and hearing recovery in experimental group was significantly higher than that of the control group, and the pure tone hearing threshold in experimental group was lower than the control group(P <0.05).After treatment, serum IgA, IgG and IgM levels were all decreased, and those indexes of experimental group were all significantly lower than those of control group(P<0.05).The whole blood viscosity, plasma viscosity, red blood cell hematocrit and red blood cell aggregation index were decreased, and those indexes of experimental group were all significantly lower than that of the control group( P <0.05).Conclusion The therapy of ginkgo biloba injection combined with alprostadil can reduce the tone of sudden deafness hearing threshold, promote the recovery of hearing, decreased in patients with immune globulin protein and hemorheology indexes, and improve clinical curative effect.

Association between poly-morphism of Ca2 + -ATPase isomer 2 gene in plasma membrane and sudden deafness / 重庆医学

Objective To investigate the association between polymorphisms of Ca2 + -ATPase isomer 2 gene (PMCA2) in plasma membrane and the development of sudden deafness .Methods Totally ,164 patients were investigated and hearing tests were conducted .According to the results of audiometry ,they were divided into two groups ,sensorineural hearing loss group(n= 82) and normal hearing group(n= 82) .Polymorphisms of two single nucleotide loci rs2289274 and rs6790640 in the PMCA2 gene were de-termined by polymerase chain reaction followed by allele specific amplication analysis .Results In the sudden deafness group ,fre-quencies of genotypes AA ,AG and GG in the rs2289274 locus were 55 .8% ,17 .4% and 26 .8% respectively ,while frequencies of al-leles A and G in the same locus were 64 .5% and 35 .5% respectively ;in the sensorineural hearing loss group ,were 26 .8% ,28 .0%and 45 .2% respectively ,while frequencies of alleles A and G were 41 .1% and 58 .9% .And ,in the sudden deafness group ,frequen-cies of genotypes CC ,CT and TT in the rs2289274 locus were18 .3% ,35 .4% and 46 .3% respectively ,while frequencies of alleles C and T in the same locus were 36 .3% and 63 .7% ;in the normal hearing group ,were 2 .4% ,63 .4% and 34 .1% respectively ,while frequencies of alleles C and T were34 .1% and 65 .9% ,respectively .Genotypes distribution of two sites and their allele frequencies of the two groups ,some differences of them had statistical significance(P< 0 .05) .Conclusion It is suggested that genetic polymor-phism of the rs2289274 and rs6790640 loci in the PMCA2 gene might be a susceptible factor for sudden deafness .

Sordera súbita: a la luz de la evidencia / Sudden deafness: in light of the evidence

La sordera súbita es una condición de hipoacusia neurosensorial aguda usualmente unilateral, de instalación en un período menor o igual a 72 horas, que en la mayoría de los casos es idiopática; sin embargo, causas infecciosas, autoinmunes y vasculares, se han propuesto como los principales mecanismos involucrados. La sordera súbita es considerada una urgencia otorrinolaringológica, sin embargo el tratamiento de ésta continúa siendo un tema controvertido.

Sudden deafness is usually a condition of acute unilateral sensorineural hearing loss, installation less than or equal to 72 hours period, which in most cases are idiopathic; however, infectious, autoimmune and vascular causes, have been proposed as key mechanisms involved. Sudden deafness is considered an ENT urgency, however this treatment remains controversial.