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[ABSTRACT]OBJECTIVETo investigate the efficacy and the related complications of combinedpostauricular methylprednisolone injection and systemic therapy for profound idiopathic sudden hearing loss (ISSNHL). METHODSTotal of 60 patients with ISSNHLwho had received therapy from June 2014 to May 2015 in Beijing Anzhen Hospital affiliated to Capital University of Medical Science,were randomly divided into 2 groups,the systemic application group (30 patients): dexamethasone (DEX) was applied intravenously in dose of 10 mg×5 d, and the postauricular injection group (30 patients): methylprednisolone sodium suecinate was injected subperiosteally near the upper one-thirds of postauricular sulcus every day, 40 mg×5 d.All 60 patients received the same medications for 2 weeks to improve the hearing. Hearing and tympanic membrane were monitered before the injections and two weeks after the termination of injections. SPSS 16.0 software was used to analyze the data.RESULTSThe postauricular injection group: 23 of 30 ears had improvement of hearing. No related complications were reported. The systemic application group: 23 of 31 ears had improvement of hearing (P>0.05) No related complications were reported.CONCLUSIONCombined postauricular methylprednisolone injection and systemic medications therapy can be considered as is an effective therapy for profound idiopathic sudden hearing loss. It can avoid the side-effects of high dose systemic corticostemid treatment. For ISSNHL patients, postauricular methylprednisolone injection may be an appropriate treatment.
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[ABSTRACT]OBJECTIVETo investigate the change of fibrinogen, soluable intercellular adhesion molecules-1 (sICAM-1), soluable vascular cell adhesion molecule-1 (sVCAM-1) in the blood of elderly patients with sudden sensorineural hearing loss (SSHL) and the difference between different type of SSHL.METHODS40 elderly patients with SSHL were subdivided into different types according to the newest guideline of diagnosis and treatment of Chinese medical association.They were subdivided into two groups with or without comorbidities.The control group were made of 40 healthy elderly people.The expression of fibrinogen, sICAM-1 and sVCAM-1 in the blood serum were detected and statistically analysed.RESULTSThe expression of fibrinogen, sICAM-1 and sVCAM-1 in SSHL patients were higher than that of the control group with statistical significance.There is no significant difference between different types of SSHL,though significant difference were found between groups with and without comorbidities. CONCLUSIONThere is increased expression of fibrinogen, sICAM-1 and sVCAM-1 in elderly SSHL patients;microcirculation dysfunction may play an dominant role in the pathogenesis of elderly patients with SSHL.
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OBJECTIVES: Hearing loss, mainly a sensorineural hearing loss (SNHL), was frequently observed in patient with chronic renal failure. Although several causes and prevalence of this hearing loss had been proposed, the etiology and prevalence are still controversial. The purpose of the present study was another study to determine the prevalence, type and comparative degree of hearing loss in chronic renal failure according to various parameters. METHODS: Subjects for this study were 39 patients with hemodialysis and 10 chronic renal failure patients before hemodialysis. Pure tone audiometry was performed and pure tone average(PTA) was estimated. At same time, pure tone threshold were estimated at the range from 250 to 500(low frequency range), from 1000 to 2000(middle frequency range) and from 4000 to 8000 Hz(high frequency range). Significant hearing loss of PTA as well as the significant loss in pure tone threshold of each frequency range was defined when the loss of hearing ability was 25dB more than the normal value. The effect of alteration in age, sex, hemoglobin, lipid profile, duration of hemodialysis, underlying diseases and ototoxic drugs were evaluated. RESULT: 1) The main type of hearing loss was SNHL and it was asymptomatic and progressive. The prevalence of SNHL by means of PTA was 76% in the patient with chronic renal failure. The SNHL of high frequency range(89%), SNHL of middle frequency range(18%) and SNHL of low frequency range (45%) were observed on the basis of the pure tone threshold. 2) There was no significant difference of SNHL according to various parameters of sex, hemoglobin, lipid profile, BUN, and underlying diseases except age. 3) The patients under hemodialysis exhibited the more SNHL over all frequency ranges than those without hemodialysis and there was the more SNHL in patients of more than 2 years of hemodialysis and those of less than 2 years of hemodialysis 4) Furosemide was significantly ototoxic in patients with chronic renal failure. CONCLUSION: The type of hearing loss was mainly sensori-neural and high tone loss. The degree was slight to moderate. The prevalence was the higher than expected. Regular hemodialysis treatment seems to affect hearing loss during even 2 years of treatment. Therefore, hearing loss appeared to be related to the duration of hemodialysis. The more precise and regular audiometric monitorings were recommanded in hemodilalysis patients.