Efficacy of Intratympanic Methylprednisolone Perfusion for the Treatment of Sudden Sensorineural Hearing Loss / 听力学及言语疾病杂志

Objective To investigate the efficacy of intratympanic methylprednisolone perfusion (IMP) for the treatment of sudden sensorineural hearing loss (SSNHL ) which failed to be fully responsive to conventional treatment .Methods The hearing outcomes of 87 patients with unilateral SSNHL were retrospectively analyzed .All of the patients received IMP after not fully responsive to conventional treatment of varying periods of time .They were hospitalized in our department between January 2008 and December 2012 and were followed up for at least one year to exclude recurrent hearing loss .Results The effective rate was 66 .67% and the mean PTA improvement was (18 .53 ± 13 .54)dB of the patients with the time interval between onset of symptoms and IMP within 15 days , 21 .21% and (5 .92 ± 15 .18)dB of the patients with the interval between 16 and 30 days ,4 .76% and (3 .69 ± 7 .00) dB of the patients with the interval more than 30 days respectively .The significant difference in the effective rates were compared among the three groups(χ2 =25 .91 ,P<0 .01) .Regarding to the PTA improvement ,the group with interval within 15 days was better than the other two groups(F=11 .182 ,P<0 .01) .A total of 30 cases acquired more than 15 dB hearing gain after IMP .One of them was hearing loss in low frequencies and the other 29 cases were hearing loss at all frequencies .The mean hearing gains of the 29 cases in 0 .25 kHz ,0 .5 kHz ,1 kHz ,2 kHz , 4 kHz and 8 kHz were 35 .17 ± 18 .15 dB ,35 .38 ± 15 .90 dB ,31 .28 ± 19 .74 dB ,21 .31 ± 17 .34 dB ,14 .97 ± 16 .00 dB and 13 .80 ± 16 .35 dB ,respectively .The mean hearing gains at lower three frequencies (0 .25~1 kHz)were better than those at higher three frequencies (2 k~8 kHz)(F=9 .494 ,P<0 .01) .Conclusion Receiving IMP earlier might help to acquire better hearing gain for the patients with SSNHL after not fully responsive to conventional treat‐ments .The hearing gains at the lower frequencies were better than those at the higher frequencies after IMP .

Relation between Stress-Related Hormone and Sudden Sensorineural Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The plasma stress-related hormonal [cortisol, growth hormone, prolactin, antidiuretic hormone (ADH), adrenocorticotropic hormone (ACTH)] levels have been reported to be elevated in sudden sensorineural hearing loss (SSNHL) patients. However, little is known regarding the mechanisms related with the elevation of stress-related hormonal levels in SSNHL. Therefore, we measured the level of plasma stress-related hormones in SSNHL patients and in normal persons to demonstrate the association between the stress-related hormones and SSNHL. SUBJECTS AND METHOD: Stress-related hormonal levels were measured from 68 patients who were diagnosed with SSNHL. These values were compared with the stress-related hormonal levels of 24 healthy control subjects. RESULTS: The plasma ADH levels was significantly higher in SSNHL group compared with that in their normal control group, as shown by their respective values, 4.46 [95% confidence interval (CI): 3.80-5.24 pg/mL] and 3.05 (95% CI: 2.34-3.98 pg/mL). The values for plasma cortisol, growth hormone, and ACTH levels whose values were 2.07 (95% CI: 1.65-2.61 microg/L), 0.20 (95% CI: 0.14-0.29 microg/L), and 12.79 (95% CI: 11.16-14.66 pg/mL), respectively, were significantly lower in the SSNHL group than those in the normal control group whose values were 7.86 (95% CI: 5.33-5.24 microg/L), 0.61 (95% CI: 0.36-1.04 microg/L), 18.48 (95% CI: 14.99-22.78 pg/mL), respectively. But there was no significant difference in prolactin between the two groups. CONCLUSION: This study demonstrates a possible role of stress-related hormones in the pathogenesis of SSNHL. However, only ADH level was higher than the control group. Furthermore, ACTH, growth hormone and cortisol levels were lower than the control groups. This means ADH, growth hormone, cortisol, ACTH levels are related with SSNHL. However, the impact of this hormone on the inner ear and endolymph homeostasis is still unknown. Further investigation is necessary to identify the action mechanism of these hormones in the inner ear.

The Expression of HDAC2 In PeripheraI BIood MononucIear CeIIs from Patients with Sudden SensorineuraI Hearing Loss / 听力学及言语疾病杂志

Objective To evaluate expression of HDAC2 in peripheral blood mononuclear cells(PBMCs)from glucocorticoid-resistant versus glucocorticoid-sensitive patients with sudden sensorineural hearing loss and identi-ty the relationship between the level of HDAC2 and glucocorticoid insensitivity.Methods PBMCs were collected from10 patients with deviation of nasal septum (control group)and 20 sudden sensorineural hearing loss patients be-fore and after intratympanic methylprednisolone for 10 days.We divided the SSNHL patients into 2 groups (GC sensitive group and GC insensitive group)according to their hearing recovery.Real time PCR and HDAC2 Assay Kit were used to detect the expression level of HDAC2 mRNA and HDAC2 activity in PBMCs.The data were analyzed with SPSS 17.0 software.ResuIts Before intratympanic methylprednisolone,the level of HDAC2 activity were sig-nificantly depressed in SSNHL patients,while the HDAC2 mRNA expressing much higher than the control group. The expression level of HDAC2 mRNA increased significantly after intratympanic methylprednisolone.The HDAC2 activity in GC sensitive group increased significantly.ConcIusion Knockdown of HDAC2 expression induces corti-costeroid in-sensitivity.Glucocorticoids can increase the expression of HDAC2 mRNA.HDAC2 activity can be down-regulated by post-translational modifications.