Assessing the Effectiveness of Different Hyperbaric Oxygen Treatment Methods in Patients with Sudden Sensorineural Hearing Loss.

INTRODUCTION: Hyperbaric oxygen therapy (HBOT) is one of the treatment methods in patients with sudden sensorineural hearing loss (SSNHL). It is recommended as an elective treatment in patients undergoing steroid therapy. According to current scientific reports, HBOT should be implemented within two weeks after the first symptoms. However, as far as the profile of HBOT is concerned, there are no straightforward recommendations. METHODS: The data obtained from the medical records of 218 patients undergoing HBOT for SSNHL at the Military Institute of Medicine-National Research Institute were analyzed statistically for the impact of the duration and the delay in implementing HBOT on the end results of pure-tone audiometry (PTA). RESULTS: A statistically significant hearing improvement in patients undergoing more than 15 cycles of HBOT was detected at all frequencies except for 1500 Hz; in the group reporting for treatment with a delay of more than 10 days, hearing improvement was statistically unsignificant at frequencies of 1500, 3000, and 4000 Hz. CONCLUSIONS: The statistical analysis showed that the urgent onset of HBOT could be a significant factor in the therapy of SSNHL.

Patogenesis of tinnitus in patients with post-COVID syndrome - preliminary report.

<b><br>Introduction:</b> Similarly to hearing loss and dizziness, tinnitus is a frequently reported complication of COVID-19 and remains the subject of numerous scientific reports. However, the exact impact of SARS-CoV-2 on the pathophysiology of tinnitus observed in post-COVID syndrome remains unclear. One suspected cause behind the development of vestibulocochlear symptoms is the inflammation of neural tissue triggered by SARS-CoV-2 infection.</br> <b><br>Aim:</b> The aim of this study was to analyze the results of Brainstem Auditory Evoked Potentials (BAEP) in the context of tinnitus development among patients diagnosed with post-COVID syndrome.</br> <b><br>Material and methods:</b> This retrospective study involved the analysis of BAEP test results of patients admitted to the Audiology Clinic of the Military Institute of Medicine at the National Research Institute and diagnosed with the post-COVID syndrome. The study compared the average latency values of waves I, II, III, IV, V, and intervals I-III, III-V, I-V. The statistical analysis of the obtained data was performed.</br> <b><br>Results:</b> Out of 18 patients (9 female, 9 male) with an average age of 54.22 years (9.65) diagnosed with post-COVID syndrome, tinnitus was identified in 5 individuals (27.78%). A statistically significant increase in wave V latency (5.98 vs. 5.63 [ms]; P < 0.05) and interval III-V (1.99 vs. 1.71 [ms]; P<0.05) was observed between the groups of patients with and without tinnitus.</br> <b><br>Discussion:</b> Study results analyzing BAEP changes in patients with post-COVID syndrome in the context of tinnitus are insufficient in current literature. The only available report linking post-COVID syndrome with sensorineural hearing loss demonstrated a statistically significant increase in latency values of waves III, V, and an increase in intervals I-III, III-V.</br> <b><br>Conclusions:</b> Tinnitus in patients suffering from post-COVID syndrome may be related to prolonged conduction of nerve impulses within the brainstem auditory pathway. Detailed pathophysiology of these changes requires further research.</br>.

The management of sudden sensorineural hearing loss during COVID-19 pandemic.

<b>Introduction:</b> The COVID-19 pandemic constituted a significant challenge for healthcare systems. Epidemiological restrictions led to deferral of healthcare and influenced the variety of symptoms reported by patients suffering from Sudden Sensorineural Hearing Loss.</br></br> <b>Aim:</b> The aim of the study was to compare the duration of treatment implementation and symptoms reported by patients suffering from SSNHL before and during the COVID-19 pandemic.</br></br> <b>Material and methods:</b> Patients admitted to the Military Institute of Medicine - National Research Institute for SSNHL treatment were included in a survey conducted between 01.10.2021-31.12.2021. Questions on symptoms reported, chronic conditions, timeframe between first symptoms and implementation of pharmacotherapy, and hyperbaric oxygen therapy were included in the survey. The results were compared with data obtained by the Team between 01.2017-12.2019.</br></br> <b>Results:</b> 34 patients (19 females, 15 males) of the average age of 46.3 who participated in the survey indicated a significantly delayed implementation of pharmacotherapy and hyperbaric oxygen therapy in comparison to population from before the pandemic (12.08 vs. 5.41 [days]; 17.5 vs. 8.29 [days]). The survey also showed differences in the number of symptoms reported.</br></br> <b>Discussion:</b> The differences in time of implementation of SSNHL treatment could have been related to pandemic restrictions which contributed to longer queueing for health benefits and fear of contact with health service. Differences in symptomatology point towards SARS-CoV-2 as a pathogenetic factor of SSNHL.</br></br> <b>Conclusions:</b> The COVID-19 pandemic significantly influenced the treatment of Sudden Sensorineural Hearing Loss. The study demonstrated a diverse symptomatology of SSNHL before and during the pandemic.

The use and effectiveness of the TRV Chair - a literature review.

<b><br>Introduction:</b> Vertigo is a subjective sensation of swaying, tilting, spinning, instability, or being off-balance [1]. The concept of vertigo is not a precise term due to the possibility of its being related to numerous variable, frequently co-occurring sensations as experienced by the patient. For this reason, diagnosing the origin of vertigo quite frequently poses a serious dilemma for physicians. Dizziness can be of peripheral or central origin. Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vertigo and is currently considered to account for about 14-42% of all cases of vertigo, depending on the authors [2-4]. However, this figure may be underestimated due to frequent misdiagnoses.</br> <b><br>Aim:</b> The aim of this paper is to review the currently available international literature on the use of the TRV chair so as to assess its usefulness and effectiveness in the diagnostics and possibly subsequent treatment of BPPV and its components.</br> <b><br>Materials and methods:</b> Included in this literature review are peer-reviewed papers authored by various research teams as available in PubMed, Google Scholar, and Scopus databases.</br> <b><br>Results:</b> The TRV chair is helpful in precise diagnosis and subsequent treatment of BPPV subtypes (canalithiasis and cupulolithiasis) as well as in the evaluation of the number of affected canals, as shown in the papers analyzed in this review.</br> <b><br>Conclusions:</b> The use of TRV in the context of diagnosis and therapy of benign paroxysmal positional vertigo presents with potential for the improvement of diagnostic results, management protocols, and patients' quality of lives.</br>.

The Influence of Steroid Therapy on the Treatment Results in Patients with Sudden Sensorineural Hearing Loss.

Oral, intravenous, or intratympanic steroid therapy (ST) are commonly applied methods of pharmacotherapy in Sudden Sensorineural Hearing Loss (SSNHL). There are vast discrepancies on the recommended initial dose and the duration of ST in medical reports. The aim of the research is a retrospective comparison of patients' examination results with different therapeutical strategies. The medical records of 218 patients treated for SSNHL at the Military Institute of Medicine were subjected to retrospective analysis by comparison of the results of pure tone audiometry prior to and after treatment with steroid therapy (first-dose delay, mass of first dose, duration of treatment). Postponement of implementation of ST to 5 days resulted in a significant improvement of hearing across all frequencies. The implementation of ST sequentially in periods (5th−10th day; >10th day) resulted in a statistically insignificant improvement of hearing in the following frequencies: 250 Hz, 1000 Hz, 1500 Hz, 2000 Hz, 3000 Hz, 4000 Hz. There was a statistical improvement of hearing within all frequencies analyzed for the initial dose of prednisone above 50 mg. For an initial dose below 50 mg, in 4000 Hz, the improvement of hearing was statistically insignificant. The research demonstrated a significant influence of steroid therapy on treatment results in patients with Sudden Sensorineural Hearing Loss.