ABSTRACT
Background and Objectives: Several treatments are available for sudden sensorineural hearing loss (SSNHL), but no studies have compared the different treatments based on the delay from the onset of the disease. Our study aims to compare the effect of hyperbaric oxygen therapy (HBOT), oral steroids (OS) and combination of both therapies (HBOT + OS) for treating SSNHL. Materials and Methods: This randomized study analyzed 171 patients with SSNHL. Patients were evaluated by pure tone audiometry test (PTA) at baseline (T0) and 20 days after treatment (T1). Three groups were available HBOT-A-, OS-B- and HBOT + OS-C-. After baseline PTA, patients were randomly assigned to each group. Statistical analysis was performed by one-way ANOVA and Chi-square. Results: Patients in the HBOT + OS and HBOT groups improved their auditory function (p < 0.05). HBOT was the best choice for treatment when started by 7 days from SSNHL onset, while HBOT + OS in case of late treatment. Profound SNHL recovered equally by HBOT and HBOT + OS (p < 0.05). Upsloping SNHL obtained better auditory results by HBOT compared to HBOT + OS (p < 0.05). Downsloping and flat SSNHL had the most improvement with HBOT + OS compared to HBOT only (p < 0.05). Conclusions: Combination of HBOT and OS is a valid treatment for SSNHL both in case of early and late treatment. Combination of HBOT and OS was the choice with the best results in case of treatment started >14 days from symptom onset.
Subject(s)
Hearing Loss, Sensorineural , Hearing Loss, Sudden , Hyperbaric Oxygenation , Humans , Hyperbaric Oxygenation/methods , Treatment Outcome , Hearing Loss, Sudden/drug therapy , Hearing Loss, Sensorineural/drug therapy , Steroids , Retrospective StudiesABSTRACT
Tapia syndrome is a rare complication after surgery, with ipsilateral paralysis of vocal cord and tongue due to extracranial involvement of recurrent laryngeal and hypoglossal nerves. Tapia's case report is extremely interesting for both the rarity of the reported cases and for the importance of an early rehabilitation. In a previous work, we reported a case of Tapia syndrome after cardiac surgery for aortic aneurysm, and the protocol of logopedic rehabilitation adopted. In the postoperative period, he developed severe dyspnea and dysphagia that required a tracheostomy and a logopedic rehabilitation therapy that led to a fast and efficient swallowing without aspiration after 47 sessions (less than 4 months). The progressive recovery of the function suggests aprassic nerve damage. However, the logopedic therapy is recommended to limit the possibility of permanent functional deficits and quickly recover swallowing and phonation.
Subject(s)
Myofunctional Therapy/methods , Paralysis/rehabilitation , Thyroidectomy/adverse effects , Tongue Diseases/rehabilitation , Vocal Cord Paralysis/rehabilitation , Humans , Paralysis/etiology , Postoperative Complications/rehabilitation , Recurrent Laryngeal Nerve Injuries/complications , Speech Therapy/methods , Syndrome , Tongue Diseases/etiology , Vestibulocochlear Nerve Injuries/complications , Vocal Cord Paralysis/etiologyABSTRACT
In this letter, we discuss possible alternatives and future perspectives in the therapy of Meniere's disease. Special attention should be paid to the role of dietary restrictions for glucose in patients with Meniere's disease, as there is a strong evidence about the presence of insulin receptors in the saccule, the main structure affected by pathological changes due to endolymphatic hydrops; to the possible use of endogenous antisecretory factor administered in specially processed cereals; and to the effects of low-dose intratympanic gentamicin, especially in patients with intractable Meniere's disease.
