[Sudden hearing loss. Treatment with piracetam]. / Sordera súbita. Tratamiento con piracetam.

From January 1993 to December 1994, 9 patients (median age 40 years, range 29-71) were evaluated for sudden hearing loss at the Valme de Sevilla University Hospital, Spain. All had severe or profound initial hearing loss, which was bilateral in 3 (33%) cases. Total deafness affected 5 (41%) ears. All subjects were treated with a 3-day course of intravenous piracetam, 10 g/day diluted in 250 ml of saline solution and administered in a 15-minute intravenous infusion. No side effects occurred. The parameters examined were age, sex, side of lesion, contralateral hearing status, time from onset of symptoms to admission, vestibular symptoms, tinnitus, erythrocyte sedimentation rate, initial hearing loss, and audiogram configuration. After treatment, 6 (50%) ears showed improved hearing. Eight (89%) patients had vestibular symptoms, and 5 (55%) reported tinnitus.

[Sudden hearing loss and HIV infection]. / Sordera brusca e infección por el VIH.

A case is reported of left sudden hearing loss in a 29-year-old male with HIV infection and a history right sudden hearing loss 2 years earlier. The low frequency of sudden hearing loss in HIV+ patients is discussed. Neurosyphilis and cryptococcus infection were ruled out. The patient recovered his hearing in the left ear after three days of treatment with intravenous piracetam, 10 g/day.

[Structure and functioning of otorhinolaryngology specialized care in a hierarchical area]. / Estructura y funcionamiento de la atención especializada de otorrinolaringología en área jerarquizada.

The basis and the objectives of attention to patients of our specialty are studied within a hierarchical area, showing that paying more attention to the proximity of the patients residence and being integrated into the hospital setting achieves the best use of technical and human resources which leads to better medical care.