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.

[Evaluation of hyperbaric oxygen and pharmacological therapy in sudden hearing loss]. / Ocena wyników leczenia naglej gluchoty idiopatycznej z zastosowaniem terapii tlenem hiperbarycznym.

UNLABELLED: Treatment of idiopathic sudden hearing loss (SHL) is still a big problem for the otolaryngologists, due to the still unexplained etiopathogenesis of the illness. The aim of this study was to evaluate effectiveness of pharmacotherapy combined with the hyperbaric oxygen (HBO) in idiopathic sudden sensorineural hearing loss treatment. Patients who received HBO and medical treatment in the Department of Otolaryngology of Military Institute of Health Service and Warsaw Center for Hyperbaric Therapy and Wounds Treatment were studied. MATERIAL AND METHODS: Nine patients, with idiopathic sudden hearing loss--patients treated in 2007 year were studied. There were 5 women and 4 men involved in our study--mean age: 41 years old. Patients with sensorineural hearing loss of minimum 15 dB at 0.25-8 kHz and tinnitus were included in the treatment group. Improvement of hearing of minimum 10 dB at 0.25-8 kHz in pure tone audiometry and decrease in the intensity of tinnitus was considered as an improvement. RESULTS: Statistically significant difference in Pure Tone Audiometry results obtained before and after the treatment was noted in 500 Hz, 1 kHz, 2 kHz, 3 kHz, 4 kHz and 8 kHz. Statistically significant difference was noted in 500 Hz, 2 kHz, 3 kHz when treatment was started within 6 days since the acoustic trauma. No side effects of therapy were observed. CONCLUSIONS: Hyperbaric oxygen therapy is the unique method of increasing concentration of oxygen in the inner ear fluids thus facilitates the regeneration process. Hyperbaric oxygen therapy combined with steroids is an effective method of sensorineural hearing loss treatment. Important is to start the therapy quickly after hearing loss.

[Hemorrhage from stomach ulceration in chronically hemodialysed patient after planned tonsillectomy]. / Krwotok z wrzodu zoladka u chorego przewlekle hemodializowanego po planowej tonsillektomii.

We present a chronically hemodialysed patient who developed an acute throat hemorrhage after standard tonsillectomy, planned as a standard surgery for purulent tonsillitis being contraindication to kidney transplantation in this case. Hemorrhage diagnosed firstly as a local post tonsillectomy complication proved to be caused by in the acute stomach ulcer. In the discussion we present the differentiate diagnosis as well as procedures which should be undertaken in hemodialysed patients who develop acute hemorrhage episodes from upper respiratory tract after tonsillectomy.

[Assessment of betahistine dihydrochloride effectiveness in the treatment of disturbance of balance system, based on analysis of doctors and patients questionnaires results]. / Ocena zastosowania dichlorowodorku betahistyny w leczeniu zaburzen ukladu równowagi na podstawie analizy ankiet wypelnionych przez lekarzy i chorych.

In balance system assessment there is no single set of tests applicable for all patients. A comprehensive medical history plays a main role in balance assessment. Patients often describe the same disorders in different ways. The aim of our work was to analyze effectiveness of betahistine hydrochloride (Betaserc) treatment on vertigo, nausea, vomiting, tinnitus and progressive hearing loss basing on the medical assessment (interview) performed by doctors and patient's personal questionnaires as well as to collect and accumulate data about balance system disorders. We prepared questionnaires for both doctors and patients. The doctor's questionnaire was divided into three sections. In the first section we included questions about direct cause of visit at the doctor's office. Questions were covering problems regarding balance system disorders (difficulty to keep erect position), vertigo, tinnitus, hearing impairment and other problems. The second section of the questionnaire included assessment of treatment effectiveness through the first 14 days and on the 28th day (a control visit). A third section of the questionnaire was focused on estimation of intensity of balance system disturbances. Patient's questionnaire included everyday self observations of intensity of disturbances within the 14 days observation period. We analyzed data of 980 patients, of the age between 16 and 96 years (mean age--54.1). There were 57.8% females and 42.2% males. From the group of 980 patients we separated a group of patients under 40 and over 60 years of age for additional analysis. Having analyzed doctors questionnaires we noted that the most frequent cause of patients' visits were: vertigo--in 770 people (78.57%), tinnitus--in 708 people (72.24%), disturbance of balance system--in 612 people (62.45%), hearing loss--in 607 people (61.94%) and other problems--in 72 people (7.35%). Patients over 60 years of age described vertigo as rolling and falling (38.92%). Patients under 40 years of age described vertigo as a body rotation and they were able to indicate direction of rotating movement (53.78%) in this group balance disturbances were intensified by moving of the head (56.49%). Both doctors and patients noticed higher percentage of answers "none" and "minimal difficulty in everyday life" on 14th and 28th day of observation in all analyzed groups, especially in people under 40 years of age. Properly prepared questionnaire for doctors and patients is very helpful not only at initial interview but also at reviewing the current condition of patient as well as at monitoring effects of treatment. Aliments and symptoms self noticed by patients are more serious and troublesome than those noticed by doctors. Ailments linked to disturbances of balance system noticed by group of patients under 40 years of age are usually sudden and shorter in duration and more intensive than in group of patients over 60 years of age. Betaserc used in treatment of balance system disorders lessens the insensitivity of vertigo, gait disturbances and nausea/vomiting. It does not affect hearing loss or tinnitus. The first therapeutic goals are achieved (especially in patients under 40 years of age) after 14 days of treatment.

[Application of the fusafungine in perioperative period in patients after tonsillectomy]. / Zastosowanie fusafunginy w okresie pooperacyjnym u chorych po tonsillektomii.

The only treatment method in chronic palatine tonsillitis is the removal of tonsils (tonsillectomy). The study aimed at a clinical evaluation of postoperative fusafungine use in patients who underwent tonsillectomy. The study included 200 patients who underwent tonsillectomy for chronic palatine pyotonsillitis in the Otolaryngology Clinic of the Military Institute for the Health Services in Warsaw between 2000 and 2002. The patients were divided into two groups, each group including 100 patients: group I--patients who underwent tonsillectomy, including 67 females and 33 males, aged 16 to 52 (mean age 34.8), in whom fusafungine was used; group II--patients who underwent tonsillectomy, including 58 females and 42 males, aged 17 to 56 (mean age 36.1), who did not receive fusafungine. The subjects were observed during the first 14 days following the operation. The treatment was administered from the first day after the operation, by spraying 4 doses into the throat, 4 times a day, at 8.00 hrs, 12.00 hrs, 16.00 hrs and 20.00 hrs. The two groups were then compared in terms of: symptoms of sore throat, body temperature, swallowing difficulties, the course of healing, appearance of the pharyngeal mucosa, quality of life and general affection. Post-tonsillectomy fusafungine use was found to improve the patients' quality of life, appeases the sore throat and swallowing difficulties, decreases the need for general antibiotic therapy; the above results are statistically significant. Fusafungine was not found to influence body temperature, the appearance of the pharyngeal mucosa or the healing process.