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Meng XD, Li TT, Deng LM. Therapeutic efficacy of methylprednisolone sodium succinate via diverse administration routes for mid- to high-frequency sudden sensorineural hearing loss. World J Clin Cases 2024; 12:3321-3331. [DOI: 10.12998/wjcc.v12.i18.3321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 04/24/2024] [Accepted: 05/08/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND Sudden sensorineural hearing loss (SSNHL), characterized by a rapid and unexplained loss of hearing, particularly at moderate to high frequencies, presents a significant clinical challenge. The therapeutic use of methylprednisolone sodium succinate (MPSS) via different administration routes, in combination with conventional medications, remains a topic of interest.
AIM To compare the therapeutic efficacy of MPSS administered via different routes in combination with conventional drugs for the treatment of mid- to high-frequency SSNHL.
METHODS The medical records of 109 patients with mid- to high-frequency SSNHL were analyzed. The patients were divided into three groups based on the route of administration: Group A [intratympanic (IT) injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection], Group B (intravenous injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection), and Group C (single IT injection of MPSS). The intervention effects were compared and analyzed.
RESULTS The posttreatment auditory thresholds in Group A (21.23 ± 3 .34) were significantly lower than those in Groups B (28.52 ± 3.36) and C (30.23 ± 4.21; P < 0.05). Group A also exhibited a significantly greater speech recognition rate (92.23 ± 5.34) than Groups B and C. The disappearance time of tinnitus, time to hearing recovery, and disappearance time of vertigo in Group A were significantly shorter than those in Groups B and C (P < 0.05). The total effective rate in Group A (97.56%) was significantly greater than that in Groups B and C (77.14% and 78.79%, χ2 = 7.898, P = 0.019). Moreover, the incidence of adverse reactions in Groups A and C was significantly lower than that in Group B (4.88%, 3.03% vs 2.57%, χ2 = 11.443, P = 0.003), and the recurrence rate in Group A was significantly lower than that in Groups B and C (2.44% vs 20.00% vs 21.21%, χ2 = 7.120, P = 0.028).
CONCLUSION IT injection of MPSS combined with conventional treatment demonstrates superior efficacy and safety compared to systemic administration via intravenous infusion and a single IT injection of MPSS. This approach effectively improves patients' hearing and reduces the risk of disease recurrence.
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Affiliation(s)
- Xiang-Da Meng
- Department of Otolaryngology, The First Affiliated Hospital of Qiqihar Medical University, Qiqihar 161041, Heilongjiang Province, China
| | - Ting-Ting Li
- Department of Otolaryngology Head and Neck Surgery, Harbin Medical University Affiliated Fourth Hospital University, Harbin 150001, Heilongjiang Province, China
| | - Li-Min Deng
- Department of Facial Ward, The First Affiliated Hospital of Qiqihar Medical University, Qiqihar 161041, Heilongjiang Province, China
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McGwin G, Owsley C, Vicinanzo MG. Teprotumumab Related Hearing Loss: A Large-Scale Analysis and Review of Voluntarily Reported Patient Complaints to the Food and Drug Administration (FDA). Ophthalmic Plast Reconstr Surg 2024:00002341-990000000-00405. [PMID: 38771914 DOI: 10.1097/iop.0000000000002668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2024]
Abstract
PURPOSE Accumulating case reports and series have suggested that teprotumumab may significantly increase the risk of hearing impairment that, in some cases, does not resolve. This study investigates the association between hearing impairment and teprotumumab use. METHODS A disproportionality analysis was conducted using the United States Food and Drug Administration Adverse Event Reporting System, a publicly accessible database used for postmarketing surveillance and research. All adverse event reports containing the terms "teprotumumab" or "Tepezza" and a similar comparison group from all patients with the same indications for teprotumumab use (e.g., autoimmune thyroiditis, endocrine ophthalmopathy, and hyperthyroidism) but who had not received the drug were selected. Hearing impairment events were identified using the hearing impairment Standardized MedDRA Query. RESULTS A total of 940 teprotumumab-associated adverse events were identified, including 84 hearing-related adverse events, with the first reported to the Food and Drug Administration in April 2020. A comparison group of 32,794 nonteprotumumab adverse events was identified with 127 hearing-related adverse events reported. Use of teprotumumab in patients with thyroid conditions was associated with a nearly 24-fold (proportional reporting ratio [PRR] 23.6, 95% confidence interval [CI]: 18.1-30.8) increased likelihood of any hearing disorder (p value <0.0001). The association was specifically elevated for a variety of deafness conditions (e.g., bilateral deafness [PRR: 41.9; 95% CI: 12.8-136.9]), Eustachian tube disorders (PRR: 34.9; 95% CI: 4.9-247.4), hypoacusis (PRR: 10.1; 95% CI: 7.6-13.3), and tinnitus (PRR: 8.7; 95% CI: 6.2-12.1). CONCLUSIONS Patients treated with teprotumumab should receive warnings regarding the increased risk of hearing-related impairments and receive audiometry before, during, and after treatment.
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Affiliation(s)
- Gerald McGwin
- Department of Epidemiology, School of Public Health
- Department of Ophthalmology and Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham
| | - Cynthia Owsley
- Department of Ophthalmology and Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham
| | - Matthew G Vicinanzo
- Department of Epidemiology, School of Public Health
- Alabama Ophthalmology Associates, Birmingham, Alabama, U.S.A
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Rozbicki P, Usowski J, Krzywdzińska S, Jurkiewicz D, Siewiera J. Assessing the Effectiveness of Different Hyperbaric Oxygen Treatment Methods in Patients with Sudden Sensorineural Hearing Loss. Audiol Res 2024; 14:333-341. [PMID: 38666900 PMCID: PMC11047301 DOI: 10.3390/audiolres14020029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/29/2024] Open
Abstract
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.
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Affiliation(s)
- Paweł Rozbicki
- Department of Otolaryngology with Division of Cranio-Maxillo-Facial Surgery, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, Poland
| | - Jacek Usowski
- Department of Otolaryngology with Division of Cranio-Maxillo-Facial Surgery, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, Poland
| | - Sandra Krzywdzińska
- Department of Otolaryngology with Division of Cranio-Maxillo-Facial Surgery, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, Poland
| | - Dariusz Jurkiewicz
- Department of Otolaryngology with Division of Cranio-Maxillo-Facial Surgery, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, Poland
| | - Jacek Siewiera
- Department of Hyperbaric Medicine, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, Poland
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Zhou Y, Wen J, Yang Z, Zeng R, Gong W, Jing Q. The potential relationship between uric acid and the recovery in sudden sensorineural hearing loss. Braz J Otorhinolaryngol 2024; 90:101368. [PMID: 38006724 PMCID: PMC10724551 DOI: 10.1016/j.bjorl.2023.101368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/19/2023] [Accepted: 11/12/2023] [Indexed: 11/27/2023] Open
Abstract
OBJECTIVE Serum uric acid is proven to be associated with chronic hearing loss, but its effect on Sudden Sensorineural Hearing Loss (SSNHL) is unclear. This study aims to evaluate the prognostic values of serum uric acid levels in SSNHL patients. METHODS The clinical records of SSNHL patients were retrospectively reviewed. Patients were divided into different groups based on hearing recovery and audiogram type, and uric acid levels were compared. Based on uric acid levels, patients were categorized into normouricemia and hyperuricemia groups, and clinical features and hearing recovery were evaluated. Univariate and multivariate analyses were performed to identify prognostic factors. RESULTS In total, 520 SSNHL patients were included in this study, including 226 females and 294 males. In female patients, 186 patients were included in the normouricemia group, and 40 patients were enrolled in the hyperuricemia group. Significant differences were observed in uric acid levels, Total Cholesterol (TC), rate of complete recovery, and slight recovery between the two groups. In male patients, 237 subjects were categorized into the normouricemia group, and 57 patients were included in the hyperuricemia group. The rate of complete recovery and slight recovery was lower in the hyperuricemia group compared to the normouricemia group. All patients were further divided into good recovery and poor recovery groups based on hearing outcomes. The uric acid levels, initial hearing threshold, rate of hyperuricemia, and TC were lower in the good recovery group than the poor recovery group both in female and male patients. Binary logistic regression results showed that uric acid levels, initial hearing threshold, and hyperuricemia were associated with hearing recovery. CONCLUSION Hyperuricemia might be an independent risk factor for hearing recovery in SSNHL patients. Serum uric acid and initial hearing threshold possibly affected the hearing outcome in males and females with SSNHL. LEVEL OF EVIDENCE Level 4.
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Affiliation(s)
- Yandan Zhou
- Changsha Aier Eye Hospital, Aier Eye Hospital Group, Changsha, Hunan, China
| | - Jie Wen
- University of South China, Hengyang Medical School, The Affiliated Changsha Central Hospital, Department of Otolaryngology Head and Neck Surgery, Changsha, Hunan, China; University of South China, Changsha, Hengyang Medical School, Institute of Otolaryngology Head and Neck Surgery, Changsha, Hunan, China
| | - Zhongchun Yang
- University of South China, Hengyang Medical School, The Affiliated Changsha Central Hospital, Department of Otolaryngology Head and Neck Surgery, Changsha, Hunan, China; University of South China, Changsha, Hengyang Medical School, Institute of Otolaryngology Head and Neck Surgery, Changsha, Hunan, China
| | - Ruifang Zeng
- University of South China, Hengyang Medical School, The Affiliated Changsha Central Hospital, Department of Otolaryngology Head and Neck Surgery, Changsha, Hunan, China; University of South China, Changsha, Hengyang Medical School, Institute of Otolaryngology Head and Neck Surgery, Changsha, Hunan, China
| | - Wei Gong
- University of South China, Hengyang Medical School, The Affiliated Changsha Central Hospital, Department of Otolaryngology Head and Neck Surgery, Changsha, Hunan, China; University of South China, Changsha, Hengyang Medical School, Institute of Otolaryngology Head and Neck Surgery, Changsha, Hunan, China
| | - Qiancheng Jing
- University of South China, Hengyang Medical School, The Affiliated Changsha Central Hospital and Institute of Otolaryngology Head and Neck Surgery, Changsha, Hunan, China.
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Wang Y, Xiong W, Sun X, Duan F, Lu K, Wang H, Wang M. Characteristics and prognostic analysis of simultaneous bilateral sudden sensorineural hearing loss. Front Neurol 2023; 14:1179579. [PMID: 37213906 PMCID: PMC10196351 DOI: 10.3389/fneur.2023.1179579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 04/19/2023] [Indexed: 05/23/2023] Open
Abstract
Objective To evaluate the clinical characteristics of simultaneous bilateral sudden sensorineural hearing loss (Si-BSSNHL) as well as its prognostic factors. Methods Patients with Si-BSSNHL who were admitted to the Department of Otology Medicine between December 2018 and December 2021 were enrolled in the case group. Propensity score matching (PSM) for sex and age was used to select the control group, which included people who had unilateral sudden sensorineural hearing loss (USSNHL) during the same time period. Hearing recovery, audiological examinations, vestibular function assessments, laboratory tests, and demographic and clinical manifestations were analyzed for intergroup comparisons. Binary logistic regressions were used for both univariate and multivariate analyses of Si-BSSNHL prognostic factors. Results Before PSM, the Si-BSSNHL and USSNHL groups differed significantly (p < 0.05) in terms of time from onset to treatment, initial pure-tone average (PTA), final PTA, hearing gain, audiogram curve type, proportion of tinnitus, high-density lipoprotein level, homocysteine level, and effective rate. After PSM, significant differences were also observed in time from onset to treatment, initial PTA, final PTA, hearing gain, total and indirect bilirubin levels, homocysteine level, and effective rate between the two groups (p < 0.05). There was a significant difference in the classification of therapeutic effects between the two groups (p < 0.001). For prognostic analysis, the audiogram curve type was significantly different between the effective group and the ineffective groups of Si-BSSNHL (p = 0.01), in which the sloping type was an independent risk factor for the prognosis of the right ear in Si-SSNHL (95% confidence interval, 0.006-0.549, p = 0.013). Conclusion Patients with Si-BSSNHL had mild deafness, elevated total and indirect bilirubin and homocysteine levels, and poorer prognosis than those with USSNHL. Audiogram curve type was linked to the therapeutic effect of Si-BSSNHL, and the sloping type was an independent risk factor for a poor prognosis in the right ear of Si-SSNHL.
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Affiliation(s)
- Yingjun Wang
- Department of Otology Medicine, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Shandong Institution of Otolaryngology, Jinan, China
| | - Wenping Xiong
- Department of Otology Medicine, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Shandong Institution of Otolaryngology, Jinan, China
| | - Xiao Sun
- Department of Otology Medicine, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Fujia Duan
- Department of Otology Medicine, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Kunpeng Lu
- Department of Otology Medicine, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Haibo Wang
- Department of Otology Center, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Mingming Wang
- Department of Otology Medicine, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Shandong Institution of Otolaryngology, Jinan, China
- *Correspondence: Mingming Wang,
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Liang C, Fang Q, Chen H, Wang Z, Qiao X, Liao Y, Lv C, Chen M, Li L, Yang J. Vulnerable frequency as an independent prognostic factor for sudden sensorineural hearing loss. Front Neurol 2022; 13:962376. [PMID: 36237617 PMCID: PMC9552834 DOI: 10.3389/fneur.2022.962376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesSudden sensorineural hearing loss (SSNHL) is a common otology emergency in the practice. Its severe hearing impairment and prognosis impair the quality of life. Given that cochlear hair cell vulnerability is not consistent across frequencies, this study aims to investigate the impact of frequency-specific hearing loss on prognosis in SSNHL.MethodsThe study included 255 patients with full-frequency SSNHL. The baseline, clinical, and hearing characteristics, as well as possible cardiovascular predictors in blood, were collected for analysis.ResultsThe 4,000 and 8,000 Hz hearing levels in the responder group were significantly lower than those in the non-responder group (p = 0.008, p < 0.001), while the average hearing was not (p = 0.081). Logistic regression showed that only vertigo (OR, 95% CI, 0.265, 0.102–0.684, p = 0.006) and 8,000 Hz hearing level (OR, 95% CI, 0.943, 0.916–0.971, p < 0.001) were strongly associated with treatment outcome.ConclusionsCompared with other frequencies, 8,000 Hz hearing level was closely related to prognosis in SSNHL. In an adjusted model, our study did not find an effect of mean hearing on prognosis in SSNHL. However, further multicenter prospective studies are needed for validation.
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Lin W, Xiong G, Yan K, Yu W, Xie X, Xiang Z, Wu J, Ge Y, Wang Y. Clinical Features and Influencing Factors for the Prognosis of Patients With Sudden Deafness. Front Neurol 2022; 13:905069. [PMID: 35720064 PMCID: PMC9201483 DOI: 10.3389/fneur.2022.905069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 05/09/2022] [Indexed: 11/24/2022] Open
Abstract
Backgrounds Studies on risk factors influencing the prognosis of patients with sudden onset deafness are lacking. Methods From March 2018 to March 2021, 500 patients, from the Tongde Hospital in Zhejiang Province, with sudden onset deafness were enrolled. We collected clinical information from the hospital medical records, including certain demographic characteristics, information related to sudden-onset deafness, and laboratory parameters. Univariate and multivariate analyses were performed to determine independent prognostic risk factors for patients with sudden deafness. Additionally, we also employed orthogonal partial least squares discriminant analysis (OPLS-DA) to analyze the data of these enrolled patients. Results The baseline clinical characteristics of the enrolled patients were analyzed. Based on their prognoses, the included patients were divided into the overall effective and ineffective groups. Between these two groups, the univariate and multivariate analyses were performed. Age, type of hearing curve at the initial diagnosis, acute phase, and sudden deafness site were found to be independently associated with the prognoses of patients with sudden deafness (all P < 0.05). Through the OPLS-DA, the sudden deafness site was found to be an indicator with the highest predictive power. Conclusions Age, type of hearing curve at the initial diagnosis, acute phase, and sudden deafness site were all independently correlated with the prognoses of patients with sudden deafness and, therefore, need to be emphasized.
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Affiliation(s)
- Wei Lin
- Department of Otolaryngology, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Gaoyun Xiong
- Department of Otolaryngology, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Kailei Yan
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Wumin Yu
- Basic Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaoxing Xie
- Department of Otolaryngology, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Ze Xiang
- Zhejiang University School of Medicine, Hangzhou, China
| | - Jian Wu
- Department of Clinical Laboratory, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Yanping Ge
- Department of Otolaryngology, Tongde Hospital of Zhejiang Province, Hangzhou, China
- Yanping Ge
| | - Ying Wang
- Department of Infection Management, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
- *Correspondence: Ying Wang
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