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Luu K, Shaffer AD, Chi DH. Practice trends in pediatric sudden sensorineural hearing loss management: An unresolved diagnosis. Am J Otolaryngol 2023; 44:103845. [PMID: 36963235 DOI: 10.1016/j.amjoto.2023.103845] [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: 12/22/2022] [Revised: 03/07/2023] [Accepted: 03/14/2023] [Indexed: 03/26/2023]
Abstract
PURPOSE Assess practice patterns amongst pediatric otolaryngologist for the management of children with SSNHL. MATERIALS AND METHODS A cross-sectional online survey of members of the American Society of Pediatric Otolaryngology (ASPO) was performed; 135 responded. Patterns in treatment modalities, ancillary tests, and timing of treatment and follow-up were evaluated. These patterns were compared between respondents with different characteristics (number of years in practice, clinic location, and number of pediatric SSNHL cases within the last year) using ordered logistic regression, Kruskal-Wallis, Wilcoxon rank-sum, and Fisher's exact tests. RESULTS Mean time from onset of hearing loss to presentation to a pediatric otolaryngologist was 10 days (range 1-60 days). The most cited reasons for delay in care were 'patient not seeking any healthcare evaluation' (65 %) and 'lack of access to obtain an audiogram' (54 %). The most ordered blood work was complete blood count (14 %) and herpes simplex testing (15 %). Complete blood count was ordered more frequently by physicians in practice for >10 years compared with those in practice 1-10 years, P = 0.03. Most respondents reported treating with systemic steroids (86/92, 93 %), including intratympanic steroids (32/92, 35 %). Treatment with systemic steroids was more common in academic compared with private practice, P = 0.03. Antivirals were the most common additional agent prescribed (14/89, 16 %). Most patients were seen in follow-up 1-4 weeks after diagnosis (63/85, 74 %). CONCLUSIONS Most pediatric otolaryngologists treat SSNHL with systemic steroids. The remainder of the diagnostic and management paradigm varies significantly, highlighting the need to systematically define which treatment optimizes outcomes in this population.
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Affiliation(s)
- Kimberly Luu
- University of California San Francisco, Division of Pediatric Otolaryngology, 550 16th Street, San Francisco, CA 94158, USA.
| | - Amber D Shaffer
- UPMC Children's Hospital of Pittsburgh, Division of Pediatric Otolaryngology, 4401 Penn Avenue, Pittsburgh, PA 15224, USA.
| | - David H Chi
- UPMC Children's Hospital of Pittsburgh, Division of Pediatric Otolaryngology, 4401 Penn Avenue, Pittsburgh, PA 15224, USA.
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Barron KA, Haimowitz SZ, Shah VP, Cowan P, Raia N, Ying YLM. A review of bilateral sudden sensorineural hearing loss in pediatric patients. Int J Pediatr Otorhinolaryngol 2023; 165:111459. [PMID: 36696710 DOI: 10.1016/j.ijporl.2023.111459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 12/16/2022] [Accepted: 01/19/2023] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Bilateral, sudden sensorineural hearing loss (SSNHL) in the pediatric population is a rare phenomenon potentially detrimental to language acquisition and social development. This study comprehensively reviews and analyzes existing literature to determine any correlation or commonality in etiologies, presentations, and management of this condition. METHODS PubMed, Cochrane, Scopus, and Web of Science databases were systematically searched for articles related to pediatric SSNHL from 1970 to 2021. Case series, case reports, and cohort studies were included. Data on patient demographics, etiology, diagnostic testing, management, and hearing recovery were collected. RESULTS Excluding duplicates, 553 unique titles were identified by established search criteria, of which 342 titles were relevant to pediatric sudden hearing loss. Forty-six papers reported cases of bilateral SSNHL, totaling 145 individual cases. Not included in the analysis were 45 cases documented as non-organic hearing loss. The average age of the total 145 included patients was 8.5 years and 51 were male. Reported etiologies included cytomegalovirus (n = 3), meningitis (n = 13), mumps (n = 5), ototoxin exposure (n = 13), and enlarged vestibular aqueduct (n = 9). Tinnitus (n = 30) was the most reported concurrent symptom, followed by vertigo (n = 21). Systemic steroid therapy was the most common treatment and, when follow up was reported, most patients (51.2%) had complete or partial recovery of hearing. CONCLUSIONS This is a comprehensive review of pediatric bilateral SSNHL. Though often idiopathic, etiologies also include infectious, structural, and autoimmune. Treatment largely consists of systemic steroid therapy, with variables rates of recovery. Further studies on intratympanic administration of steroids may guide future treatment.
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Affiliation(s)
- Kendyl A Barron
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, 07101, USA.
| | - Sean Z Haimowitz
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, 07101, USA
| | - Vraj P Shah
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, 07101, USA
| | - Paul Cowan
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, 07101, USA
| | - Nicole Raia
- Audiology Service, University Hospital, Newark, NJ, 07101, USA
| | - Yu-Lan Mary Ying
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, 07101, USA
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Analysis of clinical features and prognostic correlation factors of sudden sensorineural hearing loss in children. Int J Pediatr Otorhinolaryngol 2023; 164:111400. [PMID: 36446225 DOI: 10.1016/j.ijporl.2022.111400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/06/2022] [Accepted: 11/22/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This study aimed to investigate the clinical features and prognostic correlation factors of sudden sensorineural hearing loss in children (CSSNHL). METHODS From January 2016 to December 2021, the clinical data of hospitalized children presenting with sudden sensorineural hearing loss, including age, gender, the ear of onset, onset of treatment, concomitant symptoms, the degree of hearing loss, and audiogram curve type, were retrospectively collected and the effective rate of treatment and the factors affecting prognosis were statistically analyzed. RESULTS The effective rate of CSSNHL was 29.97%. Univariate analyses showed that the onset of treatment, the degree of hearing loss, audiogram curve type, and tinnitus were associated with prognosis (P < 0.05). Multivariate analyses showed that onset of treatment was correlated with prognosis (OR = 0.939, 95% CI = 0.911-0.969, P < 0.001). Compared with patients in the profound group, the therapeutic performance of the severe, moderate, and mild groups were significantly different (OR = 9.951, 11.264, 13.373, 95% CI = 2.311-42.856, 2.818-45.028, and 5.310-33.677, P < 0.05). Compared with patients with profound audiogram, ascending audiogram and flat audiogram were related to therapeutic performance (OR = 13.373 and 14.481, 95% CI = 5.310-33.677, 6.509-32.217, P < 0.001). CONCLUSIONS The prognosis of CSSNHL patients was related to the onset of treatment, the degree of hearing loss, and the audiogram curve type. Patients who received earlier treatment, had lighter hearing loss and the ascending and flat audiograms exhibited improved prognosis.
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陆 翼, 雍 军, 夏 寅, 刘 志. [Multifactorial analysis of the degree of hearing loss and outcome in patients with sudden hearing loss]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2022; 36:827-834. [PMID: 36347574 PMCID: PMC10127571 DOI: 10.13201/j.issn.2096-7993.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Indexed: 06/16/2023]
Abstract
Objective:To investigate the relationship between the severity and curative effect of hearing loss and clinical indicators in patients with sudden hearing loss (SHL). Methods:The Spearman correlation coefficient was used to analyze the correlation between the efficacy of SHL and clinical indicators.A total of two hundred and seventy-three patients with SHL were selected and divided into three quantile groups according to the average hearing threshold of the the involved ear frequency of the first pure tone audiometry at admission. Univariate and multivariate ordered logistic regression were used to evaluate the relationship between initial hearing level and clinical indicators of SHL patients. The Spearman correlation coefficient was used to analyze the correlation between efficacy of SHL and clinical indicators. Results:Compared with patients with lower hearing loss (≤50 dB HL),patients with higher hearing loss (>50 dB HL) had higher Neutrophil, Monocyte, Triglycerides, Hemoglobin, Fibrinogen, Glucose, Neutrophil/high-density lipoprotein cholesterol ratio (NHR), Monocyte/high-density lipoprotein cholesterol ratio, Monocyte/lymphocyte cell ratio, age, dizziness, and lower Platelet/ lymphocyte cell ratio and High-density lipoprotein cholesterol, and poor final hearing threshold.Multivariate logistic regression showed that NHR and age were independent risk factors for initial hearing loss in SHL patients.And the NHR, Neutrophil/lymphocyte cell ratio (NLR), course of disease, type of hearing curve, and final hearing threshold were significantly negatively correlated with curative effect. Conclusion:SHL patients with higher NHR and NLR values, the longer time from onset to visit, and the more severe hearing loss had worse efficacy.However, SHL patients with higher NHR and age values had greater initial hearing loss,the degree of hearing loss and curative effect are different in SHL patients with different types of hearing threshold curve and age.
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Affiliation(s)
- 翼年 陆
- 新疆医科大学第一附属医院耳鼻咽喉头颈外科(乌鲁木齐,830000)Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830000, China
| | - 军 雍
- 新疆医科大学第一附属医院耳鼻咽喉头颈外科(乌鲁木齐,830000)Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830000, China
| | - 寅 夏
- 首都医科大学附属北京天坛医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, Beijing Tiantan Hospital, Capital Medical University
| | - 志连 刘
- 新疆医科大学第一附属医院耳鼻咽喉头颈外科(乌鲁木齐,830000)Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830000, China
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Assessment of seasonal pattern of idiopathic sudden sensorineural hearing loss: a retrospective cross-sectional study. J Laryngol Otol 2022; 137:515-519. [PMID: 35855639 DOI: 10.1017/s0022215122001669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND A seasonal trend of patients with idiopathic sudden sensorineural hearing loss may direct research into possible aetiology. METHODS This study reviewed data from the medical records of patients who presented from 2004 to 2019 and who were diagnosed with new-onset idiopathic sudden sensorineural hearing loss. Seasonal pattern was assessed using chi-square and Rayleigh tests, and further confirmed by Monte Carlo simulation. RESULTS The study included 740 patients with a mean age of 48.3 years and a median age of 49 years. There was no statistical evidence for a difference in the distribution of sensorineural hearing loss cases for the four seasons of each year or with the cumulative data. New-onset idiopathic sudden sensorineural hearing loss cases averaged around 11 per month; there was no statistical evidence for a seasonal difference, as determined either by the Rayleigh test or with Monte Carlo simulation. CONCLUSION There was no evidence to support the claim that idiopathic sudden sensorineural hearing loss incidence displays a seasonal pattern. More research is necessary to explore potential external factors such as climate or infection.
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AYSEL A, DALĞIÇ A, MÜDERRİS T, YILMAZ F, ATSAL G, BOYACIOĞLU H, ÖZDEMİR ŞİMŞEK Ö, ALTAŞ E. Çocuklarda ani sensörinöral işitme kaybı: etiyoloji, prognostik faktörler ve tedavi sonuçları. EGE TIP DERGISI 2022. [DOI: 10.19161/etd.1126855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: Sudden sensorineural hearing loss (SSNHL) may have a negative impact on the language and psychological development of children, especially if it is not diagnosed early and treated promptly. This study were aimed to determine and compare the etiological factors, treatment outcomes and prognostic factors in the pediatric patients who were followed up with the diagnosis of SSNHL.
Materials and Methods: The files of 28 children were analyzed retrospectively. In pure tone audiometry, the average of pure tone thresholds of 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz were accepted as pure tone averages (PTAV). Patients' recovery status was determined according to Siegel criteria. Audiometric curve types were evaluated as ascending, descending, and flat.
Results: The ages of patients with SSNHL was mean ± SD 14.89 ± 3.24 (min-max: 7 and 18). The pre-treatment PTAV was mean ± SD 55.27 ± 12.39 dB HL (min-max: 38.5 and 85.25 dB HL) and the PTAV after treatment was mean ± SD 23.13 ± 18.22 dB HL (min-max: 5 and 72.5 dB HL). Audiometric curve types were detected as descending curve (n: 11, 39.2%), ascending curve (n: 5, 17.9%), flat curve (n: 12, 44.9%). Eighteen (64.3%) patients had complete recovery, 8 (28.6%) patients had partial recovery, and 2 (7.1%) patients had no recovery after the treatment.
Conclusion: The response to treatment was found to be high. Descending audiometric curve type was found as a positive prognostic factor. Although the presence of tinnitus was a better prognostic factor than the presence of vertigo.
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Affiliation(s)
- Abdulhalim AYSEL
- Health Sciences University İzmir Bozyaka Health Research and Practice Center, The Clinic of Otorhinolaryngology, Head and Neck Surgery, Izmir, Turkiye
| | - Abdullah DALĞIÇ
- Health Sciences University İzmir Bozyaka Health Research and Practice Center, The Clinic of Otorhinolaryngology, Head and Neck Surgery, Izmir, Turkiye
| | - Togay MÜDERRİS
- Department of Otorhinolaryngology and Head and Neck Surgery, Bakirçay University, Çiğli Training and Research Hospital, Izmir, Turkiye
| | - Fatih YILMAZ
- Health Sciences University İzmir Bozyaka Health Research and Practice Center, The Clinic of Otorhinolaryngology, Head and Neck Surgery, Izmir, Turkiye
| | - Görkem ATSAL
- Department of Otorhinolaryngology and Head and Neck Surgery, Siirt State Hospital, Siirt, Turkiye
| | - Hayal BOYACIOĞLU
- Ege University Faculty of Science, Department of Statistics, İzmir, Turkiye
| | - Özgür ÖZDEMİR ŞİMŞEK
- Health Sciences University İzmir Tepecik Education and Research Hospital Konak, Izmir, Turkiye
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Meng X, Wang J, Sun J, Zhu K. COVID-19 and Sudden Sensorineural Hearing Loss: A Systematic Review. Front Neurol 2022; 13:883749. [PMID: 35572936 PMCID: PMC9096262 DOI: 10.3389/fneur.2022.883749] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 03/30/2022] [Indexed: 12/23/2022] Open
Abstract
A growing body of evidence suggests that patients with the 2019 Coronavirus disease (COVID-19) have a risk of developing sudden sensorineural hearing loss (SSNHL). The pathogenesis of COVID-19-related SSNHL remains unclear. This systematic review examined whether COVID-19 causes an increased incidence of SSNHL and the clinical characteristics of patients with COVID-19-related SSNHL according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. SSNHL usually developed between a few days and 2 months after the diagnosis of COVID-19, and a proportion of patients developed it before the diagnosis of COVID-19. The literature is inconsistent regarding whether COVID-19 causes an increased incidence of SSNHL, and this matter remains unclear. This review included 23 patients with COVID-19-related SSNHL, all adult patients with an average age of 43.1 years. Of these patients, 60.9% had accompanying tinnitus symptoms. Glucocorticoids are the preferred medication to treat COVID-19-related SSNHL. Intratympanic administration may be considered to reduce the side effects of the drug. Hearing tests are suggested when hearing loss is suspected in COVID-19 individuals, and if SSNHL is detected, prompt and aggressive treatment is vital. Large-scale, multicenter research on the pathophysiology, treatment, and prognosis of COVID-19- related SSNHL should be conducted in the future.
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Affiliation(s)
- Xiangming Meng
- Department of Otolaryngology, Wuxi Huishan District People's Hospital, Wuxi, China
- *Correspondence: Xiangming Meng
| | - Jing Wang
- Department of Otolaryngology, Huadong Sanatorium, Wuxi, China
| | - Jian Sun
- Department of Rheumatology and Immunology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Kangxu Zhu
- Department of Otolaryngology, Wuxi Huishan District People's Hospital, Wuxi, China
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Xiao L, Su S, Liang J, Jiang Y, Shu Y, Yao H, Ding L. Clinical features and prognostic factors of children with profound sudden sensorineural hearing loss. Front Pediatr 2022; 10:1023781. [PMID: 36419913 PMCID: PMC9676955 DOI: 10.3389/fped.2022.1023781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 10/11/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To investigate the clinical features and factors affecting the prognosis of children with profound sudden sensorineural hearing loss (SSNHL). METHODS We retrospectively analyzed the clinical data of 147 children with profound SSNHL who received inpatient treatment at our department from January 2016 to January 2021. All children were administered with systemic steroid therapy and/or intratympanic steroid (ITS) treatment for 2 weeks. Statistical analyses were performed for the clinical features, treatment effectiveness, and factors affecting the prognosis using SPSS 23.0. RESULTS The median age of the study population was 8 (6-10) years. The median treatment onset time was 8 (4-20) days. The most common concomitant symptom was tinnitus (45.58%). Laboratory findings showed that the percentages of children with abnormal leukocytes was 25.85%, abnormal platelet counts was 17.01%, abnormal cytomegalovirus IgG antibodies was 36.73% and abnormal Epstein-Barr (EB) virus IgG antibodies was 41.50%. The overall recovery rate of the treatment was 20.04%. The univariate analysis showed that age, treatment onset time, tinnitus, and ITS treatment were associated with the prognosis (p < 0.05). Regarding laboratory findings, the neutrophil count, lymphocyte count, and neutrophil-to-lymphocyte ratio differed significantly between the effective and invalid treatment effect groups (p < 0.05). The multivariable logistic regression analysis showed that treatment onset time [odds ratio (OR) = 0.936, 95% confidence interval (CI): 0.881-0.994] and ITS treatment (OR = 0.174, 95% CI: 0.044-0.0687) correlated with hearing recovery (p < 0.05). CONCLUSION In this study, the earlier the treatment start time of children with profound SSNHL, the better was the prognosis. Further, ITS could be an effective treatment option.
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Affiliation(s)
- Ling Xiao
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Shuping Su
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Jia Liang
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Ying Jiang
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Yan Shu
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Hongbing Yao
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Ling Ding
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
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Garov EV, E Garova E, Pryakhina MA. [Corticosteroids for acute sensorineural hearing loss treatment. The contemporary state of problem. Literature review. Part 1]. Vestn Otorinolaringol 2022; 87:51-56. [PMID: 35818946 DOI: 10.17116/otorino20228703151] [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] [Indexed: 06/15/2023]
Abstract
The article presents modern literary data relating to the expediency of the purpose of glucocorticosteroids in sudden sensorineural hearing loss (SSHL) of various genes. In detail, the radar molecular mechanisms and the anatomo-physiological features of the exposure to the inner ear, side effects, the introduction methods, their comparative efficacy and modern schemes of the SSHL.
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Affiliation(s)
- E V Garov
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - E E Garova
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - M A Pryakhina
- Pirogov Russian National Research Medical University, Moscow, Russia
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Vestibular function of pediatric patients with sudden sensorineural hearing loss: based on vertigo symptom and vestibular function testing. World J Pediatr 2021; 17:637-642. [PMID: 34767192 DOI: 10.1007/s12519-021-00471-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 09/29/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND This study aimed to evaluate the relationship between vestibular and auditory functions in pediatric patients with sudden sensorineural hearing loss (SSHL). METHODS A total of 30 pediatric patients experiencing unilateral SSHL between 5.9 and 13.0 years of age were enrolled in this study. Pure tone audiometry was evaluated prior to treatment initiation and again after one month of treatment. Prior to treatment initiation, vertigo symptoms were noted; then several vestibular function tests were conducted including caloric testing, ocular vestibular evoked myogenic potentials (o-VEMPs) and cervical vestibular evoked myogenic potentials (c-VEMPs). Associations between pre and post-treatment vestibular function and hearing threshold levels were analyzed. RESULTS Initial hearing thresholds of children with vertigo were higher than thresholds of children without vertigo (92 dB vs 79 dB, P = 0.033), while initial hearing thresholds of children with abnormal caloric test findings were higher than thresholds of children with normal caloric test findings (93 dB vs 67 dB, P = 0.014). Cutoff values of hearing thresholds for those with vertigo symptoms and abnormal vestibular test results were 86.000- and 89.583-dB HL, respectively. Regarding prognosis, children with vertigo exhibited lower recovery rates than children without vertigo (33% vs 75%, P = 0.025); recovery rates of children with abnormal caloric test results were lower than the overall recovery rate (25% vs 73%, respectively, P = 0.039). CONCLUSION Assessments of vertigo symptoms and vestibular function are useful tools in predicting pediatric SSHL patient disease severity and prognosis.
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Bhatta S, Sharma S, Sharma D, Maharjan L, Bhattachan S, Sah MK, Singhal A, Ghanpur AD, Ganesuni D. Study of Hearing Status in COVID-19 Patients: A Multicentered Review. Indian J Otolaryngol Head Neck Surg 2021; 74:3036-3042. [PMID: 34277385 PMCID: PMC8274964 DOI: 10.1007/s12070-021-02710-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/20/2021] [Indexed: 12/25/2022] Open
Abstract
To evaluate the hearing status of COVID-19 patients and compare with control group. Prospective study carried out in 9 institutes. The pure tone audiogram and impedance audiometry of COVID-19 patients performed initially and at 3 months follow up. The control group consisted COVID-19 negative individuals with no history of ear related diseases. The average of air and bone conduction threshold (AC and BC) were compared between the COVID-19 patients and control group using independent t-test with a p value of less than 0.05 considered significant. Total of 331 patients, age 32 ± 4.3 years, 66.7% males and 33.3% females were included in the study. There were 80 individuals in the control group. Aural symptoms were, tinnitus in 1.8%, aural fullness in 1.4%, hearing loss in 3. 9%, and ear ache in 1.8% were present initially, resolved at 3 months follow up. The impedance audiometry demonstrated type B and type C curve in 5.1% and 1.15% ears, and out of these 64.7% and 40% improved at 3 months follow up respectively. No significant difference observed between the average AC and BC of the COVID-19 patients and control group. The COVID-19 infection may present with aural symptoms; however, it was concluded that there was no significant difference in the hearing status of the COVID-19 positive patients in comparison to the control group. The presence of some changes in the normal functioning of the eustachian tube and middle ear in the COVID-19 infection was also highlighted.
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Affiliation(s)
| | | | - Dibya Sharma
- Indira Gandhi Memorial Hospital, Male', Maldives
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Radiologic Findings in Pediatric Sudden Sensorineural Hearing Loss. Otol Neurotol 2021; 42:1201-1207. [PMID: 33973955 DOI: 10.1097/mao.0000000000003188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Pediatric sudden sensorineural hearing loss (pSSNHL) is a rare phenomenon. There is currently no consensus on the role of imaging in the work-up for this patient population. We aim to evaluate the efficacy of magnetic resonance imaging (MRI) and high-resolution computed tomography (CT) studies in determining the etiology of pSSNHL. STUDY DESIGN Retrospective case review. SETTING Tertiary Hospital and Ambulatory Otolaryngology Clinic. PATIENTS Patients ≤18 years of age with sudden sensorineural hearing loss (SSNHL) and who had either MRI or CT imaging between January 2010 and May 2019 were included. INTERVENTION Diagnostic imaging. MAIN OUTCOME MEASURES Clinical characteristics and radiology impressions. RESULTS A total of 11 patients were identified, and 10 had unilateral SSNHL. MRI was performed on all patients, five patients had additional CT imaging. Abnormal imaging findings relevant to SSNHL were observed in five patients (45.5%), which included enlarged endolymphatic duct and sac, labyrinthine ossification, apical petrositis, hypoplastic cochlear nerve, and arachnoid cyst in the internal auditory canal; one patient had unrelated findings (enlarged pituitary gland), all remaining imaging studies were normal. CONCLUSION In our cohort, we found a higher imaging yield on pSSNHL than what has been reported for adult populations, indicating that the use of imaging in the diagnostic work-up is especially important in children.
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Reading JCS, Hall A, Nash R. Paediatric Sudden Sensorineural Hearing Loss: Pooled Analysis and Systematic Review. J Int Adv Otol 2021; 17:64-71. [PMID: 33605224 DOI: 10.5152/iao.2020.8902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Sudden sensorineural hearing loss (SSNHL) is defined as hearing loss of ≥30 dB in one or both ears, developing within 3 days, affecting ≥3 contiguous frequencies. It is rare in children, but if untreated can cause significant morbidity. During the critical developmental period, it may cause lifelong social, behavioral, and mental sequelae. Currently, little guidance exists on prognosis and management within a pediatric population. A systematic literature review of pediatric SSNHL on PubMed, EMBASE, and the Cochrane CENTRAL database was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. A total of 620 papers met the Medical Subject Headings criteria, of which 14 met analysis criteria-13 were level 4 and 1 was level 2b evidence. A population of 732 individuals was analyzed. Most reported cases of pediatric SSNHL were idiopathic. Other etiologies included viral infection, trauma, ototoxic drugs, and structural abnormalities. Recovery was defined as any improvement in hearing after the initial loss, from "slight" to "complete." Recovery ranged from 20% to 100%, with a pooled rate of 56%. Systemic steroids were the mainstay of treatment, although salvage intratympanic steroid therapy had a role after the failure of systemic steroids. Children with bilateral SSNHL had poorer outcomes than those with unilateral loss, with 29% showing improvement. Two studies reported outcomes with no treatment, for which recovery rate was 7%. This analysis of SSNHL shows that 61% of children with unilateral and 29% of children with bilateral SSNHL demonstrate some recovery, a worse prognosis than adults. Multiple treatment regimens exist, although comparison is challenging owing to inconsistently reported improvement parameters.
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Affiliation(s)
| | - Andrew Hall
- Great Ormond Street Hospital NHS Foundation Trust
| | - Robert Nash
- Great Ormond Street Hospital NHS Foundation Trust
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Franz L, Gallo C, Marioni G, de Filippis C, Lovato A. Idiopathic Sudden Sensorineural Hearing Loss in Children: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg 2020; 165:244-254. [DOI: 10.1177/0194599820976571] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective Idiopathic sudden sensorineural hearing loss (ISSNHL) is uncommon in children, and its treatment and outcome are debated. We aimed to critically review evidence in the literature about treatment options and functional outcomes of pediatric ISSNHL. Additionally, we performed a meta-analysis of the results of combined systemic-intratympanic steroid therapy versus solely systemic treatment. Data Sources A search was run in the PubMed, Scopus, and Google Scholar databases. Review Methods Included articles were original ISSNHL case series, written in English, with a population age ranging from 2 to 19 years. Other study types (single case reports, editorials, and reviews) and case series with known etiology of sudden hearing loss were excluded. Descriptive data of patients, treatments, outcomes, and possible prognostic factors were extracted and recorded for every included study. Results Twelve articles (7 cohort and 5 case-control studies) met all the selection criteria. Based on only the studies that provided sufficient data about clinical outcome, the pooled overall recovery rate was 67.91% (95% CI, 58.34%-77.48%). No studies showed a significant difference between systemic steroid and combined systemic-intratympanic steroid. The pooled odds ratio for combined systemic-intratympanic steroid versus systemic steroid alone was 0.90 (95% CI, 0.36-2.27) based on a random effects model, ruling out any significant difference between these treatment options. Conclusions The results of our meta-analysis did not support combination therapy more than systemic steroid alone. Further prospective clinical trials are necessary to establish evidence-based therapies.
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Affiliation(s)
- Leonardo Franz
- Department of Neuroscience, Otolaryngology Section, University of Padova, Padova, Italy
| | - Chiara Gallo
- Department of Neuroscience, Audiology Section, University of Padova, Treviso, Italy
| | - Gino Marioni
- Department of Neuroscience, Otolaryngology Section, University of Padova, Padova, Italy
| | - Cosimo de Filippis
- Department of Neuroscience, Audiology Section, University of Padova, Treviso, Italy
| | - Andrea Lovato
- Department of Neuroscience, Audiology Section, University of Padova, Treviso, Italy
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Carré F, Blanchard M, Achard S, Parodi M, Denoyelle F, Loundon N. Pediatric sudden sensorineural hearing loss: Experience in a pediatric ENT emergency care center. Int J Pediatr Otorhinolaryngol 2020; 135:110067. [PMID: 32408010 DOI: 10.1016/j.ijporl.2020.110067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Sudden sensorineural hearing loss (SSNHL) is relatively rare and its physiopathology remains unclear, particularly in children. Our goal was to evaluate clinical characteristics, etiologies, management, treatment outcomes and prognostic factors in the pediatric population. METHODS We performed a retrospective chart review of all children registered for SSNHL between August 2004 and September 2017 in a tertiary care pediatric hospital. We analysed data regarding clinical symptoms, audiological characteristics, diagnostic investigations and treatment outcomes. RESULTS Thirty-five patients were included. Mean age was 12 years (range 4-18 years). Male:female ratio was 15:20. Hearing loss was left-sided for 18 patients, right-sided for 12 patients and bilateral for 5 patients. Degree of hearing loss varied from mild to profound across frequencies in the 40 ears studied. Thirty-four patients had associated otologic symptoms: the most frequent was tinnitus (28 ears), followed by vertigo (23 ears), otalgia (5 ears) and sensation of blocked ear (5 ears). Twenty-nine patients received systemic steroids and 3 intra-tympanic steroids. In the treated group, 69% had improvement on the audiograms (14% total, 55% partial). Vestibular tests were performed in 16 patients and were abnormal in 10 patients. Radiological examination included computed tomography scan (n = 16) and/or magnetic resonance imaging (n = 33). They revealed 2 bilateral enlarged vestibular aqueducts, 1 labyrinthitis, 1 intra-cochlear haemorrhage. CONCLUSION SSNHL can affect speech and language development in children. There are differences among the pediatric population, including inner ear malformation and immune disease. Specific work up is proposed. Appropriate diagnosis and therapeutic management are discussed.
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Affiliation(s)
- Fabienne Carré
- ENT Department, Hôpital Necker-Enfants Malades, AP-HP, 149 Rue de Sèvres, 75015, Paris, France; Université de Paris, Paris, France.
| | - Marion Blanchard
- ENT Department, Hôpital Necker-Enfants Malades, AP-HP, 149 Rue de Sèvres, 75015, Paris, France; Université de Paris, Paris, France
| | - Sophie Achard
- ENT Department, Hôpital Necker-Enfants Malades, AP-HP, 149 Rue de Sèvres, 75015, Paris, France; Université de Paris, Paris, France
| | - Marine Parodi
- ENT Department, Hôpital Necker-Enfants Malades, AP-HP, 149 Rue de Sèvres, 75015, Paris, France; Université de Paris, Paris, France
| | - Françoise Denoyelle
- ENT Department, Hôpital Necker-Enfants Malades, AP-HP, 149 Rue de Sèvres, 75015, Paris, France; Université de Paris, Paris, France
| | - Natalie Loundon
- ENT Department, Hôpital Necker-Enfants Malades, AP-HP, 149 Rue de Sèvres, 75015, Paris, France; Université de Paris, Paris, France
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Wood JW, Shaffer AD, Kitsko D, Chi DH. Sudden Sensorineural Hearing Loss in Children-Management and Outcomes: A Meta-analysis. Laryngoscope 2020; 131:425-434. [PMID: 32673420 DOI: 10.1002/lary.28829] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 04/03/2020] [Accepted: 05/19/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To identify which patient characteristics and treatments are associated with hearing improvement in patients with pediatric sudden sensorineural hearing loss (SSNHL). METHODS PubMed, Web of Science, Cochrane Library, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature were systematically searched for articles published before February 5, 2019, and references of relevant articles were screened. Original English-language case series and cohort studies were included if they addressed SSNHL in patients <20 years of age. Study characteristics, patient demographics, symptoms, treatments, and hearing outcomes were extracted. The primary outcome was hearing improvement. RESULTS Thirteen studies were included, totaling 605 patients (670 ears). Hearing did not improve in 46.7% of ears (95% confidence interval [CI]: 34.4% to 59.0%). Imaging (computed tomography and/or magnetic resonance imaging) results were described in three studies, and 24.2% of ears (95% CI: 7.7% to 40.6%) had abnormal findings. The most common serological finding was cytomegalovirus immunoglobulin (Ig)G or IgM (34.3% of ears tested, 95% CI: -2.9% to 71.6%). Unilateral hearing loss (odds ratio [OR]:3.85, P < .001), tinnitus (OR: 2.20, P = .003), age >12 years (OR: 2.11, P = .002), and ascending audiogram (OR: 3.66, P = .005), but not systemic or intratympanic steroids, were associated with increased odds of partial or complete improvement. In contrast, profound hearing loss (OR: 0.29, P < .001) and treatment delay of >6 days (OR: 0.27, P < .001) were associated with decreased odds of improvement. CONCLUSIONS Despite treatment, half of patients had no improvement in hearing. Prognostic factors associated with hearing improvement were generally consistent with those established in the adult population. Further research with consistent definitions for hearing improvement is needed to improve the understanding and treatment of pediatric SSNHL. LEVEL OF EVIDENCE Laryngoscope, 131:425-434, 2021.
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Affiliation(s)
- Joshua W Wood
- Division of Pediatric Otolaryngology, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Amber D Shaffer
- Division of Pediatric Otolaryngology, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Dennis Kitsko
- Division of Pediatric Otolaryngology, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - David H Chi
- Division of Pediatric Otolaryngology, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Abstract
OBJECTIVE To investigate the characteristics, treatment, and prognostic factors of sudden sensorineural hearing loss (SSNHL) in children. METHODS Seventy-five cases (78 ears) of SSNHL in children from February 2011 to June 2016 were retrospectively analyzed. We scrutinized the clinical manifestations, audiological assessments, and serologic examinations of these pediatric cases by univariate and multivariate logistic analysis methods. The patients were divided into four groups according to their audiometric curve type: ascending, descending, flat, and profound. RESULTS Of the 75 patients (78 ears), 25 patients were in the ascending group (32.00%), 9 patients were in the descending group (12.00%), 17 patients were in the flat group (22.67%), and 24 patients were in the profound group (32.32%). The overall recovery rates (complete + partial + slight) of the different groups were as follows: ascending group, 96.00%; flat group, 76.47%; profound group, 50.00%; and descending group, 44.44%. The overall recovery rate of all patients was 70.67%. The multivariate logistic analysis showed that the type of audiometric curve and the interval from onset to intervention were two independent risk factors that correlated with the prognosis of SSNHL in children. Some children had positive cytomegaoviyns, rubella virus, and herpes simplex virus immunoglobulin G antibodies. Twenty-one children were treated with additional intratympanic methylprednisolone as salvage therapy and 13 of these children showed improved (complete + partial + slight) recoveries. Three children had postauricular compound betamethasone injections, but none of them showed improvement. One of three children recovered slightly after treatment with intratympanic methylprednisolone combined with postauricular betamethasone injection. CONCLUSIONS The prognosis of SSNHL in children is closely related to the type of audiometric curve and the onset of treatment. Intratympanic methylprednisolone and compound betamethasone injected postauricularly could be effective for SSNHL in children.
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Young YH. Contemporary review of the causes and differential diagnosis of sudden sensorineural hearing loss. Int J Audiol 2019; 59:243-253. [DOI: 10.1080/14992027.2019.1689432] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Yi-Ho Young
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
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Abstract
Autoimmune inner ear disease (AIED) is a rare, but treatable cause of sudden sensorineural hearing loss in children. Most cases present acutely and involve both ears. The precise mechanism of hearing loss in AIED is not known. Many suspected etiologies have been proposed including infections, vascular abnormalities, and trauma. However, 70% of cases are defined as idiopathic. There are no standardized diagnostic criteria for AIED, and the diagnostic process may be challenging. Positive auto antibodies and response to immunosuppressive therapy support the diagnosis. Treatment may include corticosteroids and steroid-sparing immunosuppressive medications. A high index of suspicion is recommended as the hearing loss may be stabilized or even reversed with early treatment. Long-term medical treatment failures generally have good outcomes with cochlear implantation. [Pediatr Ann. 2019;48(10):e391-e394.].
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Ha R, Lim BW, Kim DH, Park JW, Cho CH, Lee JH. Predictive values of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and other prognostic factors in pediatric idiopathic sudden sensorineural hearing loss. Int J Pediatr Otorhinolaryngol 2019; 120:134-139. [PMID: 30784810 DOI: 10.1016/j.ijporl.2019.02.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 01/21/2019] [Accepted: 02/07/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND OBJECTIVES No consensus has been reached regarding the optimum treatment or factors affecting prognosis in pediatric idiopathic sudden sensorineural hearing loss (ISSNHL) due to its rarity. In the present study, treatment outcomes and prognostic factors of ISSNHL were investigated in pediatric patients who underwent steroid therapy. SUBJECTS and Methods: Forty-two patients diagnosed with ISSNHL were enrolled in this retrospective study and compared with 39 normal healthy controls with respect to demography and complete blood cell count test results. In addition, prognosis factors were sought by dividing the 42 ISSNHL patients to 3 groups according to their response to the treatment. RESULTS Neutrophil-to-lymphocyte ratio (NLR) value in the ISSNHL group were significantly higher than in the control group. NLR value in the three treatment response groups differed significantly. Early treatment with steroid and accompanying tinnitus were positive prognostic factor for hearing recovery. Other characteristics were not significant. CONCLUSION The results of this study suggest that good hearing recovery in children may be associated with early time of initial treatment and accompanying tinnitus. Also, NLR value might be useful readily accessible prognostic markers in pediatric ISSNHL patients. Further studies are required to confirm prognostic factors useful to predict prognosis and treat ISSNHL in pediatric patients.
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Affiliation(s)
- Ryun Ha
- Department of Otolaryngology, Head and Neck Surgery, Gil Medical Center, School of Medicine, Gachon University, Incheon, South Korea.
| | - Byeoung Woo Lim
- Department of Otolaryngology, Head and Neck Surgery, Gil Medical Center, School of Medicine, Gachon University, Incheon, South Korea.
| | - Dong Hyun Kim
- Department of Otolaryngology, Head and Neck Surgery, Gil Medical Center, School of Medicine, Gachon University, Incheon, South Korea.
| | - Jung Woo Park
- Department of Otolaryngology, Head and Neck Surgery, Gil Medical Center, School of Medicine, Gachon University, Incheon, South Korea.
| | - Chang Hyun Cho
- Department of Otolaryngology, Head and Neck Surgery, Gil Medical Center, School of Medicine, Gachon University, Incheon, South Korea.
| | - Ju Hyoung Lee
- Department of Otolaryngology, Head and Neck Surgery, Gil Medical Center, School of Medicine, Gachon University, Incheon, South Korea.
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Declining prevalence of pediatric sudden deafness during the past two decades. Int J Pediatr Otorhinolaryngol 2019; 119:118-122. [PMID: 30703660 DOI: 10.1016/j.ijporl.2019.01.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 01/19/2019] [Accepted: 01/19/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE This study compared the prevalence of sudden deafness (SD) in children to investigate the evolution of pediatric SD during the past two decades. METHODS From 1996 to 2005, totaling 358 SD patients were experienced. Of them, 25 patients (7%) aged <15 years were assigned to Group A. In contrast, 5 patients (2%) aged <15 years of 242 SD patients encountered during the period 2006-2015 were assigned to Group B. All patients underwent audiovestibular function testing. RESULTS The measles-mumps-rubella (MMR) vaccination reached to 95% vaccination rate in Taiwan after 1994. As 1994 (MMR vaccination years) + 11 (mean age of pediatric SD) equals 2005, this study found that declining prevalence of pediatric SD was from 7% (1996-2005) to 2% (2006-2015) at our hospital, consistent with declining annual cases of SD in Taiwan during the past decades. A significantly higher abnormality rate of mean hearing level (93%) than abnormal caloric responses (20%) was identified indicating that pediatric SD predominately affected the cochlear partition. CONCLUSION The prevalence of pediatric SD cases has significantly declined during the past 20 years, probably due to global vaccination policy. Other causal factors such as growing numbers of hospital and advancement in radiological diagnostic technique may also contribute to the declining prevalence.
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Chen K, Jiang H, Zong L, Wu X. Side-related differences in sudden sensorineural hearing loss in children. Int J Pediatr Otorhinolaryngol 2018; 114:5-8. [PMID: 30262366 DOI: 10.1016/j.ijporl.2018.08.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 08/17/2018] [Accepted: 08/17/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Most studies on sudden sensorineural hearing loss (SSNHL) do not differentiate the outcomes within varied affected ears in children. The present study was designed to determine the clinical differences between unilateral and bilateral SSNHL in children. METHODS The clinical data, from a total of 101 pediatric patients with SSNHL, was retrospectively analyzed from January 2003 to December 2016. The main outcome measures included basic characteristics, etiology, clinical symptoms and treatment courses. RESULTS When the bilateral group (n = 28) was compared to the unilateral group (n = 73), neither gender nor onset of SSNHL was significantly different (p > 0.05 each); However, bilateral SSNHL tended to occur in younger ages (8.1 ± 4.0 yrs), with higher percentages of suspected etiologies (50%) and proportion of profound deafness (55.4%, p < 0.05 each). The short-term recovery rate was superior in the unilateral cases over the bilateral cases (37.0% vs. 12.5%, p < 0.05). Milder initial hearing threshold, early onset of treatment (5.6 ± 4.8 days) with unilateral involvement and an older age (11.3 ± 3.0 yrs) in bilaterally affected cases were associated with a better prognosis in this cohort. In addition, the unilateral group showed comparable outcomes, when sub-analyzed by comparison to that in either left- (n = 42) or right-sided (n = 31) SSNHL. CONCLUSION Although bilateral and unilateral pediatric SSNHL could cause partial to complete cochlear lesion, they may be relevant to distinct backgrounds. Our data also provides valuable information about demographics and outcomes of SSNHL in children.
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Affiliation(s)
- Kaitian Chen
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University and Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, 510080, PR China
| | - Hongyan Jiang
- Department of Otorhinolaryngology, Hainan General Hospital, Haikou, 570311, PR China
| | - Ling Zong
- Department of Otorhinolaryngology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, PR China
| | - Xuan Wu
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University and Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, 510080, PR China.
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Wu X, Jiang H, Wen L, Zong L, Chen K. Delayed Recovery in Pediatric Sudden Sensorineural Hearing Loss Predicted via Magnetic Resonance Imaging. Ann Otol Rhinol Laryngol 2018; 127:373-378. [PMID: 29717656 DOI: 10.1177/0003489418769942] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: To evaluate the potential origins via magnetic resonance imaging and the relevant hearing recovery course of pediatric sudden sensorineural hearing loss. Methods: We retrospectively analyzed data of 25 pediatric patients from our center with sudden sensorineural hearing loss from January 2011 to December 2016. All individuals were closely followed up at baseline and 1 and 6 months. Results: Magnetic resonance imaging identified presumed causes in 9 cases, 5 of which showed intralabyrinthine hyperintensity, suggesting presumptive intralabyrinthine hemorrhage. The remaining 20 patients showed no hyperintensity. Restoration of hearing and speech discrimination abilities were noted in these 25 children at 6 months versus the initial levels (74.2 ± 22.6 vs 93.5 ± 20.5 dB, p = .000, and 45.8 ± 36.0 vs. 18.3 ± 22.1%, p = .004, respectively). The prognosis of the individuals with intralabyrinthine hemorrhage were superior in terms of frequency and hearing threshold at 6 months compared with that of the no-hemorrhage participants. Word recognition scores improved in either studied group. Conclusion: The potential recovery of hearing in children raises concerns about very early surgical intervention within the first 6 months. Rational imaging and sequential audiometric evaluation to monitor the progression of recovery may be beneficial.
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Affiliation(s)
- Xuan Wu
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University and Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, PR China
| | - Hongyan Jiang
- Department of Otorhinolaryngology, Hainan General Hospital, Haikou, PR China
| | - Lanying Wen
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University and Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, PR China
| | - Ling Zong
- Department of Otorhinolaryngology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Kaitian Chen
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University and Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, PR China
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Di Nardo W, Anzivino R, Cattani P, Santangelo R, De Corso E, Paludetti G. Herpes simplex virus-1 and cytomegalovirus DNAs detection in the inner ear of implanted patients with non-congenital infection. Acta Otolaryngol 2017; 137:791-796. [PMID: 28332898 DOI: 10.1080/00016489.2017.1293292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
CONCLUSIONS The detection of cytomegalovirus (CMV) and herpes simplex virus-1 (HSV-1) genome in perilymph of patients with negative serology or clinical history for congenital infections supports the hypothesis that Herpesviridae, even after acquired postnatal infections, could remain in latent phase in the spiral ganglion and damage the cochlea by a possible subsequent reactivation. Further studies are needed to identify the markers of such reactivation. OBJECTIVE To identify the presence of certain viral species in the endolabyrinthic fluid of deaf patients with non-congenital infection. The research of viral DNA within the inner ear is the only direct way to increase our knowledge about the viral role in postnatal damage to the cochlea. METHODS Thirty-six patients (1-69 years) suffering from bilateral sensorineural hearing loss (SNHL) were subjected, during cochlear implant (CI) surgery, to a sample taking of inner ear fluid. Several types of viral genome (HSV, VZV, CMV, EBV and Enterovirus) were investigated in each sample through multiplex polymerase chain reaction (PCR) and reverse transcriptase-polymerase chain reaction (RT-PCR). Radiological exams, serology (specific IgG and IgM) and PCR of peripheral blood were also performed. RESULTS While the research of the viral genome in peripheral blood was negative in all patients, multiplex PCR on endolabyrinthic fluid samples was positive in three patients (two cases of CMV-DNA and one case of HSV-1 DNA).
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Affiliation(s)
- Walter Di Nardo
- Department of Head and Neck Surgery, Institute of Otorhinolaryngology, Catholic University of Sacred Heart, Rome, Italy
| | - Roberta Anzivino
- Department of Head and Neck Surgery, Institute of Otorhinolaryngology, Catholic University of Sacred Heart, Rome, Italy
| | - Paola Cattani
- Department of Diagnostic and Laboratory Medicine, Institute of Microbiology, Catholic University of Sacred Heart, Rome, Italy
| | - Rosaria Santangelo
- Department of Diagnostic and Laboratory Medicine, Institute of Microbiology, Catholic University of Sacred Heart, Rome, Italy
| | - Eugenio De Corso
- Department of Head and Neck Surgery, Institute of Otorhinolaryngology, Catholic University of Sacred Heart, Rome, Italy
| | - Gaetano Paludetti
- Department of Head and Neck Surgery, Institute of Otorhinolaryngology, Catholic University of Sacred Heart, Rome, Italy
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Colpan B, Apiliogullari S, Erdur O, Celik JB, Duman A, Senaran H, Ozturk K. The effects of spinal anesthesia on auditory function in pediatric patients. Int J Pediatr Otorhinolaryngol 2016; 88:199-202. [PMID: 27497414 DOI: 10.1016/j.ijporl.2016.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 07/06/2016] [Accepted: 07/08/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Persistent or transient hearing loss (HL) is a less-recognized complication of spinal anesthesia (SA) in the pediatric population, although it has been previously reported in adults. The primary aim of this study was to investigate the effects of SA on auditory function in the pediatric population. METHODS After gaining institutional approval and parental consent, 30 American Society of Anesthesiologists physical status I-II children between 4 and 15 years undergoing lower extremity orthopedic surgery were enrolled in this prospective study. Spinal blocks were performed in the midline with a 25G Quincke needle using 0.5% hyperbaric bupivacaine. Transient evoked otoacoustic emission (TEOAE) and distortion product otoacoustic emission (DPOAE) tests were administered before surgery and one-day postoperative. Children with detected HL were retested on postoperative day seven. Preoperative and postoperative results were compared. A Wilcoxin Signed-Ranks test (with Bonferroni correction) was used for statistical analyses. RESULTS There was no statistically significant HL in the postoperative period compared to the preoperative period. In 29 of 30 patients, no difference was detected at any frequency tested. In one patient, TEOAE and DPOAE tests were found to be decreased on postoperative day one. In this patient, control tests were found to be improved on postoperative day seven. CONCLUSIONS Administration of SA may results in a low probability of transient hearing loss with no clinical significance in children 4-15 years of age.
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Affiliation(s)
- Bahar Colpan
- Selcuk University Medical School, Department of Otolaryngology, Konya, Turkey.
| | - Seza Apiliogullari
- Selcuk University Medical School, Department of Anesthesia and Intensive Care, Konya, Turkey.
| | - Omer Erdur
- Selcuk University Medical School, Department of Otolaryngology, Konya, Turkey.
| | - Jale Bengi Celik
- Selcuk University Medical School, Department of Anesthesia and Intensive Care, Konya, Turkey.
| | - Ates Duman
- Selcuk University Medical School, Department of Anesthesia and Intensive Care, Konya, Turkey.
| | - Hakan Senaran
- Selcuk University Medical School, Department of Orthopedics, Konya, Turkey.
| | - Kayhan Ozturk
- Selcuk University Medical School, Department of Otolaryngology, Konya, Turkey.
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Dedhia K, Chi DH. Pediatric sudden sensorineural hearing loss: Etiology, diagnosis and treatment in 20 children. Int J Pediatr Otorhinolaryngol 2016; 88:208-12. [PMID: 27497416 DOI: 10.1016/j.ijporl.2016.07.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 07/01/2016] [Accepted: 07/02/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES 1. To report our experience in children with sudden-onset sensorineural hearing loss (SSNHL). 2. To describe the etiology and management of children with SSNHL. METHODS Retrospective review of 20 children with SSNHL, from 2000 to 2013 at a tertiary pediatric facility. Patients had the following inclusion criteria: history of normal hearing, hearing loss occurring in less than 3 days, and audiogram documentation. RESULTS The average age of patients presenting with SSNHL is 11 years 3 months (22months-18years). Only 6 (30%) children presented prior to 2 weeks. Tinnitus (55%) was the most common associated symptoms followed by otalgia (25%), and vertigo (20%). Eight patients had bilateral hearing loss, 6 only right and 6 only left. Hearing loss severity ranged from profound (45%) being most common to mild. Etiology was unknown (30%), viral (25%), anatomic abnormality (25%), Meniere's disease (5%), autoimmune (5%), perilymphatic fistula (5%), and suppurative labyrinthitis (5%). Eight patients had initial treatment with oral steroids of which 50% had improvement on audiograms. Two patients underwent intratympanic injections, both showed improvement. Of the 12 patients with no treatment, only 1 had improved hearing. CONCLUSIONS The true incidence of pediatric SSNHL is not well established in our literature. Unique aspects of pediatric SSNHL are delayed presentation and higher percent of anatomic findings. In our study 70% presented more than 2 weeks after experiencing symptoms. Anatomic abnormalities are in 40% of patients. Hearing improvement occurred in 50% of children treated with oral steroids. Intratympanic steroid treatment is another option but may have practical limitation in the pediatric population.
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Affiliation(s)
- Kavita Dedhia
- Department of Otolaryngology, Emory University, Atlanta, GA, USA
| | - David H Chi
- Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA.
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