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Zhang BY, Young YH. Geriatric sudden deafness. Am J Otolaryngol 2021; 42:102985. [PMID: 33610920 DOI: 10.1016/j.amjoto.2021.102985] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 02/14/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE Sudden sensorineural hearing loss, briefly sudden deafness (SD), in the elderly remains less investigated despite rapidly aging population in most countries around the world. This study investigated whether aging process affects the treatment outcome of SD in the elderly. PATIENTS AND METHODS Eighty patients with SD, comprising 40 geriatric patients aged >65 years and 40 non-geriatric patients aged 55-64 years, were enrolled in this study. All patients underwent an inner ear test battery including audiometry, and cervical vestibular-evoked myogenic potential (cVEMP), ocular VEMP (oVEMP), and caloric tests. RESULTS Pre-treatment mean hearing level in the geriatric group (94 ± 16 dB) did not significantly differ from non-geriatric group (89 ± 20 dB). After treatment for 3 months, mean hearing gain in the geriatric group (22 ± 18 dB) with an improvement rate of 65%, did not significantly differ from non-geriatric group (21 ± 28 dB) with 58% improvement rate. Both inter-subject and intra-subject analyses revealed that the aging process greatly influenced the cVEMP and oVEMP responses, while less influenced the caloric responses. CONCLUSION The treatment outcome of SD in geriatric patients aged >65 years did not significantly differ from that in non-geriatric patients aged 55-64 years, indicating that aging process did not affect treatment outcome of SD. Unlike treatment outcome for the presbycusis is unsatisfactory, treatment outcome for the elderly with SD could be favorable.
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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
Rheopheresis has met an increasing interest and application in different disease conditions affecting microcirculation. Its last applications are for the management of Macular and Cochlear disorders. The sudden hearing loss syndrome is a condition that affects 20 out of 100000 persons per year, reduces the patient's social interaction and quality of life. It is associated with vascular and coagulation risk factors and it is considered as a result of local hypoperfusion secondary both to inflammatory and dysimmune conditions determining inadequate NO release and endothelial dysfunction. Rheopheresis treatment is a new approach which brings to satisfactory clinical results. Cascade filtration, heparin induced lipid precipitation and conventional plasma exchange are equally effective, and only 2 sessions are required for producing long lasting benefits. Our experience is with 60 patients, 90% of which getting from partial to complete recovery after treatment as measured by pure tone audiometry.
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Affiliation(s)
- M Valbonesi
- Department of Immunohematology, San Martino University Hospital, Genova, Italy.
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Zhang BY, Young YH. Sudden Deafness during Antepartum versus Postpartum Periods. ORL J Otorhinolaryngol Relat Spec 2017; 79:274-281. [DOI: 10.1159/000478936] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 06/21/2017] [Indexed: 12/12/2022]
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Shu J, Si Y, Yin S, He M. Association between the V Leiden G1691A mutation and sudden sensorineural hearing loss in Italian population: a meta-analysis. Eur Arch Otorhinolaryngol 2015; 273:2467-72. [DOI: 10.1007/s00405-015-3844-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 11/21/2015] [Indexed: 12/28/2022]
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Shu J, Yin S, Tan AZ, He M. Association between the prothrombin G20210A mutation and sudden sensorineural hearing loss in European population: a meta-analysis. Thromb Res 2014; 135:73-7. [PMID: 25466842 DOI: 10.1016/j.thromres.2014.10.032] [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: 08/16/2014] [Accepted: 10/29/2014] [Indexed: 11/17/2022]
Abstract
PURPOSE Epidemiological studies have reported inconsistent findings on the association between the prothrombin G20210A mutation and sudden sensorineural hearing loss (SSNHL) in European population. The aim of this meta-analysis was to clarify the association of this polymorphism with SSNHL in European population. METHODS PubMed, Embase, and the China National Knowledge Infrastructure (CNKI) were searched up to August 1, 2014. We used STATA12.0 to calculate summary odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS Eight studies including 1972 patients were identified. Pooled data showed no significant association between the prothrombin G20210A mutation and risk of SSNHL in European population : A vs. G (OR =1.645, 95% CI:0.78-3.49,POR =0.194); AG vs.GG (OR =1.660, 95% CI:0.77-3.60,POR=0.199). CONCLUSIONS The present meta-analysis suggests that the prothrombin G20210A mutation is not significantly associated with an increased risk of SSNHL in European population.
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Affiliation(s)
- Jingcheng Shu
- Department of Otorhinolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Shihua Yin
- Department of Otorhinolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.
| | - An-Zhou Tan
- Department of Otorhinolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Meirong He
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
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Shu J, Yin S, Tan AZ, He M. Association between the methylenetetrahydrofolate reductase gene C677T polymorphism and sudden sensorineural hearing loss: a meta-analysis. Eur Arch Otorhinolaryngol 2014; 272:2267-74. [DOI: 10.1007/s00405-014-3198-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 07/04/2014] [Indexed: 01/16/2023]
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Bogaz EA, Suzuki FADB, Rossini BAA, Inoue DP, Penido NDO. Glucocorticoid influence on prognosis of idiopathic sudden sensorineural hearing loss. Braz J Otorhinolaryngol 2014; 80:213-9. [PMID: 25153105 PMCID: PMC9535483 DOI: 10.1016/j.bjorl.2014.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 02/01/2014] [Indexed: 12/02/2022] Open
Abstract
Introduction Idiopathic Sudden Sensorineural Hearing Loss (ISSHL) is defined when a loss of at least 30 dB occurs in over 3 continuous frequencies, in up to 72 hours, of which etiology is not established, despite adequate investigation. Different types of treatment regimens have been proposed, but only glucocorticoids have shown some evidence of benefit in the literature. Objective To analyze whether the type of treatment or time of treatment with glucocorticoids have any influence on hearing recovery in ISSHL. Methods Observational retrospective cohort study. One hundred twenty-seven patients with ISSHL, treated at outpatient clinics between the years 2000 and 2010, were studied. We evaluated the prognostic correlation of the type of treatment and time to treatment with glucocorticoids and ISSHL. Results The absolute hearing gain and the relative hearing gain was as follows: 23.6 dB and 37.2%. Complete recovery was observed in 15.7% of patients, significant recovery in 27.6% and recovery in 57.5%. Conclusion In this study, there was no difference between the use and nonuse of glucocorticoids in hearing improvement. However, when started within seven days after onset, the use of glucocorticoids was a factor of better prognosis.
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Wang CT, Chou HW, Fang KM, Lai MS, Cheng PW. Treatment Outcome of Additional Dextran to Corticosteroid Therapy on Sudden Deafness. Otolaryngol Head Neck Surg 2012; 147:1125-30. [DOI: 10.1177/0194599812458219] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective This study aimed to investigate whether adding low-molecular-weight dextran to oral steroids in patients with idiopathic sudden sensorineural hearing loss resulted in better hearing outcomes than those in patients receiving oral corticosteroids alone. Study Design Historical cohort study. Setting Tertiary teaching hospital. Subjects and Methods The authors reviewed the clinical records of 166 patients with idiopathic sudden sensorineural hearing loss. Therapeutic effectiveness was measured by the gain of pure-tone averages and 4 categories of hearing outcome (complete recovery, marked recovery, mild improvement, or no improvement). To manage potential confounding factors associated with treatment allocation, the authors matched the subjects from each group according to the propensity score (ie, the predicted probability that they would receive a specific treatment). Results The authors identified 50 pairs of propensity score–matched subjects (n = 100) without significant difference of all clinical factors ( P > .05). Subsequent analyses demonstrated that the average hearing gain in subjects receiving additional dextran to oral steroid was 31.7 ± 21.5 dB, which did not differ from 33.0 ± 21.8 dB in subjects receiving steroids alone ( P = .76). Difference of hearing outcomes between the 2 groups was also nonsignificant ( P = .92). Conclusion Matching propensity scores successfully balanced the heterogeneity between the dextran and steroid groups. Analytical results demonstrated that adding low-molecular-weight dextran to oral corticosteroids was not associated with greater hearing gain or better hearing outcome in idiopathic sudden sensorineural hearing loss.
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Affiliation(s)
- Chi-Te Wang
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
- Graduate Institutes of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Oriental Institute of Technology, Taipei, Taiwan
| | - Hsu-Wen Chou
- Graduate Institutes of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Kai-Min Fang
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
- Oriental Institute of Technology, Taipei, Taiwan
| | - Mei-Shu Lai
- Graduate Institutes of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Center of Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan
| | - Po-Wen Cheng
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
- Oriental Institute of Technology, Taipei, Taiwan
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Kuo YL, Young YH. Hearing outcome of recurrent sudden deafness: ipsilateral versus contralateral types. Acta Otolaryngol 2012; 132:247-54. [PMID: 22217185 DOI: 10.3109/00016489.2011.642817] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
CONCLUSION Patients with recurrent sudden deafness demonstrating normal vestibular-evoked myogenic potentials (VEMPs) in the lesion ear of the second episode may indicate a good hearing outcome. OBJECTIVE This study retrospectively reviewed our experience of patients with recurrent sudden deafness during the past 20 years. METHODS Sixteen (1.4 %) of 1156 patients with sudden deafness were diagnosed as having a recurrent episode, including ipsilateral type in 7 and contralateral type in 9. All patients underwent an audiovestibular test battery and blood and MRI examinations. After 2000, nine patients underwent the VEMP test. RESULTS In the ipsilateral type, the mean interval between two episodes was 2 ± 2 years, which did not differ significantly from 3 ± 3 years in the contralateral type. There were no significant differences in relation to age at onset of the second episode, inter-episode interval, gender, presence of vertigo, and abnormal caloric results. However, abnormal rate of VEMP test in the contralateral type (five of five patients) was significantly higher than that in the ipsilateral type (none of four patients). At the second episode, all four patients with normal VEMPs on the lesion ear had improved hearing, while four of five patients with absent or delayed VEMPs showed unchanged hearing. Altogether, the hearing improvement rate in both types of recurrent sudden deafness was 50%.
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Affiliation(s)
- Yen-Lin Kuo
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
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Nosrati-Zarenoe R, Hansson M, Hultcrantz E. Assessment of diagnostic approaches to idiopathic sudden sensorineural hearing loss and their influence on treatment and outcome. Acta Otolaryngol 2010. [DOI: 10.3109/00016480903161541] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Retrocochlear mass lesion in mid-frequency sudden deafness. Otolaryngol Head Neck Surg 2008; 138:13-7. [DOI: 10.1016/j.otohns.2007.10.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2007] [Revised: 08/20/2007] [Accepted: 10/10/2007] [Indexed: 11/24/2022]
Abstract
Objective This study retrospectively reviewed all cases of mid-frequency sudden deafness to understand the clinical significance of this hallmark finding. Study Design Retrospective study. Subjects and Methods From 1992 to 2006, a total of 556 patients with sudden deafness were experienced. Based on the audiographic configuration, these patients were classified into: flat-type group, 272 cases; high-frequency group, 146 cases; low-frequency group, 70 cases; mid-frequency group, 30 cases; and unclassified group, 38 cases. All patients underwent a battery of audiovestibular function testing. Results Among 556 sudden deafness patients, 17 patients (3%) were proved to have a retrocochlear tumor, including mid-frequency group (10), high-frequency group (4), flat-type group (2), and low-frequency group (1). Thus, the mid-frequency group had significantly higher (33%) association with a retrocochlear tumor than other groups. Conclusion One-third of the patients with mid-frequency sudden deafness harbor a true retrocochlear mass lesion; hence, MR imaging is mandatory in such cases.
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Nosrati-Zarenoe R, Arlinger S, Hultcrantz E. Idiopathic sudden sensorineural hearing loss: results drawn from the Swedish national database. Acta Otolaryngol 2007; 127:1168-75. [PMID: 17851927 DOI: 10.1080/00016480701242477] [Citation(s) in RCA: 121] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CONCLUSION The first results from 300 patients in a Swedish national database for sudden sensorineural hearing loss (SSNHL) demonstrate that corticosteroids or 'no treatment at all' are the treatment options in use today. No significant difference in outcome was seen between treated and non-treated patients. Since spontaneous recovery might be the cause, a placebo-controlled randomized study is required before a positive effect of corticosteroids can be asserted. OBJECTIVES To investigate the treatment policy for SSNHL in Sweden, the effect on outcome, and which variables are of value in predicting the outcome. PATIENTS AND METHODS A national database was developed in Sweden which gathers data from patients with SSNHL. A form is used for data collection covering background, current disease, examinations, and treatment. Audiograms at the onset of SSNHL and after 3 months are analyzed. RESULTS Of 300 patients, 208 were considered to have idiopathic SSNHL; 50% were treated with corticosteroids, 44% did not receive any treatment. The treated patients had the same outcome as the non-treated patients. The time interval from onset of SSNHL to start of treatment was of importance for the outcome irrespective of type of audiogram or results from laboratory tests. Higher age and heredity for hearing loss gave a significantly lower chance of improvement.
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Affiliation(s)
- Ramesh Nosrati-Zarenoe
- Division of Oto-Rhino-Laryngology and Technical Audiology, Department of Neuroscience and Locomotion, Linköping University, University Hospital, SE 58185 Linköping, Sweden
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Jenkins V, Beveridge H, Low R, Mitra S. Atypical hearing loss in women with breast cancer receiving adjuvant treatment. Breast 2005; 15:448-51. [PMID: 16135407 DOI: 10.1016/j.breast.2005.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2004] [Revised: 06/08/2005] [Accepted: 06/23/2005] [Indexed: 11/19/2022] Open
Abstract
There are no reports of adjuvant treatments for early breast cancer causing hearing loss. Yet in this exploratory study 14/16 women who had received Fluorouracil, Epirubicin and Cyclophosphamide (FEC) chemotherapy regimen, 11 of whom also received endocrine treatment, had reduced hearing sensitivity, with 9/16 being atypical. It is not clear whether this finding is related to oestrogen reduction and/or ototoxicity but a more detailed investigation in this area is warranted given the large number of women with breast cancer who receive adjuvant treatments.
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Affiliation(s)
- V Jenkins
- Cancer Research UK Psychosocial Oncology Group, Brighton and Sussex Medical School, University of Sussex, Falmer, East Sussex, and Department of Audiology, Royal Sussex County Hospital, Brighton, UK.
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Abstract
Idiopathic Sudden Sensorineural Hearing Loss (ISSHL) remains one of the major unsolved otologic emergencies. It is characterized by the onset of an unilateral sensorineural hearing loss developing within 24 hours, and averaging on pure tone audiogram at least 30 dB HL for three subsequent octave steps, with no marked vestibular symptoms and no identifiable cause. ISSHL is a syndrome covering several heterogeneous entities resulting from different pathogenetic mechanisms. At this time, the audiogram is the unique tool which may help clinicians to identify these entities and provide a classification based on 5 types of hearing loss. Numerous experimental and clinical studies have investigated the mechanisms by which infectious, ischemic, mechanic or immunologic insults may induce cochlear dysfunction. However, extrapolation to humans and rationale therapeutic approaches to ISSHL remain uncertain. SSHL being a diagnosis of exclusion, retrocochlear and neurologic etiologies should be eliminated. No argument allows to consider ISSHL a therapeutic emergency. More precisely, the experimental data presently available on cochlear physiology suggests that a treatment could have some chance to be effective if undertaken within minutes following the onset of ISSHL, a condition never encountered in daily practice. Conversely, it is not justifiable to impute the absence of hearing recovery to a delay in therapy. The various therapeutic strategies currently recommended are highly empirical and should be questionned in terms of cost-effectiveness, the most common being high-dose corticosteroids. New investigation tests are required for improving our approach to ISSHL.
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Affiliation(s)
- J-B Charrier
- Service d'ORL et de chirurgie de la face et du cou, Assistance Publique-Hôpitaux de Paris, Université Paris VII Hôpital Lariboisière 2, rue Ambroise Paré 75010 Paris, France
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Nakashima T, Naganawa S, Sone M, Tominaga M, Hayashi H, Yamamoto H, Liu X, Nuttall AL. Disorders of cochlear blood flow. ACTA ACUST UNITED AC 2004; 43:17-28. [PMID: 14499459 DOI: 10.1016/s0165-0173(03)00189-9] [Citation(s) in RCA: 163] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The cochlea is principally supplied from the inner ear artery (labyrinthine artery), which is usually a branch of the anterior inferior cerebellar artery. Cochlear blood flow is a function of cochlear perfusion pressure, which is calculated as the difference between mean arterial blood pressure and inner ear fluid pressure. Many otologic disorders such as noise-induced hearing loss, endolymphatic hydrops and presbycusis are suspected of being related to alterations in cochlear blood flow. However, the human cochlea is not easily accessible for investigation because this delicate sensory organ is hidden deep in the temporal bone. In patients with sensorineural hearing loss, magnetic resonance imaging, laser-Doppler flowmetry and ultrasonography have been used to investigate the status of cochlear blood flow. There have been many reports of hearing loss that were considered to be caused by blood flow disturbance in the cochlea. However, direct evidence of blood flow disturbance in the cochlea is still lacking in most of the cases.
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Affiliation(s)
- Tsutomu Nakashima
- Department of Otorhinolaryngology, Nagoya University School of Medicine, Nagoya, Japan.
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Abstract
OBJECTIVE Pulmonary complication in cases of sudden deafness after dextran treatment is rarely reported. This study discusses the management of two cases and reviews the current literature. PATIENTS Two (1%) of 204 patients with sudden deafness patients had fever, cough, and dyspnea after intravenous dextran infusion. Pulmonary edema was diagnosed after chest radiographic examination. RESULTS After interruption of dextran, subsequent supportive treatment relieved chest discomfort and fever without any sequelae. The results of chest radiograph and laboratory studies, including hemogram, renal function, and arterial blood oxygen saturation, were normal. CONCLUSIONS Patients receiving dextran treatment should have their clinical symptoms, renal function, chest radiographs, hemogram, and coagulation profiles monitored. If fever, bleeding, cough, or dyspnea occurs during treatment, dextran must be immediately stopped. Subsequent treatment should focus on dextran clearance to prevent further cascade complications.
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Affiliation(s)
- Shuo-Tzung Kuo
- Department of Otolaryngology, National Taiwan University Hospital, Taipei
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Imamura S, Nozawa I, Imamura M, Murakami Y. Clinical observations on acute low-tone sensorineural hearing loss. Survey and analysis of 137 patients. Ann Otol Rhinol Laryngol 1997; 106:746-50. [PMID: 9302905 DOI: 10.1177/000348949710600906] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We retrospectively analyzed the clinical records of 137 patients who were treated at our clinic for acute low-tone sensorineural hearing loss of unknown cause over a period of 8 years. The analyses of the clinical records indicated the following clinical characteristics: female preponderance; peak incidence during the fourth decade of life; frequent accompanying tinnitus, sensation of ear fullness, and/ or autophony; suspicion of bilateral involvement; and association with autonomic imbalance. The hearing in most of the patients completely recovered, but some selected patients experienced fluctuating hearing loss or progression to Meniere's disease. Our results suggest that a subgroup of patients with severe initial hearing loss should be carefully followed up, although it is difficult to predict the outcome of this disorder.
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Affiliation(s)
- S Imamura
- Department of Otolaryngology, Yamanashi Medical University, Japan
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