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Yang S, Liu C, Zhao C, Zuo W. Pregnant Patients with Sudden Sensorineural Hearing Loss: Treatments and Efficacy. J Int Adv Otol 2023; 19:472-277. [PMID: 38088319 PMCID: PMC10765178 DOI: 10.5152/iao.2023.22981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 07/28/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The aim of this study was to study the safety and effectiveness of oral and tympanic hormone injection in the treatment of sudden sensorineural hearing loss during pregnancy. METHODS Data were collected via prospective method. A total of 102 pregnant women with sensorineural hearing loss as experimental group and another 102 patients of sensorineural hearing loss without pregnancy as control group were simultaneously included in the study. Pure tone audiometry test was examined at pre- and posttreatment in 1 week, 2 weeks, and 12 weeks. The experimental group received oral and tympanic hormones, while the control group was treated with the Clinical Practice Guideline: Sudden Hearing Loss (2019) of USA. Recovery rate and hearing gain were assessed by the Clinical Practice Guidelines. RESULTS After treatment, the effects of the experimental group and the control group were compared at the 1st, 2nd, and 12th week after treatment. It was found that at the 12th week after treatment, the curative effect of the experimental group was significantly different from that of the control group, and the difference was statistically significant. CONCLUSION The pregnant women with sensorineural hearing loss were more serious than nonpregnant women, and the treatment efficacies were worse than control group. For pregnancy patients with sudden deafness, oral steroids and tympanic cavity injection is an effective, safe first-line treatment options.
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Affiliation(s)
- Sen Yang
- Department of Otolaryngology, Suining Central Hospital, Suining, China
| | - Chonghua Liu
- Department of Otolaryngology, Suining Central Hospital, Suining, China
| | - Churong Zhao
- Department of Otolaryngology, Suining Central Hospital, Suining, China
| | - Wenqi Zuo
- Department of Otolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Li X, Chen WJ, Xu J, Yi HJ, Ye JY. Clinical Analysis of Intratympanic Injection of Dexamethasone for Treating Sudden Deafness. Int J Gen Med 2021; 14:2575-2579. [PMID: 34163226 PMCID: PMC8216197 DOI: 10.2147/ijgm.s304123] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/30/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction A variety of causes may induce sudden deafness. However, it remains challenging to determine the exact cause in a clinic. There is no standard treatment for this disease due to its unclear etiology. Objective The present study aims to investigate the clinical efficacy of the intratympanic injection of dexamethasone for treating sudden deafness. Methods A total of 154 patients with sudden deafness were retrospectively analyzed. The evaluation of sudden deafness was based on the AAO-HNS efficacy evaluative criteria. All patients were initially treated within seven days by an intravenous drip of methylprednisolone, vasodilator, and neurotrophic agents. These patients were divided into two groups: the treatment group (91 patients) and the control group (63 patients). Patients in the treatment group were given an intratympanic injection of dexamethasone, while patients in the control group were given conventional vasodilators and neurotrophic treatment. Results The effective rate in the treatment group was 47.25% (43/91 patients), and this was significantly higher than in the control group (14.29%, 9/63 patients). The adverse reactions in the treatment group included transient pain (7.69%, 7/91), but there was no vertigo in either group. There was one case of tympanic membrane perforation. Conclusion The intratympanic injection of dexamethasone is a better choice for refractory sudden deafness due to its high efficacy and fewer adverse reactions.
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Affiliation(s)
- Xin Li
- Department of Otorhinolaryngology, Beijing Tsinghua Changgung Hospital, Beijing, 102218, People's Republic of China.,School of Clinical Medicine, Tsinghua University, Beijing, 100084, People's Republic of China
| | - Wen-Jing Chen
- Department of Otorhinolaryngology, Beijing Tsinghua Changgung Hospital, Beijing, 102218, People's Republic of China.,School of Clinical Medicine, Tsinghua University, Beijing, 100084, People's Republic of China
| | - Jia Xu
- Department of Otorhinolaryngology, Beijing Tsinghua Changgung Hospital, Beijing, 102218, People's Republic of China
| | - Hai-Jin Yi
- Department of Otorhinolaryngology, Beijing Tsinghua Changgung Hospital, Beijing, 102218, People's Republic of China.,School of Clinical Medicine, Tsinghua University, Beijing, 100084, People's Republic of China
| | - Jing-Ying Ye
- Department of Otorhinolaryngology, Beijing Tsinghua Changgung Hospital, Beijing, 102218, People's Republic of China.,School of Clinical Medicine, Tsinghua University, Beijing, 100084, People's Republic of China
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Lyu YL, Zeng FQ, Zhou Z, Yan M, Zhang W, Liu M, Ke ZY. Intratympanic dexamethasone injection for sudden sensorineural hearing loss in pregnancy. World J Clin Cases 2020; 8:4051-4058. [PMID: 33024762 PMCID: PMC7520784 DOI: 10.12998/wjcc.v8.i18.4051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/23/2020] [Accepted: 08/12/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND As sudden sensorineural hearing loss (SSNHL) rarely occurs in pregnant women, there is a lack of knowledge and relevant research on its management.
AIM To investigate the effect of intratympanic dexamethasone injection in the treatment of pregnant patients with SSNHL.
METHODS A retrospective chart review was made for the period between June 2017 and August 2019 at our Department of Otorhinolaryngology-Head and Neck Surgery. Pregnant women who met the criteria for SSNHL were included and grouped based on the therapeutic modalities. The treatment group received intratympanic dexamethasone (2.5 mg) q.o.d. for a total of four times, while the control group received no medication other than bed rest and medical observations. All the patients were under close care of obstetricians. Pure-tone audiograms were performed before and after treatment.
RESULTS Eleven patients who met the inclusion criteria were assigned to the treatment group (n = 7) and the control group (n = 4). The mean age of patients was 31.2 ± 3.8 years; the right ear was affected in seven (63.64%) cases. Two patients (18.2%) suffered from vertigo, 10 (90.9%) suffered from tinnitus and 6 (54.5%) suffered from aural fullness. The time from onset to clinic visit was relatively short, with a mean time of 1.3 ± 0.9 d. All the women were within the second or third trimester; the average gestation period was 26.0 ± 6.2 wk. The pure-tone averages at onset between the two groups were similar. After one wk of therapy, the treatment group had a curative rate of 57.1% and a significantly better hearing threshold and greater improvement compared to the control group (all P < 0.05). Some patients experienced transient discomfort from intratympanic injections that disappeared after getting rest, while none had permanent complications. All patients delivered healthy full-term neonates with an average Apgar score of 9.7 ± 0.5.
CONCLUSION Intratympanic dexamethasone injections can be used as a first-line therapy in pregnant women with SSNHL.
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Affiliation(s)
- Yan-Lu Lyu
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Fan-Qian Zeng
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Zhou Zhou
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Min Yan
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Wei Zhang
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Ming Liu
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Zhao-Yang Ke
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
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Zeng Y, Zhang W. Ameliorative effects of ceftriaxone sodium combined with dexamethasone on infantile purulent meningitis and associated effects on brain-derived neurotrophic factor levels. Exp Ther Med 2020; 20:945-951. [PMID: 32742338 PMCID: PMC7388254 DOI: 10.3892/etm.2020.8769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 01/09/2020] [Indexed: 11/30/2022] Open
Abstract
The aim of the present study was to evaluate the role of ceftriaxone sodium combined with dexamethasone on the treatment of infant purulent meningitis (PM) and to measure brain-derived neurotrophic factor (BDNF) levels in children with PM. Of the 177 patients enrolled into the present study, 92 patients received ceftriaxone sodium+dexamethasone (combination group) and 85 patients received ceftriaxone sodium alone (monotherapy group). The time taken for the body temperature, peripheral blood (PB) and cerebrospinal fluid (CSF) white blood cell (WBC) counts to recover back to normal levels were compared between the two groups. In addition, changes in the CSF WBC counts, CSF protein and sugar concentrations, BDNF levels, effective treatment rates and incidence of adverse reactions three days before treatment (T1), after one week of treatment (T2) and after two weeks of treatment (T3) were compared between the two groups. In the combination group, the recovery time of body temperature, WBC counts in both PB and CSF were significantly lower compared with those in the monotherapy group. The combination group also exhibited lower CSF protein concentrations and higher CSF sugar concentrations at T2 and T3 compared with those in the monotherapy group (P<0.05). The effective treatment rate of the combination group was significantly higher compared with that of the monotherapy group (P=0.006). CSF protein at T1, T2 T3, and CSF sugar concentrations and BDNF levels at T1 were significantly lower in the combination group than in the monotherapy group (P<0.05) while the CSF sugar concentrations at T2, T3 were higher in the combination group than in the monotherapy group (P<0.05). Taken together, these observations suggest that ceftriaxone combined with dexamethasone was superior compared with that of ceftriaxone alone for the treatment of infantile PM, and that this combination therapy may improve the effective treatment rate and accelerate patient rehabilitation.
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Affiliation(s)
- Yiwen Zeng
- Department of Pediatrics, Yongchuan Hospital of Chongqing Medical University, Yongchuan, Chongqing 402160, P.R. China
| | - Wei Zhang
- Department of Pediatrics, Yongchuan Hospital of Chongqing Medical University, Yongchuan, Chongqing 402160, P.R. China
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Khamvongsa P, Patel N, Ali AA, Bodoukhin N, Carreno O. Using corticosteroids to treat sudden sensorineural hearing loss in pregnancy: A case report and literature review. Case Rep Womens Health 2020; 27:e00201. [PMID: 32346519 PMCID: PMC7178325 DOI: 10.1016/j.crwh.2020.e00201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 03/26/2020] [Accepted: 04/02/2020] [Indexed: 11/25/2022] Open
Abstract
Sudden sensorineural hearing loss (SSNHL) can manifest in pregnancy, but very few cases of SSNHL in pregnancy have been reported and none has been reported in the United States. Additionally, there are no established guidelines for how to treat SSNHL in pregnancy. The purpose of this report is to describe how SSNHL presents in pregnancy, to evaluate other etiologies and discuss current treatment options. A 35-year-old parous woman at 22 weeks of gestation, with a 2-week history of left-sided hearing loss, was shown to have a speech recognition threshold of 70 dB in her left ear. Otolaryngology confirmed the diagnosis of SSNHL. The patient was prescribed an oral prednisone taper that helped alleviate the hearing loss. She had an uncomplicated delivery and treatment with corticosteroids had no adverse consequences for the patient. After ruling out etiologies of SSNHL, corticosteroids may be used safely and efficaciously to treat SSNHL during the second trimester of pregnancy.
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Affiliation(s)
- Peter Khamvongsa
- Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8 St, Miami, FL, USA
| | - Naiya Patel
- Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8 St, Miami, FL, USA
| | - Ayesha Aziz Ali
- Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8 St, Miami, FL, USA
| | - Nikita Bodoukhin
- Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8 St, Miami, FL, USA
| | - Octavio Carreno
- Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8 St, Miami, FL, USA
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Xie S, Wu X. Clinical management and progress in sudden sensorineural hearing loss during pregnancy. J Int Med Res 2019; 48:300060519870718. [PMID: 31452412 PMCID: PMC7593668 DOI: 10.1177/0300060519870718] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Sudden sensorineural hearing loss (SSNHL) is a relatively rare, but distressing, disease in pregnant women. Little is known about the causes, clinical manifestations, treatments, and prognosis of SSNHL. Some hypotheses have been proposed to explain the pathophysiological mechanism of SSNHL, but most of them have not been identified. This article reviews the existing literature to present a summary of this clinical problem. Most patients suffer from SSNHL in the second or third trimester, and show moderate to profound hearing loss. The interval between the initial treatment and onset of hearing loss is less than 10 days in most patients. Some patients with SSNHL show tinnitus, vertigo, or dizziness, and fullness of the ear. Although some patients have a tendency for self-cure, treatment with intravenous dextran 40 combined with intratympanic corticosteroids is probably a safe and effective therapeutic strategy for pregnant patients with SSNHL. Further clinical research is necessary to identify the best therapeutic strategy for these patients.
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Affiliation(s)
- Shaobing Xie
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University, Changsha, Hunan, PR China.,Key Laboratory of Otolaryngology Major Diseases Research of Hunan Province, Changsha, Hunan, PR China
| | - Xuewen Wu
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University, Changsha, Hunan, PR China.,Key Laboratory of Otolaryngology Major Diseases Research of Hunan Province, Changsha, Hunan, PR China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, PR China
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