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Rodriguez-Martín M, González-Aguado R, Salvatierra-Vicario B, Dierssen-Sotos T, Morales-Angulo C. Sudden Hearing Loss as an Initial Symptom of Vestibular Schwannoma. World Neurosurg 2024; 185:e549-e554. [PMID: 38382763 DOI: 10.1016/j.wneu.2024.02.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 02/23/2024]
Abstract
OBJECTIVE This study aims to determine the prevalence of vestibular schwannoma (VS) among patients presenting with sudden hearing loss (SHL) and to characterize the clinical features of individuals diagnosed with both VS and SHL. METHODS We conducted an observational retrospective review at a tertiary referral center, spanning a 30-year period, focusing on patients diagnosed with SHL where VS was confirmed as the underlying cause. We included patients meeting these criteria while excluding those lacking imaging or with a pre-existing diagnosis of VS. We evaluated the audiological characteristics at the time of diagnosis and assessed clinical outcomes following treatment. RESULTS Among the 403 patients presenting with SHL during the study period, 9 (2.2%) were diagnosed with VS, aged between 25 and 72 years. Although audiometric profiles varied, high-frequency hearing loss predominated, mostly categorized as mild to moderate. Six patients (66%) had Koos grade I-II schwannomas. Only 2 patients achieved complete hearing recovery post-treatment, while 4 showed no improvement. CONCLUSIONS VS is a rare etiology of SHL, accounting for slightly over 2% of cases. Its symptomatology, severity, and audiometric patterns do not significantly differ from SHL caused by other factors. Tumor size does not correlate with hearing characteristics. Treatment modalities resemble those for other SHL cases, and hearing improvement does not obviate the necessity for follow-up magnetic resonance imaging (MRI) scans.
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Affiliation(s)
- Minerva Rodriguez-Martín
- Otolaryngology and Head and Neck Surgery Department, Attending Surgeon, Hospital de Urduliz-Alfredo Espinosa, Vizcaya, Vasque Country, Spain
| | - Rocío González-Aguado
- Otolaryngology and Head and Neck Surgery Department, Attending Surgeon, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Belén Salvatierra-Vicario
- Otolaryngology and Head and Neck Surgery Department, Attending Surgeon, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Tinidad Dierssen-Sotos
- Department of Medical and Surgical Sciences Medicine School, Preventive Medicine and Public Health, University of Cantabria, Santander, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; IDIVAL, Santander, Cantabria, Spain
| | - Carmelo Morales-Angulo
- IDIVAL, Santander, Cantabria, Spain; Department of Otolaryngology and Head and Neck Surgery, Marqués de Valdecilla University Hospital, Santander, Spain.
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Kaneko H, Ozono Y, Iwakiri H, Hatada H, Uchiyama N, Komaki Y, Nakamura K, Hasuike S, Nagata K, Kawakami H. Reactivation of hepatitis C virus caused by steroid monotherapy for sudden deafness. Clin J Gastroenterol 2024:10.1007/s12328-024-01944-9. [PMID: 38587568 DOI: 10.1007/s12328-024-01944-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 02/28/2024] [Indexed: 04/09/2024]
Abstract
Hepatitis C virus (HCV) reactivation has been reported to be caused due to several anticancer drugs and immunosuppressive agents; however, HCV reactivation after steroid monotherapy has rarely been reported. Here, we report the case of a 65-year-old Japanese man with HCV infection who developed HCV reactivation after the administration of prednisolone (PSL) for 6 days for sudden deafness. In the patient history, the positivity for anti-HCV antibody was observed, but serum level of HCV RNA was not measured. Two months after PSL administration, the patient experienced an alanine aminotransferase (ALT) flare and the serum level of HCV RNA was observed to be 6.2 log IU/mL; then, the patient was admitted to our hospital for hepatitis treatment. Based on the clinical course and laboratory findings, the patient was diagnosed with HCV reactivation. Although the ALT levels decreased spontaneously during follow-up, they did not drop to normal range; subsequently, sofosbuvir and ledipasvir treatments were started. A sustained virological response 24 weeks after the end of treatment was achieved. This case study suggests that HCV reactivation with hepatitis flare can occur even after a steroid monotherapy, and doctors should pay attention to HCV reactivation when administering PSL for patients with HCV infection.
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Affiliation(s)
- Hiroki Kaneko
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Yoshinori Ozono
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Hisayoshi Iwakiri
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Hiroshi Hatada
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Naomi Uchiyama
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Yuri Komaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Kenichi Nakamura
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Satoru Hasuike
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Kenji Nagata
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Hiroshi Kawakami
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
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Zhang Z, Yu C, Wang X, Ge S, Zhai G, Si S, Ma T, Li F, Cui Z, Jin X, Jin Y. The construction and validation of prognostic prediction model for sudden sensorineural hearing loss in middle-aged and elderly people. Auris Nasus Larynx 2024; 51:276-285. [PMID: 37872076 DOI: 10.1016/j.anl.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/27/2023] [Accepted: 10/13/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVE Idiopathic sudden sensorineural hearing loss (ISSNHL), as an otologic emergency, is commonly encountered and its prevalence has been climbing every year recently. To our knowledge, the prognosis of middle-aged and elderly patients is worse than that of young patients. Previous researches mainly focused on the adult population, which was considered as prognostic models who performed hearing recovery in ISSNHL. However, few studies regarding the middle-aged and elderly population who are regarded as prognostic models have been reported. Therefore, we aim to construct and validate a nomogram-based prognostic prediction model, which can provide a reference for the prognostic assessment in the middle-aged and elderly patients with ISSNHL. METHOD A total of 371 middle-aged and elderly ISSNHL patients who were admitted to the Department of Otolaryngology-Head and Neck Surgery, Yanbian Hospital, Yanbian University, from April 2018 to April 2023 were enrolled in the study. All subjects were randomly divided into two groups including training group (n = 263) and validation group (n = 108). Lasso regression and multi-factor logistic regression were jointly utilized to screen out prognosis-related independent risk factors and establish a nomogram-based risk prediction model. The accuracy and clinical application value of the model were evaluated by combining the Bootstrapping method and k-fold cross-validation, plotting the receiver operating characteristic (ROC) curve, calculating the area under the ROC curve (AUC), plotting the decision curve analysis (DCA), and the calibrating curve. RESULT We used the method of lasso regression combined with multivariate logistic regression and finally screened out eight predictors (including age, number of affected ears, degree of hearing loss, type of hearing curve, duration of disease, presence of vertigo, diabetes, and lacunar cerebral infarction) that were included into the nomogram. The C-index were 0.823 [95% CI (0.725, 0.921)] and 0.851 [95% CI (0.701, 1.000)], and the AUC values were 0.812 and 0.823 for the training and validation groups, respectively. The calibration curve for the validation group was approximately conformed to that for the modeling group, indicating favorable model calibration. The DCA results revealed the modeling group (3%-86%) and the validation group (2%-92%) showed significant net clinical benefit under the majority of thresholds. CONCLUSION This study developed and validated a nomogram-based prognostic prediction model which based on the eight independent risk factors mentioned above. The predictors are conveniently accessible and may assist clinicians in formulating individualized treatment strategies.
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Affiliation(s)
- Zhiqiang Zhang
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Changxu Yu
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Xueyan Wang
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Sitong Ge
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Guanhong Zhai
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Shurui Si
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Tianyi Ma
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Fuyao Li
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Zhezhu Cui
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Xianghua Jin
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China.
| | - Yulian Jin
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China; Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
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Wang ZH, Zhang HL. Relationship Between Serum ET-1, HDL-C, and sVCAM-1 and Hearing Loss in Patients with Sudden Deafness. Appl Biochem Biotechnol 2024; 196:1376-1385. [PMID: 37395946 DOI: 10.1007/s12010-023-04593-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2023] [Indexed: 07/04/2023]
Abstract
Vascular causes are most commonly associated with sudden sensorineural hearing loss (SSHL). This study was performed to determine the relationship between serum endothelin-1 (ET-1), high-density lipoprotein cholesterol (HDL-C), soluble vascular cell adhesion molecule-1 (sVCAM-1) levels, and the degree of hearing loss in patients with SSHL. Firstly, 60 SSHL patients were admitted to The First Hospital of Shanxi Medical University. In the same period, 60 healthy subjects matching the age and gender of SSHL patients were selected as the control group. Then, serum levels of ET-1, HDL-C, and sVCAM-1 were measured by enzyme-linked immunosorbent assay (ELISA). Next, the relationship between serum levels of ET-1, HDL-C, and sVCAM-1 with clinicopathological factors and their diagnostic and prognostic values were analyzed and evaluated. Serum ET-1 and sVCAM-1 were increased, and HDL-C was decreased in patients with SSHL. Serum ET-1 and sVCAM-1 were higher and HDL-C was lower in patients aged ≥ 45 years, or severe hearing loss patients (P < 0.05). ROC analysis determined that ET-1 (AUC = 0.839), HDL-C (AUC = 0.830), and sVCAM-1 (AUC = 0.865) had excellent diagnostic values. In addition, patients with low levels of ET-1 and sVCAM-1 and high levels of HDL-C had better hearing prognosis (P < 0.05). Abnormal serum ET-1, HDL-C, and sVCAM-1 in patients with SSHL are closely related to age, and degree of hearing loss, and perform diagnostic and prognostic values.
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Affiliation(s)
- Zhao Hua Wang
- Shanxi Medical University, Taiyuan City, 030001, Shanxi Province, China
| | - Hai Li Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, The First Hospital of Shanxi Medical University, No. 85, Jiefang South Road, Yingze District, Taiyuan City, 030001, Shanxi Province, China.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Zou T, Xu J, Lu H, Yu M. The Relationship between the Characteristics of Tinnitus and the Hearing Curative Effect of Sudden Deafness. Audiol Neurootol 2023:1-7. [PMID: 36809749 DOI: 10.1159/000528444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 09/22/2022] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Tinnitus is the most common complication of sudden deafness. There are many studies on tinnitus and tinnitus as a prognostic factor for sudden deafness. SUMMARY We collected 285 cases (330 ears) of sudden deafness to investigate the relationship between tinnitus psychoacoustic characteristics and the hearing curative effective rate. The hearing curative effective rate was analyzed and compared between the patients whether it is accompanied by tinnitus, with different tinnitus frequency and different tinnitus loudness. KEY MESSAGES Patients with tinnitus frequency (125-2,000 Hz) and no tinnitus have better hearing efficacy, and those with high frequency tinnitus (3,000-8,000 Hz) have worse hearing efficacy. Test the tinnitus frequency of patients in the initial stage of sudden deafness has some guiding significance for the evaluation of hearing prognosis.
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Affiliation(s)
- Ting Zou
- Department of Otolaryngology, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Jin Xu
- Department of Otolaryngology, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Hongyi Lu
- Department of Otolaryngology, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Mingqiang Yu
- Department of Otolaryngology, Tongde Hospital of Zhejiang Province, Hangzhou, China
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Yamin T, Oron Y, Handzel O, Abu Eta R, Muhanna N, Ungar OJ. Neurovascular conflict and sudden unilateral sensorineural hearing loss: coincidence or coexistence? Eur Arch Otorhinolaryngol 2023:10.1007/s00405-023-07878-1. [PMID: 36786926 DOI: 10.1007/s00405-023-07878-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/07/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVE To study the association between neurovascular conflict (NVC) of the 8th cranial nerve (CN8) and unilateral sudden sensorineural hearing loss SSNHL (SSNHL). METHODS A systematic literature search of "MEDLINE" via "PubMed," "Embase," and "Google-Scholar" was conducted. Meta-analysis of pooled data was performed for NVC prevalence of SSNHL affected ears versus controls. RESULTS The literature search identified 941 publications, of which, 9 included in qualitative synthesis (1030 ears) and 5 in quantitative synthesis (484 ears). NVC was as prevalent as 0.8-69% for affected ears and as 19-57% for controlled ears. No association between MRI protocol and NVC prevalence was proved. An odds ratio of 1.05 (95% confidence interval = 0.79-1.39) was calculated for association of NVC in unilateral SSNHL ears versus controls. CONCLUSION The prevalence of NVC of CN8 in unilateral SSNHL affected ears is not significantly bigger than controls. Hence, NVC of CN8 is probably NOT associated with unilateral SSNHL. LEVEL OF EVIDENCE: 1
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Affiliation(s)
- Tzahi Yamin
- Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel, affiliated to the Sackler School of Medicine, Tel-Aviv University, 6 Weizmann Street, 6423906, Tel Aviv, Israel
| | - Yahav Oron
- Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel, affiliated to the Sackler School of Medicine, Tel-Aviv University, 6 Weizmann Street, 6423906, Tel Aviv, Israel
| | - Ophir Handzel
- Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel, affiliated to the Sackler School of Medicine, Tel-Aviv University, 6 Weizmann Street, 6423906, Tel Aviv, Israel
| | - Rani Abu Eta
- Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel, affiliated to the Sackler School of Medicine, Tel-Aviv University, 6 Weizmann Street, 6423906, Tel Aviv, Israel
| | - Nidal Muhanna
- Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel, affiliated to the Sackler School of Medicine, Tel-Aviv University, 6 Weizmann Street, 6423906, Tel Aviv, Israel
| | - Omer J Ungar
- Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel, affiliated to the Sackler School of Medicine, Tel-Aviv University, 6 Weizmann Street, 6423906, Tel Aviv, Israel.
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Chavkin U, Pitaro J, Gavriel H, Taha A, Muallem Kalmovich L, Shilo S, Handzel O, Muhanna N, Warshavsky A, Horowitz G, Ungar OJ. The impact of eustachian tube function on intra-tympanic steroid administration. Eur Arch Otorhinolaryngol 2023; 280:143-9. [PMID: 35670878 DOI: 10.1007/s00405-022-07475-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 05/27/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES This study investigated the impact of eustachian tube (ET) function (ETF) on therapeutic success on candidates for intra-tympanic administration of steroids (ITAoS), due to idiopathic sudden sensorineural hearing loss (ISSNHL). METHODS Medical chart review in two university-affiliated medical centers was performed. Included were consecutive adult patients diagnosed with unilateral ISSNHL between 2012 and 2019 who were treated with ITAoS due to incomplete or no recovery following systemic steroidal therapy. ETF was assessed by means tympanometry, before the initiation of ITAoS. The cohort was divided into an ET dysfunction group (ETD(+)) and a functioning ET group (control: ETD(-)). The audiologic response to treatment was recorded at the last follow-up. RESULTS A total of 64 suitable patients [median (interquartile, IQR) age 49 (38-63) years] were enrolled. The ETD(+) group included 20 patients and the remaining 44 patients served as controls. Demographic and clinical parameters were not significantly different between the two groups at presentation. Hearing thresholds were improved significantly better, at frequencies 250, 500, 1, 2, 4, and 8 kHz (p = 0.001-0.040) in the ETD(+) group. CONCLUSION ETD(+) is associated with better efficacy of ITAoS. LEVEL OF EVIDENCE: 4
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Sakata H, Hayashi K, Suganuma E, Oishi T. Case Reports on Effect of Intratympanic Steroid Injection Therapy on Late-Onset Hearing Loss in Congenital Cytomegalovirus Infection. Int Tinnitus J 2022; 26:115-121. [PMID: 36724359 DOI: 10.5935/0946-5448.20220018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND One of the conditions or symptoms caused by congenital cytomegalovirus (cCMV) infection is late-onset hearing loss. This report examines the cases of two children exhibiting late-onset hearing loss after cCMV infection who showed improvement in hearing after undergoing intratympanic steroid injection therapy (IST). CASES Case1 is girl aged 8 years and 10 months and case2 is girl aged 5 years and 1 month. Cytomegalovirus (CMV) was not detected in the blood or urine of either child at the time of hearing loss despite them having cCMV infection. FINDINGS The hearing of both children improved as a result of IST on an outpatient basis. Case1 was given first session of IST in left ear immediately on the day of her visit and second session of IST in left ear 2 days later. Tendency for improvement in threshold on left side was observed (the differences were about 20 to 45 dB). Case2 was given a total of 2 sessions of IST on left ear, 3 days and 5 days after visiting the hospital. The test result of distortion product otoacoustic emissions changed from refer to pass. Tendency for improvement in threshold on left side was observed (the differences were about 5 to 25 dB). CONCLUSIONS Bearing in mind that late-onset hearing loss in patients with cCMV may be caused by other factors besides CMV, consideration of IST as a possible treatment option is proposed.
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Affiliation(s)
- Hideaki Sakata
- Division of Otorhinolaryngology, Kawagoe Ear Institute, Kawagoe Mine Medical Center, Kawagoe City, Saitama, Japan
| | - Ken Hayashi
- Division of Infectious Diseases and Immunology, Allergy, Saitama Children's Medical Center, 1-2 Shin-toshin, Chuo-ku Saitama City, Saitama, 330-8777, Japan
| | - Eisuke Suganuma
- Division of Infectious Diseases and Immunology, Allergy, Saitama Children's Medical Center, 1-2 Shin-toshin, Chuo-ku Saitama City, Saitama, 330-8777, Japan
| | - Tsutomu Oishi
- Division of Infectious Diseases and Immunology, Allergy, Saitama Children's Medical Center, 1-2 Shin-toshin, Chuo-ku Saitama City, Saitama, 330-8777, Japan
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Li BL, Xu JY, Lin S. Sudden deafness as a prodrome of cerebellar artery infarction: Three case reports. World J Clin Cases 2022; 10:4895-4903. [PMID: 35801026 PMCID: PMC9198885 DOI: 10.12998/wjcc.v10.i15.4895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 03/04/2022] [Accepted: 04/04/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND To summarize the clinical characteristics of acute cerebral infarction (ACI) in patients with sudden deafness (SD) as the first symptom, improve the awareness of the disease, and help diagnosis and treatment.
CASE SUMMARY From 2019 to 2020, three patients with ACI with SD as the first symptom were admitted to our hospital. Pure tone audiometry, head magnetic resonance imaging (MRI), vertebral artery and carotid artery B-ultrasound, head and neck computed tomography angiography, and other examinations were performed. Following the treatment of SD, hearing and dizziness were not significantly improved. Then, the patients developed symptoms of related cranial nerve injury, and brain MRI showed cerebral infarction in the cerebellopontine angle area. All three cases were transferred to the neurology department for relevant conservative treatment.
CONCLUSION Patients with ACI with SD as the first symptom usually attend the otolaryngology clinic. Here a diagnosis of SD, which is based on an audiological examination, is made and the corresponding treatment is administered. To reduce the misdiagnosis of this disease, close attention should be paid to the changes in the patient's clinical symptoms and related auxiliary examinations should be performed, such as brain MRI and cerebrovascular imaging. Otolaryngologists should pay attention to the type and severity of hearing loss, the accompanying symptoms, age, high-risk factors for cerebral infarction, and related cranial nerve symptoms in patients with SD. If the patient's early brain MRI does not show abnormalities, monitoring remains essential. The head MRI should be analyzed quickly based on the changes in the symptoms of the patient, to make an accurate diagnosis and provide the timely and correct treatment for the patients.
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Affiliation(s)
- Bang-Liang Li
- Department of Ear, Nose, and Throat, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Jia-Yuan Xu
- Department of Ear, Nose, and Throat, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Sen Lin
- Department of Ear, Nose, and Throat, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
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Zhu H, Yan H, Zhang Y. Effect of stellate ganglion injections guided by different approaches on hearing threshold in patients with sudden deafness. Am J Otolaryngol 2022; 43:103201. [PMID: 35490585 DOI: 10.1016/j.amjoto.2021.103201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/05/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The current study was conducted aimed at investigating the effect of stellate ganglion injection guided with different approaches on hearing threshold in patients harboring sudden deafness. METHODS There involved a total of 68 patients with sudden deafness in our study. The patients were randomly allocated into control group and study group, with 34 cases in each group. The control group and study group were respectively given conventional blind puncture block and ultrasound-guided stellate ganglion injection. The clinical efficacy, first puncture success rate, first block success rate, average block time, hearing threshold improvement value, vertigo disappearance time, hearing recovery time, hemorheological changes and complications of the two groups were compared. RESULTS The total effective rate of the study group was significantly higher than that of the control group (96.06 vs. 76.47%, P < 0.05). The first puncture success rate and the first block success rate of the study group were evidently higher than those of the control group, and the average block time of the study group was significantly shorter than that of the control group (P < 0.05). The improvement of hearing threshold in the study group was higher than that in the control group, and the time of vertigo disappearance and hearing recovery in the study group was shorter than that in the control group, with significant difference (P < 0.05). Before treatment, EAI, HCT and PV levels of the two groups were comparable (P > 0.05). After treatment, however, the levels of EAI, HCT and PV in the two groups were lower. Furthermore, the levels of EAI, HCT and PV in the study group were significantly lower compared with the control group (P < 0.05). The incidence of complications in the study group was significantly less than that in the control group (P < 0.05). CONCLUSION Ultrasound-guided stellate ganglion injection achieved beneficial effects in treating sudden deafness, which is available for wide clinical practice.
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Affiliation(s)
- Hong Zhu
- Department of Otolaryngology, Cangzhou Central Hospital, Cangzhou, Hebei, China.
| | - Huafeng Yan
- Department of Otolaryngology, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - YanE Zhang
- Department of Otolaryngology, Renqiu People's Hospital, Renqiu, Hebei, China
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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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Shao M, Xiong G, Xiang G, Xu S, Zheng Y, Zhang L. Sudden deafness as an initial presentation of varicella: case report and literature review. Ann Palliat Med 2021; 10:5891-5896. [PMID: 34107725 DOI: 10.21037/apm-21-785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/06/2021] [Indexed: 11/06/2022]
Abstract
Varicella, or chickenpox, is a highly contagious disease transmitted by the varicella zoster virus (VZV). Idiopathic sudden sensorineural hearing loss (ISSNHL) has been defined as a loss of at least 30 dB over at least three frequencies on audiogram within three days and with an uncertain cause. Deafness caused by varicella-zoster virus occasionally occurred in Ramsey hunter syndrome but associated with chickenpox is rare. We present a case of an adult varicella infection with sudden deafness as the first symptom. The patient begins with a sudden hearing loss in his left ear and developed fever 12 days later and skin rash 13 days later. He was diagnosed as chickenpox and received treatment of oral famciclovir capsule 250 mg administrated three times daily. After 2 weeks, at an outpatient follow-up the patient reported that while his scabs had fallen off and he felt well, the sudden deafness in the left ear had not improved. This kind of cases are rare and suggest the relationship between VZV and sudden deafness. Sudden deafness can be the first symptom of chickenpox. In this study, we also reviewed pathogenesis, clinical feature and the epidemiological character of chickenpox, the neurological complications of varicella zoster and the etiology of sudden deafness.
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Affiliation(s)
- Minmin Shao
- Department of Otorhinolaryngology, The Second Affiliated Hospital of Shanghai University (Wenzhou Central Hospital), Wenzhou, China
| | - Guofeng Xiong
- Department of Otorhinolaryngology, The Second Affiliated Hospital of Shanghai University (Wenzhou Central Hospital), Wenzhou, China
| | - Guangzao Xiang
- Department of Otorhinolaryngology, The Second Affiliated Hospital of Shanghai University (Wenzhou Central Hospital), Wenzhou, China
| | - Shile Xu
- Department of Otorhinolaryngology, The Second Affiliated Hospital of Shanghai University (Wenzhou Central Hospital), Wenzhou, China
| | - Yingsong Zheng
- Department of Otorhinolaryngology, The Second Affiliated Hospital of Shanghai University (Wenzhou Central Hospital), Wenzhou, China
| | - Liqun Zhang
- Department of Otorhinolaryngology, The Second Affiliated Hospital of Shanghai University (Wenzhou Central Hospital), Wenzhou, China
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Conte G, Di Berardino F, Mastrapasqua RF, Casale S, Scola E, Capaccio P, Triulzi F, Pignataro L, Zanetti D. Prognostic Value of Early Magnetic Resonance Imaging Patterns in Sudden Hearing Loss. Audiol Neurootol 2021; 27:64-74. [PMID: 33895732 DOI: 10.1159/000515153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 02/08/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Sudden sensorineural hearing loss (SSHL) is a relatively frequent disease, but a sensitive marker or a reliable test to identify the underlying cause is still unavailable. Neuroradiology appears to offer the most promising tools, especially magnetic resonance imaging (MRI). In a recent study from our group, we explored the ability of MRI to detect subtle changes in the inner ear compartments by means of a 3D-fluid-attenuated inversion recovery sequence, aiming at identifying 3 distinct MRI patterns (haemorrhagic, inflammatory, brain-labyrinth barrier breakdown). In the present study, we contrasted the MRI patterns at onset with relevant prognostic factors, with the audiological features of each patient's SSHL and with treatment outcomes. METHODS In this retrospective study, we enrolled 50 adult subjects (54.61 ± 18.26 years) with SSHL. They underwent an MRI within 72 h from admission, and 5 audiological evaluations: at admission, on the 5th day after the start of medical therapy, at the end of the first cycle of hyperbaric oxygen therapy, then 1 and 6 months later. RESULTS Abnormalities of the MRI signal and/or post-contrast enhancement asymmetry of the cochlea ("pattern+ MRI") correlated with worse audiological outcomes at 1 month, but the different MRI patterns were not correlated with any specific prognostic model, despite rigid protocol settings. However, a significant difference was found for low-tone SSHL, which were always "pattern" negative at MRI (p = 0.01), and for profound SSHL which demonstrated a pattern+ MRI in 80% (p = 0.04). At the onset of SSHL, a pattern+ MRI was found in 29/50 cases (58.0%) and was related with lesser degree of recovery of pure-tone average at 1 month and lesser chance to retain the hearing threshold benefit in the long term. Given the limited numbers of patients enrolled so far, the relative impact of comorbidities on each MRI pattern remains uncertain. At 6 months, we observed a trend of greater and more stable recovery (p = 0.023) and less frequent recurrence of SSHL in patients with a normal MRI. CONCLUSIONS The 3 observed MRI patterns did not correlate consistently with specific audio-vestibular features or any peculiar aspect of the patient's clinical history. Larger series of patients with SSHL are needed, possibly from multicentric studies.
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Affiliation(s)
- Giorgio Conte
- Neuroradiology Department, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Federica Di Berardino
- Audiology Unit, Department of Specialistic Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Rodolfo Francesco Mastrapasqua
- Audiology Unit, Department of Specialistic Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Casale
- Neuroradiology Department, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisa Scola
- Neuroradiology Department, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Pasquale Capaccio
- Otorhinolaryngology Unit, Department of Specialistic Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio Triulzi
- Neuroradiology Department, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lorenzo Pignataro
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Otorhinolaryngology Unit, Department of Specialistic Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Diego Zanetti
- Audiology Unit, Department of Specialistic Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Pihl CE, Back CF, Iversen HK, Amin FM. Sudden Bilateral Deafness in a Patient with Transient Ischemic Attack: A Case Report. Case Rep Neurol 2021; 13:119-122. [PMID: 33790769 PMCID: PMC7989795 DOI: 10.1159/000512403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/15/2020] [Indexed: 11/19/2022] Open
Abstract
Sudden-onset bilateral cortical deafness is a very rare symptom of stroke, but must be recognized as stroke, as it is a treatable condition, and the treatment is highly time dependent. We report a 53-year-old man with an acute onset of complete bilateral hearing loss that gradually improved spontaneously over 4 h. The hearing loss was explained by an infarction visualized on magnetic resonance imaging, which showed a subacute temporoparietal ischemic lesion in the left cerebral hemisphere involving the insular cortex and an older infarction in the right temporoparietal region. The location of these kinds of lesions may typically not cause motor deficits, but sensory and cognitive (e.g., aphasia) symptoms, which can be challenging to recognize in a suddenly deaf patient. Taking the possible differential diagnoses into account, immediate stroke workup should always be prioritized in patients with sudden bilateral deafness, as acute revascularizing treatment is possible.
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Affiliation(s)
- Caroline Ellinore Pihl
- Department of Neurology, Rigshospitalet Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Christina Fredsby Back
- Department of Neurology, Rigshospitalet Glostrup, University of Copenhagen, Copenhagen, Denmark
| | | | - Faisal Mohammad Amin
- Department of Neurology, Rigshospitalet Glostrup, University of Copenhagen, Copenhagen, Denmark
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Abstract
OBJECTIVES This study compared sudden deafness (SD) cases in 20-year age bands to investigate their causes and treatment outcome. DESIGN Retrospective study. STUDY SAMPLES 178 unilateral SD patients were divided into four 20-year age-groups, namely Groups I (aged 0-19 years, n = 6), II (aged 20-39 years, n = 33), III (aged 40-59 years, n = 63), and IV (aged 60-79 years, n = 76). METHODS An inner ear test battery and/or serology assay were performed. RESULTS Incidence of SD in relation to overall neurotological cases did not significantly differ among the four groups. Groups I and II showed two or three audiographic patterns, while Groups III and IV had six audiographic patterns indicating that the aetiology of Groups I and II may be of the same origin, while Groups III and IV had multiple aetiologies. The hearing improvement rate was significantly higher in Groups III (62%) and IV (62%) than in Groups I (16%) and II (33%). CONCLUSION SD inevitably affects individuals of all ages. Significant differences in the audiographic patterns and speculative causes may account for various outcomes of treatment in each 20-year age band. Those SD patients aged 40-59 and 60-79 years showed significantly better treatment outcomes than those aged 0-19 and 20-39 years.
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Affiliation(s)
- Wei-Chen Hung
- Department of Otolaryngology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Kuei-You Lin
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan.,Department of Otolaryngology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Po-Wen Cheng
- Department of Otolaryngology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Yi-Ho Young
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
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Nakata T, Okada M, Hanari T, Takagi T, Fujiwara T, Hato N. Association of the prognosis and severity of idiopathic sudden sensorineural hearing loss with cervical ultrasonographic findings. Auris Nasus Larynx 2021; 48:1074-1080. [PMID: 33745790 DOI: 10.1016/j.anl.2021.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/19/2021] [Accepted: 03/02/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the association of the prognosis and severity of idiopathic sudden sensorineural hearing loss (ISSNHL) with cervical ultrasonographic findings suggestive of cardiovascular risk. METHODS Seventy-four inpatients with ISSNHL were included in our study. Cervical ultrasonography was performed to evaluate the common carotid artery (CCA), internal carotid artery (ICA), and vertebral artery (VA). The peak systolic velocity, end diastolic velocity, intima-media thickness, pulsatility index (PI), and resistance index (RI) were evaluated. We investigated the relationship of these variables with the severity and prognosis of ISSNHL. RESULTS ICA-PI, ICA-RI, and CCA-RI were significantly higher in patients with poor hearing prognosis than in those with good prognosis. The variables of VA were not related to the prognosis of ISSNHL. There were no statistically significant differences between ISSNHL severity and cervical ultrasonographic findings. CONCLUSIONS We found that PI and RI might be prognostic factors for ISSNHL.
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Affiliation(s)
- Takahiro Nakata
- Department of Otolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon Ehime 791-0295, Japan
| | - Masahiro Okada
- Department of Otolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon Ehime 791-0295, Japan.
| | - Takahiro Hanari
- Department of Otolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon Ehime 791-0295, Japan
| | - Taro Takagi
- Department of Otolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon Ehime 791-0295, Japan
| | - Takashi Fujiwara
- Department of Public Health Research, Kurashiki Clinical Research Institute, Kurashiki, Japan
| | - Naohito Hato
- Department of Otolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon Ehime 791-0295, Japan
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18
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Xiong M, Feng X, Tang L, Li C, Yu L. Butylphthalide enhances recovery from sudden deafness. Am J Otolaryngol 2021; 42:102891. [PMID: 33422947 DOI: 10.1016/j.amjoto.2020.102891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 12/27/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Cochlear microcirculation disturbance caused by vasculopathy is a common cause of sudden deafness (SD). Reactive oxygen species (ROS) plays an important role in cochlear injury during ischemia-reperfusion. Butylphthalide can improve microcirculation, reduce ROS formation and inhibit apoptosis. The aim of this study was to investigate the therapeutic effect of butylphthalide on patients with SD. PATIENTS AND METHODS The hearing gains from 32 ears treated with butylphthalide were compared with that of 32 ears treated with non-butylphthalide. Butylphthalide capsules was administrated orally on an empty stomach for 10 continuous days. There were no significant differences in audiological and clinical data between butylphthalide and non-butylphthalide groups. RESULTS The hearing gain of butylphthalide group at 500, 1000, 2000, and 4000 Hz was significantly higher than that of non-butylphthalide group correspondingly (P<0.01). And, the hearing gain at PTA (pure-tone average of 500, 1000, 2000, and 4000 Hz) in butylphthalide group was significantly higher than that of non-butylphthalide group (P<0.01). CONCLUSION The recovery of hearing in butylphthalide group was significantly better than that of non-butylphthalide group. It is confirmed that butylphthalide has a definite therapeutic effect on SD.
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De Luca P, Cassandro E, Scarpa A, Cassandro C, Ralli M, Gioacchini FM, Re M, Chiarella G. Sudden sensorineural hearing loss and COVID-19: (commentary on "Could sudden sensorineural hearing loss be the sole manifestation of COVID-19? An investigation into SARS-COV-2 in the etiology of sudden sensorineural hearing loss" by Osman Kilic, Mahmut Tayyar Kalcioglu, Yasemin Cag, Ozan Tuysuz, Emel Pektas, Hulya Caskurlu, and Ferihan Cetın). Int J Infect Dis 2020; 101:201-2. [PMID: 33010462 DOI: 10.1016/j.ijid.2020.09.1467] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/24/2020] [Indexed: 11/22/2022] Open
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Sun B, Liu L, Ren X, Wang Z. Psychological state of patients with sudden deafness and the effect of psychological intervention on recovery. J Int Med Res 2020; 48:300060520957536. [PMID: 32967513 PMCID: PMC7521050 DOI: 10.1177/0300060520957536] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 08/14/2020] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE To determine the effect of personalized psychological interventions on the recovery of patients with sudden deafness. METHODS Participants were 438 patients with sudden deafness who were randomly allocated to observation and control groups. Patients in the control group received routine nursing care and drug treatment. Patients in the observation group received personalized psychological interventions, routine nursing care and drug treatment. The Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS) were used to measure anxiety and depression. The Simple Coping Style Questionnaire (SCSQ) and the Satisfaction With Life Scale (SWLS) were used to evaluate coping styles, attitude toward life and quality of life. RESULTS Patients in both groups had similar SAS and SDS scores at the time of admission. After treatment, there was a significant difference in SAS and SDS scores between the observation and control groups, indicating that the observation group had less anxiety and depression. Both groups had increased SCSQ and SWLS scores following treatment, indicating improvements in positive coping and satisfaction with life. CONCLUSION Effective psychological interventions may change negative thoughts, increase response rate and improve quality of life.
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Affiliation(s)
- Bin Sun
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Liangliang Liu
- Department of Otorhinolaryngology, The School Hospital, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Xiaoyong Ren
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Zhenghui Wang
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, People’s Republic of China
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21
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Si JP, Jiang H, Li YY. Correlation between effectual time and the curative effect in patients with all frequency descending sudden deafness after treatment. Am J Otolaryngol 2020; 41:102621. [PMID: 32593753 DOI: 10.1016/j.amjoto.2020.102621] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/10/2020] [Accepted: 06/16/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To discuss the correlation between effectual time and the curative effect in patients with all frequency descending sudden deafness. METHODS According to effectual time, the subjects were divided into first week effectual group and second week effectual group and the curative effect of each group was compared. RESULTS In patients with flat descent sudden deafness, the curative rate of the first week effectual group was higher than that of the second week effectual group, but there was no significant difference between the two groups (χ2 = 1.584, P = 0.208). Meanwhile, the total significant effective rate of the first week effectual group was higher than that of the second week effectual group, without obvious difference between the two groups (χ2 = 0.227, P = 0.634). Furthermore, in patients with total deafness type of sudden deafness, the curative rate of the first week effectual group was higher than that of the second week effectual group, showing no remarkable difference between the two groups (χ2 = 2.726, P = 0.099). Besides, there was no remarkable difference in the comparison of the total significant effective rate (χ2 = 2.933, P = 0.087), which was higher in the first week effectual group than that in the second week effectual group. CONCLUSION The course of treatment should be at least 2 weeks in patients with all frequency descending sudden deafness after onset.
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Chen CM, Wu CH, Young YH. Response to "Acute and subacute sensorineural hearing loss after radiosurgery for vestibular schwannomas: Avoiding what is avoidable?". J Neurol Sci 2019; 401:79-80. [PMID: 31029886 DOI: 10.1016/j.jns.2019.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 04/15/2019] [Indexed: 11/23/2022]
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Zhang BY, Young YH. Declining prevalence of pediatric sudden deafness during the past two decades. Int J Pediatr Otorhinolaryngol 2019; 119:118-22. [PMID: 30703660 DOI: 10.1016/j.ijporl.2019.01.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [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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Inui H, Sakamoto T, Ito T, Kitahara T. Magnetic resonance-based volumetric measurement of the endolymphatic space in patients with Meniere's disease and other endolymphatic hydrops-related diseases. Auris Nasus Larynx 2018; 46:493-497. [PMID: 30503567 DOI: 10.1016/j.anl.2018.11.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 10/29/2018] [Accepted: 11/15/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To employ magnetic resonance imaging (MRI) to measure the volume of the inner ear endolymphatic space (ELS) in patients with acute low-tone sensorineural hearing loss (ALHL), sudden deafness (SD), cochlear Meniere's disease (cMD), and unilateral MD (uMD) compared with control subjects (CS) with chronic rhinosinusitis. METHODS Forty-one patients with ALHL, 82 with SD, 48 with cMD, 72 with uMD, and 47 CS participated in the study. With the exception of all uMD patients, none of the subjects had vertigo. Images of the inner ear fluid space, positive perilymph signal, and positive endolymph signal were acquired using a 3-T MRI scanner. Three-dimensional images were reconstructed semi-automatically by using anatomical and tissue information to fuse the inner ear fluid space images and the ELS images. RESULTS The cochlear ELS/total fluid space (TFS) volume ratio was 10.2±6.7% (mean±standard deviation) in the CS group, 12.1±5.7% in ALHL patients, 15.2±8.7% in SD patients, 18.1±8.2% in cMD patients, and 21.9±16.4% in uMD patients. The vestibular ELS/TFS volume ratio was 17.7±10.2% in the CS group, 18.9±8.3% in ALHL patients, 19.9±11.3% in SD patients, 22.5±13.7% in cMD patients, and 35.7±24.1% in uMD patients. The cochlear ELS/TFS volume ratio in patients with uMD was similar to that in the cMD group and significantly higher than that in the CS, ALHL, and SD groups (CS=ALHL<SD<cMD=uMD: p<0.05 for CS vs. SD and p<0.01 for CS vs. cMD). The vestibular ELS/TFS volume ratio in patients with uMD was significantly higher than that in the CS and all other patient groups (CS=ALHL=SD=cMD<uMD: p<0.01 for uMD vs. all other groups). CONCLUSION The cochlear ELS volume of patients with MD and other endolymphatic hydrops-related diseases differed from that of CS. Our results suggest that ALHL may not be caused by endolymphatic hydrops. We confirmed the presence of extended ELS in patients with SD.
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Affiliation(s)
- Hiroshi Inui
- Inui ENT Clinic, 47-1 Miwa, Sakurai-city, Nara, 6330001, Japan.
| | - Tsuyoshi Sakamoto
- PixSpace Ltd., 3-8-1 Asano, Kokurakita-ku, Kitakyusyu-city, Fukuoka, Japan
| | - Taeko Ito
- Department of Otorhinolaryngology Head and Neck Surgery, Nara Medical University, 840 Shijo-cho, Kashihara-city, Nara, Japan
| | - Tadashi Kitahara
- Department of Otorhinolaryngology Head and Neck Surgery, Nara Medical University, 840 Shijo-cho, Kashihara-city, Nara, Japan
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Ashtiani MK, Firouzi F, Bastaninejad S, Dabiri S, Nasirmohtaram S, Saeedi N, Ghazavi H, Sahebi L. Efficacy of systemic and intratympanic corticosteroid combination therapy versus intratympanic or systemic therapy in patients with idiopathic sudden sensorineural hearing loss: a randomized controlled trial. Eur Arch Otorhinolaryngol 2017; 275:89-97. [PMID: 29149379 DOI: 10.1007/s00405-017-4808-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 11/08/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The present study was conducted to compare the rates of recovery from idiopathic sudden deafness after the treatment with oral and intratympanic corticosteroids in both mono and combination therapies. STUDY DESIGN Triple-blind randomized clinical trial. SETTINGS Tertiary referral hospital. SUBJECTS AND METHODS A total of 112 patients who were admitted to the ENT emergency department randomly divided into three groups: an oral corticosteroid plus intratympanic placebo (systemic corticosteroid monotherapy group); an intratympanic corticosteroid plus oral placebo group (IT monotherapy group); and a combination therapy group (IT plus systemic combination group). All patients were treated additionally with antiviral and proton pomp inhibitor. An audiometry was performed once before beginning the therapies and again at the end of the therapy. RESULTS Of the total of 112 patients, 32 received intratympanic (IT) corticosteroids, 45 were receiving systemic corticosteroids, and 35 were receiving a combination of the two. A total of 74 patients (66.1%) responded positively [response to treatment was calculated as gain of at least 10 dB in 10 dB in average threshold or with the minimum improvement of 15% in speech discrimination scores (SDS)] to corticosteroid therapy. No significant differences were observed between the three groups (IT, systemic group, and combination therapy group) in their overall response to treatment (p = 0.5). Patients who suffered from concomitant tinnitus and dizziness responded less positively to the treatment (p < 0.002). Positive family history of SSNHL seems to be negative prognostic factors in the response to treatment (p < 0.001). The response to treatment was not related to the pattern (p = 0.04) and initial severity of hearing loss (p = 0.9). CONCLUSION This study did not find any difference in the rate of hearing improvement between systemic, intratympanic, and combined corticosteroid therapy for sudden hearing loss. LEVEL OF EVIDENCE 1b.
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Affiliation(s)
- Mohammadtaghi Khorsandi Ashtiani
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Otorhinolaryngology and Head and Neck Surgery, Tehran University of Medical Sciences, Tehran, Iran.,Amir'Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Firouzi
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Otorhinolaryngology and Head and Neck Surgery, Tehran University of Medical Sciences, Tehran, Iran.,Tehran University of Medical Sciences, Tehran, Iran
| | - Shahin Bastaninejad
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran. .,Department of Otorhinolaryngology and Head and Neck Surgery, Tehran University of Medical Sciences, Tehran, Iran. .,Amir'Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran. .,ENT Department, Amir'Alam Hospital, North Sadee Avenue, Tehran, Iran.
| | - Sasan Dabiri
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Otorhinolaryngology and Head and Neck Surgery, Tehran University of Medical Sciences, Tehran, Iran.,Amir'Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sevil Nasirmohtaram
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Otorhinolaryngology and Head and Neck Surgery, Tehran University of Medical Sciences, Tehran, Iran.,Tehran University of Medical Sciences, Tehran, Iran
| | - Niloufar Saeedi
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Otorhinolaryngology and Head and Neck Surgery, Tehran University of Medical Sciences, Tehran, Iran.,Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Ghazavi
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Otorhinolaryngology and Head and Neck Surgery, Tehran University of Medical Sciences, Tehran, Iran.,Tehran University of Medical Sciences, Tehran, Iran
| | - Leyla Sahebi
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Min SK, Shin JH, Chang MY, Min HJ, Kim KS, Lee SY, Yang HS, Hong YH, Mun SK. Impact of control of blood glucose level during treatment of sudden deafness in diabetics: relationship with prognosis. Eur Arch Otorhinolaryngol 2016; 274:1339-1343. [PMID: 27853944 PMCID: PMC5309272 DOI: 10.1007/s00405-016-4388-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 11/10/2016] [Indexed: 12/04/2022]
Abstract
The objective of this study is to investigate the impact of control of blood glucose level during treatment of sudden deafness. A retrospective study was performed involving 197 patients from January, 2011 to September, 2015. All patients were administrated prednisolone (Pharmaprednisolone tab®, 5 mg/T; KoreaPharma) p.o under the following regimen: 60 mg/day for 4 days, 40 mg/day for 2 days, 30 mg/day for 1 day, 20 mg/day for 1 day, and 10 mg/day for 2 days. During treatment, pure tone audiometry and blood glucose level were investigated for each patient and the results were statistically analyzed. Mean hearing improvement was 19.2 dB for the non-diabetes group and 24.8 dB for the diabetes group. The greater improvement for diabetics was not statistically significant (p = 0.146). Hearing improvement was 25.1 dB for subjects with mean blood glucose <200 mg/dl and 24.6 dB for subjects with mean blood glucose >200 mg/dl; the difference was not statistically significant (p = 0.267). Mean blood glucose level was 200.8 mg/dl for subjects with hearing improvement >20 dB and 181.8 mg/dl for subjects with hearing improvement <20 dB; the difference was not statistically significant (p = 0.286). Control of blood glucose level during treatment of sudden deafness does not have a direct effect on prognosis.
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Affiliation(s)
- Sang-Ki Min
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, Korea
| | - Ji-Ho Shin
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, Korea
| | - Mun-Young Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, Korea
| | - Hyun-Jin Min
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, Korea
| | - Kyung-Soo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, Korea
| | - Sei-Young Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, Korea
| | - Hoon-Shik Yang
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, Korea
| | - Young-Ho Hong
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, Korea
| | - Seog-Kyun Mun
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, Korea.
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Lee HY, Kim DK, Park YH, Cha WW, Kim GJ, Lee SH. Prognostic factors for profound sudden idiopathic sensorineural hearing loss: a multicenter retrospective study. Eur Arch Otorhinolaryngol 2016; 274:143-149. [PMID: 27544193 DOI: 10.1007/s00405-016-4276-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 08/18/2016] [Indexed: 10/21/2022]
Abstract
The aim of this study was to assess the outcomes of various treatment modalities for profound idiopathic sudden sensorineural hearing loss (ISSNHL) and confirm the prognostic factors. In total, 191 patients were enrolled after a thorough medical chart review of patients diagnosed with unilateral, profound ISSNHL (≥90 dB). Epidemiological profiles, therapeutic regimens, and the results of pure tone audiometry tests were recorded for all patients. Final recovery was assessed according to Siegel's criteria and by comparing the final hearing level of the affected ear with that of the unaffected ear. The mean follow-up duration and the final hearing level were 75 ± 54 days and 77 ± 24 dB, respectively. None of the evaluated prognostic factors were significantly associated with complete recovery (<25 dB). However, improved hearing in both ears, the absence of dizziness, the use of lipo-prostaglandin E1 (lipo-PGE1), and the use of plasma volume expanders were independently associated with a final hearing level of up to 45 dB (p < 0.05). Steroid dose reduction, worse initial hearing, and non-use of lipo-PGE1 increased the possibility of no recovery. Although the efficacy of oral steroid treatment for profound ISSNHL has been questioned, steroid dose reduction was significantly associated with no recovery. Therefore, adequate oral corticosteroid doses should be considered in the absence of contraindications. In addition, the use of lipo-PGE1 and/or a plasma volume expander seems preferable for better recovery, and their use for the management of profound ISSNHL should be considered.
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Affiliation(s)
- Ho Yun Lee
- Department of Otolaryngology-Head and Neck Surgery, Eulji University College of Medicine, Daejeon, South Korea
| | - Dong-Kee Kim
- Department of Otolaryngology-Head and Neck Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daeheung-dong, Jung-gu, Daejeon, South Korea.
| | - Yong-Ho Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chungnam National University, 282 Munwha-ro, Jung-gu, Daejeon, South Korea. .,Brain Research Institute, College of Medicine, Chungnam National University, Daejeon, South Korea.
| | - Wang Woon Cha
- Department of Otolaryngology-Head and Neck Surgery, Eulji University College of Medicine, Daejeon, South Korea
| | - Geun Jeon Kim
- Department of Otolaryngology-Head and Neck Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daeheung-dong, Jung-gu, Daejeon, South Korea
| | - Seung Hun Lee
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chungnam National University, 282 Munwha-ro, Jung-gu, Daejeon, South Korea.,Brain Research Institute, College of Medicine, Chungnam National University, Daejeon, South Korea
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Liu YC, Chi FH, Yang TH, Liu TC. Assessment of complications due to intratympanic injections. World J Otorhinolaryngol Head Neck Surg 2016; 2:13-16. [PMID: 29204543 PMCID: PMC5698530 DOI: 10.1016/j.wjorl.2015.11.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 10/12/2015] [Accepted: 11/11/2015] [Indexed: 11/17/2022] Open
Abstract
Objective The purpose of the study is to report and to analyze the complications following intratympanic injections (ITI) of steroids. The occurrence rate of complications at different ITI sites, four quadrants of eardrum, was also compared. Methods A retrospective clinical review in a medical center. Each patient received ITI twice in a week for 2-3 consecutive weeks as a salvage therapy for sudden sensorineural hearing loss. Post-injection complications, especially transient dizziness and vertigo, were recorded. Patients with acute or chronic vertigo episodes in 1 month were excluded. Results A total of 59 patients with sudden sensorineural hearing loss and a total of 278 times of ITI were performed in 1 year. The post-injection complications included pain, tongue numbness, transient dizziness, vertigo, tinnitus, and a small persistent perforation. There was no significant difference in the occurrence of these complications between the injections sites on the 4 quadrants of the tympanic membrane. However, there was statistical significance in the post-injection vertiginous episode after IT injections to posterior-inferior quadrant (Q3) and posterior-superior quadrant (Q4) compared to anterior-superior quadrant (Q1) and anterior-inferior quadrant (Q2) (P = 0.0113). Conclusion IT injection is recommended to be applied to the Q2 since the Q1 and Q4 injections are more likely to induce the adverse effect of tongue numbness, while the Q3 and Q4 areas are more likely to induce post-injection vertigo.
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Affiliation(s)
- Yu-Chuan Liu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan, China
| | - Fan-Hsiang Chi
- Department of Otolaryngology, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin, Taiwan, China
| | - Ting-Hua Yang
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan, China
| | - Tien-Chen Liu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan, China
- Corresponding author. Department of Otolaryngology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan, China. Tel.: +886 2 23123456; fax: +886 2 23946674.
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Chen K, Sun L, Zong L, Wu X, Zhan Y, Dong C, Cao H, Tang H, Jiang H. GJB2 and mitochondrial 12S rRNA susceptibility mutations in sudden deafness. Eur Arch Otorhinolaryngol 2015; 273:1393-8. [PMID: 26119842 DOI: 10.1007/s00405-015-3693-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 06/16/2015] [Indexed: 10/23/2022]
Abstract
Genetic susceptibility may play an important role in the pathogenesis of sudden deafness. However, the specific genes involved are largely unknown. We sought to explore the frequency of GJB2 and mitochondrial 12S rRNA susceptibility mutations in patients with sudden deafness. Between September 2011 and May 2012, 62 consecutive patients with sudden deafness were seen. In 50 of these, no etiological factors for sudden deafness were found. We detected GJB2 and mitochondrial 12S rRNA variants by direct sequencing in these 50 patients and in 53-aged matched controls with normal hearing. In addition, we undertook functional analyses of the mitochondrial mutations which we detected, applying structural and phylogenetic analysis. GJB2 sequencing identified six mutations, including three pathogenic mutations (c.235delC, c.299-300delAT, c.109G>A) and three polymorphisms, in the study participants, giving an allele frequency of 15.0 %. A homozygous c.109G>A mutation was detected in two participants. A total of 16 variants in mitochondrial 12S rRNA gene were identified in the participants. No significant differences were found in GJB2 heterozygosity or in mitochondrial 12S rRNA variants between patients with sudden deafness and in controls. Our results suggest that the homozygous GJB2 c.109G>A mutation may be a cause of sudden deafness involving both ears. This finding should increase awareness of the likely role of genetic factors in the etiology of sudden deafness in general.
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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, People's Republic of China
| | - Liang Sun
- Department of Otorhinolaryngology, the First Affiliated Hospital, Sun Yat-Sen University and Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Ling Zong
- Department of Otorhinolaryngology, the First Affiliated Hospital, Sun Yat-Sen University and Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.,Department of Otorhinolaryngology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, People's Republic of China
| | - Xuan Wu
- Department of Otorhinolaryngology, the First Affiliated Hospital, Sun Yat-Sen University and Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Yuan Zhan
- Department of Otorhinolaryngology, the First Affiliated Hospital, Sun Yat-Sen University and Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Chang Dong
- Department of Otorhinolaryngology, the First Affiliated Hospital, Sun Yat-Sen University and Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Hui Cao
- Department of Otorhinolaryngology, the First Affiliated Hospital, Sun Yat-Sen University and Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Haocheng Tang
- Department of Otorhinolaryngology, the First Affiliated Hospital, Sun Yat-Sen University and Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Hongyan Jiang
- Department of Otorhinolaryngology, the First Affiliated Hospital, Sun Yat-Sen University and Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.
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Nakashima T. Diagnosis and treatment of sudden sensorineural hearing loss. World J Otorhinolaryngol 2015; 5:41-43. [DOI: 10.5319/wjo.v5.i2.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 02/23/2015] [Accepted: 04/20/2015] [Indexed: 02/06/2023] Open
Abstract
Nationwide epidemiological surveys of idiopathic sudden sensorineural hearing loss (SSNHL) have been performed five times by the Research Committee of the Ministry of Health and Welfare or the Ministry of Health, Welfare and Labour in Japan. These surveys included patients who had SSNHL in 1972, 1987, 1993, 2001, and 2012. Using the criteria for the grading of hearing loss in SSNHL or the criteria for grading the degree of hearing recovery after SSNHL established by the Research Committee, we compared the outcomes of SSNHL between the five nationwide surveys. The results revealed that the outcomes of SSNHL have not changed in the past 40 years. In 1972, 88% of patients received steroids, but none received prostaglandin E1 (PGE1). The use of PGE1 has increased since the 1980s, but its effect on SSNHL may not be significant. Intratympanic steroid injection has been introduced recently for the treatment of SSNHL, but it does not seem to be used widely in Japan. Intratympanic therapy that can reduce the total amount of steroids administered will be used more frequently if the true effects and indications for this therapy are known. Elucidation of the etiologies of SSNHL and development of treatments specific for these etiologies are expected.
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Nakashima T, Sato H, Gyo K, Hato N, Yoshida T, Shimono M, Teranishi M, Sone M, Fukunaga Y, Kobashi G, Takahashi K, Matsui S, Ogawa K. Idiopathic sudden sensorineural hearing loss in Japan. Acta Otolaryngol 2014; 134:1158-63. [PMID: 25315915 PMCID: PMC4266072 DOI: 10.3109/00016489.2014.919406] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Conclusion An epidemiological survey of hospitals and private clinics in Japan regarding idiopathic sudden sensorineural hearing loss (SSNHL) revealed that the incidence of SSNHL was 60.9 per 100 000 population. There were more females than males in the younger generation. Objective The incidence of SSNHL varies largely by country. Because the Japanese criteria for diagnosing SSNHL have changed in accordance with those widely used in other parts of the world, a clinicoepidemiological study was undertaken using the new criteria. Methods Ehime, Aichi, and Iwate Prefectures were selected from the western, central, and northeastern regions of Japan, respectively. The subjects for this study were patients who suffered SSNHL between April 1, 2012 and March 31, 2013. Questionnaires were mailed to all hospitals and private clinics in which ENT doctors were working. Initial and final audiograms were requested for 10% of the patients. Results In all, 78 of 90 hospitals (87%) and 303 of 407 private clinics (74%) responded. It was reported that 1663 patients visited hospitals and 3090 patients visited only private clinics. It was estimated that 6205 SSNHL patients visited hospitals or private clinics in 1 year from a population of 10 145 000. Also, 23% of patients suffered acute low-tone SNHL (female to male ratio; 3:1 in definite cases).
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Affiliation(s)
- Tsutomu Nakashima
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya
| | - Hiroaki Sato
- Department of Otolaryngology-Head & Neck Surgery, School of Medicine, Iwate Medical University, Iwate
| | - Kiyofumi Gyo
- Department of Otolaryngology, Ehime University School of Medicine, Ehime
| | - Naohito Hato
- Department of Otolaryngology, Ehime University School of Medicine, Ehime
| | - Tadao Yoshida
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya
| | - Mariko Shimono
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya
| | - Masaaki Teranishi
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya
| | - Michihiko Sone
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya
| | - Yukari Fukunaga
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya
| | - Gen Kobashi
- National Institute of Radiological Science, Chiba
| | - Kunihiko Takahashi
- Department of Biostatistics, Nagoya University Graduate School of Medicine, Nagoya
| | - Shigeyuki Matsui
- Department of Biostatistics, Nagoya University Graduate School of Medicine, Nagoya
| | - Kaoru Ogawa
- Department of Otolaryngology, School of Medicine, Keio University, Tokyo, Japan
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Na SY, Kim MG, Hong SM, Chung JH, Kang HM, Yeo SG. Comparison of sudden deafness in adults and children. Clin Exp Otorhinolaryngol 2014; 7:165-9. [PMID: 25177430 DOI: 10.3342/ceo.2014.7.3.165] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 05/02/2013] [Accepted: 05/02/2013] [Indexed: 11/13/2022] Open
Abstract
Objectives Although many studies have assessed sudden deafness in adults, sudden deafness has not been evaluated in children. We therefore evaluated the differences in sudden deafness between children and adults. Methods We compared clinical manifestations, including gender, audiogram pattern of initial hearing loss, and recovery rate after treatment in 87 children and 707 adults diagnosed with sudden deafness from September 2003 and August 2012. Results There were no differences in sex, side, or audiogram between children and adults (P>0.05 each). Hearing recovery rates in children and adults were 72.4% and 70.6%, respectively (P>0.05). Both children and adults with mild hearing loss showed significantly greater hearing recovery rates than individuals with profound hearing loss (P<0.05 each). The percentage with initially mild and moderate hearing loss was higher in children than in adults, as were the recovery rates of children compared to adults with initially mild, moderate-severe, and profound hearing loss (P<0.05 each). In regard to final hearing outcome after treatment, a low percentage of children showed no improvement whereas a high percentage showed complete recovery; a higher percentage of children than of adults showed complete recovery (P<0.05). Recovery rate from profound hearing loss was significantly higher in children than in adults (60.0% vs. 45.4%, P<0.05). Conclusion Degree of hearing loss, gender, side, and recovery rate were similar in children and adults, but the rate of complete recovery was higher in children.
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Wang M, Han Y, Fan Z, Zhang D, Wang H. Therapeutic effect on idiopathic sudden sensorineural hearing loss with duration of onset more than 3 months. Indian J Otolaryngol Head Neck Surg 2013; 65:61-5. [PMID: 24381923 DOI: 10.1007/s12070-012-0604-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
The purpose of this study was to evaluate the therapeutic efficacy and stability upon idiopathic sudden sensorineural hearing loss (ISSNHL) patients with duration of onset more than 3 months. Twenty-eight patients diagnosed as ISSNHL were treated by intravenous injection and another 26 by oral medication. Pure tone tests were undertaken at pre-therapy, the 3rd, 7th, 10th, 14th day of post-treatment, and 1 and 2 months of follow-up respectively. A total of 54 ISSNHL patients with duration of onset ranged from 3 months to 19 years were concerned. In the group administrated by intravenous injection, the total effective rate was 64.29 % including 2 cases total recovery, 3 excellent and 13 partial recovery. In the oral administration group, there was no recovery or excellence case, and 8 (30.77 %) showed partial recovery. There was significant difference between the two groups in total effective rates (P < 0.05). The treatment efficacy were stable in both two groups, and the difference in stability was no statistical significance (P = 0.397). There was therapeutic value for ISSNHL duration of onset more than 3 months, especially for patients with mild and moderate hearing loss. The administration by intravenous injection should be the optimization.
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Gyo K. Experimental study of transient cochlear ischemia as a cause of sudden deafness. World J Otorhinolaryngol 2013; 3:1-15. [DOI: 10.5319/wjo.v3.i1.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 01/18/2013] [Accepted: 02/06/2013] [Indexed: 02/06/2023] Open
Abstract
The etiology of sudden deafness or idiopathic sudden sensorineural hearing loss (ISSHL) remains unclear. Over the past 15 years, we have investigated the mechanisms of ischemic-induced hearing loss using a gerbil model of transient cochlear ischemia. In the gerbil, cochlear ischemia can be induced by occluding the bilateral vertebral arteries simultaneously at the neck, because the posterior communicating arteries of the Circle of Willis close spontaneously around 1 mo after birth. When 15 min ischemia was loaded on this animal, permanent hearing loss of about 25 dB and the death of hair cells, especially inner hair cells were induced. These pathological changes were mainly due to lack of an energy source, glutamate excitotoxicity, and the production of free radicals, especially superoxide and nitrous oxide species. Ischemic damage could be prevented by various procedures, such as cooling the cochlea, intratympanic administration of insulin-like growth factor 1 or AM-111 (an anti-apoptotic agent), and systemic administration of prednisolone (steroid), edarabone (free radical scavenger), ginsenoside Rb1 (Kanpo), hematopoietic stem cells, glia-cell derived neurotrophic factor, and liposome-encapsulated hemoglobin (artificial red blood cells). We also found that the cochlea was protected by the ischemic tolerance, indicating that minor cochlear ischemia alleviates or prevents inner ear damage in subsequent severe cochlear ischemia. As ISSHL usually occurs suddenly, with no preceding sign or symptom, we suggest that most ISSHL cases are caused by circulatory disturbance, probably at the stria vascularis.
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Arastou S, Tajedini A, Borghei P. Combined intratympanic and systemic steroid therapy for poor-prognosis sudden sensorineural hearing loss. Iran J Otorhinolaryngol 2013; 25:23-8. [PMID: 24303415 PMCID: PMC3846240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2012] [Accepted: 07/22/2012] [Indexed: 11/10/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the efficacy of combined intratympanic and systemic steroid therapy compared with systemic steroid therapy alone in idiopathic sudden sensorineural hearing loss (ISSNHL) patients with poor prognostic factors. MATERIALS AND METHODS Seventy-seven patients with sudden sensorineural hearing loss (SSNHL) who had at least one poor prognostic factor (age greater than 40 years, hearing loss more than 70 db, or greater than a 2-week delay between the onset of hearing loss and initiation of therapy) were included in this study. Patients were randomized to the intervention group (combined intratympanic and systemic steroid therapy) or the control group (systemic steroid therapy alone). All patients received oral treatment with systemic prednisolone (1 mg/kg/day for 10 days), acyclovir (2 g/day for 10 days, divided into four doses), triamterene H (daily), and omeprazole (daily, during steroid treatment), and were advised to follow a low salt diet. The intervention group also received intratympanic dexamethasone injections (0.4 ml of 4 mg/ml dexamethasone) two times a week for two consecutive weeks (four injections in total). A significant hearing improvement was defined as at least a 15-db decrease in pure tone average (PTA). RESULTS Among all participants,44 patients(57.14%) showed significant improvement in hearing evaluation. More patients showed hearing improvement in the intervention group than in the control group (27 patients (75%) versus 17 patients (41.4%), respectively; P=0.001). CONCLUSION The combination of intratympanic dexamethasone and systemic prednisolone is more effective than systemic prednisolone alone in the treatment of poor-prognosis SSNHL.
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Affiliation(s)
- Shima Arastou
- Otorhinolaryngology Research Center, Amiralam Hospital, Tehran University of Medical Science, Thran, Iran.,Corresponding Author: Otorhinolaryngology Research Center, Amiralam Hospital, Tehran, Iran. Tel:+989121086725, Fax: +982166760269, E-mail:
| | - Ardavan Tajedini
- Otorhinolaryngology Research Center, Amiralam Hospital, Tehran University of Medical Science, Thran, Iran.
| | - Pedram Borghei
- Otorhinolaryngology Research Center, Amiralam Hospital, Tehran University of Medical Science, Thran, Iran.
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