Effect of stellate ganglion injections guided by different approaches on hearing threshold in patients with sudden deafness

AbstractAuditory Brainstem Evoked Potentials (ABEP) were recorded from 53 adult subjects suffering from sudden deafness at the time of examination. The onset of sudden deafness was up to three years prior to the study. ABEP were recorded in response to 75 dBHL clicks presented at rates of 10/sec and 40/sec. ABEP peak latencies as well as interpeak latency differences, and also the effect of increasing stimulus rate, were determined for each patient and compared with the clinical symptoms. The psychoacoustic and ABEP detection thresholds were also compared.A highly significant correlation was observed between ABEP detection threshold and the psychoacoustically determined hearing threshold, and the differences between them were found to be insignificant. The results of this study indicate a central component in sudden deafness. This impairment manifests itself in abnormal effects of increasing stimulus rate on ABEP, and may be related to reduced central synaptic efficacy.

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Blood Flow in Common Carotid and Vertebral Arteries in Patients with Sudden Deafness

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949710600105 ◽

1997 ◽

Vol 106 (1) ◽

pp. 27-32 ◽

Cited By ~ 12

Author(s):

Yoshimitsu Ohinata ◽

Shin-Ichi Haginomori ◽

Kazuo Makimoto ◽

Michitoshi Araki ◽

Michiro Kawakami ◽

...

Keyword(s):

Blood Flow ◽

Stellate Ganglion ◽

Stellate Ganglion Block ◽

Sudden Deafness ◽

Control Group ◽

Ganglion Block ◽

Male Patients ◽

The Common ◽

Normal Adults ◽

Carotid And Vertebral Arteries

Blood flow was measured in the common carotid artery (CCA) and the vertebral artery (VA) by the ultrasonic Doppler method in 14 male patients with sudden deafness and 70 normal adults. In the patients, blood flow on the affected side was slower than that on the normal side or that of the control group. Although these differences were not statistically significant in the CCA or in the VA, significant differences in the blood flow were noted between the group with a hearing loss of greater than 50 dB and the group with a loss of less than 50 dB. A negative correlation was found between blood viscosity and blood flow in both CCAs and both VAs. After stellate ganglion block (SGB), the blood flow of the CCA and VA increased on the side of the SGB and decreased on the opposite side. The changes in blood flow after SGB decreased with age, presumably because of changes in the blood vessel walls and a weaker response to sympathetic nerve receptors in the arterial wall.

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Pemeriksaan Otoacoustic Emission (OAE) untuk menilai keberhasilan terapi metilprednisolon

Oto Rhino Laryngologica Indonesiana ◽

10.32637/orli.v49i1.285 ◽

2019 ◽

Vol 49 (1) ◽

pp. 1

Author(s):

Brastho Bramantyo ◽

Jenny Bashiruddin ◽

Widayat Alviandi ◽

Risdawati Risdawati

Keyword(s):

Systematic Review ◽

Pure Tone ◽

Signal To Noise Ratio ◽

Hearing Threshold ◽

Otoacoustic Emission ◽

Sudden Deafness ◽

Distortion Product Otoacoustic Emission ◽

Signal To Noise ◽

Cochrane Systematic Review ◽

Distortion Product

Latar belakang: Penatalaksanaan tuli mendadak menggunakan steroid sebagai terapi utama merupakan hasil konsensus terapi tuli mendadak tahun 2010 di Madrid-Spanyol dan Cochrane systematic review tahun 2009, yang saat ini diterapkan di Divisi Neurotologi Departemen Telinga Hidung Tenggorok-Kepala Leher Rumah Sakit Cipto Mangunkusumo. Evaluasi hasil pengobatan dilakukan dengan pemeriksaan audiometri dan Distortion Product Otoacoustic Emission (DPOAE). Pasien yang mengalami kesembuhan akan memperlihatkan peningkatan ambang dengar dan nilai Signal to Noise Ratio (SNR) emisi otoakustik. Tujuan: Mengevaluasi hasil terapi metilprednisolon dosis terbaru pada tuli mendadak dengan pemeriksaan DPOAE dan audiometri nada murni. Metode: Penelitian ini menggunakan desain pre dan post eksperimental. Diberikan terapi metilprednisolon 1 mg/kgBB dengan tapering off 20 mg setiap 5 hari. Dilakukan pemeriksaan DPOAE dan audiometri sebelum dan setelah terapi. Hasil: Total sampel yang diolah adalah 22 subjek. Penelitian ini mendapatkan perubahan yang bermakna nilai audiometri nada murni sebelum dan sesudah terapi pada semua frekuensi. Nilai SNR pada OAE sebelum dan setelah terapi rata-rata mengalami perubahan nilai pass, dengan perubahan nilai SNR pass terbanyak adalah pada frekuensi 8000 Hz (6 subjek). Tingkat perubahan ambang dengar sesudah terapi yang mengalami perbaikan paling banyak pada frekuensi 2000 Hz, 3000 Hz, 6000 Hz dengan masing-masing 16 subjek. Perbaikan emisi terjadi lebih awal dibandingkan perbaikan ambang dengar. Kesimpulan: Pada penelitian ini terdapat perubahan bermakna nilai audiometri, dan nilai DPOAE. Didapatkan hubungan bermakna perubahan SNR pada OAE dengan tingkat perubahan ambang dengar frekuensi 8000 Hz dan 10.000 Hz, setelah pengobatan metilprednisolon sesuai protokol penelitian ini. Background: Methylprednisolone as a drug of choice in sudden deafness was consented in Madrid, Spain 2010 and in Cochrane systematic review in 2009, and already applied in Neurotology Division, ENT Department Cipto Mangunkusumo Hospital. Sudden deafness treatment evaluation conducted by audiometry and Distortion Product Otoacoustic Emission (DPOAE) examinations. Hearing recovery could be assessed from the improvement of hearing threshold and Signal to Noise Ratio (SNR) of otoacoustic emission (OAE). Objective: To evaluate the current dose of methylprednisolone therapy for sudden deafness, by DPOAE and pure tone audiometry. Methods: This was a pre-post experimental study using methylprednisolone 1 mg/kg body weight tapered off 20 mg in every 5 days. DPOAE and audiometry examination were conducted pre and post therapy. Result: Total sample were 22 subjects. Significant improvement was seen in overall frequencies of audiometry examination. Pass result in SNR of OAE showed remarkable improvement in 8000 Hz (6 subjects). The level of pure tone threshold mainly increased in frequencies of 2000 Hz, 3000 Hz, and 6000 Hz, each 16 subjects. Improvement of the emision level occurred earlier than the hearing threshold. Conclusion: This study revealed significant improvement of audiometry threshold and OAE level. Significant correlation was found between SNR of OAE improvement with increased pure tone level in 8000 Hz and 10.000 Hz after methylprednisolone therapy according to the protocol of this study.

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