scholarly journals Evaluation of idiopathic sudden sensorineural hearing loss

Author(s):  
Çiğdem Fırat Koca

<p class="abstract"><span lang="TR">Idiopathic sudden sensorineural hearing loss (ISSNHL) is a medical emergency. The early diagnosis and treatment should improve the complete recovery. The critical issue is diagnosis.</span></p>

Author(s):  
T Kurioka ◽  
H Sano ◽  
S Furuki ◽  
T Yamashita

Abstract Objective The effects of iron deficiency on the prognosis of idiopathic sudden sensorineural hearing loss are unclear. This study aimed to investigate the association between serum iron levels and idiopathic sudden sensorineural hearing loss prognosis and its usefulness as an independent prognostic marker for idiopathic sudden sensorineural hearing loss. Methods The audiological and haematological data, including hearing recovery and serum iron levels, of 103 patients with idiopathic sudden sensorineural hearing loss evaluated between 2015 and 2018 were retrospectively analysed. Results The overall complete recovery rate was 16.5 per cent. Initial higher hearing threshold was associated with poor idiopathic sudden sensorineural hearing loss prognosis. Serum iron levels were significantly higher in the complete recovery group than in the non-complete recovery group (p < 0.05). Conclusion The possibility of complete recovery from idiopathic sudden sensorineural hearing loss was significantly lower with lower serum iron levels, suggesting that the serum iron level might be a novel prognostic marker for idiopathic sudden sensorineural hearing loss.


Life ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 96
Author(s):  
Magdalena B. Skarżyńska ◽  
Aleksandra Kołodziejak ◽  
Elżbieta Gos ◽  
Milaine Dominici Sanfis ◽  
Piotr H. Skarżyński

(1) Background: A retrospective clinical study was conducted to compare the effectiveness of different pharmacological and non-pharmacological regimens for treating sudden sensorineural hearing loss (SSNHL). (2) Methods: Adult patients (n = 130) diagnosed with sudden sensorineural hearing loss (SSNHL) and hospitalized between 2015 and 2020 were enrolled in this study. Depending on the treatment regimen applied, patients were divided into five groups. Inclusion criteria were as follows: (i) hearing loss of sudden onset; (ii) hearing loss of at least 30 dB at three consecutive frequencies; (iii) unilateral hearing loss; (iv) age above 18 years. Exclusion criteria were as follows: (i) no follow-up audiogram; (ii) bilateral hearing loss; (iii) recognized alternative diagnosis such as tumor, disorder of inner ear fluids, infection or inflammation, autoimmune disease, malformation, hematological disease, dialysis-dependent renal failure, postdural puncture syndrome, gene-related syndrome, mitochondrial disease; and (iv) age below 18 years. (3) Results: Complete recovery was found in 14% of patients (18/130) and marked improvement was found in 6% (8/130), giving an overall success rate of 20%. The best results were obtained in the second group (i.e., patients given intratympanic glucocorticoid + prolonged orally administered glucocorticoid) where the success rate was 28%. In general, the older the patient, the smaller the improvement in hearing, a correlation that was statistically significant. (4) Conclusions: In treating SSNHL, the highest rate of hearing recovery—28%—was in the group of patients given intratympanic corticoid plus prolonged treatment with orally administered glucocorticoid.


Author(s):  
Benjamin Ng ◽  
Matthew G. Crowson ◽  
Vincent Lin

Abstract Background Sudden Sensorineural Hearing Loss (SSNHL) is a medical emergency requiring immediate attention as delayed treatment can lead to permanent and devastating consequences. Primary care physicians are likely the first to be presented with SSNHL and therefore have the crucial role of recognizing it and initiating timely and appropriate management. The aim of this study was to gain insight into the current knowledge and practice trends pertaining to the diagnosis and management of SSNHL among family physicians in Canada. Methods An 18-question survey targeting Canadian family physicians was marketed through two, physician-only discussion groups on the social media platform Facebook. Responses were collected between August 1st and December 22nd 2019 then aggregated and quantified. Results 52 family physicians submitted responses. 94.2% (n = 49) reported that in their practice, unilateral SSNHL warrants urgent referral to otolaryngology and 84.6% (n = 44) reported that unilateral sudden-onset hearing loss warrants urgent referral for audiological testing. 73.1% of participants (n = 38) reported that they would attempt to differentiate between conductive and sensorineural hearing loss if presented with unilateral, acute or sudden-onset hearing loss. 61.5% (n = 32) would rely on tuning fork tests to inform management decisions, as compared to 94.2% (n = 49) relying on case history and 88.5% (n = 46) on otoscopy. 76.9% (n = 40) would prescribe corticosteroids if presented with confirmed, unilateral SSNHL. Conclusion The majority of family physicians in the study would make appropriate referral and treatment decisions in the management of SSNHL, understanding it is a medical emergency. Tuning fork tests are under-utilized for informing management decisions compared to other means of differentiating conductive and sensorineural hearing loss. Further research is needed to understand why some family physicians do not prescribe corticosteroids for treatment of SSNHL, which may then identify any gaps in knowledge or inform improvements in clinical protocol. Graphical abstract


Author(s):  
Srirangaprasad K. ◽  
Vinay Kumar V. ◽  
Pruthvi Raj S.

<p class="abstract"><strong>Background:</strong> Sudden sensorineural hearing loss is a common otologic emergency which occurs due to various etiologies affecting the inner ear. Majority of treatment protocols are focussed on glucocorticoids either systemically or through intratympanic route due to their antioxidant and anti-inflammatory properties.</p><p class="abstract"><strong>Methods:</strong> This was a pre and post observational clinical study conducted in patients visiting Rajarajeswari medical college between December 2015 to December 2016 with a history of sudden hearing loss (30 patients). 6 of these patients presented with bilateral hearing loss, and we considered each ear as a separate case, giving us a total of 36 cases. A diagnosis of idiopathic sudden sensorineural hearing loss was made based on the patient’s history and audiological evaluation. All the patients were treated with 3 doses of Intratympanic injections of Dexamethasone (4 mg/ml), on alternate days. Pure tone audiometry (PTA) and brain stem evoked response audiometry (BERA) was done pre-treatment, at 1 and 6 months after treatment.  </p><p class="abstract"><strong>Results:</strong> Mean age of our patients was 44.8. 80% of our patients were male. The average PTA gain, 1 month after treatment was 27.917 and 6 months after treatment was 29.639 with a p value of &lt;0.001, which correlated with BERA. At the end of 6 months after treatment, 15 cases had complete recovery (41.7%), 9 cases showed slight recovery (25%), 6 cases had marked recovery and 6 cases (16.7%) had no recovery.</p><p><strong>Conclusions:</strong> Intratympanic dexamethasone injections can be used as the first line of treatment with minimal side effects. </p>


Author(s):  
Sunil N. Khot ◽  
Priyadarshini G. ◽  
Ayisha Kunnumal

<p class="abstract"><strong>Background:</strong> Sudden sensorineural hearing loss (SNHL) is sensorineural hearing loss of 30 dB or more over at least three contiguous audiometric frequencies that develop over a period of few hours to three days. The purpose of study is to make a protocol for treatment.</p><p class="abstract"><strong>Methods:</strong> 30 cases of sudden SNHL who presented to OPD of Government Medical College, Miraj between December 2015 to April 2017 were included. Detailed history taking and ENT examination was done. All patients were admitted and started on intravenous methylprednisolone. If hearing improvement was not observed, intratympanic methylprednisolone (ITS) was administered.  </p><p class="abstract"><strong>Results:</strong> 50% patients had recovery with intravenous Methylprednisolone and 50% had no recovery. “No recovery” patients were subjected to ITS, of which 20% had complete, 30% partial and 50% no recovery. Among no recovery patients of ITS, 10% had hearing loss greater than 90 dB with improvement rate of 0%; 40% had hearing loss of 90 - 50 dB with improvement rate of 50%; 50% had hearing loss of 50-30 dB with improvement rate of 60%. Among 15 cases of ITS, mean number of days between onset of symptom and starting ITS was 13 days for complete recovery patients; 17.3 days for partial or slight recovery; 20.6 days for no recovery.</p><p><strong>Conclusions:</strong> Hearing loss less than 90 dB and earlier ITS has positive influence on hearing recovery. Systemic steroids are currently the mainstay of initial treatment. ITS is an effective treatment modality for patients who fail to respond to systemic steroids.</p>


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