Hyperbaric oxygen for sudden hearing loss: Influence of international guidelines on practice in Australia and New Zealand

2021 ◽  
Vol 51 (1) ◽  
pp. 68-71
Author(s):  
Susannah Sherlock ◽  
◽  
Sharon Kelly ◽  
Michael H Bennett ◽  
◽  
...  

Introduction: Idiopathic sudden sensorineural hearing loss (ISSHL) is an otolaryngologic emergency. The Undersea and Hyperbaric Medicine Society (UHMS) revised practice guidelines in 2014 adding ISSHL to approved indications. This study investigated whether the UHMS guidelines influenced referral and practice in Australia and New Zealand. Methods: Retrospective review of 319 patient referrals in two time periods (five years prior to addition of ISSHL to indications (T-PRE) and three years post (T-POST)). Results: Seven of eight participating hyperbaric facilities provided data down to the level of the indication for HBOT for analysis. In T-PRE 136 patients were treated with HBOT for ISSHL, representing between 0% and 18% of the total cases to each facility. In the T-POST period 183 patients were treated for ISSHL, representing from 0.35% to 24.8% of the total patients in each facility. Comparison between the two periods shows the proportion of patients treated with ISSHL among all indications increased from 3.2% to 12.1% (P < 0.0009). One facility accounted for 74% (101/136) of ISSHL patients receiving HBOT in T-PRE and 63% (116/183) in T-POST. ISSHL case load at that facility increased from 18% to 24.8% (P = 0.009) after the UHMS guideline publication. Three of the seven units had a significant increase in referrals after the guideline change. Conclusion: There remains equipoise regarding HBOT in the management of ISSHL. Only three out of seven units had a significant increase in ISSHL patients after the UHMS guidelines publication. Without well controlled RCTs to develop guidelines based on good evidence this is unlikely to change and practice variation will continue.

Author(s):  
Saeid Aarabi ◽  
Nasrin Yazdani ◽  
Javad Fakhri ◽  
Vida Rahimi ◽  
Parsa Cheraghipour ◽  
...  

Introduction: This study aimed to investigate the relationship between sudden sensorineural hearing loss, vestibular neuritis, and infection with COVID-19. Materials and Methods: In this study, a total of 56 Iranians (32 females and 24 males) with a Mean±SD age of 45.12±14 years were studied in Tehran City, Iran. Individuals diagnosed with Sudden Sensorineural Hearing Loss (SSNHL) or vestibular neuritis based on definitive diagnostic criteria were included in the study. The methodology comprised four sections of underlying Sudden Hearing Loss,, auditory and vestibular inspection, SARS-CoV-2 Reverse Transcription-Polymerase Chain Reaction (RT-PCR) test, and statistical analysis. Also, the videonystagmography test was used in participants with vertigo to diagnose vestibular neuritis. Pure tone audiometry confirmed SSNHL in some patients with a complaint of hearing loss. Furthermore, tuning fork, Rinne and Weber tests were also performed. Results: The results of SARS-CoV-2 RT-PCR in 56 subjects showed that eight subjects (22.2%) with vestibular neuritis and two with SSNHL (10%) had a positive RT-PCR test. The Chi- square and Fisher exact-tests with a 95% confidence interval revealed no statistically significant (P>0.05) relationship between COVID-19 infection and vestibular neuritis or SSNHL. Conclusion: The present study showed no statistically significant relationship between audiovestibular disorders and positive SARS-CoV-2 RT-PCR test. However, the possibility of this relationship cannot be ruled out, and there is a need for studies with larger sample sizes.


2004 ◽  
Vol 118 (6) ◽  
pp. 450-452 ◽  
Author(s):  
Chul Ho Jang ◽  
Young Ho Kim

This paper reports an unusual case in which aseptic meningitis presented with sudden sensorineural hearing loss (SSNHL) associated with intralabyrinthine haemorrhage (ILH). A seven-year-old girl presented with sudden right-sided hearing loss with dizziness. She did not have a previous history of bleeding disorders. This child was assessed using audiograms and magnetic resonance imaging (MRI). The patient's hearing loss was irreversible. Steroid therapy was not effective. SSNHL associated with ILH can be one of the negative prognostic factors in children.


2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Benjamin J. Wycherly ◽  
Jared J. Thompkins ◽  
H. Jeffrey Kim

Objective. To review our experience with intratympanic steroids (ITSs) for the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL), emphasizing the ideal time to perform follow-up audiograms.Methods. Retrospective case review of patients diagnosed with ISSNHL treated with intratympanic methylprednisolone. Injections were repeated weekly with a total of 3 injections. Improvement was defined as an improved pure-tone average ≥20 dB or speech-discrimination score ≥20%.Results. Forty patients met the inclusion criteria with a recovery rate of 45% (18/40). A significantly increased response rate was found in patients having an audiogram >5 weeks after the first dose of ITS (9/13) over those tested ≤5 weeks after the first dose of ITS (9/27) ().Conclusions. Recovery from ISSNHL after ITS injections occurs more frequently >5 weeks after initiating ITS. This may be due to the natural history of sudden hearing loss or the prolonged effect of steroid in the inner ear.


2014 ◽  
Vol 128 (11) ◽  
pp. 1015-1017 ◽  
Author(s):  
M Diao ◽  
F Tian ◽  
J Sun

AbstractBackground:Sudden sensorineural hearing loss rarely occurs in patients with chronic myeloid leukaemia.Case report:We present a case report of a patient who presented with sudden sensorineural hearing loss as the first manifestation of chronic myeloid leukaemia, and review the mechanisms responsible for sudden sensorineural hearing loss in leukaemic patients.Results:A 31-year-old female presented to our clinic with unilateral sudden sensorineural hearing loss and tinnitus. Pure tone audiometry revealed profound sensorineural hearing loss in the left ear at all frequencies. During an investigation into her hearing loss, the patient was found to have chronic myeloid leukaemia.Conclusion:Every case of sudden sensorineural hearing loss must be carefully evaluated, and haematological disorders must be considered in the differential diagnosis of sudden hearing loss.


2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Alessandro Castiglione ◽  
Andrea Ciorba ◽  
Claudia Aimoni ◽  
Elisa Orioli ◽  
Giulia Zeri ◽  
...  

Background. Even if various pathophysiological events have been proposed as explanations, the putative cause of sudden hearing loss remains unclear.Objectives. To investigate and to reveal associations (if any) between the main iron-related gene variants and idiopathic sudden sensorineural hearing loss.Study Design. Case-control study.Materials and Methods. A total of 200 sudden sensorineural hearing loss patients (median age 63.65 years; range 10–92) were compared with 400 healthy control subjects. The following genetic variants were investigated: the polymorphism c.−8CG in the promoter of the ferroportin gene (FPN1;SLC40A1), the two isoforms C1 and C2 (p.P570S) of the transferrin protein (TF), the amino acidic substitutions p.H63D and p.C282Y in the hereditary hemochromatosis protein (HFE), and the polymorphism c.–582AG in the promoter of theHEPCgene, which encodes the protein hepcidin (HAMP).Results. The homozygous genotype c.−8GG of theSLC40A1gene revealed an OR for ISSNHL risk of 4.27 (CI 95%, 2.65–6.89;P=0.001), being overrepresented among cases.Conclusions. Our study indicates that the homozygous genotypeFPN1−8GG was significantly associated with increased risk of developing sudden hearing loss. These findings suggest new research should be conducted in the field of iron homeostasis in the inner ear.


2002 ◽  
Vol 111 (11) ◽  
pp. 989-997 ◽  
Author(s):  
José Ramón García Berrocal ◽  
Rafael Ramírez-Camacho

Sudden deafness constitutes a diagnostic challenge. Classically, 2 causes, viral and vascular, are considered in the origin of idiopathic sudden hearing loss. More recently added to the list of possibilities are rupture of the membranous labyrinth and immune-mediated sensorineural hearing loss. The latter can be either primary and localized to the inner ear or, in perhaps fewer than one third of cases, secondary to generalized systemic autoimmune disease. The purpose of the present review is to define immune-mediated sudden sensorineural hearing loss as a distinctive entity, on the basis of clinical, immunologic, and pathological findings, and suggest a profile of the typical patient.


2006 ◽  
Vol 120 (8) ◽  
pp. 665-669 ◽  
Author(s):  
B Satar ◽  
Y Hidir ◽  
S Yetiser

The aim of this study was to investigate the efficacy of hyperbaric oxygen (HBO) therapy in idiopathic sudden sensorineural hearing loss (ISSHL) by comparing hearing gain and improvement rate in patients who have been placed on both HBO and medical treatment (MT) (37 patients), and patients who have received MT only (17 patients). Both groups were compared with reference to pure tone average (PTA) and the number of patients who experienced hearing gain. Of 37 patients (40 ears) who received HBO + MT, 24 (60 per cent) experienced ≥ 10 decibels (dB) improvement in PTA compared to 13 (76.4 per cent) of 17 patients who were placed on MT only. Inter- or intra-group comparison of age stratification (<50 and ≥50 ages) did not produce significant differences in PTA and in the number of patients who experienced hearing gain.Although there are numerous studies showing efficacy of HBO therapy; this study did not reveal a trend in favour of HBO therapy.


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>


2007 ◽  
Vol 137 (1) ◽  
pp. 74-78 ◽  
Author(s):  
Guillermo Plaza ◽  
Carlos Herráiz

OBJECTIVE: We sought to describe our experience with intratympanic steroid treatment of sudden sensorineural hearing loss after failure of intravenous steroid treatment. STUDY DESIGN AND SETTING: We conducted a nonrandomized prospective clinical trial. Fifty patients presenting with sudden onset idiopathic hearing loss were treated intravenously over five days. After this period, patients with treatment failure (18 cases) were offered intratympanic steroid treatment. Nine patients refused, whereas the other nine patients received three weekly injections of methylprednisolone. Recovery of hearing was reported as improvement of more than 15 dB in pure tone average. RESULTS: Intratympanic steroid treatment improved hearing loss in five patients (55%). This is significant compared with those patients who refused intratympanic treatment, who showed no further improvement ( P < 0.05). No serious adverse effects were observed. CONCLUSION: Intratympanic steroids significantly improve the recovery outcome of sudden hearing loss that had not recovered after intravenous steroid treatment. SIGNIFICANCE: Intratympanic steroids are an effective and safe therapy in sudden sensorineural hearing loss cases that are refractory to standard treatment.


2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Massimo Ralli ◽  
Antonio Greco ◽  
Vincenzo Falasca ◽  
Giancarlo Altissimi ◽  
Mario Tombolini ◽  
...  

Hearing loss has been rarely reported in Takayasu’s arteritis, may present as Sudden Sensorineural Hearing Loss, and usually responds well to corticosteroid therapy. Hyperbaric Oxygen Therapy is commonly used as a supplementary treatment to corticosteroids for Sudden Sensorineural Hearing Loss. We present the case of a 36-year-old woman with Takayasu’s arteritis who had two episodes of sudden hearing loss involving one ear at a time with an 11-month delay between each episode. During the first episode, the patient was treated with high-dose intramuscular corticosteroids with a temporary improvement of auditory threshold that deteriorated 14 days after cessation of therapy. In the second episode, Hyperbaric Oxygen Therapy was associated with corticosteroids, with improvements in both ears, including the one that was unresponsive in the long term to previous pharmacologic therapy. In this case, Hyperbaric Oxygen Therapy could have acted synergically with corticosteroids playing a role in hearing restoration.


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