Validity of the Western blot immunoassay for heat shock protein-70 in associated and isolated immunorelated inner ear disease

OBJECTIVE: To assess the validity of the Western blot immunoassay for heat shock protein-70 (hsp-70) for diagnosis of autoimmune inner ear disease. STUDY DESIGN: Retrospective study of 53 patients affected by sudden deafness (n = 19), idiopathic progressive sensorineural hearing loss (n = 24), and Meniere's disease (n = 10) who were treated from 1995 to 1999. The clinical course and response to corticosteroid were evaluated. METHODS: A purified hsp-70 antigen from bovine kidney cell line was used for the Western blot immunoassay. RESULTS: Only five patients (9.4%) showed anti--hsp-70 antibodies: Two presented a sudden sensorineural hearing loss (sudden deafness group), two showed an idiopathic progressive sensorineural hearing loss (idiopathic progressive sensorineural hearing loss group), and one was affected by fluctuating hearing loss (Meniere's disease group). A systemic autoimmune condition was observed in 29.1% of patients with idiopathic progressive sensorineural hearing loss. CONCLUSIONS: The low sensitivity of Western blot immunoassay for patients affected by idiopathic progressive sensorineural hearing loss and Meniere's disease may result from either the long time elapsed from the hearing loss and vertigo to the initial examination or from the increased percentage of cases of systemic autoimmune disease present in patients with idiopathic progressive sensorineural hearing loss. More studies to detect the immune-mediated inner ear disease in Western blot immunoassay-negative patients are required.     

Clinical statistics of recurrent acute low-tone senseorineural hearing loss

Recently, acute low-tone senseorineural hearing loss (ALHL) has become common, and its good prognosis is known well. On the other hand, several reports have suggested that ALHL is frequently associated with Meniere's disease. We retrospectively examined the clinical course of 357 cases that were diagnosed and treated as ALHL at our hospitals. Forty-four of these cases that showed high-tone hearing loss in association with age-related changes were classified as atypical cases. The clinical futures of 49 "poor prognosis cases", who experienced recurrent hearing loss and/or profound hearing loss, are reported. Eight of the 49 cases who experienced recurrences had progressive hearing loss upto middle or high tones. Seventeen cases complained of vertiginous sensation, and 8 of these cases experienced recurrent attacks of vertigo and were diagnosed as having Meniere's disease. The former seventeen cases accounted for 34.7% of the "poor prognosis cases", and the latter eight accounted for 16.3% of these cases. Our results suggest that the hearing loss is more frequently associated with Meniere's disease in cases who experience recurrent hearing loss. Thus, cases initially diagnosed as ALHL may include some cases of progressive hearing loss and Meniere's disease. Even in cases in which hearing improvement is obtained, careful clinical observation is necessary, especially in older patients with bilateral affliction and atypical presentation. ALHL has been generally considered to have a good prognosis, however our examination revealed a relatively high frequency of recurrences, progressive hearing loss and complication by vertigo. We recommend, based on this evidence, that careful explanation of this disease is necessary at time of initial informed consent.     

Clinical observations of acute low-tone sensorineural hearing loss considered as cochlear hydrops

Acute low-tone sensorineural hearing loss (ALHL) has the following three criteria; obscure origin, acute onset and sensorineural hearing loss limited to low frequencies. Sixteen cases of ALHL which were considered as cochlear hydrops using glycerol test and electrocochleogram were studied. All patients visited our department within two weeks after onset and were followed up for one year or more after initial examination. The subjective symptoms, the character of vestibular and hearing impairment and prognosis of 16 cases with ALHL were also investigated. The results were as follows. 1. Patients complained of ear fullness rather than hearing impairment. Four patients were unaware of hearing loss. 2. Recruitment phenomenon was found in all of 15 cases examined. Vestibular findings were mostly normal, except that spontaneous nystagmus was found in two cases and head-shaking nystagmus in one. 3. Recurrence and fluctuation of hearing impairment occurred in 14 cases. Three cases had an attack of rotatory vertigo once and two has diagnosed as Meniere's disease later. 4. During three months prior to last examination, hearing was stabilized in nine cases and continued to fluctuate in seven cases. In the former, hearing was improved in four cases, unchanged in three, and worsened in two. 5. Two patients underwent an endolymphatic sac operation and have had a good prognosis. 6. The authors suggest that most of ALHL should be considered as transient cochlear hydrops because the subjective symptom and audiological and vestibular findings of our cases are similar to those of cases which were reported as ALHL by other investigators. According to the findings of glycerol test and electrocochleogram, endolymphatic hydrops in ALHL is considered to exist in all turns of cochlea.     

Prognosis of acute low-tone sensorineural hearing loss]

We studied 50 patients with acute low-tone sensorineural hearing loss (ALHL) who were examined at the Department of Otolaryngology, University of Tokyo, and followed up for 18 months or more. We investigated the prognosis of hearing loss within 3 months after onset, rate of recurrence during long-term follow-up, interval between the first and the second episodes of hearing loss or between onset and the time when the diagnosis of Meniere's disease was made, and factors affecting prognosis. The results were as follows. 1. Within the initial 3 months of follow-up, hearing loss continued to fluctuate in 5 patients. In the remaining 45, hearing returned to normal in 34, improved without returning to normal in 6, showed no marked change in 4, and became worse in one. 2. In long-term follow-up, the recurrence of hearing loss without vertigo occurred in 16 patients, and 5 others were eventually diagnosed as having Meniere's disease. The average interval between the first and second episodes of hearing loss was 9.2 months, and the diagnosis of Meniere's disease was made an average of 27 months after onset. 3. Recurrence was not significantly related to the initial prognosis of hearing loss. 4. Within the initial 3 months of follow-up, the prognosis of hearing loss was significantly better in patients whose hearing loss at 1 kHz was within 20 dB, and tended to be better in females and in patients attending within one week of onset. Long-term follow-up showed that the rate of recurrence was significantly lower in patients aged 40 years or more, and tended to be lower in patients who visited the hospital within one week of onset or whose hearing loss at 1 kHz was within 20 dB. 5. There were no significant differences between patients with single and recurrent attacks with respect to sex, subjective symptoms, and results of the glycerol test and electrocochleography. ALHL tends to recur without any relationship to the initial prognosis of hearing loss. Since it is still difficult to predict whether or not hearing loss will recur, long-term follow-up is necessary even in patients with good initial prognosis.     

Bilaterality in acute low-tone sensorineural hearing loss

Bilaterality in acute low-tone sensorineural hearing loss (ALHL) is more generally recognized than that in idiopathic sudden sensorineural hearing loss. Subjects were 274 patients diagnosed with ALHL based on criteria of a study group of the Ministry of Health, Labor and Welfare of Japan, i.e., total of 3 low tone hearing of 70dB or more and, a total of 3 high-tone hearing of 60dB or less, and treated at the departments of otolaryngology at Yamanashi University and Suwa Central Hospital. ALHL involving bilateral ears symptoms and/or bilateral hearing impairment conforming to diagnostic criteria was selected and summarized. Clinical ear symptoms, clinical test results, and hearing levels (total 3 low tone hearing, 1kHz, and total of 3 high-tone hearing) were statistically analyzed. We also reviewed Japanese clinical reports of ALHL that include bilateral cases. In 32 cases (11.7%) of 274 cases, both ear symptoms and hearing impairment were bilateral. In 22 (8.0%) of the 274, bilateral ear symptoms were present, but showed unilateral hearing loss conforming to diagnostic criteria. Another 22 (8.0%) out the 274 reported unilateral ear symptoms, but hearing tests indicated bilateral ALHL. A total of 76 cases (27.7%) of the 274 had bilaterality in either ear symptoms or hearing loss. Our review indicated that 9.0% (162 of 1803) ALHL patients were bilaterally affected, possibly indicating that AIHL includes a larger number of bilateral cases than currently assumed, if the opposite side were given a especially detailed clinical interview. Statistical analysis (Mann Whitney test, P<0.01) of hearing of unilateral cases indicated that 3 low tone hearing was more affected than 3 high-tone hearing, even on the normal side. These results indicate that ALHL tends to be bilateral, possibly due to the mechanism of pathogenesis, and also that the mechanism may include both local and general conditions. This more closely resembles Meniere's disease than idiopathic sudden sensorineural hearing loss. Both sides of bilateral cases were not usually the same in hearing patterns, glycerol test results, or prognosis. A statistically significant difference (Mann Whitney test, P<0.01) in total of 3 low tone hearing was seen between worse and better sides in bilateral cases. The degree of disease on both sides in bilateral cases thus was not always the same. Bilateral cases may result from both the influence of general conditions such as fatigue, stress, and lack of sleep and local conditions such as pathogenesis of endolymphatic hydrops that may cause differences in both ears. No clear difference was seen in clinical symptoms, hearing levels, and clinical examination, e.g., Schellong and glyceol tests, between unilateral and bilateral cases. Bilateral cases had a poorer prognosis (lower complete recovery ratio; chi2 test P<0.01) than unilateral cases. Our results indicated that cautious evaluation of opposite ear is necessary in diagnosis, treatment, and prognostication of ALHL.     

Prognosis of low-tone sudden deafness - does it inevitably progress to Meniere's disease?

CONCLUSION: We conclude that not all low-tone sudden deafness (SD) patients suffered from endolymphatic hydrops even if they had vertigo attack at the onset and that electrocochleography (ECochG) was a useful prognostic tool. OBJECTIVES: To investigate whether low-tone SD was a precursor of Meniere's disease and whether patients with low-tone SD suffered from endolymphatic hydrops. PATIENTS AND METHODS: This was a retrospective case review in the university hospital. A total of 184 patients with low-tone SD were divided into two groups with single and recurrent episodes. The progress, follow-up audiograms, and ECochG results of the patients were reviewed and compared with those of patients with high-tone SD and Meniere's disease. RESULTS: In all, 83 of 177 patients with low-tone SD unaccompanied by vertigo had recurrent hearing loss; 15 of the 83 developed vertiginous attacks. The remaining 94 patients had a single episode. Three of the seven patients with low-tone SD accompanied by vertigo had recurrent hearing loss; two of the three were subsequently confirmed to have Meniere's disease. The other four had a single episode. No difference in rate of progress from SD to Meniere's disease was observed among the low-tone and the high-tone SD groups. The average -SP/AP of each group with a single episode is smaller than that of other groups with recurrent episodes and Meniere's disease.     

Sudden sensorineural hearing loss: a review of diagnosis, treatment, and prognosis

Sudden sensorineural hearing loss (SSNHL) is commonly encountered in audiologic and otolaryngologic practice. SSNHL is most commonly defined as sensorineural hearing loss of 30 dB or greater over at least three contiguous audiometric frequencies occurring within a 72-hr period. Although the differential for SSNHL is vast, for the majority of patients an etiologic factor is not identified. Treatment for SSNHL of known etiology is directed toward that agent, with poor hearing outcomes characteristic for discoverable etiologies that cause inner ear hair cell loss. Steroid therapy is the current mainstay of treatment of idiopathic SSNHL in the United States. The prognosis for hearing recovery for idiopathic SSNHL is dependent on a number of factors including the severity of hearing loss, age, presence of vertigo, and shape of the audiogram.     

Vestibular functions in patients with idiopathic sudden sensorineural hearing loss and its relation to prognosis

ObjectiveBecause of the anatomically close relationship between the cochlea and the vestibular organs, cochlear function disorders may be accompanied by vestibular disorders. This study aimed to evaluate vestibular functions in patients with idiopathic sudden sensorineural hearing loss using VEMP, caloric test, and VNG test battery and its relation to prognosis.Materials and MethodsFor this study, 42 patients aged 18–55 years with idiopathic sudden sensorineural hearing loss and 30 volunteers who had no hearing and balance problems were included. Audiometry, cVEMP, oVEMP, caloric tests, and VNG tests were performed. Moreover, the effects of age, sex, time of admission, degree and configuration of hearing loss, accompanying vertigo, tinnitus, and ear fullness on improvement in hearing were evaluated.ResultsOf the 42 patients in the study group, 26 (56.52%) were male, 20 (43.48%) were female, and the mean age was 41.54 ± 12.23 years. Of the 30 individuals in the control group, 19 (63.3%) were male, 11 (36.7%) were female, and the mean age was 39.53 ± 13.03 years. There was no significant difference in the incidence of sudden sensorineural hearing loss in terms of sex and age, and the prognosis was better for female patients. Early admission to treatment was a factor of good prognosis; profound hearing loss, bilateral hearing loss and vertigo were factors of poor prognosis. Prognosis was better in patients with rising type audiogram configuration, while the prognosis was worse in patients with flat, descending and total hearing loss. Tinnitus and ear fullness had no effect on the prognosis. No anomalies were observed in VNG findings. Moreover, abnormal caloric response was higher in patients with profound hearing loss and total hearing configuration. Shortening was observed in cVEMP / oVEMP P1 and N1 latency after treatment. Furthermore, there was an improvement in abnormal responses after treatment.ConclusionIn this study, vestibular function was affected in patients with idiopathic sudden sensorineural hearing loss. The present study can help the development of a clinical strategy in the evaluation of the vestibular system in idiopathic SSNHL, patient follow-up, patient information, and the implementation of vestibular rehabilitation. Note that additional studies involving larger patients series are required.     

Autoimmune reactivity in Ménière's disease: a preliminary report

Autoimmune inner ear disease was first described by McCabe in 1979. The diagnosis is supported by cell mediated immune responses to inner ear membrane antigen stimulation. Meniere's disease consists of episodic vertigo, fluctuating sensorineural hearing loss, tinnitus and often aural pressure. Although most clinicians feel that Meniere's disease has no known cause, recently several researchers have suggested that some cases of Meniere's disease may be autoimmune in origin. In the present study, 10 patients with bilateral Meniere's disease were studied prospectively for autoimmune inner ear disease using both cellular and humoral immune tests. Results were compared with normal control subjects. One additional patient with Meniere's disease was identified retrospectively to have positive autoimmune test results. Preliminary conclusions suggest that at least some cases of presumed idiopathic Meniere's disease are autoimmune in origin. Therapeutic implications are significant: the addition of steroids, cytotoxic drugs and/or apheresis to conventional treatment may help prevent total deafness which otherwise might be inevitable.     

儿童突发性聋的临床特征及预后相关因素分析

目的 分析儿童突发性聋的临床特征、疗效及影响预后的相关因素,为临床治疗及预后评估提供依据。 方法 收集2010年1月至2017年10月就诊的67例突发性聋患儿临床资料,对其临床特征及治疗效果进行回顾性分析,同时根据疗效将患者分为总体有效组(36例)及无效组(31例),采用单因素及多因素分析的方法分析患者的性别、年龄、病程、初诊听阈、是否伴发耳鸣、眩晕、病毒感染史、发病季节和听力曲线类型对预后的影响。 结果 儿童突聋患者中64.18%在春冬季发病,其就诊时听阈为(76.62±25.97)dB HL,耳鸣及眩晕伴发率分别为70.15%和61.19%,病毒感染率为19.40%,听力曲线中10.44%为低频下降型、2.99%为高频下降型、34.33%为平坦型及52.24%为全聋型。经治疗后,患者听阈为(60.41±31.52)dB HL,总体有效率为53.73%,其中痊愈率、显效率及有效率分别为20.90%、16.42%和16.42%。多因素分析结果显示,初诊听阈越高及听力曲线为全聋型,预后越差(P均<0.05);伴有病毒感染的非全聋型患者预后较好(P<0.05)。 结论 儿童突发性聋患者病毒感染率较高且大部分在春冬季发病,就诊时听力损失较重并常伴有耳鸣及眩晕,其听力曲线以平坦型及全聋型为主。就诊时听力损伤程度轻、伴有病毒感染的非全聋型患者预后较好。     

突发性耳聋伴眩晕患者听力预后分析

摘要：目的回顾性分析突发性耳聋（sudden deafness,SD）患者的听力损失程度、预后与发病时是否伴有眩晕发作的关系。探索突发性耳聋单发听力损失、突发性耳聋伴眩晕的诊断、治疗及预后评价。 方法按中华医学会耳鼻咽喉头颈外科学分会颁布的突发性耳聋诊断标准，2012年1月~2015年12月收治突发性耳聋患者196例。对所有患者进行扩管溶栓、营养神经、抗病毒及高压氧治疗，按2007年中华耳鼻咽喉学会颁布的突发性耳聋疗效及分级标准，针对听力恢复进行疗效评价。结果伴有眩晕症状患者发病率为30.7%，听力损失在50 dB以上，听力恢复有效率23%；不伴有眩晕症状患者发病率为69.3%，听力恢复有效率73%。结论伴发眩晕的突发性耳聋患者，往往其听力损失严重，且预后不佳。     

Transtympanic gentamicin perfusion for the treatment of Meniere's disease

Meniere's syndrome is defined as the clinical disorder associated with the histopathological finding of endolymphatic hydrops (ELH). Clinically, Meniere's syndrome includes the following features: recurrent, spontaneous episodic vertigo; hearing loss; aural fullness; and tinnitus. Recognized causes of Meniere's syndrome include: 1) idiopathic, also known as Meniere's disease; 2) posttraumatic, following head injury or ear surgery; 3) post-infectious or delayed-onset Meniere's syndrome following a viral infection, usually mumps or measles; 4) late stage syphilitic; 5) classic Cogan's syndrome with episodic vertigo, hearing loss, interstitial keratitis, without syphilis; 6) variant Cogan's syndrome with episodic vertigo, hearing loss, uveitis or other ocular inflammation and without syphilis. Although Meniere's disease is by far the most common cause of Meniere's syndrome and the terms are often used interchangeably, it should be remembered that a patient has an idiopathic etiology only when the known causes have been excluded.     

Variables with prognostic value in the onset of idiopathic sudden sensorineural hearing loss

IntroductionThe establishment of an individualized prognostic evaluation in patients with a diagnosis of idiopathic sudden sensorineural hearing loss (ISSHL) remains a difficult and imprecise task, due mostly to the variety of etiologies. Determining which variables have prognostic value in the initial assessment of the patient would be extremely useful in clinical practice.ObjectiveTo establish which variables identifiable at the onset of idiopathic sudden sensorineural hearing loss have prognostic value in the final hearing recovery.MethodsProspective, longitudinal cohort study. Patients with ISSHL followed by the Department of Otology-Neurotology of a quaternary hospital were included. The following variables were evaluated and correlated with final hearing recovery: age, gender, vertigo, tinnitus, initial degree of hearing loss, contralateral ear hearing, and elapsed time to treatment.Results127 patients with ISSHL were evaluated. Rates of absolute and relative recovery were 23.6 dB and 37.2% respectively. Complete hearing improvement was observed in 15.7% patients; 27.6% demonstrated significant improvement and improvement was noted in 57.5%.ConclusionDuring the onset of ISSHL, the following variables were correlated with a worse prognosis: dizziness, profound hearing loss, impaired hearing in the contralateral ear, and delay to start treatment. Tinnitus at the onset of ISSHL correlated with a better prognosis.     

Prognostic model for predicting hearing recovery in idiopathic sudden sensorineural hearing loss.

HYPOTHESIS: To aid in realistic counseling of patients at the time of their first visit concerning their chances for recovery, we created a simple prognostic model for predicting hearing recovery in idiopathic sudden sensorineural hearing loss (ISSHL). BACKGROUND: An important element of research on ISSHL is to identify prognostic factors for this disease. Many studies have described predictive indicators to identify patients with a good prognosis needing no or minimal treatment. Only a few of these studies have included a model for calculating the probability for patient recovery, which may be important for clinical work, but these prognostic tables have not achieved widespread use clinically. METHODS: Evaluation of an electronic patient data base of 541 patients with ISSHL. The standard treatment was carbogen inhalation (95% O2 and 5% CO2 8 times per day in duration of 30 min) and prednisone orally (100 mg in 1 morning dose) for 7 days. Factors that were analyzed included the patient's age, the interval between the onset of symptoms and beginning of treatment, the presence or absence of vertigo and tinnitus, audiometric patterns, the severity of hearing loss, and hearing in the opposite ear. Hearing gain was expressed either as absolute hearing gain or as relative hearing gain. Significant recovery of hearing was defined as the final pure-tone audiometry of 30 dB or less (or the same as the pure-tone audiometry of the opposite ear). RESULTS: The absolute hearing gain was 15.1 dB. The mean relative hearing gain was 47%. Three hundred one (57%) patients had significant recovery of hearing, and 228 (43%) did not have significant recovery of hearing. Using step-wise multiple linear regression analysis, the most important factors for prognosis included severity of hearing loss, presence of vertigo, time between onset and treatment, the hearing of the other ear, and the audiogram shape (beta coefficient was -0.216, -0.231, 0.211, 0.113, and -0.064, respectively; constant, 0.968). A recovery expectancy table was developed using the data from this study. CONCLUSION: Based on a retrospective analysis, prognostic indicators for hearing recovery in ISSHL were found to be severity of hearing loss, presence of vertigo, time between onset and treatment, the hearing of the other ear, and the audiogram shape. We created a model for calculating the probability for hearing recovery based on the analysis of 529 patients with unilateral ISSHL.     

Analysis of audio-vestibular assessment in acute low-tone hearing loss

Conclusion This study demonstrated excellent hearing recovery following the combined treatment of diuretic and oral steroid, and electrocochleography (ECoG) was significantly higher than normal side. This study reports characteristics of acute low-tone hearing loss (ALHL) that show the greater low-tone hearing loss, the higher ECoG, and excellent recovery, even-though low-tone hearing loss is worse, which can be different compared with sudden deafness. Objective To analyze ALHL without vertigo, this study compared the ALHL group with all patients exhibiting low-tone hearing loss and ear fullness. Hearing changes and vestibular functions were analyzed. Materials and methods ALHL was defined as a mean hearing loss of?≥?30?dB at 125, 250, and 500?Hz, and?≤?20?dB at 2, 4, and 8?kHz. From 156 cases of low-tone hearing loss of more than 10?dB without vertigo, 31 met the ALHL criteria and were subjected to audio-vestibular assessments including PTA, ECoG, vestibular evoked myogenic potential (VEMP) testing, and caloric testing. Results In ALHL, low-tone hearing loss was 42.7?±?9.5?dB, and 83.9% of ALHL significantly recovered by more than 10?dB. The ECoG in ALHL was 0.334?±?0.11 (higher than 0.25?±?0.08 on the normal side) and ECoG abnormality was 35.5% (the greater low-tone hearing loss, the higher ECoG value).     

急性低频感音神经性听力损失的临床研究

目的　探讨急性低频感音神经性听力损失(acutelow tonesensorineuralhearingloss,ALHL)的病因病理、临床特点和诊治方法。方法　选择30例ALHL患者为研究对象,在详细采集病史和耳科检查的基础上,行系统的听力学检测,包括纯音测听、声导抗测试、听性脑干反应(auditorybrainstemresponse, ABR)和耳声发射(otoacousticemissions,OAE)。所有患者接受为期15天的皮质类固醇激素试验性治疗,疗程结束后随访6~14个月(平均10 2个月)。结果　本组患者以青年为主,临床主诉多为低音调耳鸣、耳闷和听力下降,耳科检查未见异常。所有患者(30例31耳)纯音测听显示轻到中度的低频感音神经性听力损失;鼓室图呈“A”型, 26耳引出镫骨肌声反射,其中14耳Metz试验阳性。受检的20耳中,ABR均正常;初诊时14耳瞬态诱发性耳声发射未通过,畸变产物耳声发射听力图表现为0 .5及0 .75kHz两个频率点上异常。经激素治疗后, 24耳听力完全恢复, 4耳部分恢复, 3耳无变化,总有效率90. 3%。结论　ALHL以突发的低音调耳鸣、听力下降和耳闷为主要表现,常单耳发病,听力学定位诊断提示为蜗性病变,仅累及低频区。本病尚无特效疗法,皮质类固醇激素可能是一种有希望的治疗药物。     

Delayed vertigo and profound sensorineural hearing loss

Episodic vertigo, similar to that of Meniere's disease, can occasionally develop years to decades after an ear has suffered a profound sensorineural hearing loss. Although the pathogenesis of this process is unknown, it is theorized that delayed endolymphatic hydrops develops. An inflammatory reaction could cause obstruction of the endolymphatic duct or interfere with venous drainage from the region of the endolymphatic sac, leading to hydrops. This condition is reviewed, and two adult patients with severe episodic vertigo and a unilateral profound sensorineural hearing loss which occurred in childhood are presented. Their evaluation and management are discussed.     

创伤性圆窗和卵圆窗外淋巴瘘4例报告

目的：探讨创伤性圆窗和卵圆窗外淋巴瘘的诊断和治疗。方法：回顾性分析创伤性圆窗和卵圆窗外淋巴瘘４例,其中,手掌击伤耳部２例,砖头击伤头部１例,中耳手术干扰１例。从发病至手术时间为１．５－９个月,通过头和耳部外伤或中耳手术史,听力和前庭功能检查,最后经鼓室探查确诊;用耳屏软骨岂筋膜修补外淋巴瘘。结果;４例均经手术探查证实并修补,术后眩晕控制听力改善不明显。     

急性低频感音神经性聋的临床分析

目的:评估急性低频感音神经性聋的临床疗效以及相关因素对预后的影响.方法:从398例突发性聋患者中筛选出41例急性低频听力下降者,分析经糖皮质激素等综合治疗后的效果,探讨患者的性别、病程和发病年龄与疗效的相关性.结果:急性低频感音神经性聋占突发性聋的10.30%,其中女性患者占70.73%,明显高于男性.初诊时3个低频和...     

Prognosis is predicted by early hearing improvement in patients with idiopathic sudden sensorineural hearing loss

The time-course of the recovery of the hearing level after treatment in 90 patients with idiopathic sudden sensorineural hearing loss was examined. The improvement rate calculated relative to the hearing level of the opposite ear was investigated to estimate the hearing recovery. Follow-up audiograms were performed once per week for 1 month after treatment and once per month thereafter. There were two groups that differed with respect to the characteristics of hearing recovery. One group showed an improvement rate of over 50% at 1-2 weeks and a good improvement rate at 3 months after treatment. In the other group, the improvement rate did not reach 50% at 1-2 weeks, and the improvement rate was poor at 3 months after treatment. The patients with improvement rates of over 50% at 1-2 weeks had earlier initial visits and had mild hearing loss, whereas the patients with profound hearing loss had improvement rates under 50% and poor long-term prognosis. We conclude that the improvement rate at 1-2 weeks after treatment predicts the long-term prognosis for recovery of hearing level in patients with sudden sensorineural hearing loss.