Bilateral simultaneous sudden deafness

Although sudden deafness has many causes, it is often a sensorineural hearing loss with an abrupt onset and unknown origin. The majority of these latter cases are unilateral in their occurrences, while bilateral simultaneous involvement is rarely seen. During the past 13 years, we have treated 997 patients with sudden deafness. All patients were seen at our university hospital within 2 weeks after the onset of their hearing losses and were observed until the hearing level was fixed. Among them, 10 patients were found to have bilateral simultaneous onsets. The average age and the incidence of vestibular symptoms were similar to those with unilateral deafness. The hearing recovery was much better in the ear with the lesser deafness. No improvement was observed on the side with no sound perception. Those patients in whom common cold and fever seemed to trigger the onset of deafness were also noted to have high viral antibody titers, and were more commonly seen than were those cases with unilateral deafness.     

Bilateral reversible sudden deafness

Summary A man aged 43 suffering from acute bilateral sudden deafness of sensorineural type (confirmed at repeated testings) and without signs and symptoms from the vestibular part of the inner ear regained normal hearing within 10 days. The serological examination for identification of viral antibodies in blood and liquor was negative. There was no sign of immunological disorder.Supported by grants from Karolinska Institutet, Stockholm, Sweden     

Bilateral simultaneous sudden deafness

Summary Although sudden deafness has many causes, it is often a sensorineural hearing loss with an abrupt onset and unknown origin. The majority of these latter cases are unilateral in their occurrences, while bilateral simultaneous involvement is rarely seen. During the past 13 years, we have treated 997 patients with sudden deafness. All patients were seen at our university hospital within 2 weeks after the onset of their hearing losses and were observed until the hearing level was fixed. Among them, 10 patients were found to have bilateral simultaneous onsets. The average age and the incidence of vestibular symptoms were similar to those with unilateral deafness. The hearing recovery was much better in the ear with the lesser deafness. No improvement was observed on the side with no sound perception. Those patients in whom common cold and fever seemed to trigger the onset of deafness were also noted to have high viral antibody titers, and were more commonly seen than were those cases with unilateral deafness.     

Hormones and sudden deafness

The cause of sudden deafness is often unknown; however, its treatment represents a real medical emergency. Prompt recovery should be defined as that occurring in about 15 days or less. Delayed recovery should be defined as recovery after 30 days, and in such cases the factors involved are extremely variable. ACTH gel, 40 units per cc, given intramuscularly, and heparin, 10,000 units per cc, given subcutaneously gave prompt recovery in five out of. seven cases. These patients were treated two to three times weekly for about two weeks. If recovery is not present by that time, it would appear not to be worthwhile continuing therapy. ACTH and heparin are both excellent agents. In addition seroidogenesis lipolytic ACTH has many other functions. It stimulates the production of cyclic AMP from ATP. This leaves a decrease in ADP. Cyclic AMP causes a decrease in aggregation of platelets. It also exerts a beneficial effect of beta (vasodilator) versus alpha (vaso-constrictor) catecholamines. Heparin, in addition to its anticoagulant effect, is one of the best binders of histamine in the body and, therefore, limits its cytodestructive effect. It is also an excellent antigen-antibody reaction. Both drugs would thereby tend to inhibit or ameliorate vasculitis, inhibit hypercoagulation and decrease hyperlipidemia. These effects encompass the rationale of its use in sudden deafness.     

Whole-blood filterability in sudden deafness

Sixteen patients with sudden deafness (SD), diagnosed on the basis of a battery of audiometric tests, but with no other medical or surgical pathology requiring drug treatment, underwent monitoring of their hemorheological profiles to see whether disturbances in the microcirculation could be linked to SD. Plasma viscosity, the filterabilities, (using a low-shear positive pressure system) through 5-μm-diam-eter pore Nuclepore filters, of whole blood and red and unfractionated white cells were monitored in 16 SD patients and 32 controls matched for age, sex and socioeconomic status. Whole blood filterability and the filterability of the red blood cells were significantly impaired in the SD patients, which suggests that alterations in the microcirculation are linked, in some way, to sudden deafness.     

Clinical aspects of sudden deafness

Sudden deafness is a disease of multifactorial genesis. The cause remains as ever unknown. In addition to the vascular theory, the possibility of a perilymphatic fistula due to rupture of the oval or the round window membranes has gained more significance. Therefore the treatment of sudden deafness should begin as soon as possible. We treat such patients with infusions of Dextran 40. BVK and Complamin in increasing amounts, in addition to stella-ganglion block. It is not justifiable, for legal reasons to withhold treatment, and therapy should begin immediately.     

突发性聋的临床研究进展

由中华医学会耳鼻咽喉头颈外科学分会和中华耳鼻咽喉头颈外科杂志编委会主持的全国多中心突发性聋(以下称突聋)的临床研究正在进行中,下面简单介绍本项目立项前进行的有关文献的复习报告.     

精神性聋误诊为突发性聋五例

临床上经常可碰到以突发性聋为首发症状的其他疾病，如听神经瘤、前庭导水管扩大、脑梗死、系统性红斑狼疮和白血病等。谷京城等报道1例突发性听力下降为首发症状的精神性聋。我们在临床上遇到5例双耳突发性聋为首发症状的精神性聋，对其临床特点和鉴别诊断进行分析，报道如下。     

Prognostic factors in sudden deafness

Sudden sensorineural hearing loss is still a diagnostic and therapeutic dilemma and is very difficult to predict recovery in it. Different factors may influence a prognosis like severity of hearing loss, duration of symptoms before treatment, presence of vertigo, type of audiogram and age of patients. The aim of the study was an evaluation of the hearing improvement in sudden deafness in relation to some of these elements. A retrospective analysis of 119 patients treated for sudden sensorineural hearing loss during 10 years was done. Clinical otolaryngological, neurological and ophthalmological examination, audiologic and ENG tests were carried out. Hearing improvement was obtained in 51 patients (43%). Hearing recovery was recorded in 38 patients (66%) in whom duration of disease before treatment was no longer than 7 days, in 9 patients (25%) with a period 8-14 days and in 4 patients (16%)--with period 15-30 days (66% vs 25% vs 16%, p < 0.001, 25% vs 16% p = 0.39). Hearing improvement was more frequent in patients with initially mild (51.6%) than severe (38.7%) and profound hearing loss (25%) (51.5% vs 25%, p < 0.05). Hearing recovery was observed in 18 patients (33.3%) with vertigo and in 33 patients (50.8%) without vertigo (p = 0.056). In analysis of age (five groups: until 30 years, 31-40 years, 41-50 years, 51-60 years, over 60 years) in comparison with hearing recovery it was not found any significance (45.5% vs 45.8% vs 46.4% vs 37% vs 38.9%, p = 0.94). It was stated that in patients with sudden deafness duration of the disease before treatment and level of hearing loss may significantly influence an outcome, also vertigo may worsen a recovery, contrary age of the patients does not seem as important prognostic factor.     

Sound therapy in sudden deafness

Introduction and goalsIdiopathic sudden sensorineural hearing loss is a hearing disorder of unknown cause. The spontaneous recovery rate ranges from 50 to 75% of the patients. Scientific experiments on animals support the present study in patients with sudden deafness treated with sounds.Patients and methodsDuring the period 2003-2009, patients with idiopathic sudden sensorineural hearing loss were administered steroids, piracetam and antioxidants, together with the addition of sounds by means of music and words.ResultsComparing the results of patients treated with medication (n = 65) and those treated with medication and sounds (n = 67), it was observed that patients treated with medication and sounds had higher recovery. Within the group of patients treated with medication and sounds, 25 (37%) experienced complete recovery, 28 (42%) good recovery, 11 (16%) slight recovery and 3 (5%) poor or no recovery.ConclusionThe patients who recovered more than half of their audition accounted for 54% in the group treated with medication and for 79% in the group of patients receiving medication and sounds. Auditory recuperation showed no alterations, at least up to 12 months after therapy.     

Prediction of prognosis in sudden deafness

Factors influencing the prognosis of sudden deafness were studied in 70 cases. Clinical data were analyzed and three important factors have been found: 1. Among various factors concerning the prognosis, the most important one was the presence of 8 kHz hearing. If hearing in the 8 kHz level could be obtained, prognosis would be better; 2. The time between the onset of deafness and the initial examination was found to be in close relationship with the prognosis, i.e. the sooner the patient seeks for treatment, the better would be the result; 3. The rapidity of the development of deafness was closely related to the prognosis. The faster the development of deafness, the worse would be the prognosis. An optimal regression equation for predicting prognosis has been established. According to this equation, otologists would be able to estimate the prognosis of the patients suffering from sudden deafness.     

血液光量子治疗突发性聋

目的：探讨自血光量子治疗突发性聋的疗效。方法：采用血液光量子法加常规药物、高氧压疗法加常规药物以及单纯药物治疗突发性聋各42例（48耳）。结果：光量子组、高氧压组、药物组治疗突发性聋总有效率分别为90.5%、90.5%、69.0%,光量子组与高氧压组差异无统计学意义（P＞0.05）,光量子组与药物组、高氧压组与药物组差异有统计学意义(P均＜0.01)。结论：血液光量子治疗突发性聋简便有效。