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Hyperbaric Oxygen Treatment Improves hearing Level via Attenuating TLR4/NF-κB Mediated Inflammation in Sudden sensorineural hearing loss Patients

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Biomedical and Environmental Sciences 2020年第5期33卷 331-337页

作者： LIU Xue Hua LIANG Fang JIA Xing Yuan ZHAO Lin ZHOU Yan YANG Jing Department of Hyperbaric Oxygen Medicine Beijing Chaoyang HospitalCapital Medical UniversityBeijing 100020China Institute of Basic Medicine Sciences Beijing Chaoyang HospitalCapital Medical UniversityBeijing 100020China Department of Hyperbaric Oxygen Medicine Beijing Pinggu HospitalBeijing 101200China

Objective Hyperbaric oxygen treatment(HBOT)has demonstrated efficacy in improving hearing levels of patients with idiopathic Sudden sensorineural hearing loss(ISSHL);however,the underlying mechanisms are not well understood.HBOT alleviates the inflammatory response,which is mediated by Toll-like receptor(TLR)4 and nuclear factor(NF)-κB.In this study we investigated whether HBOT attenuates inflammation in ISHHL patients via alteration of TLR4 and NF-κB expression.Methods ISHHL patients(n=120)and healthy control subjects(n=20)were enrolled in this study.Patients were randomly divided into medicine group treated with medicine only(n=60)and HBO group receiving both HBOT and medicine(n=60).Audiometric testing was performed pre-and posttreatment.TLR4,NF-кB,and TNF-αexpression in peripheral blood of ISSHL patients and healthy control subjects was assessed by ELISA before and after treatment.Results TLR4,NF-κB,and TNF-αlevels were upregulated in ISSHL patients relative to healthy control subjects;the levels were decreased following treatment and were lower in the HBO group than that in the medicine group post-treatment(Phearing loss in ISSHL patients by suppressing the inflammatory response induced by TLR4 and NF-κB signaling.

关键词： Hyperbaric oxygen treatment Sudden sensorineural hearing loss Toll-like receptor 4 Nuclear factor-kB

Association between routine hematological parameters and Sudden sensorineural hearing loss:A meta-analysis

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Journal of Otology 2021年第1期16卷 47-54页

作者： Wei Ni Shao-Peng Song Yi-Dao Jiang Department of Otolaryngology-Head and Neck Surgery Jingzhou Central HospitalThe Second Clinical Medical CollegeYangtze UniversityJing Zhou434020PR China

Objective:Recent studies have shown that chronic inflammation contributes to the development of Sudden sensorineural hearing loss(SSNHL).Some hematologic parameters have also been linked to the prognosis of SSNHL.However,the prognostic value of such hematological factors is not conclusive.This study explored the association of routine hematological parameters with SSNHL.Methods:A systematic literature search was conducted in PubMed,Cochrane Library,Web of Science and Embase to identify eligible studies.Standardized mean deviation(SMD)and the 95%confidence interval(CI)were retried from relevant studies for analysis.Heterogeneity,subgroup,and publication bias analyses were performed.Results:A total of 18 studies involving 1505 SSNHL patients and 1466 healthy persons were enrolled in the final analysis.The study population included 699 responders and 458 non-responders to treatment.Pooled results revealed that the neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)value in the SSNHL patient group were higher than in the healthy group(SMD=1.05,95%CI:0.86,1.24,p<0.001,SMD=0.52,95%CI:0.26,0.78,p<0.001,respectively).However,there was no significant difference in the mean platelet volumes(MPV)between the groups(SMD=0.03,95%CI:0.44,0.49,p=0.91).Notably,NLR and PLR values were evidently higher in the unrecovered group than in the recovered group(SMD=0.63,95%CI:1.02,0.23,p=0.002,SMD=0.4,95%CI:0.76,0.03,p=0.03,respectively).However,the MPV value was similar in both groups(SMD=0.35,95%CI:1.14,0.44,p=0.38).Conclusions:Our results show that NLR and PLR values can predict the onset and prognosis of SSNHL.

关键词： Sudden sensorineural hearing loss Prognosis Neutrophil/lymphocyte ratio Platelet/lymphocyte ratio Meta-analysis

Idiopathic Sudden sensorineural hearing loss:Effectiveness of salvage treatment with low-dose intratympanic dexamethasone

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Journal of Otology 2021年第1期16卷 6-11页

作者： Pedro Salvador Francisco Moreira da Silva Rui Fonseca Department of Otorhinolaryngology Hospital Senhora da OliveiraGuimaraesPortugal

Objectives:To evaluate hearing outcome of salvage treatment with intratympanic steroids(ITS)in idiopathic Sudden sensorineural hearing loss(ISSNHL)refractory to initial systemic steroid(SS)therapy.Material and methods:A retrospective medical chart review was conducted on 54 consecutive patients with ISSNHL refractory to SS.Salvage treatment with a low dose intratympanic dexamethasone(4 mg/ml)was offered after one week of primary treatment.Patients were divided into two groups:25 patients accepted ITS(treatment group)and 29 patients did not undergo additional treatment(control group).A pure tone average(PTA)gain of at least 10 dB was considered hearing improvement.Results:hearing improvement rate was higher in ITS group compared to control group(40%vs.13.8%,p=0.035).A mean PTA improvement of 8.6±9.8 dB was observed in the ITS group and,whereas the control group had an average hearing gain of 0.7±2 dB(phearing gain in ITS group at all tested frequencies compared to control group(phearing improvement(OR=4.2,95%CI:1.1e15.7;p=0.04).Conclusion:Intratympanic low dose dexamethasone is effective in patients with incomplete hearing recovery after primary systemic steroid treatment.

关键词： Intratympanic Steroids Salvage Sudden sensorineural hearing loss Idiopathic

Analysis of thyroid dysfunction in patients with Sudden sensorineural hearing loss

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2021年第1期7卷 1-8页

作者： Zhu Yuhua Bing Dan Wang Dayong Zhao Lidong Yin Zifang Zhang Qiujing Guan Jing Wang Qiuju Department of Otolaryngology Head and Neck Surgery Institute of OtolaryngologyChinese PLA General HospitalBeijing100853China Department of Otolaryngology Head and Neck Surgery Hainan Hospital of Chinese PLA General HospitalHainan572013China Department of Otolaryngology-Head and Neck Surgery Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China

Background:Sudden sensorineural hearing loss(SSHL)refers to the sudden occurrence of unexplained sensorineural hearing loss.The present study showed that different systemic diseases had different influence on the occurrence and hearing outcome of SSHL.Thyroid hormone is one of the important factors for the development of fetal ear and auditory function.However,the distribution of thyroid dysfunction in SSHL patients and the effect of thyroid dysfunction on the occurrence and hearing outcome of SSHL has not been studied.Methods:In this study,a retrospective analysis had been done in 676 patients with SSHL.We had described the distribution of thyroid function in patients with SSHL in detail,and by the statistical method,analyzed the relationship between the hearing outcome and thyroid dysfunction,respectively.Results:In all patients,24.41%(165/676)had abnormal thyroid function testing results.The onset age of SSHL in FT3 abnormal group(including low and high group)was younger than that in normal FT3 group.Recovery group had more patients with lower-than-normal T3 level as compared to non-recovery patients.Significant associations between T3 levels and hearing outcome were observed in the subgroup with longer time elapse between symptom onset and treatment(≥14 d).Conclusion:The incidence of thyroid dysfunction in SSHL is significantly higher than in the general population.There was obvious relationship between T3 and FT3 item of thyroid dysfunction and the onset time and hearing outcome of SSHL,which indicated that T3 or FT3 indicator may be one of the affecting factors for the SSHL.Early screening and diagnosis of thyroid dysfunction,especial T3 level,may help to evaluate the prognosis in SSHL patients.

关键词： Thyroid dysfunction Sudden sensorineural hearing loss hearing outcome

Sudden sensorineural hearing loss after Pituitary Adenoma Resection-A Case Series with Literature Review

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Chinese Medical Sciences Journal 2021年第2期36卷 120-126页

作者： Yi Wang Zhuhua Zhang Wei Lian Department of Otolaryngology Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China Department of Clinical Radiology Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China Department of Neurosurgery Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China

Objective Complications after transsphenoidal surgery for pituitary adenoma have been well documented in the literatures,but the occurrence of delved Sudden sensorineural hearing loss(SNHL)after pituitary adenoma resection is extremely rare.In this study three cases who developed sudden SNHL 3 to 7 days after pituitary adenoma surgery without experiencing cerebrospinal fluid leak or meningitis were presented,and the possible causes of SNHL were discussed.Methods Three cases with sudden hearing loss after transsphenoidal surgery for pituitary adenoma were reviewed.The past medical history,onset of sudden hearing loss,accompanying symptoms such as headache,tinnitus,dizziness and aural fullness,and the post-operative MRI images,therapy and hearing results were reported.Results Three cases developed profound sudden SNHL on the 3rd to 7th post-operative day,all accompanied by prior headache,tinnitus and dizziness.One patient developed episodic vertigo,ear fullness accompanying with fluctuating hearing loss in the first post-operative month.Two patients had past medical history of arteriosclerosis and coronary heart disease or cerebral infarction.Two of three demonstrated obstructive hydrocephalus on MRI on the first post-operative day.Under treatment with prednisone orally,dexamethasone intratympanic mjection,neurotrophic and vasodilatation drugs for 3 to 8 months,hearing of all three improved partially.Obstructive hydrocephalus and ischemia might be responsible for the hearing loss.Conclusion Post-operative obstructive hydrocephalus and ischemia of labyrinthine arteries might lead to the delayed SNHL after transsphenoidal surgery for pituitary adenoma.

关键词： transsphenoidal surgery for pituitary adenoma obstructive hydrocephalus ischemia of internal auditory arteries Sudden sensorineural hearing loss tinnitus

A novel PIK3CD C896T mutation detected in bilateral Sudden sensorineural hearing loss using next generation sequencing:An indication of primary immunodeficiency

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Journal of Otology 2016年第2期11卷 78-83页

作者： Jing Zou Xiangqiang Duan Guiliang Zheng Zhen Zhao Shiyue Chen Pu Dai Hongliang Zheng Department of Otolaryngology-Head and Neck Surgery Center for Otolaryngology-Head & Neck Surgery of Chinese PLA Changhai Hospital Second Military Medical University Department of Radiology National Key Discipline Changhai Hospital Second Military Medical University Department of Otolaryngology-Head and Neck Surgery Chinese PLA General Hospital

Objective:To investigate immune-related genetic background in bilateral Sudden sensorineural hearing loss (SSNHL). Case report and methods: The case is a 45-year-old man presenting with a 7-year history of bilateral profound SSNHL. Blood biochemical testing demonstrated increased levels of total cholesterol (5.88 mmol/L). Tests for hepatitis B showed a positive antibody against the hepatitis B core antigen. Complement C3 was below the normal value, and complement C4 and IgG were in the lower range of normal values. CT images showed a normal inner ear and vestibular aqueduct but round window membranous ossification on both sides. A total number of 232 immune-associated genes were sequenced using the next generation sequencing technique. Results: Mutations were detected in 5 genes, including the phosphoinositide 3-kinase catalytic subunit delta (PIK3CD), caspase recruitment domain-containing protein 9 (CARD9), complement factor H-related (CFHR2), immunoglobulin lambda-like polypeptide 1 Protein (IGLL1), and transmembrane channel-like gene family 8 (TMC8). In the PIK3CD gene, a C896T substitute in exon 7 was detected. This mutation causes primary immunodeficiency and is an autosomal dominant disease. Conclusion: The PIK3CD C896T mutation responsible for primary immunodeficiency may contribute to the onset of bilateral SSNHL with subsequent rapid progression.

关键词： Sudden sensorineural hearing loss Immunology Genetics Next generation sequencing

A comparison of effects of systemic and intratympanic steroid therapies for Sudden sensorineural hearing loss:A meta-analysis

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Journal of Otology 2016年第1期11卷 18-23页

作者： Dan Zhao Busheng Tong Qiang Wang Sten Hellstrom Maoli Duan Department of Otorhinolaryngology-Head and Neck Surgery The First Affiliated Hospital of Anhui Medical University Department of Audiology and Neurotology Department of Clinical Science Intervention and Technology Karolinska Institute

Objective:To evaluate the efficacy and safety of intratympanic and systemic steroid therapies in the initial treatment of Sudden sensorineural hearing loss (SSNHL) patients. Methods:A comprehensive search of PubMed, Wanfang database and CNKI (China National Knowledge Infrastructure) was performed covering the period from January 1990 to July 2014. A meta-analysis was conducted after filtering by the criteria of Cochrane Collaboration. Three hundred fifty six subjects in nine studies allocated to the group of intratympanic steroid therapies and 343 controls receiving systemic steroid therapies met the criteria for meta-analysis. The data were extracted and analyzed using the RevMan 5.3 meta-analysis software. Results: The total effectiveness rate in SSNHL patients receiving intratympanic steroid therapies did not differ statistically from patients receiving systemic therapies (RR ? 1.08, 95%CI ? 0.99e1.99, P ? 0.10), although the rate of full hearing recovery in this group differed significantly from patients receiving systemic therapies (RR ? 1.29, 95%CI ? 1.00e1.66, P ? 0.05). Conclusion: Local steroid therapy appears to generate higher rate of complete hearing recovery than systemic steroid treatment as an initial treatment for SSNHL, which may be especially useful for patients in whom systemic steroids are contraindicated.

关键词： Sudden sensorineural hearing loss Intratympanic steroids Systemic steroid Meta-analysis

Improvement in word recognition following treatment failure for Sudden sensorineural hearing loss

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2016年第3期2卷 -页

作者： Taha A. Jan Elliott D. Kozin Vivek V. Kanumuri Rosh K. Sethi David H. Jung Department of 0tolaryngology Massachusetts Eye and Ear Infirmary Harvard Medical School Boston MA 02114 USA

UNASSIGNED:Patients with Sudden sensorineural hearing loss (SSNHL) may have word recognition scores (WRS) that correlate with pure tone average (PTA). We hypothesize that there is a subset of patients with SSNHL who have improved WRS despite stable PTA.;UNASSIGNED:Retrospective case review at a tertiary otolaryngology practice.;UNASSIGNED:We identified 13 of 113 patients with SSNHL whose WRS increased despite overall stable pure tone averages. There was an observed average improvement in WRS by 23.8 points in this patient cohort at follow-up, with mean initial PTA in the affected ear at 48.7 dB.;UNASSIGNED:We identify a novel cohort of SSNHL patients that have failed treatment as measured by PTA, but who have increased WRS over time. These data have implications for patient counseling and lend insight into the pathophysiology of SSNHL.

关键词： Pure tone average sensorineural hearing loss Sudden sensorineural hearing loss Word recognition score

Vestibular function of pediatric patients with Sudden sensorineural hearing loss:based on vertigo symptom and vestibular function testing

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World Journal of Pediatrics 2021年第6期17卷 637-642页

作者： Yan-Hong Li Bing Liu Yang Yang Min Chen Wei Liu Jian-Bo Shao Xiao Zhang Jie Zhang Xin Ni Department of Otorhinolaryngology Head and Neck Surgery Beijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery Beijing Pediatric Research InstituteBeijingChina

Background This study aimed to evaluate the relationship between vestibular and auditory functions in pediatric patients with Sudden sensorineural hearing loss(SSHL).Methods A total of 30 pediatric patients experiencing unilateral SSHL between 5.9 and 13.0 years of age were enrolled in this study.Pure tone audiometry was evaluated prior to treatment initiation and again after one month of treatment.Prior to treatment initiation,vertigo symptoms were noted;then several vestibular function tests were conducted including caloric testing,ocular vestibular evoked myogenic potentials(o-VEMPs)and cervical vestibular evoked myogenic potentials(c-VEMPs).Associations between pre and post-treatment vestibular function and hearing threshold levels were analyzed.Results Initial hearing thresholds of children with vertigo were higher than thresholds of children without vertigo(92 dB vs 79 dB,F=0.033),while initial hearing thresholds of children with abnormal caloric test findings were higher than thresholds of children with normal caloric test findings(93 dB vs 67 dB.P=0.014).Cutoff values of hearing thresholds for those with vertigo symptoms and abnormal vestibular test results were 86.000-and 89.583-dB HL.respectively.Regarding prognosis,children with vertigo exhibited lower recovery rates than children without vertigo(33%vs 75%,P=0.025);recovery rates of children with abnormal caloric test results were lower than the overall recovery rate(25%vs 73%,respectively,P=0.039).Conclusion Assessments of vertigo symptoms and vestibular function are useful tools in predicting pediatric SwSHL patient disease severity and prognosis.

关键词： Prognosis Sudden sensorineural hearing loss Vertigo Vestibular function tests