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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

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Genetic Susceptibility Study of Chinese Sudden sensorineural hearing loss Patients with Vertigo

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Current Medical Science 2021年第4期41卷 673-679页

作者： Yun GAO Hong-yang WANG Jing GUAN Lan LAN Cui ZHAO Lin-yi XIE Da-yong WANG Qiu-ju WANG College of Otolaryngology Head and Neck Surgery Chinese PLA General HospitalChinese PLA Medical SchoolNational Clinical Research Center for Otolaryngologic DiseasesBeijing100853China

Objective To investigate the genetic causes of Sudden sensorineural hearing loss(SSNHL)patients in China.This study focused on analyzing variations of coding sequence of common genes related to deafness,revealing the molecular pathogenesis of sudden deafness from a genomics perspective,discovering molecular markers associated with the onset of deafness,and then supplying prevention to high-risk populations,classifying disease according to accurate etiology,and choosing a much more precision therapy.Methods We retrospectively analyzed the clinical characteristics of 51 patients diagnosed as SSNHL with vertigo treated in the Chinese PLA General Hospital.In this study,mutation screening of 307 nuclear genes and mitochondrial genome responsible for human or mouse deafness was performed on the 51 cases of unilateral sudden deafness patients with vertigo.Results We identified 51 cases of unilateral sudden deafness,including 2 cases of low-mid frequency hearing impairment,18 cases of mid-high frequency hearing loss,11 cases of flat-type hearing loss,and 20 cases of all frequency hearing loss.Among the 51 cases,8(15.69%)cases of GJB2 heterozygous variations,1(1.96%)case of GJB3 heterozygous variations,5(9.8%)cases of SLC26A4 heterozygous variations,2(3.92%)cases of COCH heterozygous variations,14(27.45%)cases of CDH23 heterozygous variations,14(27.45%)cases of OTOF heterozygous variations,1(1.96%)case of SLC17A8 heterozygous variations and 2(3.92%)cases of KCNE1 heterozygous variations.No mtDNA gene variations were identified.Conclusion SSNHL has some relationship with hereditary in Chinese population,but its complex genetic pathogenic mechanisms need further study.

关键词： Sudden sensorineural hearing loss targeted high-throughput sequencing variation gene susceptibility

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Intratympanic dexamethasone injection for Sudden sensorineural hearing loss in pregnancy

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World Journal of Clinical Cases 2020年第18期8卷 4051-4058页

作者： Yan-Lu Lyu Fan-Qian Zeng Zhou Zhou Min Yan Wei Zhang Ming Liu Zhao-Yang Ke Department of Otorhinolaryngology-Head and Neck Surgery Shenzhen People’s Hospital(The Second Clinical Medical CollegeJinan UniversityThe First Affiliated HospitalSouthern University of Science and Technology)Shenzhen 518020Guangdong ProvinceChina

BACKGROUND As Sudden sensorineural hearing loss(SSNHL)rarely occurs in pregnant women,there is a lack of knowledge and relevant research on its management.AIM To investigate the effect of intratympanic dexamethasone injection in the treatment of pregnant patients with SSNHL.METHODS A retrospective chart review was made for the period between June 2017 and August 2019 at our Department of Otorhinolaryngology-Head and Neck Surgery.Pregnant women who met the criteria for SSNHL were included and grouped based on the therapeutic modalities.The treatment group received intratympanic dexamethasone(2.5 mg)q.***.d.for a total of four times,while the control group received no medication other than bed rest and medical observations.All the patients were under close care of obstetricians.Pure-tone audiograms were performed before and after treatment.RESULTS Eleven patients who met the inclusion criteria were assigned to the treatment group(n=7)and the control group(n=4).The mean age of patients was 31.2±3.8 years;the right ear was affected in seven(63.64%)cases.Two patients(18.2%)suffered from vertigo,10(90.9%)suffered from tinnitus and 6(54.5%)suffered from aural fullness.The time from onset to clinic visit was relatively short,with a mean time of 1.3±0.9 d.All the women were within the second or third trimester;the average gestation period was 26.0±6.2 wk.The pure-tone averages at onset between the two groups were similar.After one wk of therapy,the treatment group had a curative rate of 57.1%and a significantly better hearing threshold and greater improvement compared to the control group(all P<0.05).Some patients experienced transient discomfort from intratympanic injections that disappeared after getting rest,while none had permanent complications.All patients delivered healthy full-term neonates with an average Apgar score of 9.7±0.5.CONCLUSION Intratympanic dexamethasone injections can be used as a first-line therapy in pregnant women with SSNHL.

关键词： Sudden sensorineural hearing loss Pregnancy,Intratympanic injection Audiometry Dexamethasone Obstetrics

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Sudden sensorineural hearing loss treated with intratympanic dexamethasone injection

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Journal of Otology 2010年第1期5卷 4-7页

作者： LIU Rong-rong, CHNE Ji-chuan, JI Changyou Department of Otorhinolaryngology Head and Neck Surgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China Department of Otorhinolaryngology Head and Neck Surgery Institute of Surgery Research Daping Hospital Third Military Medical University Chongqing China

Objective To evaluate the effect of different protocols of intratympanic dexamethasone injection in patients with unilateral Sudden sensorineural hearing loss (SSNHL) who have failed to respond to typical medical treatment (including systemic steroid treatment). Methods From January 2005 to January 2008, 71 patients who were diagnosed with unilateral SSNHL and failed typical medical treatment received intratympanic dexamethasone injection. Four injection protocols were employed: injection of 0.3 ml dexamethasone(5 mg / ml) three times a week for 3 weeks for a total dose of 13.5 mg (Group I, n=16); injection of 0.6 ml (5 mg / ml) dexamethasone three times a week for 3 weeks for a total dose of 27 mg (Group II, n=18); injection at 0.3 ml(5 mg/ml) week for 6 weeks for a total dose of 9 mg (Group III, n=18); injection at 0.3 ml (5 mg / ml) / 2 days for a total dose of 4.5 mg (Group IV n=19). hearing recovery was assessed by pure tone audiogram. Results The total effective rate was 37.5%, 38.89%, 33.33% and 36.84% for each treatment protocol, respectively, with no statistical difference between them (P > 0.05). The results suggest that a total dose of 4.5 mg (injected once a week for 3 weeks) is the most adequate protocol, and increasing dose or injection frequency yields no additional benefits. Conclusion Intratympanic dexamethasone significantly improves the prognosis of SSNHL. Small dose at low injection frequency is sufficient. Further multicenter studies are needed to determine the standard treatment protocol.

关键词： Intratympanic injection Dexamethasone Sudden sensorineural hearing loss

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Relationship between Sudden sensorineural hearing loss and Vascular Risk Factors

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Journal of Otology 2009年第1期4卷 55-58页

作者： ZHU Wen-yan1,DAI Yan-hong1,SHE Wandong1,WANG Lu2,Gao Xia1 1 Department of Otolaryngology-Head and Neck Surgery,Drum Tower Clinical Medical School,Nanjing Medical University,Nanjing 210008,China 2 Department of Medical English,School of Foreign Language,Nanfang Medical University,Guangzhou 510510,China Department of Otolaryngology-Head and Neck Surgery Drum Tower Clinical Medical School Nanjing Medical University Nanjing 210008 China Department of Medical English School of Foreign Language Nanfang Medical University Guangzhou 510510 China

Objective To explore the relationship between Sudden sensorineural hearing loss(SSNHL) and vascular risk factors(including serum lipids and uric acid).Method This is a retrospective analysis of 100 cases of SSNHL seen at the Drum Tower Hospital,Nanjing Medical University,between Jan.2007 and Apr.2008。 Patient history,blood test results and imaging scans were analyzed.Levels of triglyceride(TG),cholesterols(CHO),high density lipoprotein-cholesterol(HDL-CH),low density lipoprotein-cholesterol(LDL-CH),apolipoprotein AI(ApoAI),apolipoprotein B(ApoB) and uric acid(UA) from these patients were compared with a control group of 56 patients treated for vocal cord polyps or nasal septum deviation during the same period.Patients with hypertension,diabetes,heart,brain,liver or kidney disorders are excluded from the present investigation.Results HDLCH level was higher and UA level lower in the study group than the control group(P 0.05).There were no significant differences in the levels of TG,CHO,LDL-CH,ApoAI and ApoB(P > 0.05).Conclusion These data indicate that metabolic disturbances of serum lipids and/or uric acid may be potential risk factors for SSNHL

关键词： Sudden sensorineural hearing loss Lipid Uric Acid Age

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Intratympanic vs systemic use of steroids as first-line treatment for sudden hearing loss:A meta-analysis of randomized,controlled trials

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Journal of Otology 2021年第3期16卷 165-177页

作者： Ting Yang Hui Liu Fangyao Chen An Li Zhou Wang Shuangyuan Yang Shiyu Yang Wen Zhang Xi’an Medical University China Department of Otolaryngology Shaanxi Provincial People’s HospitalChina Xi’an Jiaotong University China

Background Sudden sensorineural hearing loss(SSNHL)is a common disease in otology,and steroids play an important role in its treatment.Steroids can be administered systemically or locally,and the efficacies of different administration routes remain controversial.Methods We searched the Cochrane,EMBASE,PubMed,Web of Science,CNKI,Wanfang and Weipu databases for randomized controlled trials(RCTs)on glucocorticoid treatments for SSNHL to compare the efficacy of topical and systemic steroid administration.The Review Manager 5.4 software was used for synthesis of data:the rate of reported hearing improvement and change in pure-tone audiometry(PTA).Results In all the included studies,when intratympanic administration was compared to systemic therapies,the risk difference(RD)using reported hearing improvement as an outcome measure was 0.08(95%CI:0.01–0.14,I2=45%).Using PTA changes as an outcome measure in 4 studies,the mean difference(MD)was 10.43 dB(95%CI:3.68–17.18,I2=81%).hearing improvement RD was also compared among different types of steroid,recovery criteria,follow-up times and diagnostic criteria,and showed no significant differences exception for recovery criteria(>10 dB)(RD-0.06,95%CI:0.14-0.2,I2=0%).Conclusion As the initial treatment for SSNHL,topical steroids seem to be superior to systemic steroid administration,especially in patients with contraindications to systemic steroids usage.However,further verification based on high-quality research is needed.

关键词： Intratympanic treatment Systemic treatment meta-Analysis Sudden sensorineural hearing loss

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Controlled release of dexamethasone from fibrin sealant for intratympanic administration in inner ear therapy

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Journal of Otology 2024年第1期19卷 55-58页

作者： Jing Zou Department of Otolaryngology-Head and Neck Surgery Changhai HospitalSecond Military Medical UniversityShanghai200433China Faculty of Information Technology and Communication Sciences Tampere UniversityTampereFinland

The aim of the present work was to show the sustainability of fibrin sealant in releasing dexamethasone and adjust the protocol for clinical application of the novel method in the treatment of Meniere’s disease (MD) and Sudden sensorineural hearing loss (SSHL).Gelation occurred shortly after mixing dexamethasone-containing fibrinogen with thrombin.Dexamethasone was constantly released for at least 16 d at a stable level after 7d in protocol 1 (low-dose),while it was robustly released within 4 d and slowed afterward until 10 d in protocol 2(high-dose).There were significant differences among the time points in Protocol 2 (p<0.01,ANOVA),and the exponential model with the formula y=15.299*e~(-0.483*t) fits the association.The estimated concentration of dexamethasone released on 7 d in protocol 2 was slightly lower than that observed in protocol 1.The fibrin sealant is capable of constantly releasing dexamethasone with adjustable dynamics.Targeted and minimally invasive administration of the material can be achieved in the clinic by sequential injections of the fluids using a soft-tipped catheter.

关键词： Intratympanic drug delivery Controlled release Corticosteroids Meniere's disease Sudden sensorineural hearing loss

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Role of Intratympanic Steroids in the Management of Idiopathic sudden Sensori Neural hearing loss— Our Experience of 67 Cases

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International Journal of Otolaryngology and Head & Neck Surgery 2016年第4期5卷 174-180页

作者： D. S. Deenadayal D. Vidyasagar Vyshanavi Bommakanti Madisetty Naveen Kumar Nakirikanti Ravi Kumar Ramesh Chintha Department of ENT and HNS Yashoda Hospital Secunderabad India

Objective: To assess the outcomes of intratympanic steroids in the management of idiopathic Sudden sensorineural hearing loss. Study Design: Retrospective study. Setting: Academic tertiary care medical centre. Materials and Methods: A total of 67 patients with idiopathic Sudden sensorineural hearing loss were included in our study. Pre- and post-injection audiograms were taken to assess the outcomes in improvement in hearing. hearing outcomes were assessed with respect to duration of onset of treatment and age of the patient. Improvement in the speech discrimination score was also assessed. Results: A total of 67 patients were included in our study of which unilateral cases were 59 and bilateral cases were 8. Subjectively 35 patients reported improvement in hearing after the therapy while objectively we found 44 ears [41 patients] had improvement. The mean PTA pre ITS was 62.7 and after ITS it was 56.3. Maximum improvement was noted at 2000 Hz and 1000 Hz. Conclusion: Intratympanic steroids can be offered as a first line therapy for idiopathic Sudden sensorineural hearing loss as it is minimally invasive, and can be performed as an office based procedure with no systemic side effects. No major complications have been reported in our study and results have been satisfactory.

关键词： Intratympanic Methyl Prednisolone Sudden sensorineural hearing loss

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Mechanism of aseptic inflammation upon the inner ear injury

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Journal of Bio-X Research 2020年第2期3卷 72-77页

作者： Wang Yanmei Ren Dongdong ENT Institute and Otorhinolaryngology Department Affiliated Eye and ENT Hospital of Fudan UniversityShanghaiChina Shanghai Auditory Medical Center ShanghaiChina Key Laboratory of hearing Science Ministry of HealthShanghaiChina

Many factors can cause inner ear injury,such as noise exposure,chemicals,viral infection,and radiation.The main pathological manifestations of inner ear injury are local hypoxia-ischemia,micro-trauma,and an increased level of reactive oxygen species and inflammatory mediators.The contribution of the inflammatory response to the mediation of cochlear and vestibular pathologies has received increasing attention in recent years.Aseptic inflammation can devastate audition and balance,which can lead to many typical clinical inner ear diseases.In this review,we will discuss the most pertinent and recent research on inflammatory mechanisms in inner ear injury.We will also discuss the pathophysiology of some common and significant ear diseases,such as Sudden sensorineural hearing loss,age-related hearing loss,noise-induced hearing loss,and Meniere’s disease.

关键词： age-related hearing loss immune response inflammatory response macrophages Sudden sensorineural hearing loss

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