Long-term evaluation and physical and mental effects of residual tinnitus following treatment of sudden hearing loss / 中华耳鼻咽喉头颈外科杂志

Objective: To clarify the long-term characteristics of tinnitus following treatment of sudden deafness and its long-term physical and mental effects on patients. Methods: A retrospective analysis was performed on 88 patients (46 males and 42 females; Age from 11 to 89 years) with sudden deafness treated in Department of Otoscope Surgery of Peoples's Libration Army General Hospital in Beijing from April 2020 to January 2021, and the occurrence of tinnitus and treatment effect of all patients were analyzed. Follow-up was conducted for patients with residual tinnitus after treatment for more than 1 year by the investigation and filling in the survey information collection form, Tinnitus Evaluation Questionnaire (TEQ) and Tinnitus Handicap Inventory (THI). Descriptive statistics and SPSS 22.0 software were used for statistical data analysis. Results: In this study, 93.2% (82/88) of patients with sudden deafness were accompanied by tinnitus at the onset, and the proportion of long-term tinnitus after treatment was 90.2% (74/82). After 1 year of treatment for sudden deafness, the improvement of tinnitus was significant in low-frequency sudden deafness compared with those of high-frequency, flat and total deafness sudden deafness (χ2 value was 6.801, 4.568 and 4.038, all P<0.05). In patients with residual tinnitus, 9 (12.2%) patients felt minimal loudness or even no loudness, 34 (46.0%) patients felt slight loudness, 28 (37.8%) patients felt tinnitus was relatively loud, and 3 (4.1%) patients felt tinnitus was loud or noisy. Nine (12.2%) patients's sleep was often affected, 41 (55.4%) patients's sleep was sometimes affected, 9 (12.2%) patients's sleep was rarely affected, 15 (20.3%) patients's sleep was almost not affected. Twenty-eight (37.8%) patients basically completely adapted to tinnitus and 46 (62.2%) patients did not completely adapted to residual tinnitus. Eight (10.8%) patients had no impact on life, 39 (52.7%) patients had slight impact, 22 (29.7%) patients had moderate impact, and the other 5 (6.8%) patients had greater impact. According to tinnitus evaluation questionnaire(TEQ), there were 12 cases (16.2%) of grade Ⅰ, 26 cases (35.1%) of grade Ⅱ, 28 cases (37.8%) of grade Ⅲ, 7 cases (9.5%) of grade Ⅳ and 1 case (1.4%) of grade Ⅴ. According to tinnitus handicap inventory(THI), tinnitus disability was classified into grade Ⅰ, 22 cases (29.7%), grade Ⅱ, 14 cases (18.9%), Grade Ⅲ, 27 cases (36.5%) and grade Ⅳ, 11 cases (14.9%). Conclusion: The rate of residual tinnitus following treatment of sudden deafness is high. Some of the patients can completely adapt residual tinnitus after one year, but some of them will be affected when sleep, work and study. Residual tinnitus can lead to tinnitus disability in different degrees.

Multi-center clinical study on the treatment of the low-middle frequency sudden hearing loss / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate and compare the short-term outcome of patients with low-middle frequency sudden deafness treated with alone or combination treatment.</p><p><b>METHODS</b>From August 2007 to October 2011, 205 patients with the diagnosis of low-middle frequency sudden deafness who were from 33 different clinical centers were recruited. All patients were followed up for four weeks from the initial examination. Patients were treated with steroid , Ginaton, batroxobin respectively, or Ginaton and steroid combination treatment.</p><p><b>RESULTS</b>The total effective rate was 90.73%. In Ginaton group, the total effective rate was 87.27%, 89.19% in steroid group, 87.80% in batroxobin group, and 95.83% in Ginaton and steroid group. Considering the total effective rate, there was no statistical difference between four groups (χ(2) = 7.98, P = 0.54). The clinical cure rate for steroid alone was 81.01%, Ginaton alone 76.36%, batroxobin alone 68.29%, and Ginaton and steroid combination treatment 80.56%. There were no clinically significant differences between the different treatments (P > 0.05).</p><p><b>CONCLUSIONS</b>The low-middle frequency sudden deafness tends to have a relatively favorable prognosis. The steroid played a good effect in the treatment. But different treatments either improving the microcirculation of inner ear or alleviating edema blood has undifferentiated results. Therefore the combination therapy may be more effective.</p>

Protection from noise-induced hearing loss by a nitric oxide synthase inhibitor and neurotrophin 3 in the guinea pig cochlea / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To observe the protective effect of nitric oxide synthase inhibitor-N(G)-nitro-L-arginine methyl ester (L-NAME) with or without neurotrophin 3 (NT3) on hearing in acoustic trauma.</p><p><b>METHODS</b>Eighty pigmented male guinea pigs were randomly divided into two groups: sham-exposed group (n=20) and noise-exposed group. The latter was divided into three subgroups: saline group (n=20), L-NAME group (n=20) and L-NAME + NT3 group (n=20). Two days consecutively and 30 min before noise exposure (4 kHz octave band noise at 115 dB SPL for 5 h), subjects in L-NAME and L-NAME + NT3 groups received an intraperitoneal injection of 10 mg/kg; animals in saline group received the same dosage of physiological saline at the same time. Four days before noise exposure, NT3 in artificial perilymph was delivered to the right scala tympani via a mini-osmotic pump in noise + L-NAME + NT3 group. Auditory brainstem responses (ABR) were measured before and 10 days following noise exposure. The cochlear tissue was assayed for nitric oxide (NO) level 3 days after noise exposure. Protection was assessed physiologically by the change in ABR threshold shift, and histologically by outer hair cell (OHC) survival.</p><p><b>RESULTS</b>The hearing thresholds and the number of OHC were relatively stable in sham-exposed group. The obvious threshold shift and OHC loss were observed in the noise-exposed groups. The hearing thresholds, NO level of cochlear tissue and OHC loss in the noise + saline group were significantly higher than those in the noise + L-NAME group (P < 0.01) and noise + L-NAME + NT3 group (P < 0.01). NT3 provided an additive functional (P < 0.01), but not morphological protection with L-NAME (P = 0.095).</p><p><b>CONCLUSION</b>Compared to L-NAME alone, a combination of L-NAME and NT-3 can provide an additional protection against acoustic trauma in the guinea pig cochlear.</p>

Changes in antioxidant capacity of the guinea pig exposed to noise and the protective effect of alpha-lipoic acid against acoustic trauma / 生理学报

The study was aimed at exploring the effect of noise on total antioxidant capacity (TAC) in serum, nitric oxide (NO) level in the cochlea and the protective action of alpha-lipoic acid against noise-induced hearing loss (NIHL). Sixty guinea pigs (350-400 g) were divided randomly into three groups (control group, noise+saline group and noise+alpha-lipoic acid group). Serum and cochlear tissue were treated immediately after noise exposure (4-kHz octave band, 115 dB SPL 5 h) to determine the level of TAC and NO, respectively. Auditory brainstem responses (ABRs) were measured before and immediately after exposure. The threshold of hearing in the control group was relatively stable, while the hearing threshold in the noise+saline group was significantly higher than those in the noise+alpha-lipoic acid group (P<0.05). TAC level of the noise+saline group was significantly lower than that of the control group P<0.05 . TAC level of the noise+alpha-lipoic acid group was significantly higher than that of the noise+saline group P<0.05 , while there was no significant difference in the levels between the noise+alpha-lipoic acid group and the control group (P>0.05). The NO level of the cochlear tissue in the noise+saline group was significantly higher than that of the control group (P<0.05). Cochlear NO level in the noise+alpha-lipoic acid group was significantly lower than that of the noise+saline group (P<0.05), while there was no significant difference in cochlear NO levels between the noise+alpha-lipoic acid group and the control group (P>0.05). The results obtained indicate that noise exposure causes a decrease in serum TAC and an increase in NO in cochlea. alpha-Lipoid acid exerts a protective effect against hearing loss in acoustic trauma through its antioxidant effects.

Effects of N-methyl-D-aspartate on the cochlear potentials / 第二军医大学学报

Objective: To study the effects of TNFα on wound healing. Methods: The skin lesion and incisions were made on mice and rhTNFα was applied in both skin lesion and incision. Tissue strips were evaluated for tensiometry and histologic features after healing. Results: It was found that rhTNFα markedly improved wound healing both in skin lesion and incision wound model, it also markedly enhanced the breaking strength of treated incision and increased wound cellularity in rh TNF α treated groups. Conclusion: The results suggest that TNFα play an important role in regulating inflammatory reactions of local injured tissues and it may improve the functions of fibroblasts, mononuclear phagocytes and endothelial cells. rhTNFα of suitable doses can promote wound healing. This shows that TNFα, as a wound healing promoter, has the potentials for clinical application.

Effects of N-methyl-D-aspartate on the cochlear potentials / 第二军医大学学报

Objective: To study the effects of TNFα on wound healing. Methods: The skin lesion and incisions were made on mice and rhTNFα was applied in both skin lesion and incision. Tissue strips were evaluated for tensiometry and histologic features after healing. Results: It was found that rhTNFα markedly improved wound healing both in skin lesion and incision wound model, it also markedly enhanced the breaking strength of treated incision and increased wound cellularity in rh TNF α treated groups. Conclusion: The results suggest that TNFα play an important role in regulating inflammatory reactions of local injured tissues and it may improve the functions of fibroblasts, mononuclear phagocytes and endothelial cells. rhTNFα of suitable doses can promote wound healing. This shows that TNFα, as a wound healing promoter, has the potentials for clinical application.