The psychological intervention and clinical efficacy of Rosenthal effect and acupuncture bleeding on middle-aged and young patients with sudden hearing loss.

Combining traditional Chinese medicine theory and modern medical knowledge, this study explores the pathogenesis of sudden hearing loss in middle-aged and young people. Sixty-four young and middle-aged patients with sudden hearing loss who visited a public tertiary hospital in China are chosen as experimental objects. All experimental patients are broken into an experimental group (n = 32) and a control group (n = 32). The control group receive conventional Western medicine treatment regimen. The experimental group receive select acupoint acupuncture and bloodletting combined with Rosenthal effect for psychological intervention, and both groups have a treatment course of 14 days. The changes in the patient's condition before and after treatment are observed, and the differences in hearing threshold values, tinnitus, and dizziness clinical efficacy before and after treatment are observed and recorded. It evaluates the efficacy using the Anxiety, Depression Scale, and Hope Scale and statistically analyzes the data. The dizziness score of the experimental group decreased rapidly, the treatment onset time was shorter, and the improvement effect on dizziness symptoms was better (P < .05). After 1 month of intervention treatment, the intervention of the experimental group was better (P < .05). The hope level and self-efficacy of both groups of patients were raised in contrast with before treatment (P < .05). After 1 month, the intervention effect of the experimental group was more significant (P < .01). Both groups could improve patient ear blood circulation, but the experimental group had lower plasma viscosity, hematocrit, and red blood cell aggregation index, higher red blood cell deformation index, and more significant improvement effect (P < .05). The effective rates of improving hearing and tinnitus in the experimental group reached 87.5% and 81.5%, and the clinical treatment efficacy was better than that in the control group (P < .05). The level of depression and anxiety in the experimental group remained relatively stable, while that in the control group showed a significant rebound (P < .05). In conclusion, both groups had a certain effect in treating sudden deafness, both of which could effectively improve the patient's hearing. But in contrast with the control group, the experimental group had better clinical efficacy, higher safety, and better psychological intervention results, which is worthy of clinical promotion.

The therapeutic effect of hyperbaric oxygen therapy in patients with severe to profound idiopathic sudden sensorineural hearing loss.

The optimal treatment for sudden sensorineural hearing loss (SSNHL) is unclear. Hyperbaric oxygen therapy (HBOT) has been suggested as a viable option for treatment of SSNHL as it improves vascular dysfunction. In this study, we evaluated the therapeutic effects of HBOT by retrospectively reviewing the records of 2206 patients with SSNHL. 54 who had received HBOT were selected for the HBOT groups, while 59 age-matched controls who had not were selected for the control groups. The HBOT and control groups were divided into subgroups according to intratympanic steroid (ITS) use. Groups A-D had received oral steroids + HBOT, oral steroids only, oral steroids + ITS + HBOT, and oral steroids + ITS, respectively. Of the 113 SSNHL patients, 21 had diabetes mellitus (DM) (2, 0, 9, and 10 patients in Groups A-D, respectively). There was no notable difference in hearing improvement between patients receiving HBOT and those in the control group. However, among diabetic patients, those who underwent HBOT demonstrated a significant improvement in hearing when compared to the control group. The combination of HBOT and steroids could potentially be beneficial for treating severe to profound SSNHL patients with DM.

The Effectiveness of Salvage Hyperbaric Oxygen Therapy Following Combined Steroid Therapy for Refractory Sudden Sensorineural Hearing Loss.

OBJECTIVE: Hyperbaric oxygen therapy (HBOT) is an accepted treatment option for sudden sensorineural hearing loss (SSNHL), but it is still recommended in combination with corticosteroids. We investigated the efficacy of salvage HBOT in refractory SSNHL that does not respond to corticosteroid combination therapy. METHODS: Eighty-four patients were included, who had unilateral SSNHL with an improvement of pure-tone average (PTA) less than 10 dB after using intratympanic plus systemic corticosteroids (combined therapy) as the initial therapy. The control group (n = 66) received no further treatment, and the HBOT group (n = 18) received additional treatment with HBOT (10 sessions in total with 2.5 atmospheres absolute for 1 hour). RESULTS: No differences in PTA or WDS were found between the 2 groups. However, the mean hearing gain in the HBOT group (16.8 ± 4.49 dB) was significantly higher than that in the control group (4.45 ± 1.03 dB) (P = .015). The proportion of patients with hearing recovery (hearing gain of 10 dB or more) after treatment was significantly higher in HBOT group (38.9%) than in the control group (10.6%). CONCLUSIONS: In patients with refractory SSNHL after steroid combined therapy, salvage HBOT showed a significant effect on hearing gain and recovery rate.

Sensorineural Hearing Loss due to Acute Carbon Monoxide Poisoning.

Carbon monoxide (CO) can cause "irreversible" severe-to-profound sensorineural hearing loss. However, there are few reports of detailed hearing test results. Here, we report a case of acute sensorineural hearing loss caused by acute CO poisoning with partial hearing recovery, evaluated by a detailed hearing examination. A 25-year-old woman was brought to the emergency department for attempted suicide. On admission, her consciousness was impaired, and she was treated for severe CO poisoning, including using hyperbaric-oxygen therapy. After regaining consciousness, symptoms of hearing loss and tinnitus were discovered, and a detailed audiological examination revealed bilateral hearing loss, suggesting cochlear damage. Steroids were systemically administered, and her hearing impairment was partially resolved. Sensorineural hearing loss caused by acute CO poisoning includes cochlear pathology and may be partially treatable. The early evaluation of hearing in patients with severe CO poisoning is advisable for early treatment.

Indications of Effective Hyperbaric Oxygen Therapy Combined With Steroid Therapy for Sudden Hearing Loss.

OBJECTIVE: This study evaluated the therapeutic effect of hyperbaric oxygen therapy (HBOT) combined with steroid therapy to treat sudden hearing loss and examined the index associated with excellent therapeutic effect. METHODS: We included 109 patients with sudden hearing loss. Patients were divided into the HBOT combination group (59 sides) treated with HBOT and steroid therapy and HBOT noncombination group (50 sides) involving steroid therapy only. The recovery rate of each group was compared according to the severity of hearing loss. Blood samples were evaluated and inflammatory markers, such as neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), were calculated and compared by severity. We evaluated the usefulness of inflammatory markers for predicting recovery rate, and calculated cutoff values were also evaluated. RESULTS: The HBOT combination group exhibited a higher overall recovery rate than the HBOT noncombination group, particularly in severe cases. However, there was no significant difference in the severity of hearing loss based on various inflammatory markers. NLR and PLR are useful for predicting the effect in patients treated with concomitant HBOT. By setting 2.43 and 146.67 as cutoff values for NLR and PLR, respectively, we observed that lower values resulted in better recovery rates. CONCLUSION: The use of HBOT is effective for severe cases and early blood flow disorders with low NLR and PLR and less inflammation. When determining treatment, not only should the severity of hearing loss be considered, but also the NLR and PLR should be evaluated and examined based on the cutoff values.

[Repeated transcranial acupuncture combined with electroacupuncture for flat descending sudden deafness: a randomized controlled trial].

OBJECTIVE: To observe the clinical effect of repeated transcranial acupuncture combined with electroacupuncture on flat descending sudden deafness. METHODS: A total of 80 patients with flat descending sudden deafness were randomly divided into an acupuncture and medication group (39 cases, 1 case dropped off) and a western medication group (39 cases, 1 case dropped off). Patients in the western medication group were treated with glucocorticoid + batroxobin + ginkgo leaf preparation. On the basis of the western medication group, patients in the acupuncture and medication group were treated with acupuncture at Baihui (GV 20), Ningshen, Yunting area, Mastoid 1 point, Mastoid 2 point, Fengchi (GB 20), Gongxue, Tinghui (GB 2), etc., repeated transcranial acupuncture was applied at Baihui (GV 20), Ningshen and Yunting area; Mastoid 1 point and Mastoid 2 point, Fengchi (GB 20) and Gongxue of the affected side were connected to the electroacupuncture instrument, continuous wave, 2 Hz in frequency. The needle was retained for 30 min, once a day, and rest for 1 d after 6 d of continuous treatment. All patients were treated for 3 weeks. The average hearing threshold, tinnitus handicap inventory (THI) score, dizziness handicap inventory (DHI) score and speech discrimination test score were compared between the two groups before and after treatment, and the clinical effect was evaluated. RESULTS: After treatment, the average hearing threshold, THI and DHI scores of the two groups were lower than those before treatment (P<0.05), and above indexes in the acupuncture and medication group were lower than those in the western medication group (P<0.05). The speech discrimination test scores of the two groups were higher than those before treatment (P<0.05), and the score in the acupuncture and medication group was higher than that in the western medication group (P<0.05). The total effective rate was 87.2% (34/39) in the acupuncture and medication group, which was higher than 74.4% (29/39) in the western medication group (P<0.05). CONCLUSION: Repeated transcranial acupuncture combined with electroacupuncture can improve the hearing level of patients with flat descending sudden deafness, relieve tinnitus and vertigo symptoms.

The efficacy of nurse-led hyperbaric oxygen therapy in improving the quality of life in patients with sudden hearing loss.

Background: The quality of life decreases in patients with sudden hearing loss due to hearing problems. In addition, complications due to hyperbaric oxygen therapy can reduce the quality of life. Aim: This study was conducted to examine the efficacy of nurse-led hyperbaric oxygen therapy in improving the quality of life in patients with sudden hearing loss. Subjects and Methods: This one-group pretest-posttest design study was conducted with 34 patients with Sudden Hearing Loss who applied to a university hospital for Hyperbaric Oxygen Therapy between November 2018 and February 2019. The data were collected using the Patient Information Form, World Health Organization Quality of Life Scale (WHOQOL-BREF), and Pure Tone Threshold Audiogram. Results: WHOQOL-BREF's quality of life rating (2.59 ± 0.86-3.68 ± 0.59), satisfaction with health status (2.65 ± 0.69-3.62 ± 0.60), physical domain (11.58 ± 2.08-14.84 ± 2.38), psychological domain (12.80 ± 2.21-15.82 ± 2.26), social domain (14.63 ± 3.09-16.78 ± 2.67) and environmental domain (14.25 ± 2.55-16.34 ± 2.60) mean scores significantly increased compared to the pre-treatment scores (p < 0.001). The presence of an acute illness in the last month, the persistence of sudden hearing loss symptoms, level of hearing loss, presence of chronic illness, and smoking were found to affect the quality of life. Conclusions: At the end of the nurse-led hyperbaric oxygen therapy in patients with sudden hearing loss, the quality of life increased and the hearing loss decreased. The most important factor affecting the quality of life was the persistence of symptoms of sudden hearing loss.

Analysis of Clinical Prognosis of Totally Deaf Idiopathic Sudden Sensorineural Hearing Loss in Different Ages.

Objective: The purpose of this study is to analyze the clinical prognosis of idiopathic sudden sensorineural hearing loss in patients with total deafness, and to check the differences in different age groups and hearing loss degrees. Methods: From February 2021 to January 2022, 75 patients with complete deafness and idiopathic sudden sensorineural hearing loss were analyzed retrospectively. According to different age stages, they were divided into five groups: children's group, youth group, middle-aged group, pre-senile group and elderly group, with 15 cases in each group. According to the degree of initial hearing loss, the patients were divided into three groups: 81-89dbhl (81dB Hearing Loss Group), 90-99 dbhl (90 dB group) and ≥100 dbhl (100 dB group), with 25 cases in each group. All patients were given routine comprehensive treatment. Analyze the general situation of each group, the relationship between each age group and the degree of hearing loss, the relationship between each age group and the curative effect, the relationship between each hearing loss group and the curative effect, and the relationship between each age group and the vertigo. To analyze the relationship between hearing loss group and curative effect. Results: (1) Patients with idiopathic sudden sensorineural hearing loss had more unilateral hearing loss than bilateral hearing loss, P < .05. (2) The clinical therapeutic effect of (3) 81 dB group was the highest, followed by 90 dB group. Compared with the total effective rate data of 100 dB group, P < .05. (4) The clinical efficacy of patients with complete deafness and idiopathic sudden sensorineural hearing loss without vertigo in all ages was higher than that of patients with vertigo (P < .05). The clinical effect of hearing loss in patients without vertigo was higher than that in patients with vertigo (P < .05). Conclusion: The patients with total deafness and Idiopathic sudden sensorineural hearing loss are mainly young and middle-aged people aged 14-59, with 100 dB as the boundary, and important information for predicting clinical prognosis and curative effect can be obtained.It is also suggested that for young and middle-aged patients aged 14-59, the focus of treatment may be more on restoring hearing function so that they can continue their work, study and social activities. For patients with mild hearing loss, the goal of treatment may be to maintain the existing hearing level or slow down the process of hearing loss. For patients with severe hearing loss, the focus of treatment may be to restore hearing function to improve their quality of life.

Clinical role of vitamin D, vitamin B12, folate levels and hematological parameters in patients with sudden sensorineural hearing loss.

BACKGROUND: Sudden sensorineural hearing loss (SSNHL), which is frequently observed in otolaryngology clinics, is characterized by sudden onset hearing loss that can develop within hours or days. Its etiology is still not fully understood. AIMS/OBJECTIVES: This research aims to identify prognostic biomarkers that can be utilized to assess the progress of SSNHL as well as circumstances that may predispose individuals to the disease. MATERIALS AND METHODS: Between 1 January 2019 and 1 October 2020, patients diagnosed with SSNHL in our clinic and a control group consisting of healthy people were examined retrospectively. The files of the groups were examined and the levels of hemoglobin, Neutrophil-Lymphocyte Ratio (NLR), ferritin, iron, iron binding capacity (UIBC), vitamin D, vitamin B12, folate were statistically compared with the control group. In addition, the effect of the parameters studied in the patient group on the degree of recovery was examined. RESULTS: There was no statistically significant difference between the groups in terms of mean age and gender distribution (p > .05). NLR level of the patient group was higher than the control group (p < .05). Vitamin D level of the patient group was lower than the control group (p < .05). NLR and vitamin D levels had no effect on the degree of recovery (p > .05). There was no significant difference between the groups in terms of other parameters (p > .05). CONCLUSIONS AND SIGNIFICANCE: We think that our study can be a guide for adding vitamin D as a routine laboratory test in patients with SSNHL. In addition, we think that NLR value can be used as a marker in patients with SSNHL. It is recommended to investigate the role of vitamin D supplementation in better and faster response in these patients.

The reasons that predispose to SSNHL are not fully elucidated. However, there is no laboratory marker that can be used in this disease.In our study, the prevalence of vitamin D deficiency was found to be higher than in healthy people. These results suggest that vitamin D deficiency may be associated with sudden sensorineural hearing loss.The neutrophil-lymphocyte ratio was found to be higher in the patient group. We think that the NLR value obtained from the complete blood count, which is a simple and inexpensive laboratory test, can be used as a marker in patients with SSNHL.

Steroid Efficacy on Audiologic Recovery in Patients With Sudden Sensorineural Hearing Loss and Vestibular Schwannoma: A Retrospective Review.

OBJECTIVES: The objectives of this study are to (i) estimate the incidence of vestibular schwannoma (VS) among patients in an integrated healthcare system who present for evaluation of sudden sensorineural hearing loss (SSNHL) and (ii) evaluate the efficacy of empiric steroid therapy on audiologic recovery among SSNHL patients ultimately diagnosed with VS. METHODS: A retrospective chart review was performed on patients presenting with SSNHL in 2021 at a multicenter integrated healthcare system serving over 4 million members. Patient demographics, audiometric data, VS diagnosis, therapeutic steroid intervention, and data regarding treatment response were recorded. A clinically significant audiometric improvement was defined as (i) an increase of 15% in word recognition score, (ii) a decrease of 15 dB in four-frequency pure-tone average (PTA) using frequencies of 500, 1000, 2000, and 4000 Hz, or (iii) a PTA of <20 dB on follow-up audiogram. RESULTS: Six hundred fifty-eight patients were reviewed, of which 309 (56.0% male; mean, 57.5 years) met the inclusion criteria with audiometric data and magnetic resonance imaging data. Ten patients (70.0% male; mean, 51.3 years) were found to have VS. Of these, five patients received oral steroid therapy alone, and five had combination therapy (oral + intratympanic steroid injections). No patients received intratympanic steroid therapy alone. Median PTA improvement with steroid therapy was 3.1-dB hearing loss, and median word recognition score improvement was 16.5%. Six of 10 patients demonstrated clinically significant audiometric improvement with steroid therapy. CONCLUSION: This study represents the largest US-based study showcasing the prevalence of VS in patients originally presenting with SSNHL. It also reinforces previous findings that VS does not preclude trials of steroid therapy.

Sudden hearing loss and early hyperbaric oxygen therapy: A preliminary study.

Purpose: Sudden sensorineural hearing loss (SSNHL) is a time-sensitive urgent condition. The aim of this study was to evaluate the frequency of hearing improvement in patients with idiopathic SSNHL who only received hyperbaric oxygen (HBO2) therapy within three days of symptom onset, instead of conventional corticosteroid treatment. Methods: The medical charts of patients who experienced SSNHL between January 1, 2012, and December 31, 2021, were reviewed. The present study included all adult patients who were diagnosed with idiopathic SSNHL and started HBO2 therapy within 72 hours of symptom onset. These subjects did not take corticosteroids due to contraindications or because they were concerned about possible side effects. The HBO2 therapy protocol consisted of at least 10 sessions of 85 minutes each with pure oxygen inhalation at 2.5 atmospheres absolute pressure. Results: Overall, 49 subjects (26 males and 23 females) met the inclusion criteria, with a mean age of 47 (± 20.4) years. The mean initial hearing threshold was 69.8 dB (±18.0). After HBO2 therapy, complete hearing recovery was observed in 35 patients (71.4%), and the mean hearing threshold improved significantly (p≺0.001) to 31.4 dB (±24.5). In patients with complete hearing recovery, no significant differences were found between males and females (p=0.79), right and left ears (p=0.72) or initial grades of hearing loss (p=0.90). Conclusion: This study suggests that, in the absence of the confounding effect of concurrent steroid therapy, starting HBO2 therapy within three days of symptom onset could have a positive impact on patients with idiopathic SSNHL.

Effect of Herpes Zoster Treatment and Sudden Sensorineural Hearing Loss Using National Health Insurance Claims Data of South Korea.

Background and objectives: Herpes zoster (HZ) is caused by the reactivation of a pre-existing latent varicella zoster virus, which is one of the viruses that causes hearing loss, and hearing loss may occur due to a systemic immune response even if it does not invade the auditory nerve. This study aimed to determine the correlation between sudden sensorineural hearing loss (SSNHL) in older adult patients who received HZ treatment. Materials and Methods: We used the cohort data of patients aged 60 years and above (n = 624,646) between 2002 and 2015 provided by the National Health Insurance Service. The patients were divided into two groups: those who were diagnosed with HZ between 2003 and 2008 (group H, n = 36,121) and those who had not been diagnosed with HZ between 2002 and 2015 (group C, n = 584,329). Results: In the main model (adjusted HR = 0.890, 95% CI = 0.839-0.944, p < 0.001) adjusted for sex, age, and income, and the full model (adjusted HR = 0.894, 95% CI = 0.843-0.949, p < 0.001) adjusted for all comorbidities, group H had a lower risk of SSNHL than group C. Conclusions: This study showed that patients who received HZ treatment had a lower incidence of SSNHL within five years after diagnosis.

Efficacy and safety of Ginkgo biloba extract as an adjuvant in the treatment of Chinese patients with sudden hearing loss: a meta-analysis.

CONTEXT: Ginkgo biloba Linn (Ginkgoaceae) [leaves extract (GBE)] is authorized for the treatment of sudden hearing loss (SHL); however, its clinical feasibility in SHL has not been thoroughly investigated. OBJECTIVE: To evaluate the efficacy and safety of adjuvant GBE in the treatment of SHL. MATERIALS AND METHODS: We used PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang, Chinese Scientific Journal Database, China Biomedical Database for literature research, starting from inception to 30 June 2022. The key terms: Ginkgo biloba extract, Sudden Sensorineural Deafness. This meta-analysis contained randomized controlled trials that compared the safety and efficacy of the combination of GBE and general treatments (GT) with GT alone for SHL. The extracted data were analyzed using Revman5.4 software with risk ratio (RR), 95% confidence intervals (CI) and mean difference (MD). RESULTS: Our meta-analysis included 27 articles with a total of 2623 patients. The results revealed that the effects of GBE adjuvant therapy was superior than GT (total effective rate: RR = 1.22, 95% CI: 1.18-1.26, p < 0.00001), the pure tone hearing threshold (MD = 12.29, 95% CI: 11.74-12.85, p < 0.00001) and hemorheology indexes (whole blood high shear viscosity: MD = 1.46, 95% CI: 0.47-2.44, p = 0.004) after treatment were significantly improved compared to non-treatment, while there was no significant difference as for hematocrit (red blood cells) (MD = 4.15, 95% CI: -7.15-15.45, p = 0.47). CONCLUSION: The efficacy of GBE + GT for the treatment of SHL may be more promising than GT alone.

[Tinnitus]. / Tinnitus.

Tinnitus is a highly prevalent symptom and a common reason for seeing an otolaryngologist. Since tinnitus can go hand in hand with hearing loss, the step-by-step clarification of hearing loss is one of the essential ENT examinations for tinnitus sufferers. The anamnesis and medical history are relevant, since a multidimensional interaction with the tinnitus can be important for the treatment, especially in the case of a psychological comorbidity. In the vast majority of patients, no causal factor can be found. In the absence of external stimuli, phantom perceptions of tones or noises are held responsible for subjective tinnitus, which probably arises from pathological changes of the auditory pathway, but also in non-auditory cortical structures. In the case of acute tinnitus, a comprehensive audiological assessment is needed, and if the hearing threshold is normal, counseling is the priority. The patient must be informed about the nature of these benign symptoms. So far, there is no acute therapy that has been proven to increase the probability of healing, i.e. the disappearance of the acute tinnitus. Only if the hearing threshold descended, for instance in case of sudden idiopathic hearing loss, therapy of the underlying disease can also lead to improvement or healing of the acute tinnitus. Counseling for chronic tinnitus with high burden is also about reducing exaggerated expectations of healing that cannot be fulfilled. The training of habituation strategies is important. The standard of therapy for chronic tinnitus with psychological strain represents cognitive behavioral therapy for dealing with the tinnitus in a beneficial way. Tinnitus is a symptom of a very heterogeneous group of patients. In the future, it is to be hoped that digital applications and interventions in particular will be evaluated in quality-controlled clinical studies in order to be able to further personalize patient therapy.

Comparison of Intratympanic Steroid and Hyperbaric Oxygen Salvage Therapy Hearing Outcomes in Idiopathic Sudden Sensorineural Hearing Loss: A Retrospective Study.

OBJECTIVES: Systemic steroids are the most common first-line therapy in sudden sensorineural hearing loss (SSNHL), with significant improvement in hearing outcomes in over 60% of patients. It is unknown why 40% of patients do not respond to systemic steroid therapy. Salvage treatment includes intratympanic steroids (ITS) and hyperbaric oxygenation (HBO) therapy, with inconsistent results reported. This study aimed to compare the results of ITS and HBO therapy in patients with SSNHL that previously failed systemic steroid therapy. DESIGN: This is a comparative retrospective nonrandomized interventional cohort study, enrolling 126 patients with SSNHL. Out of these, 35 patients received HBO therapy, 43 patients received ITS, and 48 patients did not receive any second-line therapy (control group). Pure-tone audiograms were performed before and after the salvage therapy in the IT and HBO groups and at the same time interval in the control group. Study variables included age, time until therapy initiation, tinnitus status, and hearing outcomes, with a cutoff criteria of cumulative >30 dB improvement on all frequencies indicating recovery. RESULTS: ITS and HBO therapy were associated with statistically significant hearing recovery at all frequencies compared to systemic steroids. The results show an average hearing improvement of 13.6 dB overall frequencies (250 to 8000 Hz) after ITS therapy and 7.4 dB in HBO therapy in comparison to the control group. Presence of significant hearing improvement positively correlated with age, ITS therapy, and HBO therapy. Presence of tinnitus before therapy was negatively correlated with hearing improvement. Patients with tinnitus present at the start of therapy improve 4.67 dB less on average compared to those without tinnitus. ITS therapy significantly reduced tinnitus compared to the other two treatment options. Patients with tinnitus present before therapy significantly improve hearing at low frequencies, compared to the control group. CONCLUSIONS: ITS and HBO therapy show superior hearing results compared to observation alone after failed oral steroid therapy for SSNHL. ITS shows an additional positive impact on tinnitus reduction and shows superior hearing outcomes after salvage therapy.

The Optimized Protocol of Hyperbaric Oxygen Therapy For Sudden Sensorineural Hearing Loss.

OBJECTIVE: This study aimed to determine the optimal protocol of hyperbaric oxygen therapy (HBOT) according to various treatment settings for sudden sensorineural hearing loss (SSNHL). METHODS: A 112 patients with SSNHL were enrolled in this prospective study. All patients were treated with systemic steroid therapy, intratympanic steroid therapy, and HBOT. According to the pressure and duration of HBOT (10 sessions in total), the patients were divided into three groups: group 1, 2.5 atmospheres absolute (ATA) for 1 h; group 2, 2.5 ATA for 2 h; and group 3, 1.5 ATA for 1 h. The pure-tone average (PTA), word discrimination score (WDS), and mean gain were compared. RESULTS: A total of 105 patients completed the 3-month follow-up, and 6 patients were excluded. Differences among groups were found in PTA, WDS, and mean gain. In the post-hoc analysis, group 3 had significantly lower WDS and mean gain than groups 1 and 2; however, group 2 showed no significant differences from group 1. The proportion of patients with hearing recovery after treatment was significantly higher in group 1 (57.6%) and group 2 (58.8%) than in group 3 (31.3%). CONCLUSIONS: When HBOT (10 sessions) was combined with corticosteroids as the initial therapy for SSNHL, a higher pressure (1.5 ATA vs. 2.5 ATA) provided better treatment results; however, increasing the duration (1 h vs. 2 h) under 2.5 ATA did not result in a significant difference. Therefore, HBOT for SSNHL may be performed at 2.5 ATA for 1 h in 10 sessions. Laryngoscope, 133:383-388, 2023.

Combination of Hyperbaric Oxygen Therapy and Oral Steroids for the Treatment of Sudden Sensorineural Hearing Loss: Early or Late?

Background and Objectives: Several treatments are available for sudden sensorineural hearing loss (SSNHL), but no studies have compared the different treatments based on the delay from the onset of the disease. Our study aims to compare the effect of hyperbaric oxygen therapy (HBOT), oral steroids (OS) and combination of both therapies (HBOT + OS) for treating SSNHL. Materials and Methods: This randomized study analyzed 171 patients with SSNHL. Patients were evaluated by pure tone audiometry test (PTA) at baseline (T0) and 20 days after treatment (T1). Three groups were available HBOT-A-, OS-B- and HBOT + OS-C-. After baseline PTA, patients were randomly assigned to each group. Statistical analysis was performed by one-way ANOVA and Chi-square. Results: Patients in the HBOT + OS and HBOT groups improved their auditory function (p < 0.05). HBOT was the best choice for treatment when started by 7 days from SSNHL onset, while HBOT + OS in case of late treatment. Profound SNHL recovered equally by HBOT and HBOT + OS (p < 0.05). Upsloping SNHL obtained better auditory results by HBOT compared to HBOT + OS (p < 0.05). Downsloping and flat SSNHL had the most improvement with HBOT + OS compared to HBOT only (p < 0.05). Conclusions: Combination of HBOT and OS is a valid treatment for SSNHL both in case of early and late treatment. Combination of HBOT and OS was the choice with the best results in case of treatment started >14 days from symptom onset.

Efficacy of Ginkgo biloba Extract Combined with Hormones in the Treatment of Sudden Deafness and Its Effect on the Reactivity of Peripheral Blood T Cell Subsets.

This work was aimed at exploring the efficacy of Ginkgo biloba extract combined with hormones in the treatment of sudden deafness and the influence on the reactivity of peripheral blood T cell subsets (PBTCSs). In this work, 64 patients with sudden deafness who were treated in The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from August 2019 to August 2022 were selected as the research objects. The patients were randomly divided into a hormone group (treatment with prednisone acetate, n = 34) and a combination group (treatment with Ginkgo-Damole combined with prednisone acetate, n = 30). After the two groups of patients were treated in different ways, their efficacy, symptom improvement, changes in blood rheology, and PBTCSs were compared. The total effective rates (TERs) of the hormone group and the combination group were 76.32% and 95.73%, respectively (P < 0.05). The fibrinogen contents of the patients in the combination group were obviously lower than those in the hormone group after 5 d, 7 d, and 10 d of treatment (P < 0.05). The high blood viscosity (HBV) values of patients in the combination group at 5 d, 7 d, and 10 d after treatment were greatly lower than those in the hormone group (P < 0.05). The low blood viscosity (LBV) values after 3 d, 7 d, and 10 d of treatment in the combined group were much lower in contrast to those in the hormone group (P < 0.05). The CD3+, CD4+, and CD4+/CD8+ in peripheral blood in the combination group were sharply higher while the CD8+ in the combined group was lower in contrast to the hormone group (P < 0.05). There was no visible difference in the incidence of adverse reactions between the two groups of patients after treatment (P > 0.05). In conclusion, the combined application of Ginkgo biloba extract and hormones could effectively improve the abnormal hemorheological indexes of patients with sudden deafness and effectively relieve the imbalance of PBTCSs, which was safe.