RESUMO
OBJECTIVE: To heighten the physician's awareness of non-organic hearing loss in teenagers in China. METHODS: Retrospective cases review of seven patients (six girls and one boy) with sudden hearing loss was conducted. RESULTS: Five patients presented with hearing loss bilaterally and two patients unilaterally. All patients suffered from severe to profound hearing loss. However, the acoustic reflex test indicated direct and indirect responses were present bilaterally at 1000 Hz 100 dB SPL. The results of ABR test revealed hearing threshold within 20-30 dB nHL. Further investigations indicated non-organic hearing loss was associated with school stress or environment conflict. Satisfactory outcomes were achieved in all patients. CONCLUSION: Non-organic hearing loss should be considered when teenagers present with severe to profound sudden hearing loss if the acoustic reflex is present. School and home stresses are associated with the occurrence of non-organic hearing loss in the present study.
Assuntos
Perda Auditiva Funcional/diagnóstico , Perda Auditiva Súbita/diagnóstico , Adolescente , Audiometria de Tons Puros , Limiar Auditivo , China , Potenciais Evocados Auditivos do Tronco Encefálico , Feminino , Seguimentos , Perda Auditiva Bilateral/diagnóstico , Perda Auditiva Bilateral/epidemiologia , Perda Auditiva Funcional/epidemiologia , Perda Auditiva Funcional/etnologia , Perda Auditiva Súbita/epidemiologia , Perda Auditiva Súbita/etnologia , Humanos , Masculino , Encaminhamento e Consulta , Estudos Retrospectivos , Estresse PsicológicoRESUMO
This study was performed to investigate the association between human leukocyte antigen (HLA) and susceptibility to sudden sensorineural hearing loss in the Korean population. HLA-A and HLA-B typing using a standard microlymphocytotoxicity technique and HLA-DRB1 genotyping were performed in 35 patients with sudden sensorineural hearing loss and in 206 healthy controls. Prednisone (usual dose 60 mg/day) was administered for 6 days and tapered for an additional 4-6 days. Both initial hearing levels at the onset of deafness and final hearing levels after treatment were examined and evaluated for association with HLA alleles. The frequency of HLA-DRB1*14 was increased in patients with sudden sensorineural hearing loss compared with controls (relative risk [RR] = 2.7, p = 0.016). The frequencies of HLA-A2, -A31, -B52, -B61, -DRB1*04, -DRB1*11 and -DRB1*12 were slightly higher than in the controls, but did not reach statistical significance. When an association between the treatment results and HLA alleles was also evaluated, the frequency of HLA-DRB1*04 was found to be increased in the patients who did not respond to steroid treatment compared with both patients who responded well to steroid (50%, vs 16%, p = 0.034) and controls (RR = 3.0, p = 0.046). These results suggest that there is an association between HLA-DRB1*14 and disease susceptibility and that the presence of HLA-DRB1*04 may be an useful marker for predicting a poor prognosis in Korean patients with sudden sensorineural hearing loss.