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1.
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 34(6): 521-523;527, 2020 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-32842183

RESUMO

Objective:To investigate the therapeutic effect of hyperbaric oxygen on sudden sensorineural hearing loss(SSNHL). Method:One hundred and seven patients with SSNHL were selected, and were randomly divided into 3 groups according to admission order. Therapeutic schedule in group A (38 cases) consisted of hyperbaric oxygen treatment once a day for 10 consecutive days, then 1 day off treatment, and on treatment for another 10 consecutive days (20 treatments in total). Twenty-seven patients in group B were treated with hyperbaric oxygen twice per day for a total of 10 days. Forty-two patients in group C didn't receive hyperbaric oxygen therapy. Meanwhile, all patients were given conventional treatment for 14 days in accordance with the recommendations of the otolaryngology, head and neck branch of the Chinese medical association for the diagnosis and treatment of sudden sensorineural hearing loss. Patients in group A underwent pure tone audiometry after the end of treatment, and patients in group B and C were reexamined 20 days after the start of treatment, and the treatment efficacy of the three groups was compared. Result:The overall effective rate of group A was 78.9%, and the improvement of hearing threshold was(27.2±17.5) dB HL. In group B, the overall effective rate was 81.5%, and the improvement of threshold value was(26.9±16.7) dB HL. The overall effective rate of group C was 61.9%, and the improvement of threshold value o was(17.6±18.5) dB HL. The effective rate of group C was significantly higher than that of group A or B, while there was no significant difference in efficacy between group A and group B. Conclusion:The efficacy of hyperbaric oxygen combined with drug therapy for SSNHL is better than that of drug therapy alone. Programs of different hyperbaric oxygen combined with drug therapy can be selected on an individual basis.


Assuntos
Perda Auditiva Neurossensorial/terapia , Perda Auditiva Súbita/terapia , Oxigenação Hiperbárica , Audiometria de Tons Puros , Glucocorticoides , Humanos , Resultado do Tratamento
2.
Zhongguo Zhen Jiu ; 40(7): 726-30, 2020 Jul 12.
Artigo em Chinês | MEDLINE | ID: mdl-32648396

RESUMO

OBJECTIVE: To compare the therapeutic effect of electro-nape-acupuncture (ENA) combined with hyperbaric oxygen therapy (HBOT) and single HBOT on refractory flat descending idiopathic sudden sensorineural hearing loss (ISSNHL). METHODS: A total of 78 patients were randomized into an ENA combined with HBOT (ENA+HBOT) group and a HBOT group, 39 cases in each one. Patients in both groups were treated with oral extract of ginkgo biloba leaves and mecobalamin tablets. On the basis of the conventional medication treatment, HBOT was adopt in the HBOT group. On the basis of the treatment in the HBOT group, electro-nape-acupuncture was applied at Fengchi (GB 20), Gongxue (Extra), Zhongzhu (TE 3), Waiguan (TE 5) and Yifeng (TE 17), Tinggong (SI 19), Tinghui (GB 2) and the vertigo-auditory area of affected side in the ENA+HBOT group. Pulse acupuncture instrument was connected at Fengchi (GB 20) and Gongxue (Extra) for 30 min (with continuous wave, 2 Hz in frequency), the needles were retained for another 30 min after electroaupuncture. The treatment was given once a day, 6 times a week for 4 weeks in both groups. Before the treatment and 2,4 weeks into the treatment, the average auditory threshold, the scores of tinnitus handicap inventory (THI) and dizziness handicap inventory (DHI) were observed, and the therapeutic effect was evaluated in both groups. RESULTS: Compared before treatment, the average auditory threshold, the scores of THI and DHI of 2,4 weeks into the treatment were decreased in both groups (P<0.000 1). Compared with the HBOT group, the average auditory threshold, the scores of THI and DHI of 4 weeks into the treatment were lower in the ENA+HBOT group (P<0.000 1). The total effective rate was 69.2% (27/39) in the ENA+HBOT group and 51.3% (20/39) in the HBOT group, there was no statistical difference (P>0.05). CONCLUSION: Electro-nape- acupuncture can improve the mean auditory threshold and the symptoms of tinnitus and dizziness in patients with refractory flat descending idiopathic sudden sensorineural hearing loss.


Assuntos
Terapia por Acupuntura , Perda Auditiva Neurossensorial/terapia , Perda Auditiva Súbita/terapia , Oxigenação Hiperbárica , Tontura/terapia , Humanos , Extratos Vegetais/uso terapêutico , Zumbido/terapia , Resultado do Tratamento , Vitamina B 12/análogos & derivados , Vitamina B 12/uso terapêutico
3.
Gene ; 747: 144677, 2020 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-32304785

RESUMO

The progressive, late-onset, nonsyndromic, sensorineural hearing loss (PNSHL) is the most common cause of sensory impairment globally, with presbycusis affecting greater than a third of individuals over the age of 65. The etiology underlying PNSHL include presbycusis, noise-induced hearing loss, drug ototoxicity, and delayed-onset autosomal dominant hearing loss (AD PNSHL). The objective of this article is to discuss the potential diagnostic and therapeutic applications of genomic medicine in PNSHL. Genomic factors contribute greatly to PNSHL. The heritability of presbycusis ranges from 25 to 75%. Current therapies for PNSHL range from sound amplification to cochlear implantation (CI). PNSHL is an excellent candidate for genomic medicine approaches as it is common, has well-described pathophysiology, has a wide time window for treatment, and is amenable to local gene therapy by currently utilized procedural approaches. AD PNSHL is especially suited to genomic medicine approaches that can disrupt the expression of an aberrant protein product. Gene therapy is emerging as a potential therapeutic strategy for the treatment of PNSHL. Viral gene delivery approaches have demonstrated promising results in human clinical trials for two inherited causes of blindness and are being used for PNSHL in animal models and a human trial. Non-viral gene therapy approaches are useful in situations where a transient biologic effect is needed or for delivery of genome editing reagents (such as CRISPR/Cas9) into the inner ear. Many gene therapy modalities that have proven efficacious in animal trials have potential to delay or prevent PNSHL in humans. The development of new treatment modalities for PNSHL will lead to improved quality of life of many affected individuals and their families.


Assuntos
Terapia Genética , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/terapia , Análise Custo-Benefício , Epigênese Genética , Técnicas de Transferência de Genes , Terapia Genética/economia , Perda Auditiva Neurossensorial/genética , Humanos
4.
Otolaryngol Head Neck Surg ; 162(3): 337-342, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31986973

RESUMO

OBJECTIVES: Idiopathic sudden sensorineural hearing loss (ISSNHL) is a distressing condition that can significantly affect quality of life. Unilateral ISSNHL, occurring first in 1 ear and then the contralateral ear at a separate and discrete time, is a rare presentation that we refer to as metachronous ISSNHL. Our objective was to characterize the presentation of metachronous ISSNHL and report on management and hearing outcomes. STUDY DESIGN: Retrospective case series. SETTING: Otology clinic at an academic tertiary referral center. SUBJECTS AND METHODS: Patients ≥18 years old presenting with metachronous ISSNHL between April 2008 to November 2017 were identified through review of the clinic electronic medical record. Metachronous ISSNHL was defined as unilateral ISSNHL occurring in temporally discrete episodes (>6 months apart) affecting both ears. Patients with identifiable causes for sudden hearing loss were excluded. Patient demographics, comorbidities, management, and audiologic outcomes were recorded. RESULTS: Eleven patients with metachronous ISSNHL were identified out of 558 patients with ISSNHL. In patients with metachronous ISSNHL, the mean ± standard deviation age at the time of ISSNHL in the second ear was 58.6 ± 15.2 years (range, 31-77 years). The mean interval between episodes was 9.6 ± 7.5 years (range, 1-22 years). Patients were treated with systemic and intratympanic steroids with variable hearing recovery; 5 patients with resultant bilateral severe to profound hearing loss underwent successful cochlear implantation. CONCLUSION: Metachronous ISSNHL is uncommon. Treatment is similar to ISSNHL, and cochlear implantation can successfully restore hearing in individuals who do not experience recovery.


Assuntos
Perda Auditiva Neurossensorial/classificação , Perda Auditiva Neurossensorial/terapia , Perda Auditiva Súbita/classificação , Perda Auditiva Súbita/terapia , Comorbidade , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Recuperação de Função Fisiológica , Estudos Retrospectivos
6.
Otolaryngol Head Neck Surg ; 162(1): 129-136, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31684823

RESUMO

OBJECTIVE: To assess quality of life (QOL) in pediatric patients with sensorineural hearing loss (SNHL) with the Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0) and the Hearing Environments and Reflection on Quality of Life 26 (HEAR-QL-26) and HEAR-QL-28 surveys. STUDY DESIGN: Prospective longitudinal study. SETTING: Tertiary care center. SUBJECTS AND METHODS: Surveys were administered to patients with SNHL (ages 2-18 years) from July 2016 to December 2018 at a multidisciplinary hearing loss clinic. Patients aged >7 years completed the HEAR-QL-26, HEAR-QL-28, and PedsQL 4.0 self-report tool, while parents completed the PedsQL 4.0 parent proxy report for children aged ≤7 years. Previously published data from children with normal hearing were used for controls. The independent t test was used for analysis. RESULTS: In our cohort of 100 patients, the mean age was 7.7 years (SD, 4.5): 62 participants had bilateral SNHL; 63 had mild to moderate SNHL; and 37 had severe to profound SNHL. Sixty-eight patients used a hearing device. Mean (SD) total survey scores for the PedsQL 4.0 (ages 2-7 and 8-18 years), HEAR-QL-26 (ages 7-12 years), and HEAR-QL-28 (ages 13-18 years) were 83.9 (14.0), 79.2 (11.1), 81.2 (9.8), and 77.5 (11.3), respectively. Mean QOL scores for patients with SNHL were significantly lower than those for controls on the basis of previously published normative data (P < .0001). There was no significant difference in QOL between children with unilateral and bilateral SNHL or between children with SNHL who did and did not require a hearing device. Low statistical power due to small subgroup sizes limited our analysis. CONCLUSION: It is feasible to collect QOL data from children with SNHL in a hearing loss clinic. Children with SNHL had significantly lower scores on validated QOL instruments when compared with peers with normal hearing.


Assuntos
Auxiliares de Audição/estatística & dados numéricos , Perda Auditiva Bilateral/psicologia , Perda Auditiva Neurossensorial/psicologia , Perda Auditiva Unilateral/psicologia , Qualidade de Vida , Adolescente , Criança , Pré-Escolar , Implantes Cocleares , Estudos Transversais , Feminino , Perda Auditiva Bilateral/diagnóstico , Perda Auditiva Bilateral/terapia , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/terapia , Perda Auditiva Unilateral/diagnóstico , Perda Auditiva Unilateral/terapia , Testes Auditivos/métodos , Hospitais Pediátricos , Humanos , Estudos Longitudinais , Masculino , Estudos Prospectivos , Reprodutibilidade dos Testes , Resultado do Tratamento , Estados Unidos
7.
J Acupunct Meridian Stud ; 13(2): 61-65, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31862344

RESUMO

Sensoryneuronal hearing loss (SNHL) is one type of hearing impairment. The incidence of hearing loss (HL) is 1-3 per 1000 births. Complementary therapies may be effective in addressing the maladies of infants with HL. The aim of this study was to assess the efficacy of foot reflexotherapy in an infant with SNHL. The patient was a 3-month-old infant with SNHL. Pretest and post-test for HL were conducted using an audiologic method (auditory brainstem responses) combined with behavioral audiometry. The subject was treated with foot reflexotherapy for 30 min per session four times per week for a period of 24 weeks. Foot reflexotherapy was effective in auditory recuperation of an infant with SNHL. The results of this novel study suggest that foot reflexotherapy can be an effective complementary treatment for infants with SNHL, especially for those 3 to 9 months of age.


Assuntos
Perda Auditiva Neurossensorial/terapia , Reflexoterapia , Potenciais Evocados Auditivos do Tronco Encefálico , Feminino , Audição , Perda Auditiva Neurossensorial/fisiopatologia , Humanos , Lactente , Masculino , Resultado do Tratamento
8.
Otolaryngol Clin North Am ; 53(1): 87-102, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31677740

RESUMO

Cochlear implant is the first approved cranial nerve stimulator that works by directly stimulating the cochlear nerve. The medical and societal impact of this revolutionary device cannot be understated. This article reviews the evolving indications for cochlear implant, patient assessment, surgical approach, and outcomes for pediatric and adult cochlear implant that demonstrate its impact. Future concepts in cochlear implant are introduced briefly. This article covers a breadth of information; however, it is not intended be entirely comprehensive. Rather, it should serve as a foundation for understanding cochlear implant.


Assuntos
Implante Coclear/métodos , Implantes Cocleares , Perda Auditiva Neurossensorial/terapia , Adulto , Limiar Auditivo , Criança , Cóclea/patologia , Cóclea/cirurgia , Nervo Coclear/fisiologia , Humanos
9.
Acta Clin Croat ; 58(2): 348-353, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31819333

RESUMO

The Vibrant Soundbridge represents a new approach to hearing improvement in the form of active implantable middle ear hearing device. Unlike conventional acoustic hearing aids, which increase the volume of sound that goes to the eardrum, the Vibrant Soundbridge bypasses the ear canal and eardrum by directly vibrating the small bones in the middle ear. Because of its design, no portion of the device is placed in the ear canal itself. The Vibrant Soundbridge has been approved by the FDA as a safe and effective treatment option for adults with moderate to severe sensorineural, conductive or mixed hearing losses who desire an alternative to the acoustic hearing aids, for better hearing. The paper presents a review of the active middle ear implant Vibrant Soundbridge, which has been also implanted at the Department of Otorhinolaryngology and Head and Neck Surgery, Sestre milosrdnice University Hospital Center, which is the Referral Center for Cochlear Implantation and Surgery of Hearing Impairment and Deafness of the Ministry of Health, Republic of Croatia.


Assuntos
Perda Auditiva/terapia , Prótese Ossicular , Perda Auditiva Condutiva/terapia , Perda Auditiva Condutiva-Neurossensorial Mista/terapia , Perda Auditiva Neurossensorial/terapia , Humanos , Implantação de Prótese/métodos , Resultado do Tratamento , Vibração
10.
Am J Audiol ; 28(4): 947-963, 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31829722

RESUMO

Purpose A growing body of evidence indicates that treatment of hearing loss by provision of hearing aids leads to improvements in auditory and visual working memory. The purpose of this study was to assess whether similar working memory benefits are observed following provision of cochlear implants (CIs). Method Fifteen adults with postlingually acquired severe bilateral sensorineural hearing loss completed the prospective longitudinal study. Participants were candidates for bilateral cochlear implantation with some aidable hearing in each ear. Implantation surgeries were carried out sequentially, approximately 1 year apart. Working memory was measured with the visual Reading Span Test (Daneman & Carpenter, 1980) at 5 time points: pre-operatively following a 6-month bilateral hearing aid trial, after 6 and 12 months of bimodal (CI plus contralateral hearing aid) listening experience following the 1st CI surgery and activation, and again after 6 and 12 months of bilateral CI listening experience following the 2nd CI surgery and activation. Results Compared to the preoperative baseline, CI listening experience yielded significant improvements in participants' ability to recall test words in the correct serial order after 12 months in the bimodal condition. Individual performance outcomes were variable, but almost all participants showed increases in task performance over the course of the study. Conclusions These results suggest that, similar to appropriate interventions with hearing aids, treatment of hearing loss with CIs can yield working memory benefits. A likely mechanism is the freeing of cognitive resources previously devoted to effortful listening.


Assuntos
Implantes Cocleares , Memória de Curto Prazo , Leitura , Adulto , Idoso , Idoso de 80 Anos ou mais , Implantes Cocleares/psicologia , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/prevenção & controle , Feminino , Perda Auditiva Neurossensorial/psicologia , Perda Auditiva Neurossensorial/terapia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Estudos Prospectivos
11.
Probl Radiac Med Radiobiol ; 24: 522-536, 2019 Dec.
Artigo em Inglês, Ucraniano | MEDLINE | ID: mdl-31841493

RESUMO

OBJECTIVE: to study the hirudotherapy efficacy in presbyacuzis praecox in clean-up workers (CUWs) of the Chornobyl disaster (ChD) during the post-accident years. MATERIALS AND METHODS: From archive data of previously examined 8,136 males' CUWs we selected among them 129 persons with the determined presbyacuzis praecox during the post-accident years. According to the physical dosime- try data the individual radiation of received by CUWs during the work on a rotational scheme in the Chornobyl exclu- sion zone from the end of 1986 to 1992-1994 amounted to 0.21-0.50 Gy. The examinations were carried out using a modern standard set of audiometric, vestibulometric and electrophysiological methods. Two forms of sensory and neural hearing loss in the elderly were distinguished, namely the presbyacuzis and presbyacuzis praecox. Prior to work in the exclusion zone, patients' auditory and vestibular functions were within normal range. Among 129 patients, 68 ones with presbyacuzis praecox were included in two main age groups (aged 40-49 and 50-59 yrs) and were treated using hirudotherapy, taking into consideration their coagulation hemostasis. Other 61 patients of analogical age groups were treated by allopathotherapy. For the analysis of results obtained, techniques of variational statistics were used. RESULTS: Direct correlation (r = 0.71) between inhibitory processes in central areas of the auditory analyzer in pres- byacuzis praecox in CUWs was established by electrophysiology and by speech audiometry data obtained before the treatment. Hyperacusis signs were detected in CUWs of two main and two control groups. Following the use of two treatment schemas, a significant improving of auditory functions was found (p < 0.05) according to tone and speech audiometries. The positive hirudotherapy effect concerning hearing functions was registered in 88% cases (in 59 CUWs among 68 ones); if allopathotherapy had been used, such effect was found in 65% cases (in 45 control patients among 61 ones of control group). The duration of allopathotherapy effect reached 6-9 months comparing to 12-18 months of hiruditherapy one, being twice longer. Improving the patients' coagulation hemostasis, hirudotherapy activated cardiovascular activity favoring the increase of social adequacy in CUWs with presbyacuzis praecox. CONCLUSIONS: It has been shown that hirudotherapy as a kind of naturopathy has significant advantages over alopa- totherapy by the absence of side effects, 23.0% higher and twice as long as improvement of auditory functions. Hirudotherapy, as an effective therapeutic and recreational measures, should be more widely implemented in clini- cal practice in order to minimize the development and progression of diseases in the special population of people who have been exposed to ionizing radiation due to the Chornobyl catastrophe to continue their vitality.


Assuntos
Acidente Nuclear de Chernobyl , Socorristas , Perda Auditiva Neurossensorial/terapia , Aplicação de Sanguessugas/métodos , Lesões por Radiação/terapia , Adulto , Audiometria da Fala , Coagulação Sanguínea/fisiologia , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Neurossensorial/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Reconhecimento Fisiológico de Modelo/fisiologia , Equilíbrio Postural/fisiologia , Doses de Radiação , Exposição à Radiação/efeitos adversos , Lesões por Radiação/diagnóstico , Lesões por Radiação/etiologia , Lesões por Radiação/fisiopatologia , Sobreviventes , Resultado do Tratamento , Ucrânia
12.
Int. arch. otorhinolaryngol. (Impr.) ; 23(4): 408-414, Out.-Dez. 2019. ilus, tab
Artigo em Inglês | LILACS | ID: biblio-1024235

RESUMO

Introduction: Acute acoustic trauma, which is a kind of sensorineural hearing loss, is caused by acoustic overstimulation. Hyperbaric oxygen therapy (HBOT) is reported to be effective against acute acoustic trauma. Objective: We aimed to evaluate the efficacy of HBOT against acoustic hearing loss based on our 20 years of experience with such cases. Methods: Patients who were treated with HBOT for acute acoustic trauma between April 1997 and August 2017 were evaluated in this study. Thirty-five patients with a mean age of 25.7 ± 9.2 (range: 16­48) years were included. Thirty-nine out of 70 ears (35 patients) were damaged. We investigated the initial level of hearing loss; the extent to which hearing recovered; subjective symptoms, such as tinnitus and aural fullness; and the treatment administered. Results: The planned HBOT was completed in 37 of 39 ears. Twenty-six of the 37 ears (70.2%) displayed improved hearing, and 31 of the 37 ears (83.9%) exhibited symptom improvement. Twenty-three (76.7%) and 26 (86.7%) of the 30 ears treated with steroids demonstrated improvements in hearing and subjective symptoms, respectively. Conclusion: A combination of HBOT and steroids should be considered as a treatment for acute acoustic trauma in cases involving symptoms such as tinnitus and aural fullness (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Perda Auditiva Provocada por Ruído/terapia , Oxigenação Hiperbárica , Esteroides/uso terapêutico , Zumbido/terapia , Resultado do Tratamento , Perda Auditiva Neurossensorial/terapia , Testes Auditivos , Hospitais Militares , Japão
13.
Undersea Hyperb Med ; 46(5): 659-663, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31683365

RESUMO

Treatment of idiopathic sensorineural hearing loss (ISSNHL) is problematic due to the unclear etiology of the illness. Corticosteroid is recommended by some papers, and hyperbaric oxygen (HBO2) by others. Recently HBO2 has been shown to be an important therapy for ISSNHL, with an increasing number of studies demonstrating its beneficial results. Recovery from ISSNHL depends on the interval period between onset and treatment, hearing loss severity and audiogram type used to determine damage. Treatment of ISSNHL requires a detailed analysis. In this retrospective study we reviewed data from 56 patients with moderate ISSNHL. These patients were divided into three groups based on different treatments: corticosteroid group; corticosteroid + HBO2 (combination)group; and HBO2-only group. Additionally, all patients received intravenous vasodilator treatment. Hearing levels before and after treatment were compared. All three groups had a similar recovery rate, with an effective rate of more than 50%, and a hearing gain average of 17.38 decibels (dB). HBO2 treatment got a higher recovery rate. The combination therapy, which included corticosteroid and HBO2, did not elevate the recovery rate.


Assuntos
Corticosteroides/uso terapêutico , Perda Auditiva Neurossensorial/terapia , Perda Auditiva Súbita/terapia , Oxigenação Hiperbárica , Vasodilatadores/administração & dosagem , Terapia Combinada/métodos , Feminino , Humanos , Injeções Intravenosas , Masculino , Pessoa de Meia-Idade , Prednisona/administração & dosagem , Recuperação de Função Fisiológica , Estudos Retrospectivos
14.
Undersea Hyperb Med ; 46(5): 665-672, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31683366

RESUMO

We compared the efficacy of hyperbaric oxygen (HBO2) therapy used in the treatment of sudden sensorineural hearing loss (SSNHL) as a supplementary therapy to the first-line medical treatment according to the different applied pressures used in HBO2 treatment while maintaining the same number of sessions, periodicity and exposure times. We evaluated data from 115 patients suffering from SSNHL within seven days of hearing loss: 35 patients received the standard treatment protocol (control group), and 80 individuals were treated with additional application of HBO2 therapy pressured to 2.0 ATA (H2.0; n=49) or 2.5 ATA (H2.5; n=31), respectively. Treatment success was assessed using pre- and post-treatment audiograms. We found significant differences in both HBO2 groups compared to the control group. In low frequencies the most significant differences can be seen in both H2.0 and H2.5. In spoken speech frequencies only the H2.0 group was statistically significant. In high frequencies the therapeutic benefits were the lowest. Furthermore, we found a notable difference in the therapeutic effect of HBO2 therapy according to the different applied pressure. At low frequencies, the use of 2.5 ATA pressure was more efficient. However, in the higher frequency ranges, the better hearing gains were obtained at the 2.0 ATA pressure. Our results support the possibility of optimizing treatments individually, depending on the type and frequency range of hearing impairment (shape of the audiogram) in favor of using the 2.0 ATA. This is important in terms of an individual approach to each patient as well as to minimize the burden of a patient in order to obtain the maximum therapeutic effect.


Assuntos
Perda Auditiva Neurossensorial/terapia , Perda Auditiva Súbita/terapia , Oxigenação Hiperbárica/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Pressão Atmosférica , Estudos de Casos e Controles , Feminino , Glucocorticoides/administração & dosagem , Perda Auditiva Neurossensorial/tratamento farmacológico , Perda Auditiva Súbita/tratamento farmacológico , Humanos , Masculino , Hemissuccinato de Metilprednisolona/administração & dosagem , Pessoa de Meia-Idade , Prednisona/administração & dosagem , Estudos Prospectivos , Adulto Jovem
15.
Acta otorrinolaringol. esp ; 70(5): 290-300, sept.-oct. 2019. graf
Artigo em Espanhol | IBECS | ID: ibc-186373

RESUMO

Introducción: La sordera súbita idiopática (SSI) es aquella hipoacusia neurosensorial de inicio súbito de causa desconocida. Objetivos: Actualización del consenso sobre el diagnóstico, tratamiento y seguimiento de la SSI. Material y métodos: Presentamos una tercera actualización del consenso de SSI, mediante revisión sistemática de la literatura sobre la SSI desde 1966 hasta marzo de 2018, sobre los términos MESH "(acute or sudden) hearing loss or deafness", con 1.508 artículos relevantes. Resultados: En cuanto al diagnóstico, ante una sospecha clínica de SSI, las pruebas diagnósticas que se consideran necesarias son las siguientes: otoscopia, acumetría, audiometría tonal, audiometría verbal y timpanograma para descartar causas transmisivas de sordera. Una vez hecho el diagnóstico clínico de SSI, antes de comenzar el tratamiento, se solicitará una batería analítica. Deberá completarse más tarde el estudio con RM de oído interno, idealmente en los primeros 15 días, para descartar causas específicas de sordera súbita neurosensorial y para contribuir a elucidar posibles mecanismos fisiopatológicos. A pesar de la controversia en cuanto al tratamiento de SSI, se recomienda, por los efectos en la calidad de vida de la SSI y los raros eventos indeseables con esteroides a corto plazo, que el tratamiento de la SSI esté basado fundamentalmente en los corticoides, que pueden utilizarse por vía oral o intratimpánica, en función del paciente. En caso de fracaso de la vía sistémica, se recomienda usar corticoides intratimpánicos como rescate. Respecto al seguimiento, se realizará un control a la semana del inicio, a los 7 días y hasta los 12 meses. Conclusiones: Como consenso, el resultado de los tratamientos aplicados debería presentarse tanto en cantidad de decibelios recuperados en el umbral auditivo tonal como con parámetros de audiometría verbal


Introduction: Idiopathic sudden sensorineural hearing loss (ISSNHL) is a sudden, unexplained unilateral hearing loss. Objectives: To update the Spanish Consensus on the diagnosis, treatment and follow-up of ISSNHL. Material and methods: After a systematic review of the literature from 1966 to March 2018, on MESH terms "(acute or sudden) hearing loss or deafness", a third update was performed, including 1508 relevant papers. Results: Regarding diagnosis, 11ISSNHL is clinically suspected, the following diagnostic tests are mandatory: otoscopy, acumetry, tonal audiometry, speech audiometry, and tympanometry, to discount conductive causes. After clinical diagnosis has been established, and before treatment is started, a full analysis should be performed. An MRI should then be requested, ideally performed during the first 15 days after diagnosis, to discount specific causes and to help to understand the physiopathological mechanisms in each case. Although treatment is very controversial, due to its effect on quality of life after ISSNHL and the few rare adverse effects associated with short-term steroid treatment, this consensus recommends that all patients should be treated with steroids, orally and/or intratympanically, depending on each patient. In the event of failure of systemic steroids, intratympanic rescue is also recommended. Follow-up should be at day 7, and after 12 months. Conclusion: By consensus, results after treatment should be reported as absolute decibels recovered in pure tonal audiometry and as improvement in speech audiometry


Assuntos
Humanos , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/terapia , Perda Auditiva Súbita/diagnóstico , Perda Auditiva Súbita/terapia , Corticosteroides/uso terapêutico , Técnicas de Diagnóstico Otológico , Oxigenação Hiperbárica , Neuroimagem , Otolaringologia , Exame Físico , Atenção Primária à Saúde , Prognóstico , Encaminhamento e Consulta , Terapia de Salvação , Revisões Sistemáticas como Assunto
17.
Artigo em Chinês | MEDLINE | ID: mdl-31446694

RESUMO

Summary Mitochondrial DNA(mtDNA) deletion is a rare occurrence that results in defects to oxidative phosphorylation. The common clinical presentations of mtDNA deletion vary but include mitochondrial myopathy, Pearson syndrome, Kearns-Sayre syndrome, and progressive external ophthalmoplegia. However, in clinical practice, some cases cannot be classified as any typical syndrome due to the absence or overlap of phenotypes. Here, we report one case of a 5-year-old girl who presented with progressive deterioration of her clinical status, which included systemic electrolyte disturbance, Fanconi syndrome and sensorineural hearing loss. Through a combination of systematic examinations and molecular analyses, mitochondrial disease was confirmed. A novel 6991-base pair deletion(deletion of mtDNA nt 7808-14798) was identified which confirmed molecular pathogeny of patient. Following treatment, the patient was stabilized and her hearing loss improved by hearing aid. This paper provided an important reference for the diagnosis and treatment of similar patients in clinical practice.


Assuntos
DNA Mitocondrial/genética , Perda Auditiva Neurossensorial/genética , Doenças Mitocondriais/genética , Deleção de Sequência , Pré-Escolar , Síndrome de Fanconi/genética , Feminino , Auxiliares de Audição , Perda Auditiva Neurossensorial/terapia , Humanos
18.
Curr Opin Otolaryngol Head Neck Surg ; 27(5): 387-391, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31460986

RESUMO

PURPOSE OF REVIEW: To evaluate the impact of cochlear implantation on hearing outcomes, quality of life, complications, and cognitive function in elderly patients. RECENT FINDINGS: Nine articles published between 2014 and 2019 pertain to cochlear implantation in the elderly population. The findings conclude that cochlear implantation improves autonomy and overall quality of life in the elderly. SUMMARY: Design: a pubmed search was employed with title search terms 'cochlear implant,' AND 'elderly' or 'aged.' Twenty-one articles were generated. Of the 21, articles without evidence-based findings were excluded and those published more than 5 years ago were excluded, yielding a final number of nine articles for review. RESULTS: nine articles published on the use of cochlear implantation in the elderly were identified through the literature search between the years 2014-2019. Outcomes included quality of life, speech recognition improvement, improvement in cognitive function as defined by geriatric validated scales, outcomes of hearing rehabilitation, improvement in verbal comprehension, surgical complications, and the ability to manage the external components of the device. CONCLUSION: cochlear implantation improves autonomy and the quality of life in the elderly. Age should not be a factor limiting surgical decision-making, and cochlear implantation can be utilized as a well tolerated, efficient treatment option for severe-to-profound hearing loss in the elderly population.


Assuntos
Implante Coclear , Perda Auditiva Neurossensorial/terapia , Idoso , Cognição , Testes Auditivos , Humanos , Qualidade de Vida , Resultado do Tratamento
19.
Ann Otol Rhinol Laryngol ; 128(12): 1198-1202, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31366220

RESUMO

OBJECTIVES: West Nile virus (WNV) has been spreading over the last 20 years. Human infection is asymptomatic in most cases. When the disease becomes clinically manifest, it may involve a range of issues, from a mild infection with flu-like symptoms to a neuroinvasive disease. Albeit rarely, WNV-associated sensorineural hearing loss (SNHL) has also been reported. Here we describe two new cases of SNHL and balance impairment caused by WNV infection. METHODS: The patients were investigated with repeated audiometric tests and, for the first time, videonystagmography was also used. RESULTS: Unlike findings in the few other published cases, an improvement in audiometric thresholds and vestibular function was documented in both of our patients. CONCLUSIONS: In the light of our findings, a prospective study would be warranted on a large series of patients with WNV infection in order: (i) to better define the epidemiology of the related cochlear-vestibular involvement; and (ii) to elucidate the virus-related changes to peripheral and central auditory and vestibular functions.


Assuntos
Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/virologia , Febre do Nilo Ocidental/complicações , Idoso , Perda Auditiva Neurossensorial/terapia , Humanos , Masculino , Pessoa de Meia-Idade
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