[Corticosteroids for acute sensorineural hearing loss treatment. The contemporary state of problem. Literature review. Part 1]. / Glyukokortikosteroidy v lechenii ostroi neirosensornoi tugoukhosti. Sovremennoe sostoyanie problemy. Obzor literatury. Chast' 1.

The article presents modern literary data relating to the expediency of the purpose of glucocorticosteroids in sudden sensorineural hearing loss (SSHL) of various genes. In detail, the radar molecular mechanisms and the anatomo-physiological features of the exposure to the inner ear, side effects, the introduction methods, their comparative efficacy and modern schemes of the SSHL.

[Glucocorticosteroids in the treatment of acute neurosensory hearing loss. The current state of the problem. Part 2]. / Glyukokortikosteroidy v lechenii ostroi neirosensornoi tugoukhosti. Sovremennoe sostoyanie problemy. Chast' 2.

Modern literature data are presented on the choice of a drug for hormonal therapy in acute neurosensory hearing loss of various origins, the doses used for systemic therapy, the features and methods of intratympanic administration of glucocorticosteroids, and the evaluation of the effectiveness of treatment with this group of drugs.

[Modern approaches and prospective directions in treatment of acute sensorineural hearing loss following acoustic trauma]. / Sovremennye podkhody i perspektivnye napravleniya v lechenii ostroi sensonevral'noi tugoukhosti akutravmaticheskogo geneza.

The article presents a review of the literature on the treatment of acute sensorineural hearing loss, acoustic trauma in people exposed to impulse noise. Groups of the most used drugs for the pharmacological correction of hearing impairment in this pathology are present, such as glucocorticosteroids, antioxidants, nootropics, antihypoxants, and others, are covered. Particular attention is paid to use of drugs taking into account the main links of pathogenesis.

[Ramsay Hunt syndrome with hearing loss and vertigo]. / Sindrom Ramseia-Khanta s kokhleovestibulopatiei.

The article contains literature review on etiology, natural history and treatment of Ramsay Hunt syndrome. Differential diagnosis in case of 8th cranial nerve involvement is discussed. We present a case of the patient with Ramsay Hunt syndrome with hearing loss and vertigo is described. Clinical symptoms and diagnosis of sensorineural hearing loss and acute unilateral vestibulopathy are presented. The successful treatment of the patient resulted in complete facial nerve recovery, hearing improvement and partial recovery of vestibular function.

Clinical practice guidelines for the diagnosis and management of acute sensorineural hearing loss.

OBJECTIVE: Acute sensorineural hearing loss represents a spectrum of conditions characterized by sudden onset hearing loss. The "Clinical Practice Guidelines for the Diagnosis and Management of Acute Sensorineural Hearing Loss" were issued as the first clinical practice guidelines in Japan outlining the standard diagnosis and treatment. The purpose of this article is to strengthen the guidelines by adding the scientific evidence including a systematic review of the latest publications, and to widely introduce the current treatment options based on the scientific evidence. METHODS: The clinical practice guidelines were completed by 1) retrospective data analysis (using nationwide survey data), 2) systematic literature review, and 3) selected clinical questions (CQs). Additional systematic review of each disease was performed to strengthen the scientific evidence of the diagnosis and treatment in the guidelines. RESULTS: Based on the nationwide survey results and the systematic literature review summary, the standard diagnosis flowchart and treatment options, including the CQs and recommendations, were determined. CONCLUSION: The guidelines present a summary of the standard approaches for the diagnosis and treatment of acute sensorineural hearing loss. We hope that these guidelines will be used in medical practice and that they will initiate further research.

Predictive factors of acute sensorineural hearing loss in adult Japanese patients for clinical application by primary care doctors: a cross-sectional study.

BACKGROUND: Several methods are used for hearing loss screening; however, their benefits are uncertain. In this study, we aimed to determine the predictive factors of acute sensorineural hearing loss for clinical application by primary care doctors. METHODS: This retrospective, cross-sectional study included 365 patients with acute sensorineural hearing loss without prior therapy. The patients' clinical data, demographic information, and medical histories were obtained, and they were asked about comorbidities. In addition, we assessed lifestyle factors such as stress level, alcohol consumption, marital status, and socioeconomic level. Logistic regression analysis was performed to investigate the diagnostic predictive ability of the selected factors associated with acute sensorineural hearing loss. The hearing levels of all patients were evaluated using pure tone audiometry. RESULTS: We identified significant predictive factors for acute sensorineural hearing loss. The absence of hyperacusis was a predictive factor for sudden sensorineural hearing loss. Younger age, female sex, and marital status were predictive factors for acute low-tone hearing loss. High body mass index, high socioeconomic level, low alcohol consumption, high stress level, hyperacusis, and vertigo/dizziness were predictive factors for Ménière's disease. High body mass index and ear fullness were predictive factors for perilymph fistula. Low stress level was a predictive factor for acoustic tumours. CONCLUSIONS: Our findings can be used to distinguish between the types of acute sensorineural hearing loss. Symptoms, physical status, and lifestyle factors identified during this study are useful markers for predicting acute sensorineural hearing loss occurrence.

Post-irradiation endolymphatic hydrops vs. post-irradiation sudden deafness.

BACKGROUND: Increasing numbers of acute sensorineural hearing loss (SNHL) are recently experienced in irradiated nasopharyngeal carcinoma (NPC) survivors. AIM: This study adopted MR imaging to differentiate between post-irradiation sudden deafness (PISD) and post-irradiation endolymphatic hydrops (PIEH) in long-term NPC survivors with acute SNHL. METHODS: From 2012 to 2021, consecutive 10 irradiated NPC survivors with acute SNHL were enrolled. All patients underwent an inner ear test battery and MR imaging using HYDROPS-Mi2 technique. Six patients (11 ears) with positive cochlear hydrops on MR images were diagnosed as PIEH, while another 4 patients (4 ears) without cochlear hydrops on MR images were referred to PISD. RESULTS: The interval from the onset of NPC to acute SNHL did not significantly differ between the PIEH (10 ± 6 years) and PISD (8 ± 2 years). No significant difference was found between the two disorders from any of the symptomatic, radiotherapeutic, audiological, or vestibular perspective. Interestingly, most (5/6) patients with PIEH had bilateral involvement, while all (4/4) patients with PISD showed unilateral affliction. A significantly declining sequence of abnormality rates in the inner ear test battery was noted in the PIEH patients, running from the audiometry (100%), cervical vestibular-evoked myogenic potential (VEMP) test (100%), ocular VEMP test (73%), to the caloric test (36%). However, such declining trend was not observed in patients with PISD. CONCLUSION: When facing an NPC survivor who had acute SNHL over a prolonged period after irradiation, MR imaging using HYDROPS-Mi2 technique should be performed to differentiate the PIEH from the PISD, since both disorders have various treatment modalities and hearing outcome.

Transient-evoked otoacoustic emission signals predicting outcomes of acute sensorineural hearing loss in patients with Ménière's disease.

Background: Fluctuating hearing loss is characteristic of Ménière's disease (MD) during acute episodes. However, no reliable audiometric hallmarks are available for counselling the hearing recovery possibility.Aims/objectives: To find parameters for predicting MD hearing outcomes.Material and methods: We applied machine learning techniques to analyse transient-evoked otoacoustic emission (TEOAE) signals recorded from patients with MD. Thirty unilateral MD patients were recruited prospectively after onset of acute cochleo-vestibular symptoms. Serial TEOAE and pure-tone audiogram (PTA) data were recorded longitudinally. Denoised TEOAE signals were projected onto the three most prominent principal directions through a linear transformation. Binary classification was performed using a support vector machine (SVM). TEOAE signal parameters, including signal energy and group delay, were compared between improved (PTA improvement: ≥15 dB) and nonimproved groups using Welch's t-test.Results: Signal energy did not differ (p = .64) but a significant difference in 1-kHz (p = .045) group delay was recorded between improved and nonimproved groups. The SVM achieved a cross-validated accuracy of >80% in predicting hearing outcomes.Conclusions and significance: This study revealed that baseline TEOAE parameters obtained during acute MD episodes, when processed through machine learning technology, may provide information on outer hair cell function to predict hearing recovery.

Acute sensorineural hearing loss in patients with vestibular schwannoma early after cyberknife radiosurgery.

OBJECTIVE: This study reviewed our experience in treating patients with vestibular schwannoma (VS) who had acute sensorineural hearing loss (ASHL) early after radiosurgery. PATIENTS AND METHODS: Seventy VS patients underwent cyberknife radiosurgery. Of them, 6 patients had ASHL early (<6 m) after radiosurgery (Group A), accounting for 8.6% prevalence. The remaining 64 patients without ASHL were assigned to Group B. Another 10 VS patients with tiny tumor and serviceable hearing adopted observation policy (Group C). All patients underwent a test battery for inner ear function, and tumor size was measured via MR imaging. RESULTS: The mean hearing level of Group A was 39 ±â€¯16 dB before radiosurgery, which deteriorated to 67 ±â€¯14 dB at the onset of ASHL after radiosurgery. Three months after treatment for ASHL, hearing improvement was noted in only one patient (17%). Mean tumor volumes of Group A before and after ASHL were 1.54 ±â€¯1.48 cc and 1.33 ±â€¯1.04 cc, respectively, showing non-significant difference. Receiver operating characteristic curve analysis revealed that the optimal cutoff value for tumor size was 1.45 cm for predicting absence of ASHL, with a sensitivity of 96% and a specificity of 67%. In contrast, Group C with mean tumor size of 0.64 ±â€¯0.15 cm adopted observation policy, and none of them had ASHL two years after diagnosis. CONCLUSION: Prevalence of ASHL in VS patients early after radiosurgery is 8.6%, likely due to radiation injury to the cochlear nerve. Thus, when tumor size is <1.45 cm, serviceable hearing is the criteria for determining whether observation policy (with serviceable hearing) or radiosurgery (lack of serviceable hearing) is given. For those tumor sizes ranged 1.45-3.0 cm, radiosurgery is indicated regardless of hearing level.

Preclinical and clinical otoprotective applications of cell-penetrating peptide D-JNKI-1 (AM-111).

There is a growing interest in the auditory community to develop novel prophylactic and therapeutic drugs to prevent permanent sensorineural hearing loss following acute cochlear injury. The jun-N-terminal protein kinase (JNK) pathway plays a crucial role in acute sensory hearing loss. Blocking the JNK pathway using the cell-penetrating peptide D-JNKI-1 (AM-111/brimapitide) has shown promise as both a prophylactic and therapeutic agent for acute cochlear injury. A number of pre-clinical and clinical studies have determined the impact of D-JNKI-1 on acute sensorineural hearing loss. Given the inner-ear selective therapeutic profile, local route of administration, and ability to diffuse across cellular membranes rapidly using both active and passive transport makes D-JNK-1 a promising oto-protective drug. In this review article, we discuss the application of D-JNKI-1 in various auditory disorders as well as its pharmacological properties and distribution in the cochlea.

Sealing of the round and oval window niches with triamcinolone-soaked fascia as salvage surgical therapy in sudden sensorineural hearing loss.

CONCLUSIONS: Triamcinolone-soaked fascia seems to show better hearing improvement when added to tympanotomy for sudden idiopathic sensorineural hearing loss (SSHL), compared to fascia round window occlusion without triamcinolone. OBJECTIVES: To analyse if adding triamcinolone to sealing the round and oval window niches with fascia results in improved audiological outcome for acute SNHL. METHODS: Fifty-three patients (27m:43 ± 12 years, 26f:45 ± 14 years) with acute SSHL ≥50dB over 3 frequencies, who failed primary therapy, underwent transcanal tympanotomy. Twenty-five patients (Group A;cortisone:14m, 11f:46 ± 9 years) received sealing of the round and oval window with fascia soaked in triamcinolone (1ml; 40mg/ml) and 28 controls (Group B;no-cortisone:13m, 15f, 42 ± 12 years) without triamcinolone. Frequency specific and pure tone average (PTA =500-1000-2000-3000Hz) results were compared between Group A and B pre- and postoperatively. RESULTS: In Group A the PTA improved by ≥10dB in 21/25(83%) cases; in Group B 18/28(63%). Group A showed a statistically significantly better improvement across all frequencies, while linear regression revealed a significant decrease of posttherapeutic PTA to 94.96% of the initial PTA (p = .037). The overall PTA improved by 24dB. Group A improved from 73dB to 41dB(-32dB) PTA, Group B improved from 76dB to 56dB PTA (-20dB) (p < .05). Group A showed a significant additional decrease of 12.8dB (p < .001).