BACKGROUND AND OBJECTIVES: High dose systemic steroid therapy is currently the mainstay of the treatment for sudden sensorineural hearing loss (SSNHL). However, it makes a glycemic control worse in patients with diabetes. Intratympanic steroid injection (ITSI) can result in reduced systemic steroid toxicity and higher perilymph steroid level selectively. The purpose of this study is to compare the efficacy of ITSI (IT group) with that of systemic steroid (IV group) on SSNHL with diabetes. SUBJECTS AND METHOD: Thirty eight SSNHL patients who were diagnosed with diabetes were divided into the IV group (19 patients) and the IT group (19 patients). In the IV group, prednisolone was administrated intravenously for 7 days followed by tapered doses orally for 7 days. In the IT group, dexamethasone was administrated 4 times within a 2 week-period. Hearing outcome was assessed before and after treatment. RESULTS: In the IV group, 10 patients (58.8%) showed an improvement in the pure tone audiogram (PTA), with a mean improvement of 17.6 dB (p=0.023). In the IT group, 16 patients (84.2%) showed improvement in the PTA, with the mean improvement of 25.1 dB (p=0.000). But there was no significant difference in hearing gain and the recovery rate between the two groups. And it is more difficult to control blood sugar in the IV group rather than in the IT group. CONCLUSION: ITSI treatment is as effective as the systemic steroid treatment for SSNHL patients with diabetes and it can avoid a significant side effect of systemic steroids. So it could be considered as an initial treatment for the SSNHL patient with diabetes.
Blood Glucose ; Dexamethasone ; Hearing ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Humans ; Perilymph ; Prednisolone ; Steroids

Idiopathic sudden sensorineural hearing loss (ISSNHL) in children is rare, accounting for less than 10% of all sudden deafness. The etiology of ISSNHL is uncertain, but viral infeqction and the distribution of blood circulation in the inner ear are suspected as the causes of the disease. Therefore, stellate ganglion block (SGB) and antiviral agent have been used for its treatment. Recently we experienced an effective series of 12 SGBs in pediatric patient with ISSNHL, with no severe complication.
Blood Circulation ; Child ; Ear, Inner ; Hearing Loss, Sensorineural* ; Hearing Loss, Sudden ; Humans ; Stellate Ganglion*

BACKGROUND AND OBJECTIVES : Diabetes mellitus (DM) is a risk factor for sudden sensorineural hearing loss (SSNHL), possibly due to microvascular damage as well as increased blood viscosity and embolic and thrombotic episodes. To perform a prospective, randomized clinical trial to evaluate the therapeutic effect of lipo-prostaglandin E(1) (lipo-PGE(1)) on SSNHL in Korean patients with type 2 diabetes. MATERIALS AND METHOD : The study group consisted of 270 patients (130 males, 140 females) consecutively diagnosed with SSNHL. Patients were classified as diabetic or nondiabetic by the new American Diabetes Association criteria. With the approval of the institute ethics committee, patients were randomly assigned to treatment with a continuous infusion of 10 L lipo-PGE(1) (lipo-PGE(1) group) or saline (placebo group). In addition, all patients studied were treated with 48 mg methylprednisolone for 5 days. RESULTS : The overall recovery rates after treatment were 51.5% in diabetic and 64.2% in nondiabetic patients. In diabetic patients, there was a significantly higher rate of hearing improvement in the lipo-PGE(1) group (64.7%) than in the placebo group (37.5%), whereas, in nondiabetic patients, there was no significant difference in the rate of hearing improvement between the lipo-PGE(1) group (70.3%) and the placebo group (58.3%). CONCLUSION : Lipo-PGE(1) may have beneficial effects in the treatment of SSNHL in Korean patients with type 2 diabetes.
Blood Viscosity ; Diabetes Mellitus ; Ethics Committees ; Hearing ; Hearing Loss, Sensorineural* ; Hearing Loss, Sudden ; Humans ; Male ; Methylprednisolone ; Prospective Studies ; Risk Factors

BACKGROUND AND OBJECTIVES: The etiology of Idiopathic sudden sensorineural hearing loss (ISSHL) is uncertain, but viral infection and disturbance of blood circulation in the inner ear are suspected as the causes of the disease, and a stellate ganglion block (SGB) and antiviral agent (Acyclovir) have been used in its treatment. The purpose of this study was to find out the effect of SGB and antiviral agent in the treatment of ISSHL and to find out appropriate patients to evaluate the therapeutic effect. MATERIALS AND METHODS: We reviewed the records of 193 patients (202 ears) who were admitted to the Presbyterian Medical Center from January 1994 to August 2000. Fifty-eight ears were treated with acyclovir and sixty nine ears were treated with SGB and seventy five ears were treated as a control group. RESULTS: The therapeutic result of SGB was better than that of control group and acyclovir had more effect on the subgroups when the initial hearing loss was 41dB~70dB. In the patients with initial hearing level worse than 71dB, the recovery rates were constant regardless of the group. And the patients who were treated after 8 days from the onset had analogic recovery rate to each remedy. CONCLUSION: The patients with the initial hearing level of worse than 71dB and who visited the clinic within 7days of the onset were found to be appropriate candidates for the evaluation of therapeutic effects of ISSHL and SGB. SGB was recommended for the treatment of ISSHL and antiviral agents for patients between the hearing levels of 410dB-70dB.
Acyclovir ; Antiviral Agents ; Blood Circulation ; Ear ; Ear, Inner ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural* ; Humans ; Protestantism ; Stellate Ganglion*

BACKGROUND AND OBJECTIVES: The idiopathic sudden sensorineural hearing loss is a disease that develops within several hours to several days. Its etiology is not verified yet, but disturbance of blood circulation in the inner ear, intracochlear membrane break, inner ear hydrops and viral infection are considered as possible causes of disease. The herpes virus family is one of the possible viral pathogens that can cause a sudden hearing loss. The purpose of this study was to evaluate the effect of antiviral agent (Vacrovir, 200 mg/T, acyclovir) on sudden sensorineural hearing loss. MATERIALS AND METHOD: Fifty-eight ears were studied from 56 patients who were admitted to Konkuk University Medical Center Minjoong Hospital from December 1993 to August 1999. Fifty eight ears were divided into experimental (30 ears) and control (28 ears) groups. Acyclovir (3000 mg/ day) was added to the therapeutic regimen in the experimental group. The effect of antiviral agent therapy was analyzed according to the factors relating to the prognosis. RESULT: 1) Total recovery rate of the experimental group(76.7%) was significantly (p<0.05) better than that of the control group (46.4%). 2) In the patients whose age was less than fifty, the recovery rate of experimental group (84.2%) was significantly better than that of the control group (50,0%). 3) The patients who had been treated within 2 weeks after symptoms had developed had a better recovery rate in the experimental group (80.8%) as compared with the control group (48.0%) significantly(p<0.05). 4) If the initial hearing loss was in the mild to severe range, the recovery rate of experimental group (77.8%) was better than that of the control group (41.7%) with the significance of p<0. 05. 5) In the patients who had tinnitus as a accompanying symptom, the recovery rate of experimental group (76.0%) was better than that of the control group (43.5%) significantly (p<0.05). 6) In the patients who had no dizziness, the recovery rate of experimental group (80.0%) was better than that of the control group (47.4%) significantly (p<0.05). 7) In the cases associated with URI (upper respiratory infection), the recovery rate of experimental group (100.0%) was better than that of the control group (66.7%), but this was not statistically significant (p>0.05). CONCLUSION: These results suggest that the antiviral agent therapy seems to be effective on the recovery of sudden sensorineural hearing loss. The factors which affect good prognosis in the antiviral agent therapy were age (less than fifty years), early initial treatment that began within 2 weeks, mild to severe hearing loss, accompanying symptom of tinnitus and no dizziness.
Academic Medical Centers ; Acyclovir ; Blood Circulation ; Dizziness ; Ear ; Ear, Inner ; Edema ; Hearing Loss ; Hearing Loss, Sensorineural* ; Hearing Loss, Sudden ; Humans ; Membranes ; Prognosis ; Tinnitus

Action Potentials ; Animals ; Ear, Inner ; blood supply ; Facial Nerve ; physiopathology ; Hearing Loss, Sensorineural ; etiology ; Rabbits

The autosomal dominant deafness disorder at the DFNA9 locus has been described and the clinical aspects extensively characterized, showing adult-onset, progressive sensorineural hearing loss and vestibular dysfunction. DFNA9 is caused by mutations of the human Coagulation factor C homology (COCH)gene. COCH encodes cochlin, a highly abundant secreted protein of unknown function in the inner ear. Several mutations have been identified so far: P51S, V66G, G87W, G88E, V104del, I109T, I109N, W117R, A119T, M512T, C542F, C542T. We hereby report a case of cochlear implantation in a 55-year-old man with bilateral sensorineural hearing loss, which is caused by a mutation in COCH gene (W117R).
Blood Coagulation Factors ; Cochlear Implantation ; Cochlear Implants ; Deafness ; Ear, Inner ; Hearing Loss, Sensorineural ; Humans ; Middle Aged

OBJECTIVES: Korean red ginseng (KRG) has hypoglycemic, antioxidant, antithrombotic, and other beneficial effects in human. The present study evaluate the therapeutic effects of KRG on hearing recovery and glucocorticoid-induced hyperglycemia in patients with idiopathic sudden sensorineural hearing loss (SSNHL) undergoing systemic steroid therapy. METHODS: The patients were divided into 2 groups: the steroid, and the combination of steroid and red ginseng. Pure tone averages (PTA) were assessed at the first visit and 2-month follow-up. All patients underwent fasting blood glucose analyses just before and on the fifth day of treatment. Both groups were treated with a 10-day course of oral methylprednisolone at tapering doses starting from a daily dose of 48 mg. To the combination group, KRG extract was administered by mouth at a daily dose of 3 g for 20 days in addition to methylprednisolone. Hearing gain was calculated comparing the initial PTA and PTA at 2 months' follow-up. Treatment responses were classified according to Siegel's criteria. RESULTS: Pretreatment conditions were similar between the steroid (n=37) and combination groups (n=36). At 2 months after the treatment, PTA improved significantly in both groups, but there was no significant difference in the mean hearing gain & recovery rate. The non-diabetic subjects in the steroid group (n=27) exhibited a 24% increase in the mean blood glucose level during the systemic steroid therapy, while those in the combination group (n=34) showed no changes. CONCLUSION: Although the KRG did not provide greater therapeutic effects on hearing recovery, we suggest that red ginseng can be a useful adjuvant to the current steroid therapy to normalize glucocorticoid-induced hyperglycemia in non-diabetic patients during the treatment of SSNHL.
Blood Glucose* ; Fasting ; Follow-Up Studies ; Glucose ; Hearing Loss, Sensorineural* ; Hearing* ; Humans ; Hyperglycemia ; Methylprednisolone ; Mouth ; Panax* ; Steroids

BACKGROUND AND OBJECTIVES: We investigated whether the intratympanic steroid injections might be an effective initial treatment for sudden sensorineural hearing loss (SSNHL) in patients with diabetes mellitus (DM). SUBJECTS AND METHOD: We assessed a total of 167 patients with DM and SSNHL who visited a tertiary referral otolaryngology department between January 2010 and April 2018. Forty-two patients with DM and SSNHL received intratympanic steroid injections; 48 patients with DM and SSNHL received systemic steroid treatment; and 77 patients with DM and SSNHL received a combination of systemic and intratympanic treatment. Initial and post treatment hearing levels and fasting blood sugar (FBS) were assessed, and correlations between hearing gain and the duration of DM, HbA1c, FBS were investigated. RESULTS: After steroid treatment, hearing levels were 38.87±25.35 dB in the intratympanic injection group, 41.09±28.49 dB in the systemic steroid treatment group, and 47.81±27.12 dB in the combined treatment group. Final hearing levels and hearing gain in the three groups did not differ significantly. FBS after treatment in the systemic steroid treatment and combined steroid treatment group worsened relative to the intratympanic injection group (202.00±9.40 mg/dL to 326.63±7.85 mg/dL). FBS, duration of DM, and HbA1c levels did not affect the hearing gain in patients with DM and SSNHL. CONCLUSION: Intratympanic steroid injections are comparable to the systemic steroid treatment modality for SSNHL in patients with DM. Thus, intratympanic steroid injections may serve as an effective initial treatment modality for SSNHL in patients with DM.
Blood Glucose ; Diabetes Mellitus ; Fasting ; Hearing ; Hearing Loss, Sensorineural ; Humans ; Injection, Intratympanic ; Methods ; Otolaryngology ; Referral and Consultation ; Steroids

OBJECTIVE: To study the relationship between fibrinogen level and pathogenesis of sudden sensorineural hearing loss(SSHI.). METHOD: Fifty patients (55 ears) with SSHL within 7 days of the onset were studied: a control group was consist of 50 normal-hearing people who were individually matched on a pairwise basis according to the same gender and age. Both the patients and the normal people were tested for the parameters of hemorheology, blood biochemistry, whole blood cell count and clotting function. RESULT: Fibrinogen level and plasma viscosity in patients with SSHL were significantly higher than that in control subjects. Prothrombin time and activated partial thromboplastic time were significantly less in the patients group than that in the control group (P < 0.05). There were statistical difference. The parameters of blood biochemistry, whole blood cell count and platelet adhesion test of two groups had no significant difference (P > 0.05). CONCLUSION Elevated plasma fibrinogen may be a major pathogenesis of SSHL. An increase in plasma fibrinogen level may lead to elevated plasma viscosity. All these may promote a prothrombin or hypercoagulable state and impair blood perfusion of cochlea.
Adolescent ; Adult ; Aged ; Case-Control Studies ; Female ; Fibrinogen ; metabolism ; Hearing Loss, Sensorineural ; blood ; etiology ; Hearing Loss, Sudden ; blood ; etiology ; Hemorheology ; Humans ; Male ; Middle Aged ; Young Adult