Sudden deafness may be defined as a sensorineural hearing loss that develope over a period of hours or a few days. The severity of the hearing loss may vary from mild to total loss of perception of the most intense sound. The loss of hearing may be permanent, or the hearing may spontaneously return to normal or near normal. Proposed explanations for sudden idiopathic sensorineural loss revolve primarily around viral or vascular etiologies. In addition to noise-induced deafness, which can be divided into a slowly progressive deafness caused by prolonged intense noise exposure and acute acoustic trauma caused by a single exposure to very intense sound. 45- and 52-year-old healthy male smokers with no previous otologic history, noted the acute loss of hearing with tinnitus in his right ear during his unusual intense noise exposed activities. There were no other associated symptoms of dizziness or visual change. After several days without improvement, they presented to the department of otolaryngology. Physical examination, neurologic evaluation, and otorhinolaryngologic examination were essentially within normal limits except for the hearing loss on the right ear. An audiogram revealed a severe primarily sensorineural sensitivity loss on the right. Routine laboratory studies were within normal limits. Two patients denied previous barotrauma, atypical or unusual drug usage, and unusual physical exertion or strain. We observed evidence of cochlear abnormality. The presence of cochlear dysfunction is supported by acoustic reflex threshold and auditory brain-stem response. These findings strengthened the probability of an acoustic trauma origin for the sudden sensorineural hearing loss.
Barotrauma ; Deafness ; Dizziness ; Ear ; Hearing ; Hearing Loss ; Hearing Loss, Noise-Induced ; Hearing Loss, Sensorineural* ; Hearing Loss, Sudden ; Humans ; Male ; Middle Aged ; Noise* ; Otolaryngology ; Physical Examination ; Physical Exertion ; Reflex, Acoustic ; Tinnitus

OBJECTIVE: To investigate the current situation of early diagnosis and intervention in 0-9 months old infants with hearing loss and analysis factors that will affect early diagnosis and intervention. METHOD: One hundred and eighty-six infants referred to the West China hospital from February 2014 to September 2014 were included. All 186 children were referred due to the fact that either they failed infant hearing screening or outer ear malformation. Early diagnosis and/or intervention were performed on those 186 children and their records of early diagnosis and intervention were analyzed. RESULT: Among the 186 infants, 167 (89.8%) were diagnosed with an average age at (4.0 ± 1.4) months. Among the 167 infants with final diagnosis, there were 31 (18.6%) infants diagnosed as conductive hearing loss (CHL), and 99 cases (59.3%) diagnosed as sensorineural hearing loss (SNHL), among whom, there were 75 (44.9%) bilateral SNHL and 24 (14.4%) unilateral SNHL. There were 2 cases (1.20%) with SNHL on one side and atresia on the other side. 5 (2.99%) of all conductive hearing loss cases with unilateral atresia and 2 cases with auditory neuropathy (AN) were found. 33 infants (19.8%) were found to have normal hearing. 30.7% (23/75) infants diagnosed as bilateral SNHL and 8.3% (2/24) infants diagnosed as unilateral SNHL were fitted with hearing aids. The fitting rate in infants with bilateral SNHL with mild, moderate, severe to profound degrees were 0 (0/23), 24.0% (6/25), 66.7% (6/9), 61.1% (11/18) respectively. The average intervention age was (5.0 ± 2.1) months. CONCLUSION Although the early diagnosis and intervention situation in this study are very close to international standard, there are still infants without final diagnosis and infants with hearing loss without hearing aid fitting. Further studies and efforts to promote early diagnosis and intervention in infants with hearing loss are needed.
China ; Deafness ; Early Diagnosis ; Hearing Aids ; Hearing Loss, Bilateral ; Hearing Loss, Central ; Hearing Loss, Conductive ; diagnosis ; Hearing Loss, Sensorineural ; diagnosis ; Hearing Tests ; Humans ; Infant ; Infant, Newborn

Superior semicircular canal dehiscence syndrome (SCDS) is characterized by cochleovestibular hyper-responsiveness symptoms including sound- and pressure-evoked vertigo and oscillopsia, autophony, hyperacusis and ear fullness. The typical audiometric feature of SCDS is known as conductive hearing loss at low frequency. A 43-year-old man presented with unilateral sudden deafness after several events of heading during soccer game. High-resolution temporal bone computed tomography revealed a dehiscence of superior canal encased by superior petrous sinus. We reviewed audio-vestibular findings in this patient and speculated potential pathogenic mechanisms of sudden deafness in SCDS with literature review.
Adult ; Deafness ; Ear ; Head ; Hearing Loss, Conductive ; Hearing Loss, Sudden ; Humans ; Hyperacusis ; Semicircular Canals ; Soccer ; Temporal Bone ; Vertigo

OBJECTIVES: The problem of noise-induced hearing loss (NIHL) was objectively and systematically investigated by diagnosing three workers who complained of tinnitus and hearing disturbance. METHODS: Atypical hearing loss is diagnosed as a work-related disease by using general medical methods, such as environmental survey, neurological examination, otoscopy, pure-tone audiometry, speech audiometry, otoacoustic emissions (OAE), auditory-evoked potentials, and interview on the history of past disease, family and occupation. RESULTS: Three results were found according to the work-related hearing loss as follows; (1) hearing loss that is caused by exposure to continuous noise of less than 85 dB(A) or impact noise of greater than 135 dB peak, (2) mixed hearing loss that has progressed due to noise with past otitis media, and (3) atypical hearing loss that showed remarkable differences between air and bone conduction due to tinnitus. CONCLUSIONS: The criteria for work-related hearing loss should be carefully investigated by considering exposure to impact noise, the effect of continuous noise on mixed hearing loss patients, and the hearing loss caused by tinnitus.
Audiometry, Pure-Tone ; Audiometry, Speech ; Bone Conduction ; Hearing ; Hearing Loss ; Hearing Loss, Mixed Conductive-Sensorineural ; Hearing Loss, Noise-Induced* ; Humans ; Neurologic Examination ; Noise ; Occupations ; Otitis Media ; Otoscopy ; Tinnitus

Tinnitus is a perception of sound without external stimuli. The increase of noise from industrialization, complex psychological state, increase of old age people, and excessive medication make tinnitus a more common disease than ever before. However, the knowledge regarding diagnosis and treatment of tinnitus is still limited. Tinnitus can be categorized into paraauditory tinnitus and sensory neural tinnitus. Paraauditory tinnitus may occur from the sound generated by the vessel near the ear such as an arteriovenous fistula, abnormal vessel, a tumor around vessel, palatal myoclonus, and patent E tube. Sensory neural tinnitus can arise from senile hearing loss, noise-induced hearing loss, sudden deafness, sensorineural hearing loss associated with chronic otitis media, excessive medication, and so on. But there are many cases in which the specific cause cannot be defined. Diagnosis needs thorough history taking, physical examination, and radiologic and audiologic examination. Treatments for the paraauditory tinnitus are vessel ligation or coil embolization of arteriovenous fistula and removal of the causative factors. Although there are many treatment modalities for managing sensory neural tinnitus, a standardized treatment modality has not been established. Sensory neural tinnitus can be managed with tinnitus retraing therapy and electrical stimulation therapy. Although tinnitus is essentially not a life-treatening disease, advancing quality of life and the increasing number of patients with tinnitus mandate health-care providers to be more concerned with the disease tinnitus.
Arteriovenous Fistula ; Classification ; Deafness ; Diagnosis ; Ear ; Electric Stimulation Therapy ; Embolization, Therapeutic ; Hearing Loss, Noise-Induced ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Humans ; Ligation ; Myoclonus ; Noise ; Otitis Media ; Physical Examination ; Quality of Life ; Tinnitus*

During treatment of inner ear diseases, the blood-cochlear barrier limits the drug delivery into the cochlea. Intratympanic drug injection for inner ear diseases is a safe procedure where drugs reach high concentrations in the cochlea and systemic side effects are minimized. This paper reviews the updated status of intratympanic drug injections for the treatment of inner ear disease. Intratympanic drug injection is an effective procedure for the control of inner ear disorders such as Meniere's disease and sudden sensorineural hearing loss. Although the effect of intratympanic injection on tinnitus and noise-induced hearing loss is open to discussion, its indications could be extended, like as drug, gene, and cell-based therapy.
Aminoglycosides ; Cochlea ; Ear, Inner ; Hearing Loss, Noise-Induced ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Labyrinth Diseases* ; Meniere Disease ; Tinnitus

BACKGROUND AND OBJECTIVES: In this study, we tried to study the criteria and characteristics of patients with noise-induced hearing loss by analyzing the pure tone audiogram such as "C5 dip" or "4 kHz notch". SUBJECTS AND METHOD: Out of 553 patients who complained of tinnitus and hearing loss, medical examination by interview, physical examination, hearing test, brain MRI and survey of tinnitus were performed from January 2010 to December 2012, targeting 81 patients who underwent pure tone hearing test. We analyzed the clinical characteristics of 81 patients with the exception of systemic disease or a history of otologic disease, conductive hearing loss, and vestibular schwannomas. Patients consisted of 70 men and 11 women (34 persons on both sides, 31 persons on right side, and 16 persons on left side), with an average of 48.1+/-12.9 years. 4 kHz notch-type sensorineural hearing loss was compared with contralateral hearing. RESULTS: The audiogram of 4 kHz notch was analyzed, and the results were as follows; 0.5 kHz (11.2+/-9.9 dB HL), 1 kHz (13.2+/-9.9 dB HL), 2 kHz (19.4+/-15.4 dB HL), 3 kHz (38.1+/-18.7 dB HL), 4 kHz (49.3+/-16.2 dB HL), 8 kHz (27.2+/-16.2 dB HL). Among all frequencies of 4 kHz notch audiogram, there was no significant hearing loss in 0.5 kHz and 1 kHz, but significant hearing loss was noted in higher frequencies (paired t-test, p>0.05). The contralateral ear showed a ski-slope hearing loss in about half of the patients. CONCLUSION: Remarkable points of the 4 kHz notch audiogram analysis, known as a typical characteristic of noise-induced hearing loss, were as follows; First, there was hearing loss of about 50 dB HL at 4 kHz. Second, the hearing threshold was improved to about 30 dB HL at 8 kHz. Third, the 4 kHz-notch audiogram showed a significant hearing loss in a high-pitched tone of over 2 kHz, but otherwise there were no significant hearing loss observed in 0.5 kHz and 1 kHz. Fourth, even if there were no symptoms, contralateral ear can still show the ski-slope type of hearing loss.
Brain ; Ear ; Ear Diseases ; Female ; Hearing Loss* ; Hearing Loss, Conductive ; Hearing Loss, Noise-Induced ; Hearing Loss, Sensorineural ; Hearing Tests ; Hearing* ; Humans ; Magnetic Resonance Imaging ; Male ; Neuroma, Acoustic ; Noise* ; Physical Examination ; Tinnitus

OBJECTIVE: We studied whether frontal skull base fracture has an impact on the occurrence and recovery of anosmia and/or ageusia following frontal traumatic brain injury (TBI). METHODS: Between May 2003 and April 2005, 102 consecutive patients who had hemorrhage or contusion on the frontal lobe base were conservatively treated. Relevant clinical and radiographic data were collected, and assessment of impaired smell and taste sensation were also surveyed up to at least 12 months post-injury. RESULTS: Among 102 patients, anosmia was noted in 22 (21.6%), of whom 10 had ageusia at a mean 4.4 days after trauma. Bilateral frontal lobe injuries were noted in 20 of 22 patients with anosmia and in all 10 patients with ageusia. Frontal skull base fracture was noted in 41 patients, of whom 9 (21.4%) had anosmia and 4 (9.5%) had ageusia. There was no statistical difference in the occurrence of anosmia and ageusia between patients with or without fracture. Of the 22 patients with anosmia, recovery from anosmia occurred in nine (40.9%) at the interval of 6 to 24 months after trauma, of whom six had frontal skull base fracture and three were not associated with fracture. Recovery of anosmia was significantly higher in patients without fracture than those with fracture (p<0.05). Recovery from ageusia occurred in only two of 10 patients at the interval of 18 to 20 months after trauma and was not eminent in patients without fracture. CONCLUSION: One should be alert and seek possibile occurrence of the anosmia and/or ageusia following frontal TBI. It is suggested that recovery is quite less likely if such patients have fractures on the frontal base, and these patients should wait for at least 6 to 18 months to anticipate such recovery if there is no injury to the central olfactory structures.
Ageusia* ; Brain Injuries ; Contusions ; Frontal Lobe ; Hemorrhage* ; Humans ; Incidence* ; Olfaction Disorders* ; Sensation ; Skull Base ; Smell

OBJECTIVE: To verify the relationship between THI and VAS scores in patients with sudden hearing loss and tinnitus in a prospective study. METHOD: Forty-four patients classified their tinnitus according to VAS and THI before and after treatment, and both scores were compared through the Pearson's correlation coefficient test and Nonparametric tests. RESULT: There was a correlation between VAS and THI scores in patients with sudden hearing loss and tinnitus. Tinnitus assessment scores were significantly reduced after treatment. Decreasing of THI and VAS scores were not depended on frequency and loudness of tinnitus and severity of deafness, but therapeutic effect of sudden sensorineural hearing loss. CONCLUSION THI and VAS scores are useful for assessment of tinnitus in patients with sudden hearing loss and tinnitus.
Audiometry ; Deafness ; Hearing Loss, Sensorineural ; complications ; Hearing Loss, Sudden ; complications ; Humans ; Prospective Studies ; Tinnitus ; complications

BACKGROUND AND OBJECTIVES: Taste disorders have not received sufficient attention by otolaryngologists and only a few studies have documented the clinical characteristics of taste disorders. We therefore analyzed the characteristics of patients with taste disorders who visited our Taste and Smell Clinic over a 3-year period. SUBJECTS AND METHOD: Sixty patients with taste disorders were investigated. The efficacy of treatment was evaluated according to the age, sex, duration of symptom, cause, and severity of taste disorder. RESULTS: Sixty percent of patients visited the clinic within 6 months of the onset of decrease in taste sensation. Multiple etiology was more common than single etiology. Taste disorder due to olfactory disorder was the most frequent etiology, followed by drug induced taste disorder and taste disorder due to zinc deficiency. Sixty percent of the patients experienced improvement of the taste abnormality. The efficacy of treatment decreased with increasing severity of taste disorder at the initial visit. CONCLUSION: Careful history taking and physical examination are needed for determination of the cause of any taste abnormality. The site and severity of dysgeusia should be determined through the chemical and electrical taste threshold test. Treatment should direct toward the causative abnormality, if possible.
Dysgeusia ; Humans ; Physical Examination ; Sensation ; Smell ; Taste Disorders ; Taste Threshold ; Zinc