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Hanyang Medical Reviews.2015;35(2):92-96. doi:10.7599/hmr.2015.35.2.92

Sudden sensorineural hearing loss (SSNHL) is defined as a sensorineural hearing loss of at least 30 dB in 3 consecutive speech frequencies that occurred within the previous 3 days. In most cases the cause is not identified, although various infective, vascular, and miscellaneous causes have been proposed. It has a reported incidence of 5 to 20 per 100,000 patients per year. Many treatments are used, including corticosteroids, antiviral drugs, hemodilution agents, minerals, vitamins, herbal preparations, batroxobin, carbogen, and oxygen-based treatments. Intra-tympanic dexamethasone injection into the middle ear may be useful to SSNHL patients with profound hearing loss that is intractable to medical treatment or who also have diabetes mellitus. In SSNHL, early treatment with combined modalities that include steroid injection is generally recognized as the current best practice. The spontaneous recovery rates have been reported to be between 32-70%, and although various treatment protocols have been tried, only about half of patients completely recover, usually within 2 weeks. There is much to learn about pathogenesis of sudden sensorineural hearing loss, and more clinical trials are needed to establish evidence-based management.
Adrenal Cortex Hormones ; Antiviral Agents ; Batroxobin ; Clinical Protocols ; Dexamethasone ; Diabetes Mellitus ; Ear, Middle ; Hearing Loss ; Hearing Loss, Sensorineural* ; Hearing Loss, Sudden ; Hemodilution ; Humans ; Incidence ; Minerals ; Plant Preparations ; Practice Guidelines as Topic ; Steroids ; Vitamins

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Noise-Induced Hearing Loss.

Hyun Joon SHIM

Hanyang Medical Reviews.2015;35(2):84-91. doi:10.7599/hmr.2015.35.2.84

Noise-induced hearing loss (NIHL) is the second most common cause of permanent hearing impairment after age-related hearing loss. NIHL is influenced by environmental and genetic factors and the effects of noise can be exacerbated by the administration of ototoxic drugs or exposure to chemicals. The pathophysiology of NIHL is classified as either mechanical injury or metabolic (or biochemical) injury. Exposure of cochleae to intense sounds has been found to disrupt the stereocilia on the hair cells by separating the tip links and to depolymerize actin filaments, resulting in a disturbance in signal transduction. Major mechanisms of metabolic injuries include accumulation of reactive oxygen species enhanced by oxidative stress, cochlear ischemia followed by reperfusion injury, and excitotoxicity to auditory neuron induced by excessive release of the cochlear afferent neurotransmitter, glutamate. Many studies involving therapeutic or preventive trial with antioxidants, JNK inhibitors, and NMDA antagonists have shown partial effectiveness. However, protection from noise before cochlear injury occurs is very important because damaged hair cells and auditory neurons in the mammalian cochleae are unable to regenerate.
Actin Cytoskeleton ; Antioxidants ; Apoptosis ; Cochlea ; Glutamic Acid ; Hair ; Hair Cells, Auditory ; Hearing Loss ; Hearing Loss, Noise-Induced* ; Ischemia ; N-Methylaspartate ; Neurons ; Neurotransmitter Agents ; Noise ; Oxidative Stress ; Reactive Oxygen Species ; Reperfusion Injury ; Signal Transduction ; Stereocilia

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Presbycusis.

Sang Hoon KIM ; Seung Geun YEO

Hanyang Medical Reviews.2015;35(2):78-83. doi:10.7599/hmr.2015.35.2.78

Presbycusis is gradual hearing loss in both ears that commonly occurs as people age. Presbycusis is a complex phenomenon characterized by audiometric threshold shift, deterioration in speech-understanding and speech-perception difficulties in a noisy environment. Factors contributing to presbycusis include mitochondria DNA mutation, genetic disorders, hypertension, diabetes, metabolic disease and other systemic diseases in the intrinsic aspects. Extrinsic factors include noise, ototoxic medication and diet. However, presbycusis may not be related to the intrinsic and extrinsic factors separately. Presbycusis can greatly affect one's quality of life; impaired hearing restricts communication and untreated presbycusis could result in social isolation and even depression. Current amplification methods related to auditory rehabilitation can provide improved communication ability to users. Nevertheless, only a minority of elderly people with impaired hearing use hearing aids. The purpose of this review is to raise the awareness of presbycusis, to update our current understanding of presbycusis with a focus on age-related deficits in auditory and cognitive processing of speech and to explore strategies of prevention, identification, amplification, and aural rehabilitation. The ultimate goal is to improve the quality of hearing health care and the overall quality of life of older adults.
Adult ; Aged ; Communication ; Correction of Hearing Impairment ; Delivery of Health Care ; Depression ; Diet ; DNA ; Ear ; Hearing ; Hearing Aids ; Hearing Loss ; Humans ; Hypertension ; Metabolic Diseases ; Mitochondria ; Noise ; Presbycusis* ; Quality of Life ; Rehabilitation ; Social Isolation

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Newborn Hearing Loss and Newborn Hearing Screening.

Su Kyoung PARK

Hanyang Medical Reviews.2015;35(2):72-77. doi:10.7599/hmr.2015.35.2.72

The incidence of bilateral profound hearing loss of newborns is 1 to 2 per 1,000 newborns. It is higher in infants with risk factors for hearing loss. Congenital hearing loss can cause many problems in language, learning, speech development and educational and occupational performance. Most developed countries have conducted the Universal Newborn Hearing Screening (UNHS) with automated otoacoustic emissions (AOAE) or automated auditory brainstem response (AABR). UNHS reduced the average age of identification of permanent hearing loss in infants 6 months or less after birth. This early identification and intervention of hearing loss with amplification and speech therapy optimizes communication during the early critical period of language acquisition and can improve language outcomes in children between 2 and 5 years of age. The aims of this paper are to explain the incidence of newborn hearing loss, the importance of early detection of hearing loss and intervention and newborn hearing screening methods.
Child ; Critical Period (Psychology) ; Developed Countries ; Evoked Potentials, Auditory, Brain Stem ; Hearing Loss* ; Hearing* ; Humans ; Incidence ; Infant ; Infant, Newborn* ; Learning ; Mass Screening* ; Neonatal Screening ; Parturition ; Risk Factors ; Speech Therapy

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Etiology of Hearing Loss and Genetic Hearing Loss.

So Young KIM ; Byung Yoon CHOI

Hanyang Medical Reviews.2015;35(2):66-71. doi:10.7599/hmr.2015.35.2.66

Hearing loss is one of the most common sensory disorders and has numerous environmental and genetic factors that influence its onset and development. Hearing loss can be classified by either the affected anatomic or functional lesion of hearing loss, or as conductive or sensorineural hearing loss (SNHL). Genetic factors account for about 50% of congenital SNHL, and are therefore the most common cause. Molecular genetics research has identified more than 100 genes related to hearing and hearing loss, and shown that the risk of hearing loss caused by non-genetic factor is modified by genetic susceptibility. About 30% of genetic hearing loss is syndromic related and has affected phenotypic markers in other organs that make it easier to correctly diagnose the etiology of the hearing loss. In some cases, hearing loss can precede the pathologies of other organs and in these cases, hearing loss acts as a predictor of the syndrome associated pathologies of other organs. Inheritance of nonsyndromic hearing loss follows common inheritance patterns such as autosomal dominant, autosomal recessive, sex chromosome related, and mitochondrial inheritances. The paucity of predominant phenotypes and ethnic specificity of the prevalence and types of mutations may hinder the genetic diagnosis in nonsyndromic hearing loss. However, progress in elucidating the causal mutations is going forward using stratified genetic diagnostic strategies of candidate genes identified by hearing phenotypes and patterns of inheritance.
Diagnosis ; Fibrinogen ; Genetic Predisposition to Disease ; Genetics ; Hearing ; Hearing Loss* ; Hearing Loss, Sensorineural ; Inheritance Patterns ; Molecular Biology ; Pathology ; Phenotype ; Prevalence ; Risk Factors ; Sensation Disorders ; Sensitivity and Specificity ; Sex Chromosomes ; Wills

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Sensorineural Hearing Loss: Causes and Hearing Rehabilitation.

Moo Jin BAEK

Hanyang Medical Reviews.2015;35(2):57-65. doi:10.7599/hmr.2015.35.2.57

Sensorineural hearing loss is one of the most common chronic clinical disorders that we can easily encounter. The etiology of sensorineural hearing loss is multifactorial: congenital, idiopathic, traumatic, noise-induced, head injury induced, infectious disease, drug induced, degenerative, immune disorder, vestibular schwannoma and Meniere's disease. Many people are living with the discomfort of hearing loss because fundamental treatment is has not yet been found. Also due to the progress of medical science, human life span has been extended. As the result, the number of patients suffering from hearing loss has increased. But the present situation does not measure up to the demand for recovery of hearing loss. Hearing loss has a great influence on the quality of life. To overcome this situation, neural prostheses such as the cochlear implant and auditory brainstem implant are helpful for the rehabilitation of total deaf patients. Recently, due to the advancement of studies related to hair cell regeneration and the field of gene therapy on the inner ear has made big progress during the last few years. The purpose of this study is to describe the latest known causes and rehabilitation of sensorineural hearing loss.
Auditory Brain Stem Implants ; Cochlear Implants ; Communicable Diseases ; Correction of Hearing Impairment ; Craniocerebral Trauma ; Ear, Inner ; Genetic Therapy ; Hair ; Hearing Loss ; Hearing Loss, Sensorineural* ; Hearing* ; Humans ; Immune System Diseases ; Meniere Disease ; Neural Prostheses ; Neuroma, Acoustic ; Quality of Life ; Regeneration ; Rehabilitation*

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Etiology and Rehabilitation of Sensorineural Hearing Loss.

Seung Hwan LEE

Hanyang Medical Reviews.2015;35(2):55-56. doi:10.7599/hmr.2015.35.2.55

No abstract available.
Hearing Loss, Sensorineural* ; Rehabilitation*

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Risk Factor and Prevention of Coronary Artery Disease.

Jeong Bae PARK

Hanyang Medical Reviews.2006;26(2):16-22.

Atherosclerosis is characterized by a long period of silent disease progression, allowing early diagnosis and the potential of early therapeutic intervention. From an epidemiological perspective, a risk factor of atherosclerosis is a characteristic of an individual that appears early in life and is associated with an increased risk of developing future cardiovascular disease (CVD), particularly coronary artery disease. The risk factor can be an acquired behavior, an inherited trait, or a laboratory measure, such as cholesterol or recently high sensitivity C-reactive protein. Some risk factors, such as dyslipidemia and hypertension, are modifiable and clinical trials have shown that lowering these factors reduces vascular morbidity and mortality. Here, the epidemiological evidence of underlying risk factors for atherosclerosis with some evidence in Koreans will be reviewed into 2 parts; 1) the conventional risk factors of smoking, hypertension, dyslipidemia, insulin resistance and diabetes, physical activity, and obesity as well as general strategies for reducing risk related to these disorders, 2) a series of novel atherosclerotic risk factors, including high sensitivity C-reactive protein (hsCRP) and other markers of inflammation, homocysteine, and lipoprotein(a).
Atherosclerosis ; C-Reactive Protein ; Cardiovascular Diseases ; Cholesterol ; Coronary Artery Disease* ; Coronary Vessels* ; Disease Progression ; Dyslipidemias ; Early Diagnosis ; Homocysteine ; Hypertension ; Inflammation ; Insulin Resistance ; Lipoprotein(a) ; Mortality ; Motor Activity ; Obesity ; Risk Factors* ; Smoke ; Smoking

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Epidemiology of Coronary Heart Disease.

Il SUH

Hanyang Medical Reviews.2006;26(2):11-15.

Coronary heart disease(CHD) is one of the leading causes of death in the world. The pattern of morbidity and mortality of CHD changes with epidemiologic transition. The mortality changes of CHD in Korea are consistent with the change that occurs during the transition from the age of receding pandemics to the age of degenerative and man-made disease. Mortality of CHD has been declining in the developed countries. However, age-adjusted mortality from CHD in Korea increased significantly during the past 20 years. The changes of CHD risk factors in Korea observed during the similar period were a decrease in hypertension prevalence, although still present at a high level, an increase in serum total cholesterol level and intake of total fat along with a high, although decreasing, prevalence of cigarette smoking. Further epidemiologic studies are needed to reduce the CHD burden in Korea.
Cause of Death ; Cholesterol ; Coronary Disease* ; Developed Countries ; Epidemiologic Studies ; Epidemiology* ; Heart ; Hypertension ; Korea ; Mortality ; Pandemics ; Prevalence ; Risk Factors ; Smoking

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Pathophysiology of Atherosclerosis.

Jeong Euy PARK

Hanyang Medical Reviews.2006;26(2):4-10.

In humans, early lesions of atherosclerosis, fatty streaks, already begin to be observed from the twenties. In animals grown in nature, atherosclerosis is not known to exist and serum cholesterol levels in the animals are lower than 100mg/dL. Recent clinical trials suggest that if we lower the LDL cholesterol to below 40mg/dL, we can probably halt the progression of atherosclerosis. Atherosclerosis can either progress or regress according to the control of risk factors. If the risk factors are not well controlled, the pressure in the core can be increased and the cap weakens because of the infiltration of macrophages and foam cells instead of healthy smooth muscle cells and the matrix metalloprotenases secreted from these cells weakens the collagen. Acute coronary syndrome results when rupture or erosion occurs in the cap. Recently, atherosclerosis is understood as an inflammatory process, because the infiltrating cells, inflammatory cytokines and T-cells are very much similar to the other inflammatory lesions such as rheumatoid arthritis. Endothelial dysfunction, lipid oxidation and insulin resistance are also the main abnormal findings observed from the early stages of atherosclerosis. HMG Co-A reductase inhibitors can effectively prevent and regress atherosclerosis and is now very widely prescribed for these purposes.
Acute Coronary Syndrome ; Animals ; Arthritis, Rheumatoid ; Atherosclerosis* ; Cholesterol ; Cholesterol, LDL ; Collagen ; Cytokines ; Foam Cells ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Inflammation ; Insulin Resistance ; Macrophages ; Myocytes, Smooth Muscle ; Oxidoreductases ; Risk Factors ; Rupture ; T-Lymphocytes

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