Objective:This study aimed to evaluate the therapeutic effect of intratympanic injection of ganglioside in patients with refractory sudden deafness. Methods:A total of 120 patients with sudden deafness, aged 18-65 years, whose onset was within 11-42 days, failed to respond to conventional treatment, and had an average hearing threshold（500-4 000 Hz）>60 dB were selected. They were prospectively and randomly divided into a control group of 61 cases and an experimental group of 59 cases. The control group was treated according to the recommended protocol of the Chinese Medical Association（postauricular injection of methylprednisolone）, while the experimental group was treated with intratympanic injection of monosialotetrahexosylganglioside sodium+postauricular injection of methylprednisolone. Both groups were simultaneously administered oral ginkgo biloba extract and citicoline tablets. Hearing was re-examined two weeks after the completion of treatment, and the therapeutic effects of the two different treatment methods were compared and analyzed. Results:The effective rate was 29.51% in the control group and 54.24% in the experimental group（P<0.01）. The average hearing threshold improved by 11.57 dB HL in the control group and 22.50 dB HL in the experimental group（P<0.05）. Conclusion:The combination of postauricular injection of methylprednisolone and intratympanic injection of ganglioside is more effective than postauricular injection of methylprednisolone alone in the treatment of refractory sudden deafness. The earlier the treatment, the better the therapeutic effect.
Humans ; Middle Aged ; Hearing Loss, Sudden/drug therapy* ; Adult ; Prospective Studies ; Young Adult ; Aged ; Adolescent ; Male ; Female ; Injection, Intratympanic ; Gangliosides/administration & dosage* ; Methylprednisolone/therapeutic use* ; Treatment Outcome

BACKGROUND AND OBJECTIVES: The effectiveness of intratympanic dexamethasone injections (ITD) alone is compared against the combination therapy of ITD and oral diuretics as treatments for acute low frequency sensorineural hearing loss (LFHL) without vertigo. SUBJECTS AND METHOD: A total of 36 patients, with LFHL < or =500 Hz that had been developed within the last 1 month, were enrolled and then were retrospectively categorized into two groups: 1) those treated with ITD four times each day for 4 consecutive days (ITD only group; 19 patients) and 2) those treated with ITD in the same way and diuretics orally for 2 weeks (combination group; 17 patients). After 8 weeks, treatment outcomes were analyzed for LFHL using subjective improvement and audiometric change. RESULTS: Hearing thresholds at low frequencies < or =500 Hz were significantly reduced at 8 weeks after treatment in both ITD only and combination group (p<0.05). The cure rate of the combination group was higher than that of the ITD only group but was not statistically significant (52.9% vs. 42.1%, p>0.05). For subjective symptoms, there were no statistically significant differences in the improvement rate in either group (combination 58.8% vs. ITD only 63.2%, p>0.05). In pure tone audiometry, the improvement rate of the combination group was not significantly different from that of the ITD only group (76.5% vs. 73.7%, p>0.05). There was a significant correlation between the complete recovery rate and duration of symptoms. CONCLUSION: ITD alone is an effective treatment modality for LFHL within 1 month after onset. Diuretics have no additive effect for the recovery of hearing in patients with acute LFHL without vertigo.
Audiometry ; Dexamethasone ; Diuretics* ; Drug Therapy, Combination ; Hearing ; Hearing Loss, Sensorineural* ; Hearing Loss, Sudden ; Humans ; Retrospective Studies ; Steroids ; Vertigo*

OBJECTIVE: To observe the efficacy of intratympanic steroid injection as supplementary or initial treatment for sudden sensorineural hearing loss (SSNHL). METHOD: A total of 68 patients diagnosed with SSNHL were randomized into group A (45 cases including systemic steroid for 33 cases and systemic steroid + intratympanic steroid as supplementary treatment for 12 cases) and group B (23 cases, initial intratympanic steroid). Then observe the therapeutic effect in two groups. RESULT: The total effective rate was 55.6% in group A and 56.5% in group B. No statistical difference was detected between these two groups (P > 0.05). There was statistical difference after therapy of intratympanic steroid as supplementary treatment for 12 patients due to poor hearing improvement after systemic steroid in group A (P < 0.05). CONCLUSION Both systemic and intratympanic steroid injection for SSNHL are effective. The efficiency of intratympanic steroid injection as supplementary or initial treatment for SSNHL is similar to that of systemic steroid. The intratympanic steroid injection for SSNHL as initial protocol or as supplementary treatment when poor hearing improvement after systemic steroid is recommended.
Hearing Loss, Sensorineural ; drug therapy ; Hearing Loss, Sudden ; drug therapy ; Humans ; Injection, Intratympanic ; Steroids ; administration & dosage ; therapeutic use ; Treatment Outcome ; Tympanic Membrane

OBJECTIVE: To explore the treatment of sudden sensorineural hearing loss with steroid from different administration routes. METHOD: One hundred and eighty-eight patients with diagnosis of sudden sensorineural hearing loss were selected, in accordance with the random number table, and all patients were divided into three groups. With different administration routes, they were devided into systemic steroid therapy group, intratympanic steroid therapy group and postauricular steroid therapy group,and the curative effects were collected and analyzed. RESULT: The total effective rate was 78.26% in systemic steroid therapy group, 80.70% in intratympanic steroid therapy group and 80.65% in postauricularsteroid therapy group,and no statistical difference was detected among these three groups (P > 0.05). CONCLUSION The treatment of sudden sensorineural hearing loss with steroid from different adminsthation routes all can achieve a relatively favorable prognosis, and there were no obvious different among those different treatments.
Administration, Oral ; Audiometry, Pure-Tone ; Dexamethasone ; administration & dosage ; Glucocorticoids ; administration & dosage ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; drug therapy ; Humans ; Prognosis ; Steroids ; Treatment Outcome ; Tympanic Membrane

OBJECTIVE: To evaluate the efficacy of intratympanic dexamethasone injection for the moderate and severe sudden deafness with BPPV. METHOD: A total of 63 patients diagnosed with sudden sensorineural hearing loss with BPPV were treated through OPD. Patients were divided into three groups: 20 cases in intratympanic dexamethasone injection as initial treatment (group A); 18 cases in systemic hormone therapy group (group B); 25 cases in intratympanic dexamethasone injection as salvage treatment (group C). In addition, routine drugs were used to all patients. RESULT: The overall effective rate of group A, B and C in hearing recovery was 60.0%, 38.9% and 48.0%, respectively: (1) No significant difference of hearing recovery was observed among three groups (P > 0.05); (2) A significant difference of hearing recovery was evidenced between group A and C (P < 0.05); (3) A significant difference of hearing recovery was evidenced between group A and C (P < 0.05); (4) No statistically significant difference was found in the hearing recovery between group B and C (P > 0.05). CONCLUSION Our data showed that intratympanic dexamethasone should be used as initial therapy for treating the moderate and severe sudden deafness with BPPV.
Benign Paroxysmal Positional Vertigo ; complications ; Dexamethasone ; administration & dosage ; therapeutic use ; Hearing Loss, Sensorineural ; complications ; drug therapy ; Hearing Loss, Sudden ; complications ; drug therapy ; Hearing Tests ; Humans ; Injection, Intratympanic ; Salvage Therapy ; Treatment Outcome

OBJECTIVE: To evaluate the clinical efficacy on the treatment of the low-middle frequency sudden hearing loss with postaurical injection of methylprednisolone. METHOD: The 80 cases of the low-middle frequency sudden hearing loss were randomly divided into postaurical injection and oral hormone groups. The postaurical injection group (42 cases) received the postaurical injection of methylprednisolone, 40 mg/2 d, combined with the treatment of Ginkgo dipyidamolum and Alprostadil for 14 d; The oral hormone group (38 cases) received the oral prednisone, 1 mg/kg/d, administrated once on the morning for 3 d, if effective, prolonging for another 2 d, as mentioned above for Ginkgo dipyidamolum and Alprostadil. RESULT: The total effective rate was 88.10% in postaurical injection group and 86. 4o%in oral hormone group. There was no significant difference between the twbogroups( P> 0. 5). CONCLUSION Postaurical injection of methylprednisolone for the low-middle frequency sudden hearing loss is effective, safe and simple, which may be an alternative for systemic administration of gulcocorticoid.
Alprostadil ; therapeutic use ; Biological Products ; therapeutic use ; Glucocorticoids ; administration & dosage ; therapeutic use ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; drug therapy ; Humans ; Injections ; Methylprednisolone ; administration & dosage ; therapeutic use ; Prednisone ; administration & dosage ; therapeutic use ; Treatment Outcome

OBJECTIVE: To explore the effective treatment of sudden sensorineural hearing loss and factors affecting its prognosis. METHOD: The clinical data and follow-up results of 164 patients with sudden sensorineural hearing loss were analyzed retrospectively. All the 164 patients were given intravenous vasodilator, neurotrophic drugs treatment, oral prednisone treatment, and intratympanic dexamethasone injection. All patients were divided into low frequency hearing loss type,intermediate frequency hearing loss, high frequency hearing loss, all frequency hearing loss and total deafness group. Pure tone hearing threshold test were performed before and 3 months after treatment. All patients and different groups were compared before and after treatment damage frequency of average air conduction and various frequency air conduction hearing. Analysis of gender, age, process and hearing curve type, frequency hearing of impaired before treatment, the symptoms with or without vertigo. RESULT: All the patients' hearing improved after treatment. The treatment efficiency was 46.3%, and low frequency hearing improvements were better than the high frequency hearing. Including age, process, frequency hearing of impaired before treatment, with or without vertigo isindependent factors influencing its prognosis. CONCLUSION Based on the regular treatment,oral and intratympanic injection glucocorticoid therapy are safe and effective for sudden hearing loss,The prognosis and age, course, impaired hearing before curve type, treatment frequency hearing level is closely related, with or without vertigo.
Administration, Oral ; Audiometry, Pure-Tone ; Deafness ; diagnosis ; drug therapy ; Dexamethasone ; therapeutic use ; Hearing Loss, High-Frequency ; diagnosis ; drug therapy ; Hearing Loss, Sensorineural ; diagnosis ; drug therapy ; Hearing Loss, Sudden ; diagnosis ; drug therapy ; Humans ; Prednisone ; therapeutic use ; Prognosis ; Retrospective Studies ; Treatment Outcome ; Tympanic Membrane ; Vasodilator Agents ; Vertigo ; complications

OBJECTIVE: To assess the efficacy and safety of glucocorticoid in initial treatment of sudden hearing loss with intratympanic (IT) and systemic ways. METHOD: We searched the database of PubMed, Cochrane, Embase,CBM, CNKI, VIP, Wanfang systematically. Literatures were screened according to the preestablished inclusion and exclusion standards,and all the RCT literatures associated with intratympanic and systemic glucocorticoid in the initial treatment of sudden hearing loss before may 2015 were collected. All the data, which meet the inclusion standards, were analyzed by using Meta-analysis software. RESULT: Among all the qualified literatures, 11 randomized controlled trials were included. A total of 1298 cases were involved, including 521 cases with intratympanic administration, 410 with IV-therapy, and 201 with oral therapy. Meta analysis results showed that there was significant difference of the total effective rate and improvement rate between the intratympanic and systemic administration. Intratympanic injection (P > 0.05) was more effective than systemic administration. There was no significant difference between intratympanic group and oral group (RR = 1.15, 95% CI: 0.92-1.42, P > 0.05). A significant difference of the effective rate occurred between intratympanic group and IV therapy group (RR = 1.17, 95% CI: 1.02-1.34, P < 0.05). The major complications of intratympanic were pain, dizziness/vertigo, which occurred more frequently than systemic therapy group; The major complications of systemic therapy group were hyperglycaemia, loss of appetite and insomnia. CONCLUSION This study shows that the intratympanic (IT) glucocorticoid for sudden deafness is more effective than the systemic administration. But it was not the first choice in clinical treatment. Further studies are warranted.
Administration, Oral ; Glucocorticoids ; administration & dosage ; therapeutic use ; Hearing Loss, Sudden ; drug therapy ; Humans ; Hyperglycemia ; Injection, Intratympanic ; Randomized Controlled Trials as Topic ; Steroids ; administration & dosage ; therapeutic use ; Treatment Outcome

OBJECTIVE: To study the clinical efficacy of mouse nerve growth factor (NGF) in the treatment of sudden deafness. METHOD: A retrospective analysis was performed on 115 cases of hospitalized patients who were suffered from sudden deafness. Patients were divided into two groups according to treatment medicine. Control group: patients were treated with intravenous vasodilators, energy mixture, steroid pulse therapy, and methylcobalamin neurotrophic therapy. NGF group: intramuscular NGF treatment was added on the basis of conventional therapy mentioned above. Both treatments lasted 14 days, the total efficiency were compared. Patients were further divided into sub-groups according to age, duration and the level of pre-treatment PTA, and the treatment efficiency was further compared. By SPSS 11.0 statistical analysis, a P < 0.05 was considered as statistical significant difference. RESULT: (1) The total efficiency of NGF group was significantly higher than control group. (2) Regard of age, the efficiency of NGF treatment group was significantly higher than control group. (3) For the patients whose duration were less than 7 d, or the PTA < or = 60 dBHL, the efficiency of NGF group were significantly higher. For the patients whose duration were more than 7 d, or the PTA>60 dBHL, the efficiency of NGF therapy was not superior to the traditional treatment. CONCLUSION NGF can significantly improve the symptom of patients with short duration or low PTA. For this kind of patients, NGF adjuvant therapy should be recommended. For the patients with longer duration and higher level of PTA, NGF therapy is not advocated. NGF treatment should not be in consideration of the age.
Adolescent ; Adult ; Aged ; Female ; Hearing Loss, Sudden ; drug therapy ; Humans ; Male ; Middle Aged ; Nerve Growth Factor ; therapeutic use ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVE: To investigate the clinical features and therapeutic effects of sudden deafness after radiotherapy combined with chemotherapy in nasopharyngeal carcinoma patients. METHOD: Clinical data of 42 nasopharyngeal carcinoma patients suffered from sudden deafness after radiotherapy combined with chemotherapy were analyzed retrospectively. Among the 42 patients, 2 showed moderate deafness, 4 presented excessive deafness, 30 suffered from severe deafness, and 6 exhibited profound deafness. The audiogram pattern of 33 patients met with the type of high tone frequencies hearing loss, and that of the rest 9 cases showed hearing loss at all frequencies. All patients received medical therapy combined with hyperbaric oxygen therapy. RESULT: Of all the cases with hearing loss, 2 were cured, 2 showed excellent recovery, 9 came out partial recovery, and 29 showed no response to the treatment. The total effective rate was 30.95%. For the accompanied symptoms, none of the 30 cases of tinnitus were relieved, 3 out of 10 cases of aural fullness were cured, and the 5 cases of dizziness or vertigo were all improved. CONCLUSION The sudden deafness after radiotherapy combined with chemotherapy in patients with nasopharyngeal carcinoma is closely related to radiotherapy. The hearing loss is serious, and the therapeutic effects are not satisfactory.
Antineoplastic Agents ; adverse effects ; Carcinoma ; Dizziness ; etiology ; therapy ; Hearing Loss, High-Frequency ; etiology ; therapy ; Hearing Loss, Sudden ; etiology ; therapy ; Hearing Tests ; Humans ; Hyperbaric Oxygenation ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; drug therapy ; radiotherapy ; Radiotherapy ; adverse effects ; Retrospective Studies ; Tinnitus ; etiology ; therapy ; Vertigo ; etiology ; therapy