1.Clinical characteristics of sudden sensorineural hearing loss patients accompanying diabetes mellitus and efficacy analysis via propensity score matchin.
Xiaohui ZHAO ; Suwei MA ; Qingxuan CUI ; Jiao ZHANG ; Dayong WANG ; Qiuju WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(3):207-213
Objective:To summarize and analyze the clinical characteristics of patients with sudden sensorineural hearing loss(SSHL) accompanying diabetes mellitus, to explore whether diabetes affects the treatment outcomes during hospitalization, and to identify the factors influencing the efficacy of SSHL patients with diabetes. Methods:A retrospective analysis was conducted on clinical data from 939 patients with SSHL. The baseline characteristics, and onset conditions of the diabetes group(79 cases) and the non-diabetes group(860 cases) were compared. Propensity score matching(PSM) was applied in a 1︰ 2 ratio to match initial hearing levels with baseline characteristics such as age, sex, and BMI, resulting in 73 diabetes cases and 144 non-diabetes cases for treatment efficacy comparison. For the analysis of prognostic factors, a logistic regression model was established based on the treatment outcomes of 217 patients with SSHL. Results:The proportion of SSHL patients accompanying diabetes was 8.40%(79/939). Compared to non-diabetic patients, those with diabetes were older(median age of 53 years in the diabetes group and 39 years in the non-diabetes group) and had a higher proportion of hypertension(43.04% vs 12.67%), with significant difference observed(P<0.05). After PSM, the treatment efficacy during hospitalization was better in the diabetes group than in the non-diabetes group(58.90% vs 47.92%), although the difference was not statistically significant(P>0.05). The prognosis of patients with SSNHL accompanied by diabetes was analyzed using a multivariate logistic regression model that included age, HDL-C, and INR as variables; however, no statistically significant differences were found(P>0.05). Conclusion:Patients with SSHL accompanying diabetes are generally older with a higher incidence of hypertension. The presence of diabetes does not affect the treatment outcomes during hospitalization.
Humans
;
Propensity Score
;
Retrospective Studies
;
Hearing Loss, Sensorineural/therapy*
;
Hearing Loss, Sudden/therapy*
;
Middle Aged
;
Diabetes Mellitus
;
Male
;
Female
;
Prognosis
;
Adult
;
Logistic Models
;
Diabetes Complications
;
Aged
;
Treatment Outcome
2.Prospective randomised controlled observation of tympanic chamber injection of gangliosides in the treatment of refractory sudden deafness.
Mengyuan WANG ; Qi DONG ; Yuqin XU ; Yaxiu LI ; Jing LIU ; Jie LI ; Wenyan ZHU ; Wandong SHE
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(3):218-222
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
3.Clinical characteristics and therapeutic effect analysis of blast-induced hearing loss.
Yang CAO ; Xiaonan WU ; Jin LI ; Hongyang WANG ; Qiuju WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(3):228-238
Objective:To investigate the clinical characteristics and treatment outcomes of patients with blast-induced hearing loss(BIHL). Methods:The clinical features, laboratory parameters, audiometric profiles, and treatment efficacy of patients with blast induced hearing loss and those with idiopathic sudden hearing loss(ISHL) were analyzed using t-tests, Wilcoxon rank-sum tests, and chi-square tests, with a significance level set at P<0.05. Results:A total of 59 patients in the BIHL group and 117 patients in the ISHL group were included in this study. The mean age of the BIHL group was(39.07±14.49) years, comprising 45 males and 14 females. After the blast, 21 patients went to the hospital within the initial 14-day period, and an additional 38 patients seeking admission thereafter. In the BIHL group, 33 patients had unilateral hearing loss with PTA of (50.30±28.85) dB HL, while 26 had bilateral hearing loss with a PTA of(44.54±26.22) dB HL. In comparison, among the ISHL group, 112 patients had unilateral hearing loss with a PTA of(56.28±14.19) dB HL, and 5 had bilateral involvement with a PTA of(56.25±35.14) dB HL. The effective treatment rate within 14 days for the BIHL group was 31.8%, while for the ISHL group, the effective rate within 14 days was 77.0%. Conclusion:Blast-induced hearing loss is caused by exposure to high-intensity noise. The overall treatment effectiveness during hospitalization is lower compared to idiopathic sudden hearing loss, and the treatment window is shorter. Therefore, greater emphasis should be placed on prevention.
Humans
;
Male
;
Female
;
Adult
;
Middle Aged
;
Young Adult
;
Blast Injuries/therapy*
;
Treatment Outcome
;
Hearing Loss, Sudden/etiology*
;
Adolescent
;
Hearing Loss, Noise-Induced/diagnosis*
4.Amplification effect of hearing mechanics in unilateral hearing loss.
Quanran LIN ; Kai FANG ; Wendi SHI ; Yuan WANG ; Shihua ZHA ; Yang LI ; Yonghua WANG ; Zhengnong CHEN
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(3):239-242
Objective:To evaluate the effectiveness of amplification intervention with hearing aids for restoring binaural auditory function in patients with unilateral moderate to severe sensorineural hearing loss. Methods:This study selected 30 patients with normal hearing in one ear and moderate to severe sensorineural hearing loss in the other ear. They were fitted with hearing aids for the worse ear and underwent more than half a year and one year of adaptation training. The Chinese translation of the Twelve-item version of SSQ(C-SSQ12), angle identification test, speech recognition score(SRS) at different signal-to-noise ratios(SNR=5 and SNR=10) and audiometric thresholds were used to compare the results before and after hearing aid use to evaluate the effectiveness of the unilateral hearing loss intervention. Results:The results of the audiometric thresholds, C-SSQ12 scores, angle identification test, and SRS at SNR=5 and SNR=10 in the worse ear of the unilateral hearing loss patients after hearing aid use were all statistically significant compared to before hearing aid use(P<0.01). Conclusion:Amplification intervention with hearing aids has significant effects on restoring binaural auditory function in patients with unilateral moderate to severe sensorineural hearing loss.
Humans
;
Hearing Aids
;
Hearing Loss, Unilateral/therapy*
;
Middle Aged
;
Hearing Loss, Sensorineural/rehabilitation*
;
Adult
;
Female
;
Male
;
Auditory Threshold
;
Young Adult
;
Aged
5.Study on gene therapy for DPOAE and ABR threshold changes in adult Otof-/- mice.
Zijing WANG ; Qi CAO ; Shaowei HU ; Xintai FAN ; Jun LV ; Hui WANG ; Wuqing WANG ; Huawei LI ; Yilai SHU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(1):49-56
Objective:This study aims to analyze the threshold changes in distortion product otoacoustic emissions(DPOAE) and auditory brainstem response(ABR) in adult Otof-/- mice before and after gene therapy, evaluating its effectiveness and exploring methods for assessing hearing recovery post-treatment. Methods:At the age of 4 weeks, adult Otof-/- mice received an inner ear injection of a therapeutic agent containing intein-mediated recombination of the OTOF gene, delivered via dual AAV vectors through the round window membrane(RWM). Immunofluorescence staining assessed the proportion of inner ear hair cells with restored otoferlin expression and the number of synapses.Statistical analysis was performed to compare the DPOAE and ABR thresholds before and after the treatment. Results:AAV-PHP. eB demonstrates high transduction efficiency in inner ear hair cells. The therapeutic regimen corrected hearing loss in adult Otof-/- mice without impacting auditory function in wild-type mice. The changes in DPOAE and ABR thresholds after gene therapy are significantly correlated at 16 kHz. Post-treatment,a slight increase in DPOAE was observeds,followed by a recovery trend at 2 months post-treatment. Conclusion:Gene therapy significantly restored hearing in adult Otof-/- mice, though the surgical delivery may cause transient hearing damage. Precise and gentle surgical techniques are essential to maximize gene therapy's efficacy.
Mice
;
Animals
;
Otoacoustic Emissions, Spontaneous/physiology*
;
Hearing/physiology*
;
Ear, Inner
;
Hearing Loss/therapy*
;
Genetic Therapy
;
Auditory Threshold/physiology*
;
Evoked Potentials, Auditory, Brain Stem/physiology*
;
Membrane Proteins
6.Research on the prognosis and efficacy criteria of sudden sensorineural hearing loss.
Changshuo SHAN ; Dayong WANG ; Qiuju WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(11):1085-1090
Sudden sensorineural hearing loss is a common and frequently-occurring disease. Looking at the efficacy evaluation of the diagnosis and treatment of sudden sensorineural hearing loss at home and abroad, each country has its own characteristics in the indicators and criteria of the treatment efficacy evaluation, and the common indicators of efficacy evaluation include: average pure-tone hearing threshold, the absolute value of hearing improvement of impaired frequency, the percentage of average pure-tone hearing threshold increase, speech discrimination score, speech recognition threshold, etc. The evaluation criteria mostly take the efficacy grade or the improvement level of average hearing threshold as the criterion of effective treatment, and the lack of unified standards is not conducive to the homogenization of global research related to sudden sensorineural hearing loss. In order to provide reference for the clinical evaluation of sudden sensorineural hearing loss in China, this study systematically reviewed the clinical practice guidelines and the evaluation indexes and criteria of clinical efficacy in high quality clinical multicenter studies of the disease in many countries.
Humans
;
Hearing Loss, Sensorineural/diagnosis*
;
Hearing Loss, Sudden/therapy*
;
Prognosis
;
Audiometry, Pure-Tone
;
China
;
Auditory Threshold
;
Treatment Outcome
7.Long-term evaluation and physical and mental effects of residual tinnitus following treatment of sudden hearing loss.
Xin PENG ; Xiao Hua ZHU ; Bang Qing HUANG ; Zi Yi ZHAO ; Qiu Jing ZHANG ; Li ZHU ; Fang Yuan WANG ; Ming Fang DIAO ; Zhao Hui HOU ; Yu Hua ZHU
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2023;58(1):42-46
Objective: To clarify the long-term characteristics of tinnitus following treatment of sudden deafness and its long-term physical and mental effects on patients. Methods: A retrospective analysis was performed on 88 patients (46 males and 42 females; Age from 11 to 89 years) with sudden deafness treated in Department of Otoscope Surgery of Peoples's Libration Army General Hospital in Beijing from April 2020 to January 2021, and the occurrence of tinnitus and treatment effect of all patients were analyzed. Follow-up was conducted for patients with residual tinnitus after treatment for more than 1 year by the investigation and filling in the survey information collection form, Tinnitus Evaluation Questionnaire (TEQ) and Tinnitus Handicap Inventory (THI). Descriptive statistics and SPSS 22.0 software were used for statistical data analysis. Results: In this study, 93.2% (82/88) of patients with sudden deafness were accompanied by tinnitus at the onset, and the proportion of long-term tinnitus after treatment was 90.2% (74/82). After 1 year of treatment for sudden deafness, the improvement of tinnitus was significant in low-frequency sudden deafness compared with those of high-frequency, flat and total deafness sudden deafness (χ2 value was 6.801, 4.568 and 4.038, all P<0.05). In patients with residual tinnitus, 9 (12.2%) patients felt minimal loudness or even no loudness, 34 (46.0%) patients felt slight loudness, 28 (37.8%) patients felt tinnitus was relatively loud, and 3 (4.1%) patients felt tinnitus was loud or noisy. Nine (12.2%) patients's sleep was often affected, 41 (55.4%) patients's sleep was sometimes affected, 9 (12.2%) patients's sleep was rarely affected, 15 (20.3%) patients's sleep was almost not affected. Twenty-eight (37.8%) patients basically completely adapted to tinnitus and 46 (62.2%) patients did not completely adapted to residual tinnitus. Eight (10.8%) patients had no impact on life, 39 (52.7%) patients had slight impact, 22 (29.7%) patients had moderate impact, and the other 5 (6.8%) patients had greater impact. According to tinnitus evaluation questionnaire(TEQ), there were 12 cases (16.2%) of grade Ⅰ, 26 cases (35.1%) of grade Ⅱ, 28 cases (37.8%) of grade Ⅲ, 7 cases (9.5%) of grade Ⅳ and 1 case (1.4%) of grade Ⅴ. According to tinnitus handicap inventory(THI), tinnitus disability was classified into grade Ⅰ, 22 cases (29.7%), grade Ⅱ, 14 cases (18.9%), Grade Ⅲ, 27 cases (36.5%) and grade Ⅳ, 11 cases (14.9%). Conclusion: The rate of residual tinnitus following treatment of sudden deafness is high. Some of the patients can completely adapt residual tinnitus after one year, but some of them will be affected when sleep, work and study. Residual tinnitus can lead to tinnitus disability in different degrees.
Male
;
Female
;
Humans
;
Child
;
Adolescent
;
Young Adult
;
Adult
;
Middle Aged
;
Aged
;
Aged, 80 and over
;
Hearing Loss, Sudden/therapy*
;
Tinnitus/therapy*
;
Retrospective Studies
;
Deafness/complications*
;
Audiometry
9.Medical Therapy of Hearing Impairment and Tinnitus with Chinese Medicine: An Overview.
Ying ZHANG ; Hui XIE ; Zhong-Mei HE ; Feng ZHANG ; Ling-Long LI ; Na WANG ; De-Hong MAO
Chinese journal of integrative medicine 2023;29(8):761-768
The current review gives a comprehensive overview of the recent development in Chinese medicine (CM) for treating several kinds of acquired nerve deafness and tinnitus, as well as links the traditional principle to well-established pharmacological mechanisms for future research. To date, about 24 herbal species and 40 related ingredients used in CM to treat hearing loss and tinnitus are reported for the treatment of endocochlear potential, endolymph growth, lowering toxic and provocative substance aggregation, inhibiting sensory cell death, and retaining sensory transfer. However, there are a few herbal species that can be used for medicinal purposes. Nevertheless, clinical studies have been hampered by a limited population sample, a deficiency of a suitable control research group, or contradictory results. Enhanced cochlear blood flow, antiinflammatory antioxidant, neuroprotective effects, and anti-apoptotic, as well as multi-target approach on different auditory sections of the inner ear, are all possible benefits of CM medications. There are numerous unknown natural products for aural ailment and tinnitus identified in CM that are expected to be examined in the future utilizing various aural ailment models and processes.
Humans
;
Tinnitus/drug therapy*
;
Medicine, Chinese Traditional
;
Hearing Loss/drug therapy*
10.Clinical analysis of 11 cases of otogenic intracranial complications treated by multidisciplinary collaboration.
Zhongyi SONG ; Wenjie LIU ; Ning WANG ; Ying FU ; Zejing LI ; Chunfang WANG ; Yongqiang SUN
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(10):819-828
Objective:To analyze the clinical diagnosis, treatment ,and surgical timing of otogenic intracranial complications. Methods:The clinical data of 11 patients with intracranial complications with ear symptoms as the first manifestation in Department of Otorhinolaryngology Head and Neck Surgery, Qilu Hospital of Shandong University(Qingdao) from December 2014 to June 2022 were collected, including 8 males and 3 females, aged from 4 to 69 years. All patients had complete otoendoscopy, audiology, imaging and etiology examination, and the diagnosis and treatment plan was jointly developed through multidisciplinary consultation according to the critical degree of clinical symptoms and imaging changes. Among the 11 patients, 5 cases were treated with intracranial lesions first in neurosurgery department and middle ear lesions later in otolaryngology, 3 cases of meningitis, were treated with middle ear surgery after intracranial infection control, 1 case was treated with middle ear lesions and intracranial infection simultaneously, and 2 cases were treated with sigmoid sinus and transverse sinus thrombosis conservatively. They were followed up for 1-6 years. Descriptive statistical methods were used for analysis. Results:All the 11 patients had ear varying symptoms, including ear pain, pus discharge and hearing loss, etc, and then fever appeared, headache, disturbance of consciousness, facial paralysis and other intracranial complication. Otoendoscopy showed perforation of the relaxation of the tympanic membrane in 5 cases, major perforation of the tension in 3 cases, neoplasia in the ear canal in 1 case, bulging of the tympanic membrane in 1 case, and turbidity of the tympanic membrane in 1 case. There were 4 cases of conductive hearing loss, 4 cases of mixed hearing loss and 3 cases of total deafness. Imaging examination showed cholesteatoma of the middle ear complicated with temporal lobe brain abscess in 4 cases, cerebellar abscess in 2 cases, cholesteatoma of the middle ear complicated with intracranial infection in 3 cases, and sigmoid sinus thrombophlebitis in 2 cases. In the etiological examination, 2 cases of Streptococcus pneumoniae were cultured in the pus of brain abscess and cerebrospinal fluid, and 1 case was cultured in streptococcus vestibularis, Bacteroides uniformis and Proteus mirabilis respectively. During the follow-up, 1 patient died of cardiovascular disease 3 years after discharge, and the remaining 10 patients survived. There was no recurrence of intracranial and middle ear lesions. Sigmoid sinus and transverse sinus thrombosis were significantly improved. Conclusion:Brain abscess, intracranial infection and thrombophlebitis are the most common otogenic intracranial complications, and cholesteatoma of middle ear is the most common primary disease. Timely diagnosis, multidisciplinary collaboration, accurate grasp of the timing in the treatment of primary focal and complications have improved the cure rate of the disease.
Female
;
Humans
;
Male
;
Brain Abscess/therapy*
;
Cholesteatoma
;
Deafness/etiology*
;
Hearing Loss/etiology*
;
Lateral Sinus Thrombosis/therapy*
;
Retrospective Studies
;
Thrombophlebitis/therapy*
;
Child, Preschool
;
Child
;
Adolescent
;
Young Adult
;
Adult
;
Middle Aged
;
Aged
;
Cholesteatoma, Middle Ear/therapy*
;
Central Nervous System Infections/therapy*
;
Sinus Thrombosis, Intracranial/therapy*
;
Ear Diseases/therapy*

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