Middle ear adenoma is a very rare disease which is benign and originates from the middle ear mucosa. Patients of middle ear adenoma usually come to the clinic for unilateral hearing loss or tinnitus, but rarely for accompanied facial palsy. It is non-gender specific and occurs over a wide range of ages. The recurrence rate is known to be very low, but few authors argue that neuroendocrine adenoma should be considered as a low grade carcinoma due to some cases of recurrence. A 18 years-old male who had a left side facial palsy about 3 years ago but has currently improved as compared with the initial onset, visited our clinic for the left side hearing loss. Pure tone audiogram showed about 30 dB of conductive hearing loss and a pinkish polypoid mass involving the left tympanic membrane. We removed a tumor via transmastoid approach. The final diagnosis was middle ear adenoma with neuroendocrine differentiation. Neither signs of complication nor recurrence were observed after six months of the surgery.
Adenoma ; Diagnosis ; Ear, Middle ; Facial Paralysis ; Hearing Loss ; Hearing Loss, Conductive ; Hearing Loss, Unilateral ; Hearing ; Humans ; Male ; Mucous Membrane ; Rare Diseases ; Recurrence ; Tinnitus ; Tympanic Membrane

OBJECTIVE: To evaluate the characteristics and prognosis of sudden sensorineural hearing loss through vestibular evoked myogenic potentials. METHOD: Fifty patients with unilateral sudden hearing loss underwent an ear test battery, including audiometry, cervical vestibular evoked myogenic potential (cVEMP) and ocular vestibular evoked myogenic potential(oVEMP). The cVEMP and oVEMP in patients with sudden sensorineural hearing loss were investigated. Their associations with initial hearing threshold, the type of audiogram, the results of coloric test and hearing recovery were also accessed. RESULT: After one-month treatment, the average threshold declined significantly in affected ears, with normal VEMP rates improved significantly (P < 0.05). Initial hearing threshold and hearing recovery were significantly associated with the results of coloric test and the results of VEMP test (P < 0.05). CONCLUSION Our study indicated that vestibular evoked myogenic potential examination was not only a useful additional diagnostic tool in the neurotological evaluation of patients suffering sudden hearing loss, but also very valuable in the prognosis of sudden sensorineural hearing loss.
Hearing Loss, Sensorineural ; diagnosis ; Hearing Loss, Sudden ; diagnosis ; Hearing Loss, Unilateral ; diagnosis ; Hearing Tests ; Humans ; Otolithic Membrane ; physiopathology ; Prognosis ; Vestibular Evoked Myogenic Potentials

OBJECTIVE: The aim of this retrospective study was to analyze the recovery rate of sudden sensorineural hearing loss in children, and explore the prognostic factors in order to guide the clinical diagnosis and treatment. METHOD: A retrospective review was conducted for the prognosis of children with sudden sensorineural hearing loss during the past 5 years (from November 2010 to May 2015) in Chinese PLA General Hospital. This paper have a complete clinical data of 101 patients (113 ears)with sudden hearing loss, ranging from 0 to 18 years old Patients were divided into four groups according to hearing recovery and eight putative prognostic factors were analyzed. RESULT: Among 101 patients (113 ears), the ratio of male and female was 60:53. Treatment was initiated from 1 to 183 days after disease onset, with an average of (18.5 ± 22.1) d. Bilateral and unilateral hearing loss were 24 ears and 89 ears, respectively. The proportion of mild hearing loss, moderate hearing loss, severe hearing loss and profound hearing loss were 7.1%, 6.2%, 23.9% and 62.8%, respectively. Vertigo and tinnitus occurred in 54.9% and 77.9% of the patients, respectively. After the treatment, the complete recovery rate was 9.7% and the overall recovery rate was 36.3%. The degree of hearing loss, earlier treatment onset, sex and bilateral involvement were significantly associated with hearing recovery (P < 0.05). CONCLUSION Sudden sensorineural hearing loss in children was generally identified as severe and profound hearing loss, but after positive and timely treatment, it can be improved or even cured. The mild hearing loss, earlier treatment onset, unilateral hearing loss and female were positive prognostic factors. The concurrence of tinnitus or vertigo, the results of ABR and DPOAE had no significant influence on prognosis.
Adolescent ; Child ; Child, Preschool ; Female ; Hearing Loss, Sensorineural ; diagnosis ; Hearing Loss, Sudden ; diagnosis ; Hearing Loss, Unilateral ; diagnosis ; Hearing Tests ; Humans ; Infant ; Infant, Newborn ; Male ; Prognosis ; Retrospective Studies ; Tinnitus ; complications ; Vertigo ; complications

BACKGROUND AND OBJECTIVES: ZLow frequency hearing loss is known to be the most common hearing loss form in Meniere's disease (MD) and episodic dizziness with low frequency sensorineural hearing loss is considered a very crucial symptom for the diagnosis of MD. However, flat or high frequency hearing loss is also commonly encountered in the Ear, Nose and Throat clinic. The aim of this study is to investigate the differences in clinical manifestation between episodic dizzy patients with low frequency hearing loss (LFHL) group and non-low frequency hearing loss (non-LFHL) group. SUBJECTS AND METHOD: We reviewed medical records of 78 patients (36 of LFHL group and 42 of non-LFHL group) who had episodic dizziness with unilateral hearing loss and analyzed clinical characteristics according to hearing loss pattern. RESULTS: The clinical features of LFHL include a predominance of female sufferers, high incidence of tinnitus and short duration of dizziness. There was no significant difference in frequency, nature of dizziness, and results of vestibular function test. Although the proportion of patients diagnosed with definite MD was higher in LFHL group at initial and final diagnosis, there were no statistically significant differences between two groups. CONCLUSION: Therefore, when episodic dizziness is accompanied with unilateral hearing loss, not only low frequency but flat or high frequency hearing loss could be considered as a critical sign for possible progression to Meniere's disease and careful observation should be taken.
Diagnosis ; Dizziness* ; Ear ; Female ; Hearing Loss* ; Hearing Loss, Sensorineural ; Hearing Loss, Unilateral* ; Humans ; Incidence ; Medical Records ; Meniere Disease ; Nose ; Pharynx ; Tinnitus ; Vestibular Function Tests

BACKGROUND AND OBJECTIVES: Unilateral auditory dysfunction such as tinnitus and hearing loss could be a warning sign of a retrocochlear lesion. Auditory brainstem response (ABR) and internal auditory canal magnetic resonance image (MRI) are suggested as novel diagnostic tools for retrocochlear lesions. However, the high cost of MRI and the low sensitivity of the ABR test could be an obstacle when assessing patients with unilateral ear symptoms. The purpose of this study was to introduce the clinical usefulness of three-dimensional fast imaging employing steady-state acquisition (3D-FIESTA) MRI in patients with unilateral ear symptoms. SUBJECTS AND METHODS: Two hundred and fifty-three patients with unilateral tinnitus or unilateral hearing loss who underwent 3D-FIESTA temporal bone MRI as a screening test were enrolled. We reviewed the abnormal findings in the 3D-FIESTA images and ear symptoms using the medical records. RESULTS: In patients with unilateral ear symptoms, 51.0% of the patients had tinnitus and 32.8% patients were assessed to have sudden sensory neural hearing loss. With 3D-FIESTA imaging, twelve patients were diagnosed with acoustic neuroma, four with enlarged vestibular aqueduct syndrome, and two with posterior inferior cerebellar artery aneurysm. Inner ear anomalies and vestibulocochlear nerve aplasia could be diagnosed with 3D-FIESTA imaging. CONCLUSIONS: 3D-FIESTA imaging is a highly sensitive method for the diagnosis of cochlear or retrocochlear lesions. 3D-FIESTA imaging is a useful screening tool for patients with unilateral ear symptoms.
Aneurysm ; Arteries ; Diagnosis ; Ear ; Ear, Inner* ; Evoked Potentials, Auditory, Brain Stem ; Hearing Loss ; Hearing Loss, Unilateral ; Humans ; Magnetic Resonance Imaging ; Mass Screening ; Medical Records ; Methods ; Neuroma, Acoustic ; Retrocochlear Diseases ; Temporal Bone ; Tinnitus ; Vestibular Aqueduct ; Vestibulocochlear Nerve

The present study was undertaken to learn the outcome of patients with idiopathic sudden sensorineural hearing loss (ISSNHL) in their only hearing ear. Timing to conduct a cochlear implantation was also determined in those who did not recover the hearing. The study group comprised 25 patients who confronted ISSNHL in their only hearing ear. A total of 192 patients, who had ISSNHL in one ear and had normal contralateral ear, served as the control. Demographically there were no significant differences between the groups. The recovery rate was similar between the groups: 64.0% in the experimental and 62.5% in the control group. The duration until the recovery of ISSNHL in the only hearing ear was 5-90 days (average 17.6 days). In the experimental group, 8 patients did not recover from ISSNHL, and underwent cochlear implantation in 6 with satisfactory results. These results suggest that the same treatment is applicable for patients with ISSNHL regardless of whether their contralateral ear is deaf or normal. For those who do not recover from ISSNHL in their only hearing ear, culminating in bilateral deafness, we may consider further definitive treatment including cochlear implantation as early as 3 months after initiating the treatment of ISSNHL.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; *Cochlear Implantation ; Demography ; Female ; Hearing Loss, Sudden/surgery/*therapy ; Hearing Loss, Unilateral/*diagnosis ; Humans ; Male ; Middle Aged ; Patient Selection ; Retrospective Studies ; Severity of Illness Index ; Treatment Outcome

OBJECTIVE: To analyze the clinical characteristics and treatment effect between bilateral (bi-) and unilateral (uni-) sudden sensorineural hearing loss (SSNHL). METHOD: Four hundred and eighty cases of SSNHL were retrospective study, which were divided into two groups of bi-SSNHL (n = 40) and uni-SSNHL (n = 440). Clinical characteristics and treatment effects were compared of the two groups. RESULT: The incidence rate of bi-SSNHL was 8.3 percent and uni-SSNHL was 91.7 percent of all patients with SSNHL. Bi-SSNHL occurs more commonly in patients of old age, diabetes mellitus, and lipid panes abnormalities compared to uni-SSNHL. Twenty-eight ears in the bi-SSNHL group showed hearing recovery (35%), compared with 56.4 percent of patients with uni-SSNHL. CONCLUSION Bi-SSNHL and uni-SSNHL may have a completely different clinical characteristics and treatment effect, that implies a different pathophysiology and prognosis. Recognition their different clinical characteristics and treatment effect between bilateral and unilateral SSNHL can help in counseling and managing the patients and correctly evaluate the prognosis.
Adult ; Female ; Hearing Loss, Bilateral ; diagnosis ; therapy ; Hearing Loss, Sudden ; diagnosis ; therapy ; Hearing Loss, Unilateral ; diagnosis ; therapy ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: To investigate the audiological characteristics in unilateral auditory neuropathy (UAN). METHOD: By the retrospective studies, 11 patients which were diagnosed as UAN and bilateral auditory neuropathy (AN) group and control group were measured. RESULT: By the statistical studies of patients from otology clinic data from January 2001 to September 2006,11 patients (11 ear, 5 left ear and 6 right ear, 3.2%) in 340 AN patients diagnosed as UAN were summarized. Four patient were male and 7 were female in 11 patients (1: 1.75). The average age of 11 patients was 20 years old and the average period of diseases was 3.1 years. All patients complained of unilateral gradual hearing loss, and 6 patients in all UAN patients can't discriminate speech correctly. Four patients complained of tinnitus and none of UAN patients complained of dizziness. The pure tone audiograms of 5 patients in all UAN patients (45.4%) were descending curve and those of 4 patients (36.4%) were ascending curve. Eleven patients mostly showed severity degree or midrange degree (6 ear, 54.5%) sensorineural hearing loss. The average pure tone threshold of UAN was obviously higher than the AN group and the speech hearing of UAN is obviously worse, and ABR of all patients was absent, while uninjured side of UAN was normal. Bilateral ears of UAN patients were evoked distortion products otoacoustic emissions. The amplitude of DP-gram and SNR in UAN group was lower obviously (P < 0.05) than the normal control group at all frequencies (0.5-8.0 kHz) and was lower significantly (P < 0.01) at flat and high-frequency, but was lower obviously (P < 0.01) than the AN group at low-frequency. The contralateral suppression effect of DPOAE amplitude in 4 UAN patients of normal ears was suppressed, and that in injured ears was reduced or disappeared, even 0.5 kHz increased DPOAE amplitude. ENG and VEMP were observed in 5 UAN patients, and 1 patients shows semicircular canal failure and 1 patients shows paralysis unilateral. The VEMP of them showed no response in 1 (2 ear) of 5 and showed response in 4 of 5, but the amplitudes of VEMP were lower in 2 UAN patients. CONCLUSION The UAN patients mostly showed ascending curve and ponderosity degree sensorineural hearing loss. The diagnosis of UAN is different from other common sensorineural deafness. The detection of DPOAE and ABR has great significance in diagnosing the UAN.
Adolescent ; Adult ; Audiometry, Pure-Tone ; Auditory Threshold ; Case-Control Studies ; Child ; Child, Preschool ; Evoked Potentials, Auditory, Brain Stem ; Female ; Hearing Loss, Central ; diagnosis ; physiopathology ; Hearing Loss, Unilateral ; diagnosis ; physiopathology ; Humans ; Male ; Retrospective Studies ; Young Adult

BACKGROUND AND OBJECTIVES: It is not easy to detect the small-sized vestibular schwannomas because they sometimes show atypical clinical presentation such as sudden deafness and detection by chance. However, it is very important to diagnose a vestibular schwannoma in the earlier stage to preserve facial nerve function and hearing. This study aimed to analyze clinical characteristics of small vestibular schwannomas and to make decision analysis of their diagnostic work-up. MATERIALS AND METHOD: we reviewed retrospectively 42 patients who were diagnosed with vestibular schwannoma of size less than 1.5cm at the Departments of Otolaryngology, Ajou University Hospital and Yonsei University Hospital from June, 1994 to May, 2002. This study analyzed chief complaints, size of tumor, audiological studies, caloric test, imaging study, and treatment modality. RESULT: Sixteen of 42 patients (38.1%) were in group IC , 20 patients (47.6%) for group 0 and 6 patients (14.3%) for group 1. One third of cases presented initial symptoms such as sudden hearing loss, the other third presented tinnitus, and 4 cases were detected by chance. Fourteen cases showed near normal hearing and auditory brainstem response (ABR) showed 76.2% sensitivity, which was relatively lower than we expected. CONCLUSION: Because acoustic neuroma was suspected in patients with unilateral hearing loss, tinnitus, and dizziness were very important considerations. We made the decision analysis in the diagnosis of small vestibular schwannoma. It consisted of earlier intervention of fast spin echo magnetic resonance imaging (MRI) based on a cost-effective approach.
Caloric Tests ; Decision Support Techniques ; Diagnosis ; Dizziness ; Evoked Potentials, Auditory, Brain Stem ; Facial Nerve ; Hearing ; Hearing Loss, Sudden ; Hearing Loss, Unilateral ; Humans ; Magnetic Resonance Imaging ; Neuroma, Acoustic* ; Otolaryngology ; Retrospective Studies ; Tinnitus

BACKGROUND AND OBJECTIVES: With great development that took place in the last 10 years in the imaging techniques such as MRI with gadolinium, small acoustic tumors can be detected before significant symptoms have developed. However, suspicion of acoustic neuroma is not easy at its earlier stage due to the lack of its characteristic symptoms. The detection rate of acoustic neuroma using traditional audiologic methods such as ABR and pure tone audiogram with speech discrimination score is relatively low contrary to expectation. Therefore, there is a need to develop other methods of diagnosis at an earlier stage. The aim of this study was to review symptomatology, diagnostic approach and the management of acoustic neuroma and to make a decision analysis tree of the diagnostic work-up. MATERIALS AND METHODS:From June 1994 through May 1998, eight patients with a small acoustic neuroma were treated at Ajou University Hospital. We analysed these 8 patients by age, sex, chief complaint, size of tumor, preoperative and postoperative audiologic studies, caloric test, treatment modalities and preoperative and postoperative imaging study. RESULTS: Acoustic neuroma had variable symptoms, with the most common initial symptom of our cases being sudden hearing loss. The sensitivity of ABR was relatively lower than we thought. Two out of three in the observation group showed an abrupt deterioration of hearing. CONCLUSION: When acoustic neuroma is suspected in patients with unilateral hearing loss, tinnitus and dizziness are very important symptoms to consider. We developed a decision analysis tree for diagnosis of small acoustic neuroma, which should be treated with earlier intervention of MRI.
Acoustics* ; Caloric Tests ; Decision Support Techniques* ; Diagnosis* ; Dizziness ; Gadolinium ; Hearing ; Hearing Loss, Sudden ; Hearing Loss, Unilateral ; Humans ; Magnetic Resonance Imaging ; Neuroma, Acoustic* ; Speech Perception ; Tinnitus