Clinical Practice Guideline: Sudden Hearing Loss

Stachler, Robert J.; Chandrasekhar, Sujana S.; Archer, Sanford M.; Rosenfeld, Richard M.; Schwartz, Seth

doi:10.1177/0194599811415818a59

Cited by 314 publications

(816 citation statements)

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“…On the contrary the smoking habit is a negative prognostic factor in the hearing recovery. We agree with the last recommendation of the American Academy in the field of SSHL [25] that considers the salvage intratympanic steroids as a recommended therapy.…”

Section: Resultssupporting

confidence: 78%

Sudden Sensorineural Hearing Loss: Results of intratympanic steroids as salvage treatment

Stefano

Costantino

Marchese

et al. 2013

American Journal of Otolaryngology

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Objective: The aim of the present study was to verify the efficacy and the safety of intratympanic dexamethasone to treat sudden sensorineural hearing loss as salvage therapy. Materials and methods: A prospective study was conducted on patients affected by idiopathic sudden hearing loss who were treated before with some systemic therapy, but without recovery of the hearing The patients able to undergo the study, but who refused salvage treatment were considered as control group. A solution of Dexamethasone 4 mg/ml was then injected through the posterior-inferior quadrant filling completely the middle ear.The follow-up in the following 6 months included an audiogram every month. Results: The number of patients treated with salvage therapy was 36. The patients who refused treatment were further 10. The salvage treatment was done with a mean delay of 24.3 days from the onset of symptoms. Mean hearing threshold after the onset of sudden hearing loss at PTA was 66.5 dB. After the failed treatment the mean PTA was 59.6 dB. The mean PTA after the intratympanic steroid administration was 46.8 dB, with a mean improvement of 12.8 dB. No hearing change was noted in the 10 patients who refused salvage therapy. The patients that assumed systemic steroid as first therapy showed a better PTA threshold after the salvage intratympanic treatment (p < 0.01). A significant difference (p < 0.05) of hearing recovery was evidenced between non-smoker patients and those with smoking habit. Conclusions: Our data showed that a salvage treatment with intratympanic dexamethasone should be suggested to all patients who failed the first systemic treatment. The systemic steroid therapy done before the salvage treatment seems to exert a protective role for the inner ear, as shown by our series. On the contrary the smoke habit is a negative prognostic factor in the hearing recovery.

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Section: Resultssupporting

confidence: 78%

Sudden Sensorineural Hearing Loss: Results of intratympanic steroids as salvage treatment

Stefano

Costantino

Marchese

et al. 2013

American Journal of Otolaryngology

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“…The most common diagnostic criteria are a sensorineural hearing loss of at least 30 dB over three consecutive frequencies occurring within a 72-h period (Stachler et al, 2012). SSNHL is generally unilateral, isolated and with variable clinical features in terms of hearing loss degree, accompanying symptoms and post-treatment outcomes.…”

Section: Introductionmentioning

confidence: 99%

Sudden sensorineural hearing loss: is there a relationship between routine haematological parameters and audiogram shapes?

Salvago

Rizzo

Bianco

et al. 2016

International Journal of Audiology

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Objective: To investigate the relationship between haematological routine parameters and audiogram shapes in patients affected by sudden sensorineural hearing loss (SSNHL). Design: A retrospective study. All patients were divided into four groups according to the audiometric curve and mean values of haematological parameters (haemoglobin, white blood cell, neutrophils and lymphocytes relative count, platelet count, haematocrit, prothrombin time, activated partial thromboplastin time, fibrinogen and neutrophil-to-lymphocite ratio) of each group were statistically compared. The prognostic role of blood profile and coagulation test was also examined. Study sample: A cohort of 183 SSNHL patients without comorbidities. Results: With a 48.78% of complete hearing recovery, individuals affected by upsloping hearing loss presented a better prognosis instead of flat (18.36%), downsloping (19.23%) and anacusis (2.45%) groups (p ¼ 0.0001). The multivariate analysis of complete blood count values revealed lower mean percentage of lymphocytes (p ¼ 0.041) and higher platelet levels (p ¼ 0.015) in case of downsloping hearing loss; with the exception of fibrinogen (p ¼ 0.041), none of the main haematological parameters studied resulted associated with poorer prognosis. Conclusions: Our work suggested a lack of association between haematological parameters and a defined audiometric picture in SSNHL patients; furthermore, only fibrinogen seems to influence the prognosis of this disease.

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“…American Society of Otolaryngology definition was used for sudden sensorineural hearing loss (SSHL), according to which SSHL is defined as greater than 30 dB hearing reduction, over at least three contiguous frequencies, occurring over a period of 72 hours or less. 13 Maximum axial AN diameter was considered the main measure outcome. The axial magnetic resonance image showing the largest tumor size was identified and measured.…”

Section: Methodsmentioning

confidence: 99%

Predictive factors of acoustic neuroma growth

Kikidis

Xenellis

Kyrodimos

et al. 2016

Int J Otorhinolaryngol Head Neck Surg

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Background:Since the use of magnetic resonance imaging (MRI) as the gold standard for acoustic neuroma diagnosis, the size of the majority of newly diagnosed acoustic neuromas has decreased. Management strategy is challenging, especially in young patients with small tumors. Therefore, prognostic factors for tumor growth may facilitate physicians to optimize treatment choice.Methods:Patients diagnosed with acoustic neuromas were recruited in this study. Gender, age, side, presence of hearing loss, tinnitus, vertigo, unsteadiness, other symptoms, hearing level in the affected ear and tumor growth at the first follow up MRI were recorded. Two primary endpoints were set: overall acoustic neuroma (AN) growth and growth correlated to treatment plan change (clinically significant growth). Multivariate and survival analysis were conducted to this end. Results:85 patients were finally included in the study. The most prevalent presenting symptoms were hearing loss (76%), tinnitus (56%) and unsteadiness (46%). The tumour grew in size in less than 50% of the cases during the observation period. Clinically significant growth was observed in 27% of the cases. Mean initial diameter was 10.41mm and mean final follow-up diameter (diameter at the end of the observation period) 12.73 mm. Following binary logistic regression analysis, tumour growth during the initial follow up visit was found to be correlated in a statistically significant level to overall tumour growth (p-value 0.023). Regarding clinically significant growth, three factors were found to be statistically significant: growth at the initial visit (p-value 0.02), initial diameter (p-value 0.045) and existence of unsteadiness at diagnosis (p-value 0.02).Conclusions:Acoustic neuroma overall growth is not identical to clinically significant growth. Growth at first visit is a significant prognostic factor and intervention potential should be considered under this perspective.

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Clinical Practice Guideline: Sudden Hearing Loss

Cited by 314 publications

References 0 publications

Sudden Sensorineural Hearing Loss: Results of intratympanic steroids as salvage treatment

Sudden Sensorineural Hearing Loss: Results of intratympanic steroids as salvage treatment

Sudden sensorineural hearing loss: is there a relationship between routine haematological parameters and audiogram shapes?

Predictive factors of acoustic neuroma growth

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