Diagnostics and therapy of sudden hearing loss

Plontke, Stefan K.

doi:10.3205/cto000144

Cited by 22 publications

(12 citation statements)

References 129 publications

(156 reference statements)

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“…A tympanoscopy (middle ear exploration) is a standard otological procedure and has been applied for many years in combination with “sealing” of the RW niche in patients with ISSHL ( Loader et al, 2013 ; Kampfner et al, 2014 ) and for removal of possible RWM obstructions in patients with ISSHL ( Plontke, 2018 ) or with Meniere’s disease ( Crane et al, 2009 ) who have failed therapy with (“blind”) intratympanic injections. All patients in our institution, who this individual treatment attempt was offered to, had quasi lost a sensory organ (complete hearing loss or non-serviceable hearing in the affected ear) and failed other guideline-conform therapies.…”

Section: Discussionmentioning

confidence: 99%

“…(A,C–F) Microscopic images; (B) endoscopic image, 1.7 mm, 30°). Figures (A–C) after Plontke (2018) with permission.…”

Section: Methodsmentioning

confidence: 99%

“…They are lost rapidly from the middle ear, enter perilymph slowly through the RWM, and in the inner ear, they are quickly dephosphorylated to the active drug form, but due to higher lipophilicity are then rapidly eliminated to the bloodstream ( Salt and Plontke, 2018 ). (4) After a surgical tympanoscopy for exploration and removal of possible obstructions of the round window (RW) niche involving the risk of some blood in the middle ear and with a tympanomeatal flap requiring an ear canal dressing, repeated transtympanic injections are often not feasible for some time, suggesting the application of a drug depot or controlled release system in the RW niche at the time of surgery ( Plontke, 2018 ). We previously reported on five patients with ISSHL, who were treated with an approved intravitreal implant for continuous dexamethasone application to the inner ear by implantation into the RW niche ( Plontke et al, 2014 ).…”

Section: Introductionmentioning

confidence: 99%

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Safety and audiological outcome in a case series of tertiary therapy of sudden hearing loss with a biodegradable drug delivery implant for controlled release of dexamethasone to the inner ear

et al. 2022

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BackgroundIntratympanic injections of glucocorticoids have become increasingly common in the treatment of idiopathic sudden sensorineural hearing loss (ISSHL). However, due to their fast elimination, sustained applications have been suggested for local drug delivery to the inner ear.Materials and methodsThe study is based on a retrospective chart review of patients treated for ISSHL at a single tertiary (university) referral center. We included patients who were treated with a solid, biodegradable, poly(D,L-lactic-co-glycolic acid) (PLGA)-based drug delivery system providing sustained delivery of dexamethasone extracochlear into the round window niche (n = 15) or intracochlear into scala tympani (n = 2) for tertiary therapy of ISSHL in patients without serviceable hearing after primary systemic and secondary intratympanic glucocorticoid therapy. We evaluated the feasibility and safety through clinical evaluation, histological examination, and functional tests [pure-tone threshold (PTA), word recognition scores (WRS)].ResultsWith adequate surgical preparation of the round window niche, implantation was feasible in all patients. Histologic examination of the material in the round window niche showed signs of resorption without relevant inflammation or foreign body reaction to the implant. In patients where the basal part of scala tympani was assessable during later cochlear implantation, no pathological findings were found. In the patients with extracochlear application, average preoperative PTA was 84.7 dB HL (SD: 20.0) and 76.7 dB HL (SD: 16.7) at follow-up (p = 0.08). The preoperative average maximum WRS was 14.6% (SD: 17.9) and 39.3% (SD: 30.7) at follow-up (p = 0.11). Six patients (40%), however, reached serviceable hearing. The two patients with intracochlear application did not improve.ConclusionThe extracochlear application of the controlled release system in the round window niche and – based on limited observations - intracochlear implantation into scala tympani appears feasible and safe. Due to the uncontrolled study design, conclusions about the efficacy of the treatment are limited. These observations, however, may encourage the initiation of prospective controlled studies using biodegradable controlled release implants as drug delivery systems for the treatment of inner ear diseases.

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Section: Discussionmentioning

confidence: 99%

“…(A,C–F) Microscopic images; (B) endoscopic image, 1.7 mm, 30°). Figures (A–C) after Plontke (2018) with permission.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Safety and audiological outcome in a case series of tertiary therapy of sudden hearing loss with a biodegradable drug delivery implant for controlled release of dexamethasone to the inner ear

et al. 2022

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“…Statistisch soll sich hinter jedem 25. Hörsturz ein Vestibularisschwannom verbergen [17]. In Studien zur Lebensqualität werden Schwindelprobleme als einschränkender bewertet als Hörstörungen oder Ertaubungen [18].…”

Section: Symptomatikunclassified

Vestibularisschwannome – Basis- und Verlaufsdiagnostik

Kemper

Paliege²,

Zahnert³

2022

Laryngorhinootologie

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“…Sudden hearing loss (SHL) is an otorhinolaryngological emergency defined as a hearing loss of at least 30 dB, at three consecutive audiometric frequencies, of sudden onset within 72 h. 1 In most cases, it manifests unilaterally in individuals in the fourth decade of life, 1 with no gender preference. 2 Its incidence in developed countries is estimated at 5–20 cases per 100,000 inhabitants/year. 1 …”

Section: Introductionmentioning

confidence: 99%