Treatment with HELP‐apheresis in patients suffering from sudden sensorineural hearing loss: A prospective, randomized, controlled study

Abstract

The analysis enabled us to consider HELP-apheresis as the element that makes a difference in hearing recovery. In a specific group of patients, with alterations in cholesterol and/or fibrinogen, the HELP-apheresis treatment is a further option available in SSHL therapy.

Acute hyperfibrinogenemia impairs cochlear blood flow and hearing function in guinea pigsin vivo

“…In the present study, serum fi brinogen levels achieved in guinea pigs correspond to levels in human pathophysiology. In several clinical studies of hearing loss where pathologic values of fi brinogen were assessed, the range of fi brinogen values was 3.03 -4.00 g/L (Suckfull, 2002;Suckfull et al, 2002;Mosges et al, 2009;Bianchin et al, 2010). Those values are in line with data from the present study in guinea pigs, suggesting a coincidence of increased levels of fi brinogen and onset of hearing loss in those patients.…”

“…apheresis (heparin induced LDL cholesterol and fi brinogen precipitation) is benefi cial for patients suffering from sensorineural hearing loss, particularly when blood levels of fi brinogen or LDL cholesterol are increased (Suckfull, 2002;Mosges et al, 2009;Bianchin et al, 2010). Furthermore, in an animal model, lowered levels of fi brinogen by infusion of batroxobin increased cochlear blood fl ow.…”

“…Furthermore, it is well established that patients with elevated serum fi brinogen levels benefi t from H.E.L.P. apheresis (heparin induced LDL and fi brinogen precipitation) after SSNHL (Suckfull, 2002;Bianchin et al, 2010). Despite several clinical studies, the underlying pathophysiolgy is still a matter of discussion.…”

Rheopheresis in treatment of idiopathic sensorineural sudden hearing loss

“…The superiority of rheopheresis over established first-line standard treatment could not be shown in general. Rheopheresis seems to be especially effective in patients with high fibrinogen or cholesterol [18]. Only few retrospective data are available [19] for refractory SISHL.…”

Role of Lipoprotein Apheresis in Cardiovascular Disease Risk Reduction

“…Notably, LA in nephrotic syndrome can improve proteinuria and lipid levels, preventing the progression of renal disease [90][91][92]. LA has also been utilized in sudden sensorineural hearing loss [93], diabetic foot ulcers [94], and peripheral artery disease [95]. In addition to reduction of lipid levels, LA therapy also reduces inflammatory markers (including C-reactive protein and cellular adhesion molecules) [96][97][98][99][100][101] and circulating coagulation proteins (including fibrinogen and tissue factor) [102,103].…”