Objective:To evaluate the efficacy and safety of intratympanic and systemic steroid therapies in the initial treatment of Sudden Sensorineural Hearing Loss (SSNHL) patients. Methods:A comprehensive search of PubMed, ...Objective:To evaluate the efficacy and safety of intratympanic and systemic steroid therapies in the initial treatment of Sudden Sensorineural Hearing Loss (SSNHL) patients. Methods:A comprehensive search of PubMed, Wanfang database and CNKI (China National Knowledge Infrastructure) was performed covering the period from January 1990 to July 2014. A meta-analysis was conducted after filtering by the criteria of Cochrane Collaboration. Three hundred fifty six subjects in nine studies allocated to the group of intratympanic steroid therapies and 343 controls receiving systemic steroid therapies met the criteria for meta-analysis. The data were extracted and analyzed using the RevMan 5.3 meta-analysis software. Results: The total effectiveness rate in SSNHL patients receiving intratympanic steroid therapies did not differ statistically from patients receiving systemic therapies (RR ? 1.08, 95%CI ? 0.99e1.99, P ? 0.10), although the rate of full hearing recovery in this group differed significantly from patients receiving systemic therapies (RR ? 1.29, 95%CI ? 1.00e1.66, P ? 0.05). Conclusion: Local steroid therapy appears to generate higher rate of complete hearing recovery than systemic steroid treatment as an initial treatment for SSNHL, which may be especially useful for patients in whom systemic steroids are contraindicated.展开更多
目的:颈前庭诱发肌源性电位(cVEMP)测试在评估球囊和末梢前庭神经功能方面有重要的临床意义,也可评估上半规管裂综合征(SCD)患者对声音的前庭超敏性。cVEMP测试使用的常规刺激是高强度500Hz的短纯音。本研究的目的是比较高强度短纯音和...目的:颈前庭诱发肌源性电位(cVEMP)测试在评估球囊和末梢前庭神经功能方面有重要的临床意义,也可评估上半规管裂综合征(SCD)患者对声音的前庭超敏性。cVEMP测试使用的常规刺激是高强度500Hz的短纯音。本研究的目的是比较高强度短纯音和低强度的click,诊断SCD的有效性。方法:研究38例单侧SCD患者对500Hz的短纯音和click响应的cVEMP振幅。结果:采用高强度500 Hz短纯音的cVEMP测试不能区分SCD患者。高强度500Hz的刺激可能饱和。使用90和80dB nHL clicks少有饱和度。用80和90dB nHL clicks测试与只用90dB nHL clicks相比,并没有明显的优势。结论:90dB nHL clicks和高强度500 Hz的短纯音cVEMP,都可用于筛查SCD。展开更多
Background：The prevalence of sudden sensorineural hearing loss in children （CSSNHL） is consistently increasing.However,the pathology and prognosis of CSSNHL are still poorly understood.This retrospective study eval...Background：The prevalence of sudden sensorineural hearing loss in children （CSSNHL） is consistently increasing.However,the pathology and prognosis of CSSNHL are still poorly understood.This retrospective study evaluated clinical characteristics and possible associated factors of CSSNHL.Methods：One hundred and thirty-six CSSNHL patients treated in Department of Otolaryngology-Head and Neck Surgery and Institute of Otolaryngology at Chinese PLA General Hospital between July 2008 and August 2015 were included in this study.These patients were analyzed for clinical characteristics,audiological characteristics,laboratory examinations,and prognostic factors.Results：Among the 136 patients （151 ears）,121 patients （121 ears,80.1%） were diagnosed with unilaterally CSSNHL,and 15 patients （30 ears,19.9%） with bilateral CSSNHL.The complete recovery rate of CSSNHL was 9.3%,and the overall recovery rate was 37.7%.We found that initial degree of hearing loss,onset of treatment,tinnitus,the ascending type audiogram,gender,side of hearing loss,the recorded auditory brainstem response （ABR）,and distortion product otoacoustic emissions （DPOAEs） had prognostic significance.Age,ear fullness,and vertigo had no significant correlation with recovery.Furthermore,the relevant blood tests showed 30.8% of the children had abnormal white blood cell （WBC） counts,22.1% had elevated homocysteine levels,65.8% had high alkaline phosphatase （ALP）,33.8% had high IgE antibody levels,and 86.1% had positive cytomegalovirus （CMV） IgG antibodies.Conclusions：CSSNHL commonly occurs unilaterally and results in severe hearing loss.Initial severe hearing loss and bilateral hearing loss are negative prognostic factors for hearing recovery,while positive prognostic factors include tinnitus,gender,the ascending type audiogram,early treatment,identifiable ABR waves,and DPOAEs.Age,vertigo,and ear fullness are not correlated with the recovery.Some serologic indicators,including the level of WBC,platelet,homocysteine,ALP,positive CMV IgG antibody,fibrinogen,and some immunologic indicators,are closely related to CSSNHL.展开更多
文摘Objective:To evaluate the efficacy and safety of intratympanic and systemic steroid therapies in the initial treatment of Sudden Sensorineural Hearing Loss (SSNHL) patients. Methods:A comprehensive search of PubMed, Wanfang database and CNKI (China National Knowledge Infrastructure) was performed covering the period from January 1990 to July 2014. A meta-analysis was conducted after filtering by the criteria of Cochrane Collaboration. Three hundred fifty six subjects in nine studies allocated to the group of intratympanic steroid therapies and 343 controls receiving systemic steroid therapies met the criteria for meta-analysis. The data were extracted and analyzed using the RevMan 5.3 meta-analysis software. Results: The total effectiveness rate in SSNHL patients receiving intratympanic steroid therapies did not differ statistically from patients receiving systemic therapies (RR ? 1.08, 95%CI ? 0.99e1.99, P ? 0.10), although the rate of full hearing recovery in this group differed significantly from patients receiving systemic therapies (RR ? 1.29, 95%CI ? 1.00e1.66, P ? 0.05). Conclusion: Local steroid therapy appears to generate higher rate of complete hearing recovery than systemic steroid treatment as an initial treatment for SSNHL, which may be especially useful for patients in whom systemic steroids are contraindicated.
文摘目的:颈前庭诱发肌源性电位(cVEMP)测试在评估球囊和末梢前庭神经功能方面有重要的临床意义,也可评估上半规管裂综合征(SCD)患者对声音的前庭超敏性。cVEMP测试使用的常规刺激是高强度500Hz的短纯音。本研究的目的是比较高强度短纯音和低强度的click,诊断SCD的有效性。方法:研究38例单侧SCD患者对500Hz的短纯音和click响应的cVEMP振幅。结果:采用高强度500 Hz短纯音的cVEMP测试不能区分SCD患者。高强度500Hz的刺激可能饱和。使用90和80dB nHL clicks少有饱和度。用80和90dB nHL clicks测试与只用90dB nHL clicks相比,并没有明显的优势。结论:90dB nHL clicks和高强度500 Hz的短纯音cVEMP,都可用于筛查SCD。
基金This study was financially supported by grants from the National Key Basic Research Program of China，the National Natural Science Foundation of China
文摘Background：The prevalence of sudden sensorineural hearing loss in children （CSSNHL） is consistently increasing.However,the pathology and prognosis of CSSNHL are still poorly understood.This retrospective study evaluated clinical characteristics and possible associated factors of CSSNHL.Methods：One hundred and thirty-six CSSNHL patients treated in Department of Otolaryngology-Head and Neck Surgery and Institute of Otolaryngology at Chinese PLA General Hospital between July 2008 and August 2015 were included in this study.These patients were analyzed for clinical characteristics,audiological characteristics,laboratory examinations,and prognostic factors.Results：Among the 136 patients （151 ears）,121 patients （121 ears,80.1%） were diagnosed with unilaterally CSSNHL,and 15 patients （30 ears,19.9%） with bilateral CSSNHL.The complete recovery rate of CSSNHL was 9.3%,and the overall recovery rate was 37.7%.We found that initial degree of hearing loss,onset of treatment,tinnitus,the ascending type audiogram,gender,side of hearing loss,the recorded auditory brainstem response （ABR）,and distortion product otoacoustic emissions （DPOAEs） had prognostic significance.Age,ear fullness,and vertigo had no significant correlation with recovery.Furthermore,the relevant blood tests showed 30.8% of the children had abnormal white blood cell （WBC） counts,22.1% had elevated homocysteine levels,65.8% had high alkaline phosphatase （ALP）,33.8% had high IgE antibody levels,and 86.1% had positive cytomegalovirus （CMV） IgG antibodies.Conclusions：CSSNHL commonly occurs unilaterally and results in severe hearing loss.Initial severe hearing loss and bilateral hearing loss are negative prognostic factors for hearing recovery,while positive prognostic factors include tinnitus,gender,the ascending type audiogram,early treatment,identifiable ABR waves,and DPOAEs.Age,vertigo,and ear fullness are not correlated with the recovery.Some serologic indicators,including the level of WBC,platelet,homocysteine,ALP,positive CMV IgG antibody,fibrinogen,and some immunologic indicators,are closely related to CSSNHL.
