Sudden deafness as a prodrome of cerebellar artery infarction:Three case reports

BACKGROUND To summarize the clinical characteristics of acute cerebral infarction(ACI)in patients with sudden deafness(SD)as the first symptom,improve the awareness of the disease,and help diagnosis and treatment.CASE SUMMARY From 2019 to 2020,three patients with ACI with SD as the first symptom were admitted to our hospital.Pure tone audiometry,head magnetic resonance imaging(MRI),vertebral artery and carotid artery B-ultrasound,head and neck computed tomography angiography,and other examinations were performed.Following the treatment of SD,hearing and dizziness were not significantly improved.Then,the patients developed symptoms of related cranial nerve injury,and brain MRI showed cerebral infarction in the cerebellopontine angle area.All three cases were transferred to the neurology department for relevant conservative treatment.CONCLUSION Patients with ACI with SD as the first symptom usually attend the otolaryngology clinic.Here a diagnosis of SD,which is based on an audiological examination,is made and the corresponding treatment is administered.To reduce the misdiagnosis of this disease,close attention should be paid to the changes in the patient's clinical symptoms and related auxiliary examinations should be performed,such as brain MRI and cerebrovascular imaging.Otolaryngologists should pay attention to the type and severity of hearing loss,the accompanying symptoms,age,high-risk factors for cerebral infarction,and related cranial nerve symptoms in patients with SD.If the patient's early brain MRI does not show abnormalities,monitoring remains essential.The head MRI should be analyzed quickly based on the changes in the symptoms of the patient,to make an accurate diagnosis and provide the timely and correct treatment for the patients.

Cochlear and Vestibular Functional Study in Patients with Sudden Deafness and Lyme Disease

Lyme disease (LD) and idiopathic sudden deafness (ISD) are supposed to be different diseases with different aetiologies. In an attempt to confirm this assumption, 10 patients with confirmed LD and 12 patients with ISD were consecutively included into the study. Further to the laboratory and audio logical investigation, a low frequency sound (LFS) stimulation on posturography was performed and evaluated. Patients with ISD had higher pure tone average (PTA) than patients with LD (PTA ISD/LD was 72 decibel (dB)/23 dB). There was no difference of vertigo between LD and ISD patients. Patients with ISD have more body sway velocity during the first stimulation than patients with LD. We conclude that the cochlear organ is more affected in ISD patients than in patients with LD. However, the vestibular organ seems to be affected in both diseases. ISD and LD are two different disease entities with different aetiologies but with common otological clinical signs.

Initial steps on the analysis of the underlying pharmacological mechanisms of Wendan decoction on sudden deafness using network pharmacology and molecular docking

Background:Despite its widespread therapeutic use and effectiveness,the underlying pharmacologic mechanisms of Wendan decoction(WDD)and how it works to treat sudden deafness(SD)remain unclear.In this study,the pharmacological mechanisms of WDD underlying SD were analyzed using network pharmacology and molecular docking.Methods:The Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP)was employed to identify the active compounds and target genes of WDD,and genes associated with SD were screened on five databases.RGUI conducted Gene Ontology(GO)functional and the Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses.A compound-target network was established using Cytoscape,and the STRING database created a protein-protein interaction(PPI)network to identify the key compounds and targets.Subsequently,a network of crucial compound-target was generated for further molecular docking analysis.For molecular docking simulations of the macromolecular target proteins and their matching ligand molecules,AutoDock Vina and AutoDockTool were utilized.Results:TCMSP identified 162 active target genes and 36 active compounds for WDD.The active target genes were compared with the 2271 genes associated with SD to identify 70 intersecting active target genes linked to 34 active compounds.The GO functional enrichment and KEGG pathway enrichment analyses were undertaken,and compound–target,and PPI networks were built.The key compounds and protein targets were identified and integrated to form a key compound–target network.Eventually,molecular docking was performed to investigate the interactions of the protein targets with their respective compounds.Conclusion:This study highlights the mechanisms of multi-compounds,targets,and pathways of WDD acting on SD and provides further evidence of crucial compounds and their matching target proteins of WDD acting on SD.

Expression relationship and significance of miR-155 and HDAC2 in peripheral blood mononuclear cells of patients with sudden deafness

Objective:To investigate the expressions of microRNA-155 (miR-155) and histone deacetylase 2 (HDAC2) in peripheral blood mononuclear cells (PBMC) of patients with sudden deafness (SSNHL) and their clinical significances.Methods:112 patients with SSNHL who were treated in our hospital from February 2017 to September 2018 were selected as the study subjects, and they were referred to as sudden deafness group, and another 115 healthy examinees in the same period were compared and studied as normal group. The relative expression levels of miR-155, HDAC2, ICAM-1, TNF-α and interleukin-8 (IL-8) in PBMC of all subjects were detected by real-time fluorescence quantitative analysis (qRT-PCR). Pearson method was used to analyze the relationships between miR-155, HDAC2 and the expressions of ICAM-1, TNF-α, IL-8, and miR-155 and the expression of HDAC2 in PBMC of SSNHL patients. Logistic regression analysis was used to analyze the risk factors of SSNHL. The predictive diagnostic values of miR-155 and HDAC2 in PBMC for SSNHL were evaluated. Results:The relative expression levels of miR-155, ICAM-1, TNF-α and IL-8 in PBMC of sudden deafness group were significantly higher than those of normal group (P<0.05), while the relative expression levels of HDAC2 were significantly lower than those of normal group (P<0.05). In SSNHL patients, miR-155 were positively correlated with the expression levels of ICAM-1, TNF-α and IL-8 (P<0.05). The expression level of HDAC2 was negatively correlated with the expression levels of TNF-α and IL-8 (P<0.05). The expression level of miR-155 in PBMC of SSNHL patients was negatively correlated with HDAC2 (P<0.05). MiR-155, ICAM-1, TNF-α and IL-8 were risk factors for SSNHL (P<0.05), while HDAC2 was protective factor for SSNHL (P<0.05). The areas under curve (AUC) of miR-155 and HDAC2 in PBMC for SSNHL diagnosis were 0.855 and 0.835 respectively, the truncation values of which were 1.449 and 0.959 respectively, at this moment, the sensitivities were 75.0% and 81.3% respectively, and the corresponding specificities were 86.1% and 70.1% respectively. The AUC of combined diagnosis of SSNHL was 0.927, and the sensitivity and specificity were 86.7% and 85.3% respectively.Conclusions:The expressions of miR-155 is high and HDAC2 is low in PBMC of SSNHL patients, which are negatively correlated, and both of them may participate in the occurrence and development of SSNHL through mutual influence, which is a risk factor of SSNHL. The combination of the two can effectively improve the predictive diagnostic value of SSNHL.

Effect of batroxobin combine with ginkgo-damole injection on hemodynamics, coagulation function, fibrinolytic function and related factors in patients with sudden deafness

Objective: To study the effects of combined use of Batroxobin and Ginkgo Leaf Extract and Dipyridamole Injection on hemodynamics, coagulation function, fibrinolytic function and related factors in patients with sudden deafness. Methods: A total of 94 patients with sudden deafness in our hospital were selected, and divided them into control group and observation group randomly, 47 cases in each group. All patients were given 10BU batroxobin injection intravenous drip after admission every other day;And the patients of observation group were given intravenous drip of 30ml ginkgo-damole injection, 1 time a day. The hemodynamics, coagulation function, fibrinolytic function and related factors were detected and compared between the two groups before and after treatment. Results: Before treatment, there was no statistical difference in hemodynamics, coagulation function, fibrinolytic function and related factors between the two groups;After treatment, the levels of WBV and PV in the control group was (5.21±0.58) mPa/s and (1.78±0.32) mPa/s, and the observation group was (4.13±0.47) mPa/s and (1.31±0.26) mPa/s, compared with the same group before treatment, there were statistical difference, and there was also statistical difference between the two groups;The levels of PT, APTT, TT and PF was (19.22±3.98) s, (43.57±9.88) s, (15.64±3.27) s and (58.22±10.58) μg/L, and the observation group was (23.97±4.82) s, (52.49±10.38) s, (20.59±4.15) s and (41.03±8.46) μg/L, compared with the same group before treatment, there were statistical difference, and there was also statistical difference between the two groups;The levels of Fib, D-dimer and FDP was (4.52±0.93) g/L, (6.53±1.88) mg/L and (8.17±2.34)μg/mL, and the observation group was (3.13±0.75 g/L, (9.75±2.14) mg/L, (13.52±2.58) μg/mL, compared with the same group before treatment, there were statistical difference, and there was also statistical difference between the two groups;The serum levels of ET, NO and SOD was (66.92±5.87) ρg/mL, (48.75±7.61) μmol/L, (95.01±12.38) NU/mL, and the observation group was (63.97±5.24) ρg/mL, (43.11±6.83) μmol/L, (104.79±13.15) NU/mL, compared with the same group before treatment, there were statistical difference, and there was also statistical difference between the two groups. Conclusion: The treatment of patients with sudden deafness using batroxobin combine with ginkgo-damole injection, can improve the hemodynamics, coagulation function, fibrinolytic function of patients, decrease the serum levels of ET and NO, improve the levels of SOD, the effect is curative, it's worthy of clinical application.

Clinical Efficacy of Hyperbaric Oxygen Therapy at Different Pressures in the Treatment of Sudden Deafness

Objective:To analyze the efficacy of hyperbaric oxygen at different pressures in the treatment of sudden deafness.Methods:Eighty-two patients with sudden deafness treated in the Affiliated Hospital of Hebei University from September 2019 to September 2021 were selected as the research subjects.The patients were randomly divided into study group 1 and study group 2,and they were treated with hyperbaric oxygen on the basis of routine treatment,in which the pressure used was 1.8 ATA and 2.2 ATA,respectively.Oxygen was delivered via the pressure stabilizing mask for 60 minutes.The patients received two courses of treatment,each lasting 10 days.The changes in hearing(pure tone audiometry)and the clinical efficacy of both the groups were compared before and after treatment.The data obtained were statistically analyzed using SPSS 19.0.Results:The total effective rate of study group 1 was 90.00%,while that of study group 2 was 76.19%.The differences between the two groups were statistically significant(p<0.05).Conclusion:For patients with sudden deafness treated with hyperbaric oxygen,the clinical efficacy of 1.8 ATA is more significant than that of 2.2 ATA.

The Clinical Effects of Hyperbaric Oxygen in the Treatment of Sudden Deafness

Objective:To observe the clinical effect of hyperbaric oxygen in the treatment of sudden deafness.Methods:Ninety-six patients with sudden deafness diagnosed by the otolaryngology department were divided into 2 groups which comprised of 48 patients in the conventional treatment group and the other 48 patients in the hyperbaric oxygen treatment group.Both groups were treated with methylcobalamin,vitamin B1,and ginkgo biloba extract.The patients in the hyperbaric oxygen treatment group were given hyperbaric oxygen therapy of 2.0 ATA once a day.Each course of treatment lasted 10 days and after two courses of treatment,the clinical efficacies of the two groups were compared.Results:After two courses of treatment,the effect of treatment in the hyperbaric oxygen treatment group was significantly better than that of the conventional treatment group.Conclusion:Hyperbaric oxygen therapy can effectively improve the hearing level of patients with sudden deafness and the overall effective rate of treatment.

Outcomes of treatment of sudden deafness using different Protocols:a retrospective analysis of 104 cases

Objective To compare different treatment protocols for sudden deafness(SD), for the purpose of identifying an appropriate approach to SD. Methods A total of 104 patients with diagnosis of sudden hearing loss treated from Jan 2006 to December 2008 were included in this study, of which 31 received the typical pharmaceutical treatment (groupⅠ), 40 received the typical pharmaceutical treatment plus polarized liquid (GroupⅡ) and 33 received the hyperbaric oxygen in addition to the treatment included in Group Ⅱ(Group Ⅲ). Results The total improvement rate (67.74%, 62.50% and 75.76% for Groups Ⅰ, Ⅱ and Ⅲ respectively) was not statistically different between the three groups (P > 0.05). Conclusion The three treatment protocols are similar when judged by the treatment outcomes in SD, neither being superior to the others. The two important factors that appear to influence treatment outcomes are the audiogram pattern and duration of hearing loss before seeking treatment. Patients with upsloping or peak-type audiograms and treated within 7 days from the onset have better prognosis than others.

Concurrent symptoms and disease conditions in sudden deafness

Objective To study concomitant symptoms and disease conditions in sudden deafness. Methods Clinical data of 418 cases of sudden deafness treated in this department from 2000 to 2007 were reviewed. Results Of the 418 cases, 201 were males and 217 were females. Right ear was involved in 184 cases and left ear in 191 cases. Bilateral involvement was seen in 43 cases. The average age was 44.1 years. Tinnitus was reported in 369 cases (88.3%) either before or after hearing loss, of which 64.5% was of low pitch, 27.1% of high pitch and 8.4% of mixed tones. Constant tinnitus was reported in 83% of the cases, and muffled feelings in 33.3% of the cases. Hearing loss was the only complaint in 221 cases (52.9%). Dizziness was reported in 77 cases (18.4%) and vertigo attacks in 120 cases (28%). Hypertension, coronary artery disease and diabetes were found in 19.6% of 418 cases and hyperlipidemia in 54.5% of 211 cases. CT and / or MRI data were available in 147 cases, with positive findings in 18 cases (12.3%): 2 with acoustic neuroma (1.36%); 4 with emphraxis in the basal ganglia, cerebellum, temporal lobe or parietal lobe, and 12 with poor pneumatization of ipsior contralateral mastoid cells. Conclusion In this case series of sudden deafness, low-pitch constant tinnitus was a common complaint. Most of the studied cases presented with simple hearing loss. Vertigo attacks were more common than dizziness in this group of patients. The most common concomitant disorder was hyperlipidemia, especially high triglycerides. Imaging studies are important in managing sudden deafness in ruling out acoustic neuroma and other intracranial diseases.

Traditional Chinese Medicine Nursing Protocols for Sudden Deafness( Sudden Sensorineural Hearing Loss)

Sudden deafness is one of the commonest acute symptoms in otolaryngology.In recent years,the incidence of sudden deafness is on the rise all over the world,but its etiology is still unclear,and the prognosis is greatly different.Traditional Chinese medicine(TCM)believes that the onset of sudden deafness is related to the liver,gallbladder,heart and triple energizer meridians.This article mainly explored the key points of common syndromes,TCM nursing methods and health guidance of sudden deafness.

Current State of Clinical Studies on Diagnosis and Treatment of Sudden Deafness in China

Objective To evaluate the current status of clinical studies on diagnosis and treatment of sudden deafness (SD) in China by retrospective reviewing articles on SD published in Chinese journals in the past 5 years. Special attention is given to whether the diagnosis and treatment standards established in 1996 by the otolaryngology branch of Chinese Medical Association (the'1996 standard') were followed. Methods The terms of 'Sudden deafness' and 'treatment' were used as the keywords in searching articles published between 2000 and 2004 in the Chinese biomedicine literature database and Chinese journal network. Principles of evidence-based medicine were applied in reviewing the articles. Results Two hundreds and thirty- four articles were identified, including 176 between 2000 and 2002 and 58 between 2003 and 2004. Among the 176 articles published between 2000 and 2002, effects of medications were studies in 126 articles, of which only 26 (20.6%) followed the'1996 standards'. Eighty-nine (70.6%) were reported based on controlled clinical trials (CCT) and 36 (28.5%) met the criteria of randomized controlled trails (RCT). Of the 58 articles published between 2003 and 2004, drug effects were evaluated in 25 articles, which were all based on the '1996 standards'. However, there lacked placebo control, follow-up data or statistical analysis in these papers. Only 6 articles reported side-effects from pharmacological treatment. Conclusions While a significant number of articles on SD were published in the past 5 years, the '1996 standards' were followed only in a small number of them. The standards may not be appropriate in guiding research and need to be modified for improved guidance to SD management. Multi-center, RCTs should be a crucial part in studies on SD.

Diuretic Agents in Treatment of Sudden Deafness

Objective To study the role of diuretic agents in treating sudden deafness (SD) and explore the possibility of endolymphatic hydrops as a potential cause of SD. Methods Twenty-eight SD cases were reviewed. In 23 cases, treatment was initiated with routine agents. Diuretic agents were later added in 8 of these cases that failed to respond to routine treatment agents. Diuretic agents were included in the initial treatment in the rest 5 cases. In total, 13 cases received diuretics in addition to routine treatment agents and 15 cases received conventional treatment only. Results In the 8 cases who received diuretics after failed conventional treatments, 4 showed hearing improvement, whereas all 5 cases in which diuretics were included in the initial treatment demonstrated hearing improvement. Conclusion These results suggest a possible role of endolymphatic hydrops in the pathophysiologic course of SD. Diuretics should be considered when clear indications exist with no conflicts to other medical conditions.

Experimental study of transient cochlear ischemia as a cause of sudden deafness

The etiology of sudden deafness or idiopathic sudden sensorineural hearing loss(ISSHL) remains unclear. Over the past 15 years, we have investigated the mechanisms of ischemic-induced hearing loss using a gerbil model of transient cochlear ischemia. In the gerbil, cochlear ischemia can be induced by occluding the bilateral vertebral arteries simultaneously at the neck, because the posterior communicating arteries of the Circle of Willis close spontaneously around 1 mo after birth. When 15 min ischemia was loaded on this animal, permanent hearing loss of about 25 d B and the death of hair cells, especially inner hair cells were induced. These pathological changes were mainly due to lack of an energy source, glutamate excitotoxicity, and the production of free radicals, especially superoxide and nitrous oxide species. Ischemic damage could be prevented by various procedures, such as cooling the cochlea, intratympanic administration of insulin-like growth factor 1 or AM-111(an anti-apoptotic agent), and systemic administration of prednisolone(steroid), edarabone(free radical scavenger), ginsenoside Rb1(Kanpo), hematopoietic stem cells, glia-cell derived neurotrophic factor, and liposome-encapsulated hemoglobin(artificial red blood cells). We also found that the cochlea was protected by the ischemic tolerance, indi-cating that minor cochlear ischemia alleviates or prevents inner ear damage in subsequent severe cochlear ischemia. As ISSHL usually occurs suddenly, with no preceding sign or symptom, we suggest that most ISSHL cases are caused by circulatory disturbance, probably at the stria vascularis.

Clinical observation on the different frequency hearing damages in sudden deafness treated by electroacupuncture combined with western medicine comprehensive therapy

Objective To compare the difference in the clinical efficacy on the different frequency hearing damages for the patients with sudden deafness between the comprehensive therapy of electroacupuncture and western medicine and the simple western medicine comprehensive therapy. Methods Fifty-eight cases were randomized into an acupuncture plus medication group （28 cases, 32 damaged ears） and a western medicine group （30 cases, 34 damaged ears）. In the acupuncture plus medication group, the comprehensive therapy of electroacupuncture and western medicine was used. The main points were ěrmén （耳门 TE 21）, Tīnggōng （听宫 SI 19）, Tīnghuì （听会 GB 2）, Yìfēng （翳风 TE 17）, etc. The western medicine therapy was the comprehensive treatment with vasodilators, the medicines for promoting nerve function and releasing inner ear edema and hyperbaric oxygen. In the western medicine group, the western medicine comprehensive therapy was adopted. 10-day treatment made one session. Two sessions of treatment were required. In 1 or 2 sessions of treatment, the efficacy was observed, the electric audiometry was evaluated. Additionally, the blood routine and liver and kidney functions were detected. Results The total effective rate was 50.0% （16/32） in the acupuncture ＋ medication group and was 55.9% （19/34） in the western medicine group. The efficacies were similar between the two groups （P〉0.05）. In 1 and 2 sessions of treatment, at 250 Hz, 500 Hz and 1 kHz, the electric audiometry values in either group were recovered significantly as compared with those before treatment （all P〈0.01）. At 2 kHz, in 1 and 2 sessions of treatment, the improvements of the electric audiometry values were significant as compared with those before treatment in the acupuncture plus medication group separately （P〈0.05, P〈0.01）. At 4 kHz, the differences were not significant statistically before and after treatment in either group （all P〉0.05）. There were no abnormalities in the blood routine and liver and kidney function detections before and after treatment in either group. Conclusion Either the comprehensive therapy of electroacupuncture and western medicine or the simple western medicine comprehensive therapy is effective in the treatment of low frequency hearing damage of sudden deafness. Either of them has no effect on high frequency hearing damage. But for the middle frequency hearing damage, the efficacy of the comprehensive therapy of electroacupuncture and western medicine is superior to that of the simple western medicine comprehensive therapy.

Observation on therapeutic effects of acupuncture plus Chinese herbs for sudden deafness

Objective： To observe the clinical effect of wind-expelling method of acupuncture and Chinese herbs for sudden deafness. Methods： A total of 90 cases with sudden deafness were randomly divided into three groups based upon their visit order and random digital table, an acupuncture plus Chinese herbs （APCH） group, an acupuncture group, and a Western medication （WM） group, 30 cases in each group. The APCH group was treated by puncturing Fengchi （GB 20）, Fengfu （GV 16） and Fengmen （BL 12）, without retaining the needles, and then by puncturing Zhongwan （CV 12）, Guanyuan （CV 4）, Qihai （CV 6） and Tianshu （ST 25） with reinforcing technique after arrival of the needling sensation, and the needles were retained for 30 min, plus oral administration of wind-expelling Chinese herbs. The acupuncture group was treated with the acupoints selected by syndrome differentiation in reference to the textbook of Acupuncture ond Moxibustion Science. The WM group was treated by intravenous infusion of Alprostadil injection, Adenosine Disodium Triphosphate and Coenzyme A and muscular injection of Vitamin B12 and Vitamin BI. The decibel values of hearing loss before and after treatment were respectively recorded and analyzed comparatively. Results： In the intra-group comparison after treatment among the three groups, the decibel values of hearing loss all declined, with statistically significant differences （all P〈0.05）. After treatment, the decibel value of hearing loss in the APCH group was better than those in the acupuncture group （P〈0.05） and the WM group （P〈0.05）. The total effective rate was respectively 83.3% in the APCH group, 60.0% in the acupuncture group and 56.7% in the WM group. The total effective rate in the APCH group was better than those in other two groups （both P〈0.05）. Conclusion： The therapeutic effect was better for sudden deafness by wind-expelling method of acupuncture and Chinese herbs than by acupuncture alone or by Western medication.

Treatment of Sudden Deafness by Acupuncture plus Hyperbaric Oxygen

Yifeng (TE 17), Tinghui (GB 2), Zhongzhu (TE 3) and Xiaxi (GB 43) were selected as key acupoints plus hyperbaric oxygen to treat 50 cases of sudden deafness, and the total effective rate was 98%. Key Words Acupuncture Therapy - Hyperoxygenation - Deafness, Sudden Author: GUO Min (1971-), female, acupuncturistTranslator: WU Xue-fei

突发性耳聋患者血清T淋巴细胞亚群和Th1/Th2相关细胞因子水平及其临床意义

目的探讨突发性耳聋患者血清T淋巴细胞亚群和Th1/Th2相关细胞因子水平及其临床意义。方法选取60例突发性耳聋患者作为研究组,60例同期体检健康者作为对照组。检测并比较两组外周血CD3^+、CD4^+、CD8^+T淋巴细胞水平,以及血清白细胞介素(IL)-2、IL-4、IL-10、肿瘤坏死因子α(TNF-α)。分析研究组各细胞因子之间的相关性,并比较不同听力下降程度患者细胞因子水平。结果研究组CD3^+、CD4^+、CD8^+T淋巴细胞水平均低于对照组(均P<0.05),但两组CD4^+/CD8^+比值差异无统计学意义(P>0.05)。研究组患者血清IL-4、IL-10水平低于对照组,IL-2水平高于对照组(均P<0.05),但两组TNF-α水平差异无统计学意义(P>0.05);研究组患者IL-2/IL-4、TNF-α/IL-4比值高于对照组(均P<0.05),两组IL-2/IL-10、TNF-α/IL-10比值差异均无统计学意义(均P>0.05)。突发性耳聋患者血清IL-2、TNF-α水平与IL-4水平无明显相关性(P>0.05),与IL-10水平呈负相关性(均P<0.05)。极重度耳聋患者血清IL-4水平低于重度耳聋患者,IL-10水平低于中度耳聋患者,TNF-α水平高于中度、重度耳聋患者(均P<0.05)。结论突发性耳聋患者外周血T淋巴细胞水平降低,同时存在Th1/Th2失衡。Th1介导的IL-2分泌增加,Th2介导的IL-4、IL-10分泌降低,可能参与疾病的发生、发展。

Diagnosis and treatment of sudden sensorineural hearing loss

Nationwide epidemiological surveys of idiopathic sudden sensorineural hearing loss(SSNHL) have been performed five times by the Research Committee of the Ministry of Health and Welfare or the Ministry of Health, Welfare and Labour in Japan. These surveys included patients who had SSNHL in 1972, 1987, 1993, 2001, and 2012. Using the criteria for the grading of hearing loss in SSNHL or the criteria for grading the degree of hearing recovery after SSNHL established by the Research Committee, we compared the outcomes of SSNHL between the five nationwide surveys. The results revealed that the outcomes of SSNHL have not changed in the past 40 years. In 1972, 88% of patients received steroids, but none received prostaglandin E1(PGE1). The use of PGE1 has increased since the 1980 s, but its effect on SSNHL may not be significant. Intratympanic steroid injection has been introduced recently for the treatment of SSNHL, but it does not seem to be used widely in Japan. Intratympanic therapy that can reduce the total amount of steroids administered will be used more frequently if the true effects and indications for this therapy are known. Elucidation of the etiologies of SSNHL and development of treatments specific for these etiologies are expected.

行气复聪方治疗突发性耳聋遗留耳鸣的THI评价

目的观察自拟行气复聪方治疗突发性耳聋遗留耳鸣的临床疗效。方法对87例突发性耳聋经常规治疗(活血剂、抗凝剂、糖皮质激素、神经营养剂等药物及高压氧舱)两周后仍有耳鸣的患者,予汤剂行气复聪方口服,治疗3个月后采用耳鸣残疾度量化表(tinnitus handicap inventory,THI)评价耳鸣变化情况。结果行气复聪方治疗后,患者耳鸣残疾度构成比减轻(P<0.01),听力曲线为平坦型、上升型、下降型改善效果明显,全聋型效果较差(P<0.05,P<0.01);治疗前听力有无恢复与疗效无关(P>0.05),发病两周后与发病3个月后开始中药治疗比较,耳鸣疗效无显著性差异(P>0.05)。结论中药治疗突发性耳聋遗留耳鸣疗效显著。

CLINICAL APPLICATION OF THE TINGGONG POINT

Accurate and comprehensive understandingof the relative specificity of individual pointsand their combination is the essential basis ofacupuncture treatment.Through practice,theauthor studied the therapeutic effect of Tinggong(SI 19)and its combination with other points.Tinggong(SI 19)is in front of the tragus