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As mentioned above, Sudden Hearing Loss or sudden sensorineural hearing loss is a type of hearing loss where there is a hearing reduction of more than 30 Decibel, over a three contagious frequencies, which occurs over a time period of 72 hours or less. People of all ages can be affected to such a kind of hearing loss all of a sudden; however it is mostly seen in adults from the age groups 30 to 60 years of age.
Sudden hearing loss or the sudden deafness is also called as sudden sensorineural hearing loss (SSHL) which is caused by damage in the vestibulocochlear nerve, the inner ear or the central processing centers of brain. There are some rational approaches in the treatments available for sudden hearing loss which must be given a thought.
It is obvious that the first step of diagnosis of sudden hearing loss begins from documenting the recent reduction in hearing or the recent level of hearing loss, with the help of an audiogram.
Now let us look for some of the special tests particularly advised for checking the status of a sudden hearing loss for further treatments or precautions. MRI Brain Testing: There can be certain conditions related to sudden hearing loss or the sudden sensorineural hearing loss, like the acoustic neuroma or the tumors, strokes etc. Audiometric Testing: There are some kind of audiometric testing for sudden hearing loss, which are done with the help of an audiometer. It is now obvious that when a condition of sudden hearing loss is diagnosed; then the prime most thing of consideration is to look after the possible treatments available for treating the sudden hearing loss condition in the patient.
Treatments via Rheologic Agents: Reducing the viscocity of blood can help in an improved oxygen delivery and a proper flow of blood to the cochlea. Vasodialators For Treating Sudden Hearing Loss: Vasodialators are the agents which help in enhancing the blood flow to the cochlea.
Anti-Inflammatory Treatments Via Steroids And Corticosteroids: Various studies and trials have found that steroids are useful in treating sudden hearing loss to some extent and that oral steroids as well as steroid injections can be given to the affected person while treating the condition. Anti-Viral Treatments: There are some known anti-viral agents which are proposed in treating sudden hearing loss.
Treatments via Triiodobenzoic Acid Derivatives: There are some agents which are thought to help in maintaining the endocochlear potential. Hyperbaric Oxygen Therapy For Sudden Hearing Loss: It is also regarded that improving the oxygen tension in the hyperbaric chamber, helps in treating the sudden hearing loss. Now, apart from all these diagnosis and treatment procedures; one must be very cautious on keeping self safe from any unwanted condition and prevent self from the sudden hearing loss in a better way. Objetivo: Observar a evolucao da surdez subita em pacientes incluidos em diferentes grupos de tratamento, de acordo com o tempo de evolucao da doenca e com as contra-indicacoes para uso das medicacoes. Objective: Determine the follow-up between pacients sudden sensorineural hearing loss treated in five different groups according to duration of disease and the drugs used for treatment. INTRODUCAOA surdez subita (SS) e definida como perda auditiva (PA) neuro-sensorial, igual ou maior que 30 decibel (dB), em 3 ou mais frequencias consecutivas, instalada num periodo de ate 3 dias (1). SSNHL is a frightening occurrence in which the hearing is lost dramatically, usually in one ear, over a short time period of a few hours to 3 days.
The cause of SSNHL is rarely identified, although a thorough workup by an otolaryngologist or otologist such as Dr.
The natural history of ISSNHL is that between 50% and 70% of patients will recover their hearing spontaneously. IT steroid injection is an office procedure with minimal discomfort and even less risk to the patient. Often, patients with ISSNHL are also given antiviral drugs and other medications to boost circulation.
If you are worried about SSNHL, please make sure you are seen by an otolaryngologist and receive a hearing test as soon as possible, so that treatment can be instituted in a timely fashion. Svrakic M, Pathak S, Goldofsky E, Hoffman R, Chandrasekhar SS, Sperling N, Alexiades G, Ashbach M, Vambutas A. If you have any questions about treatment, billing, or insurance, please feel free to call for an appointment. Prediction of hearing outcomes by distortion product otoacoustic emissions in patients with idiopathic sudden sensorineural hearing loss. Mori T, Suzuki H, Hiraki N, Hashida K, Ohbuchi T, Katoh A, Udaka T.SourceDepartment of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Japan. Govindaraju R, Omar R, Rajagopalan R, Norlisah R, Kwan-Hoong N.SourceDepartment of Otorhinolaryngology, University of Malaya, Kuala Lumpur, Malaysia. The higher field strength magnetic resonance imaging (MRI) such as 3 Tesla (T) and above generates noise that has potential detrimental effects on the hearing.
Topical insulin-like growth factor 1 treatment using gelatin hydrogels for glucocorticoid-resistant sudden sensorineural hearing loss: a prospective clinical trial.
Permanent deafness is a condition in a person's life where he is restricted from hearing completely forever. The diagnosis procedures usually decide about the type of treatment to be undertaken by the patient. It is first necessary to understand the level of loss a person has suffered or the hearing reduction percentage that has encountered a victim which further would require the treatment. These audiograms are actually the graphical presentation of the audible threshold for the standardized frequencies that are measured by an audiometer. Pure tone and speech audiometry, tympanometry, otoacoustic emissions (OAE) etc are some of the known audiometric testing. Accordingly there are special tests for the special cases that lead to sudden hearing loss. Any treatment begins with the thorough consultation and mutual understanding between the doctor and the patient. This reduction in blood viscocity can be done with the use of low molecular weight dextrans or anticoagulants like Heparin.
However, it is also found that oral steroid doses have a lot of side effects and the steroid injections are pretty costly. Acyclovir and Amantadine are two such names, but with limited use in the treatment procedure. Angiographic contrast agent like the Diatrizoate meglumine was found to have an effect on sudden hearing loss and is thus considered as the most commonly used derivative of triiodobenzoic acid. Treatments via diurectics and certain minerals and vitamins can be effective but there are no proper evidences or explanation on the same.


It is needed to keep yourself away from the loud noise that can cause the noise-induced sudden hearing loss, keep self safe from any harsh physical trauma which can damage the inner ear and lead to sudden hearing loss, and also be very much sure about the drugs or medicines being taken for illness, have got no side effects like the hearing loss on temporary basis and keeping safe from ear infection & thus restricting the sudden hearing loss caused due to viral infections. The hearing loss is of a nerve type and is often accompanied with significant tinnitus (head noise), and may be accompanied by vertigo (spinning dizziness). In the vast majority of cases in which the cause is not identified, the disease is renamed idiopathic SSNHL (ISSNHL).
These are usually patients whose hearing loss is in the mild to moderate range, and not those who experience severe or profound SNHL.
Oral prednisone at high doses should be prescribed as soon after the problem occurs as possible, unless there is a medical contraindication to this treatment, such as hypertension or diabetes or other immunocompromised states. Diagnostic and prognostic utility of measuring tumor necrosis factor in the peripheral circulation of patients with immune-mediated sensorineural hearing loss.
Temporary threshold shifts following MRI examination have been reported for MRI with lower field strength. Sudden Sensorineural Hearing Loss (SSHL), or sudden deafness, is a rapid loss of hearing. Explains both sudden conductive hearing loss and various kinds of Sudden Sensorineural Hearing Loss (SSHL) Sudden deafness (sudden sensorineural hearing loss): diagnosis, causes and treatment Sudden Sensorineural Hearing Loss is a Medical Emergency. There are certain important reasons that may cause permanent deafness, which may includes damage in the ear or damage in the nerve that serves for transmitting sound to the brain.
There are problems which come in to live at certain circumstances which are pretty different from the usual ones.
It is found that 60 % of the patients suffer from sudden loss of hearing due to the viral diseases like those caused by influenza type B virus, CMV or Mumps virus, about 1% of the sufferers are those who get in to Sudden Hearing Loss due to vascular disease. Let us discuss on the diagnosis and some of the treatment procedures for sudden hearing loss or sudden sensorineural hearing loss.
In order to know the condition, it is required to go for certain diagnosis and tests under expert professionals in a proper manner. It is very much true that checking the history of a victim for any infectious causes having its roots leading to sudden hearing loss can also help in a great way for diagnosing the condition of hearing loss. Electrolysis, comprehensive metabolic screen test, CT scan for temporal bone and Lyme test are some of the common tests done under special cases for knowing about the condition of hearing reduction.
Now coming to the treatments available for SHL, there are no such preferred treatments noted.
Some of the most common agents used for improving the cochlear blood flow, includes Papaverine, Histamine, Procaine, Niacin, Nicotinic acid, Carbogen etc. Two alternative names Famiclovir and Valacyclovir, have come in to the list of consideration for treatment for sudden hearing loss. One study done during 2004 by Narozony; has found that the hyperbaric oxygen therapy comprising of a 100% oxygen at a 250kPa pressure for about 60 minutes in a multi-place hyperbaric chamber along with the high doses of Glucocorticosteroids enhances the treatment results in conventional sudden sensorineural hearing loss.
It is also to be noted that be very much sure to immediately sought treatment for any of the causative diseases or conditions like the vascular or the neural etc.
Metodo: Analise de pacientes atendidos no Ambulatorio de surdez subita submetidos a tratamento padronizado de janeiro de 1996 a janeiro de 2006, divididos em cinco grupos de tratamento para receber expansor plasmatico, dexametasona, aciclovir, acido nicotinico, cloridrato de papaverina e ou vitamina A.
Method: Review of patients records included in a standardized protocol of treatment of the sudden sensorineural hearing loss outpatient unit between January 1996 and January 2006.
Em cerca de um terco dos casos podem ocorrer queixas associadas como zumbido, vertigem ou tontura e plenitude aural (2,3). MRI evaluation is also a necessary portion of the evaluation, along with appropriate hearing and, if needed, balance tests. Intratympanic (IT) injection of steroids is an excellent alternative to oral steroid use in those patients, as it penetrates the inner ear effectively in animal studies and has shown its usefulness in clinical (human) studies. Chandrasekhar has been at the forefront of both animal and human studies of this treatment modality. Sudden Sensorineural Hearing Loss (SSHL, Sudden Deafness) Sudden Sensorineural Hearing Loss (SSHL), or sudden deafness, is a rapid loss of hearing. However there are also conditions in man when all of a sudden there is a 30 decibel reduction in hearing over three contagious frequencies that occurs over 72 hours or even less and when the outside sounds gets unreachable to the ear, or may be a kind of ringing ear or tinnitus is felt inside the ear.
There are some unusual circumstance that get a kind of instant or sudden deafness, a kind of ringing ear symptom or tinnitus, which may be mild, moderate or may be severe based on the level of hearing reduction. Studies involving sudden hearing loss have also found that 20% to 60% of the sudden hearing loss resulted from Vertigo. However, there are some possible treatments available for such conditions which are based on rational approaches. Studies have found that carbogen when combined with drugs, works better than the therapeutic drugs for the treatment of sudden hearing loss.
A audiometria foi realizada antes (inicial) e apos o inicio da terapia (30, 90, 120 e 180 dias). Inclusion criteria were sudden sensorineural hearing loss occurring within 72 hours and 30 dB or more at three serial frequencies.
Sometimes patient might suffer from a kind of hearing loss all of sudden in the morning instantly and some meet with the loss of hearing gradually over some days time. Some of the common causes of sudden hearing loss include the loud noises, physical trauma, certain drugs or medicines, some neurological issues, vascular diseases and some viral diseases or infection. There can be side effects of the treatments available for the sudden hearing loss, but again it is solely up to the patient's agreement while undergoing any treatment procedure for SHL.
These anti-viral agents actually inhibit the Viral DNA polymerase and thus restrict the viral DNA from replicating. Pacients were included in five treatment groups and had received Dextran®, dexamethasone, acyclovir, nicotinic acid, papaverine chloridrate and or vitamin A.
Dentre os fatores associados temos os disturbios metabolicos que sao mais frequentes entre cocleo-vestibulopatas do que na populacao geral (7).
Resultados: A amostra compreende 139 pacientes com idade media de 45,4 anos, 52,5% do sexo feminino e 47,5% masculino, em 92,8% a surdez subita era unilateral e em 7,2% bilateral. Explains both sudden conductive hearing loss and various kinds of Sudden Sensorineural Hearing Loss (SSHL).
Outcome was determined by subtracting baseline PTA (first day of the medical assessment) from final PTA (after 180 days).


Nao pode ser detectada diferenca significante na resposta audiometrica entre os grupos de tratamento. Results: Complete data were collected for 139 subjects, mean age were 45,4 years, 52,5% were female and 47,5% were male, 92,8% had unilateral sudden sensorineural hearing loss and 7,2% had bilateral one. Definitions of sudden hearing loss have been based on severity, time course, audiometric criteria, and frequency spectrum of the loss. Observamos correlacao linear inversa significante entre o tempo decorrido do inicio da doenca e o primeiro atendimento e a evolucao ou resposta audiometrica. Conclusoes: O expansor plasmatico nao melhorou a eficacia da associacao entre o corticoide e o aciclovir no tratamento da surdez subita. Nevertheless, no significant difference could be noted in audiometric assessment between treatment groups. Foram incluidos neste grupo aqueles que possuiam contra-indicacao clinica ao uso do expansor plasmatico (hipertensao arterial sistemica, cardiopatia, disturbio da coagulacao e insuficiencia renal). We observed a significant linear correlation between time from sudden sensorineural hearing loss onset to initial visit and audiometric recovery. Conclusion: Dextran® did not provide more benefit than steroid and acyclovir in the treatment of SSHL. As soon as treatment begins better will be the outcome prognosis for sudden sensorineural hearing loss.
Sudden hearing loss or sudden sensorineural hearing loss, SSNHL, is defined as a loss greater than 30 dB in three contiguous frequencies, occurring over a period of less than three.
Nestes casos, a audiometria tonal limiar foi realizada em dias alternados,sendo programada a suspensao da medicacao e alta hospitalar na ausencia de melhora dos limiares auditivos apos tres dias. Intratympanic dexamethasone with hyaluronic acid in the treatment of idiopathic sudden sensorineural hearing loss after failure of. Nos casos de melhora audiometrica, o esquema terapeutico foi mantido por ate 10 dias.Para documentacao da variacao audiometrica foi utilizado o PTA, pure tone average ou limiar tonal puro. Sudden hearing loss (SHL) is a medical emergency for which definitive diagnosis and treatment is still.
O PTA para frequencias graves foi determinado pela media dos limiares tonais das frequencias de 250, 500 e 1000 Hertz (Hz) e o PTA para frequencias agudas a partir da media das frequencias de 2000, 4000 e 8000 Hz.
A evolucao ou resposta audiometrica dos pacientes entre os diversos grupos de tratamento foi determinada subtraindo-se o PTA inicial (primeiro dia de avaliacao medica) do final (apos 180 dias).Para analise estatistica dos resultados, foram utilizados o teste t de Student e a analise de variancia (ANOVA).
O nivel de significancia considerado foi de p RESULTADOSEm 129 (92,8%) pacientes a surdez subita (SS) era unilateral e em apenas 10 (7,2%) era bilateral. Quanto a etnia 77 (55,4%) eram brancos, 35 (25,2%) eram negros e 4 (2,9%) eram da raca amarela.
Assim, para as frequencias graves observamos um coeficiente de correlacao de Spearman r = - 0,45 (p Grafico 1. Correlacao entre o tempo de inicio do tratamento e a evolucao nas frequencias graves.Grafico 2. Correlacao entre o tempo de inicio do tratamento e a evolucao nas frequencias agudas.DISCUSSAOA literatura mostra que a idade media dos pacientes com surdez subita (SS) varia de 43 a 53 anos, que a distribuicao por sexo e equivalente e que o acometimento em mais 95% dos casos e unilateral, semelhante ao que observamos neste levantamento (2, 4, 13, 15, 16).
O unico levantamento epidemiologico de SS publicado ate o momento foi feito no Japao em tres anos distintos, em diferentes decadas e mostra que o tempo entre o inicio da SS e o primeiro atendimento variou de 11,6 ± 12,1 dias em 1974, 9,1 ± 9,8 dias em 1987 a 8,1 ± 9,1 dias em 1993 (15). Nao podemos comparar diretamente nossa casuistica com a de NAKASHIMA et al (15), pelo tipo de desenho e por serem populacoes diferentes, porem observamos retardo ate o primeiro atendimento o que pode ser atribuido em parte a descaso dos pacientes em relacao ao sintoma ou a dificuldade de acesso ao medico.Partindo de grupos homogeneos quanto as medias iniciais do PTA e considerando-se todos os casos atendidos, houve reducao significante na media do PTA.
Esta media de melhora (PTA inicial - final) foi de 21,6dB para frequencias graves e de 16,7dB para as agudas. Apesar de nao haver grupo controle para comparacao, a literatura mostra que a melhora espontanea (sem tratamento) ocorre em 32% dos casos de SS e e em media de 15dB de PTA (3, 8), portanto menor do que a observada neste estudo. A recuperacao audiometrica estimada com o tratamento e de aproximadamente 25dB de PTA (3), semelhante a que observamos para frequencias graves.Quanto a evolucao dos pacientes (PTA inicial - PTA final) nos cinco grupos de tratamento, a diferenca observada nao se mostrou significante, tanto para frequencias graves como para agudas. Embora nao tenhamos observado significancia estatistica, a melhora do PTA foi menor nos pacientes dos grupos IV e V, que iniciaram o tratamento apos 15 dias do inicio da SS. Os grupos I, II e III iniciaram o tratamento nos primeiros 15 dias de SS, porem o melhor PTA foi observado no grupo II, o unico a nao receber expansor plasmatico por contra-indicacao clinica. Embora algumas doencas de base sejam capazes de interferir na microcirculacao da orelha interna dificultando a melhora clinica da SS, as comorbidades apresentadas pelos pacientes do grupo II, aparentemente nao significaram fatores de pior prognostico.
Em nosso levantamento, o expansor plasmatico nao contribuiu para potencializar os efeitos do corticosteroide e do aciclovir no tratamento da SS, uma vez que o grupo que melhor respondeu a terapia nao o utilizou.Observamos uma correlacao linear inversa significante entre o tempo decorrido ate o inicio do tratamento e a resposta audiometrica apresentada pelo paciente, tanto para frequencias graves quanto para agudas. Prognosis of sudden deafness with special reference to risk factors of microvascular pathology. Oral steroid treatment of sudden sensorineural hearing loss: a ten year retrospective analysis. Sudden complete or partial loss of function of the octavus system in apparently normal persons. Antiviral treatment of idiopathic sudden sensorineural hearing loss: a prospective, randomized, double-blind clinical trial. Treatment of idiopathic sudden sensorineural hearing loss with antiviral therapy: a prospective, randomized, double-blind clinical trial. Prognosis for sudden sensorineural hearing loss: a retrospective study using logistical regression analysis. Clinicoepidemiologic features of sudden deafness diagnosed and treated at university hospitals in Japan. Usefulness of high doses of glucocorticoids and hyperbaric oxygen therapy in sudden sensorineural hearing loss treatment.
Assistente Doutor do Setor de Otoneurologia do Departamento de Otorrinolaringologia da FMUSP.2. Antiviral treatment of idiopathic sudden sensorineural hearing loss: A prospective, randomized, double-blind clinical trial. Prognostic indicators of management of sudden sensorineural hearing loss in an Asian hospital.



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