Sudden onset tinnitus and hearing loss funciona,pearl stud earrings accessorize,ear infection symptoms upset stomach,home remedies for ringing ears after concert 3600 - Review

19.04.2015
Come in for a free hearing evaluation and receive a FREEcaption call phone (restrictions apply). Imagine waking up one morning to discover that you had spontaneously lost most of your hearing in one or both ears, with no warning or explanation.
If you or a loved one experiences a sudden hearing loss, please call your doctor or visit an ER or urgent care center immediately! Forty hospitalized patients with sudden hearing loss and tinnitus were compared to a control group (N = 28) of inpatients of an ear-nose-throat ward.
Certain single-case studies have reported the association between stress and SHL [9], as have some group studies that used qualitative interviews as assessment instruments [10,11]. From a physiological point of view, the assumption of the contribution of stress to the onset of SHL and TIN has some plausibility. The main objective of the current study is to examine the association between stress SHL and TIN in a control group design, using a comprehensive and methodologically refined assessment strategy.
Our study, therefore, tested the following assumptions: Onset of SHL and TIN is associated with a high level of stress defined by life events and daily hassles, habitual dysfunctional coping strategies, a high level of worrying, and a low level of social support.
Because a prospective design relating to the stress hypothesis with hundreds of non symptomatic subjects was beyond our research capacities, a control group design was used.
Daily hassles (DH) were assessed by the German questionnaire Alltagssorgen-Skala [33] (Cronbach's alpha = 0.96), which is based on the Daily Hassles Scale by Kanner et al. To determine the level of worrying (W), the German version of the Penn State Worry Questionnaire [36] (16 items; a 5-point rating scale) was presented to the subjects. The experimental subjects were contacted by telephone 3 months after they had been assessed for the first time. Patients with SHL and TIN show significantly higher scores on both measures of stress, on the life event scale, and on the daily hassles scale than those in the clinical control group. As expected, significantly more negative coping strategies (COPneg) were found in the experimental group. The prospective part of our study examined the connection of psychological test variables (LOCint, LOCpow, LOCfat and LE, DH, W, and social support), sociodemographic variables (age, gender, family status, number of children), and characteristics associated with the disorder (TIN in the past, acute TIN, disability due to TIN and SHL, and WB at the onset of the disorder), all measured at onset of the hearing disorder, to the chronicity of TIN and hearing loss 3 months later.
The chronicity of TIN is correlated most closely to WB at disorder onset, COPneg, and LOCfat (Table 5). In a discriminant analysis, the six variables of all three categories (WB, COPneg, LOCfat, acute TIN, age, disability due to TIN) associated most highly with chronicity of TIN were used to separate the group of patients with TIN from recovered patients. Chronicity of SHL (n = 18 of 35 subjects) is associated most closely with WB at the onset of the disorder, with disability due to TIN and SHL, and with the degree of anxiousness concerning SHL and LOCfat. The six variables-WB, disability due to acute TIN, SHL, LOCfat, anxiety concerning SHL, and number of SHL-correlated most highly to the chronicity of hearing loss were entered into a discriminant analysis at the same time. The hypothesis regarding the stress differences expected between SHL and TIN patients and the control group before the onset of the disorder was confirmed fully. The affective state of certain persons often has been shown to influence memory; in a negative state, more negative memory contents are activated and retrieved.
At first glance, the data about worrying confirm our hypothesis that it is more intense in SHLITIN patients. The discrimination analysis fully supported the foregoing conclusions, selecting daily hassles as the strongest variable in the prediction of group membership and coping as a further relevant aspect. The second part of our study was concerned with the prediction of chronicity of SHL or TIN 3 months after onset. Though the validity of these predictions cannot be guaranteed and has to be cross-checked, an interesting note is that the supposedly predisposing stress factors that seem important for the onset of the studied hearing disorders do not contribute to its chronicity. All in all, our study suggests that psychological variables related to stress and its processing are predisposing for TIN and SHL and that the actual subjective state of well-being shortly after onset of the di sorder is a relevant predictor of chronicity of both disorders.
Though our data support the hypothesis of psychological influences on disease etiology and prognosis in SHL and TIN, some methodological limitations of the study have to be taken into account. The intent of our study was to sample similar groups maximally except for the disorder itself.
Furthermore, the conclusions drawn from the prospecti ve part of the study, especially regarding the importance of psychological variables, are somewhat uncertain. Idiopathic sudden sensorineural hearing loss is a medical emergency that requires urgent diagnosis and treatment, and the adaptation of a proper protocol for management is a priority.
Idiopathic sudden sensorineural hearing loss (ISSNHL) [1] is a well-known clinical condition characterized by a sudden occurrence in one or both ears of sensorineural hearing loss of more than 30 dB in at least three contiguous audiometric frequencies over a time course of no more than 72 hours. Hearing impairment is a common problem worldwide and even more problematic in developing countries.
Sensorineural hearing loss [4-9] (or nerve-related deafness) involves damage to the ear caused by aging, prenatal and birth-related problems, viral and bacterial infections, heredity, trauma, exposure to loud noise, fluid backup, or tumor in the inner ear. This retrospective study was conducted from January 2002 to December 2003 to identify patients with ISSNHL. We found no age relation or significant side predilection, and the duration of improvement was variable, extending from less than 1 week to up to 6 weeks. The prognosis of tinnitus involved full recovery in all but one of the grade 4 patients; the unrecovered patient had at 8 kHz a dip that did not improve. All but three patients who developed dizziness (those with very severe hearing loss) had fully recovered in a few days; the unrecovered group had dizzy spells that lasted more than a few days. ISSNHL is a symptom of cochlear injury and is characterized by sudden onset; within a few hours, it reaches its maximum peak. Although called sudden, hearing loss seems unlikely to be abrupt but rather probably evolves over a few hours [6]. Research conducted by the Institute of Audiology in Turin documented that 5,925 cases were diagnosed over a 5-year period (1990-1995) [7].
Many causes can trigger sudden hearing loss [6-10] but, despite extensive evaluation, the majority of cases elude definitive diagnosis and, therefore, remain idiopathic. Our study revealed that the treatment protocol involving steroid therapy in Qatar resulted in hearing improvement in 57.4% of patients with ISSNHL. Classic stigmata of congenital syphilis SNHL, interstitial keratitis, Hutchinson teeth (notched incisors), mulberry molars, Clutton joints (bilateral painless knee effusions), nasal septal perforation & saddle deformity& frontal bossing. Under these conditions, your lungs can gather up to three times more oxygen than would be possible breathing pure oxygen at normal air pressure. Many insurance carriers are approving this costly procedure without question for victims of sudden hearing loss. Most studies dealing with chronic TIN focus on its symptomatology, consequences, and treatment [13-21]. One presently prominent theory postulates that both disorders result from a diminished supply of blood to the inner ear, which impairs the inner and outer hair cells by lack of oxygen [1,5,10,22]. Stress is assessed by psychometrically validated inventories of life events and daily hassles. The study examines whether psychological predictors exist for maintenance of hearing loss and TIN 3 months after onset. The main guideline for the selection of the control group was to assess patients with maximal similarity to those in the experimental group of patients with SHL and TIN so as to rule out threats to internal validity, as addressed by Kazdin [29]. At the time of the assessment, all patients selected for the study were hospitalized in the ear-nose-throat ward. Patients were on the average approximately 40 years old, and nearly one-half (48.5%) were female.
The first questionnaire asked for sociodemographic data (age, gender, family status, number of children, profession), information regarding the circumstances of the disorder (both groups), and a detailed description of SHL and TIN (experimental group only). Stober [37] found a Cronbach's alpha of 0.86 for the German version of the Penn State Worry Questionnaire, which is similar to the Cronbach's alpha found by Molina and Borkovec [38]. This outcome is true for both aspects, the number and stressfulness of events (Table 3), though subjective strain differentiates more clearly between the groups. However, in contrast to expectation, they also showed significantly more positive strategies (COPpos, see Table 3). This finding indicates that the lower the state of wellbeing, the higher is the probability of TIN maintenance. The number of predictors is limited to six, as the number of subjects should not be less than the number of predictors multiplied by five. Chronicity of hearing loss is not correlated to the other sociodemographic variables or characteristics attributed to the disorder (Table 6). Life events and daily hassles before the onset of the disorder were significantly more frequent, and their stressfulness was more distinct in the experimental group. As a marked difference in well-being was found between the two groups (worse mood in the experimental subjects), the variance between groups attributed to differences in well-being was eliminated by partial correlation.
The hypothesis of more COPneg strategies in the experimental group was supported, but the level of positive coping endeavors also is much higher in the SHLITIN group, a finding contrary to expectation. However, after controlling for well-being, this effect vanished, which demonstrates that the process of worrying is intensified markedly by an individual's negative state.
The general assumption is that the probability of remission of these special hearing disorders at that time is rather low, so that a chronic state can be assumed. The only psychological trait variable with some predictive power for TIN is negative coping. Only habitual processing variables (coping, fatalistic LOC) show some influence on chronicity, but the best predictor is well-being, probably an indicator of the subjective evaluation of the biopsychosocial state of an individual. Habitual psychological trait characteristics (coping, LOC) exhibit some, but not a strong, influence. The experimental group exists of patients suffering predominantly from both types of hearing disorders; very few persons were afflicted with TIN or SHL only.


This was successful in nearly all assessed variables, with the exception of well-being, which turned out to be an important variable.
Management of Idiopathic Sudden Sensorineural Hearing Loss: Experience in Newly Developing Qatar. A report prepared by the Department of Otolaryngology [3] at University of Texas Medical Branch documented approximately 15,000 reported cases of ISSNHL per year worldwide, with 4,000 of those cases occurring in the United States. Therefore, we have a pressing need to study the causes of ISSNHL and suggest a treatment protocol for ISSNHL.
Of the studied subjects, 81% were male and 19% were female (median age, 43 years; range, 24-67 years).
Of the seven patients (33.3%) who showed no improvement in their hearing both audiologically and clinically (grade 1), six patients had dizzy spells when first seen, four had audiometric HTLs of 65 dB or no response at 8 kHz, five had high-frequency sloping audiometric curves, and all showed no improvement at 6 weeks' duration. Incidentally that patient developed recurrence of hearing loss 12 week later but in the opposite ear, which was also treated with steroid therapy and showed remarkable improvement.
ISSNHL is the most intractable of hearing loss types, because its fundamental cause is hair cell death. The researchers concluded that sudden idiopathic hearing loss, often attributed to general vascular causes, was one of the most frequent reasons for monolateral hearing loss. Furthermore, we concluded that results can be improved if the disorder is diagnosed early in patients using proper protocols and if early treatment is undertaken. Department of Medical Statistics and Epidemiology, Hamad General Hospital and Hamad Medical Corporation, Doha, Qatar. Skeletal findings osteochondritis& periostitis of long bones SNHL, interstitial keratitis, Hutchinson teeth (notched incisors), mulberry molars, Clutton joints (bilateral painless knee effusions), nasal septal perforation & saddle deformity& frontal bossing. Human blood carries this oxygen throughout the body, stimulating the release of substances called growth factors and stem cells, which promote healing. The main objective of our study was to test the hypothesis of stress as a predisposing risk factor in the development of sudden hearing loss and tinnitus. Their pathophysiological features, the assumptions concerning their pathogenesis, and their medical treatment are rather similar [5-8]. Patients suffering from SHL (N = 98) reported more stress than did 13 patients with morbus Meniere who were used as control subjects. Vascular processes, mainly responsible for blood flow, are regulated by the sympathetic nervous system and the hypothalamic pituitary adrenal axis, the main systems activating cardiovascular stress responses.
Because external stressors have no direct influence on health but are mediated by subjective evaluation and processing of the stressful situation [23], habitual coping strategies also are studied. The variables examined as possible predictors are the same as those mentioned earlier as assessed at the time of the onset of the disorder. Additionally to the disorder itself being different in the control group, the disease should not be associated conceptually with stress in its etiology. Furthermore, patients rated their actual well-being (WB) on a 5-point scale from very good (5) to very bad (0). The 56 items reflect a variety of everyday hassles concerning work, household, marriage, money, friends, and family. The Streβverarbeitungsbogen assesses the likelihood of various habitual coping behaviors in situations leading to discomfort, arousal, or tension. The contacted subjects were interviewed about the status of their hearing disorder, especially whether their TIN or hearing deficit still were present.
Also, the more negative coping strategies individuals exhibit and the stronger a fatalistic locus of control in individual patients, the more probable is the maintenance of TIN. Interestingly, the reported strain due to the stressful events differentiates more clearly between groups than does their number. Otherwise, the reported higher amount of stress could be ascribed to the negative state of those in the hearing loss and TIN group at time of assessment. One can assume that the classification of coping behaviors into "bad" or "good" regarding their problemsolving or palliative capacity may be invalid, as some often have argued that the effectiveness of coping also depends on the kind of stressor and other characteristics of the situation. The discrimination between groups was well above chance but, with an error rate of 25%, was not really very satisfactory. Interestingly, this global self-evaluation is more important than is the rating of disability due to TIN and SHL and variables related to the history of the disorder. The definitely worse state of well-being in the experimental group points to the fact that the comorbidity of SHL and TIN probably is very stressing and annoying. Nevertheless, our data support the hypothetical role played by stress and related psychological factors in the etiology of SHL and TIN. Verhaltensmedizinische Untersuchungen zum HOrsturz [The behavioral medicine of sudden hearing loss].
Plotzliche doppelseitige Ertaubung durch psychische Konfliktsituation [SHL in both ears as a consequence of psychological conflict]. General and specific coping strategies used by middle aged males with noise induced hearing loss, with or without tinnitus.
Structure of perceived handicap in middleaged males with noise-induced hearing loss, with and without tinnitus. The management of chronic tinnitus-comparison of a cognitive-behavioral group training with yoga. Psychologische Behandlung des chronischen Tinnitus [Psychological treatment of chronic tinnitus].
Multidimensional health locus of control as partial predictor of serum phosphorus in chronic hemodialysis. Zur interund intraindividuellen Reliabilitat einer modifizierten deutschen Fassung der Social Readjustment Rating Scale [Inter- and intraindividual reliability of the modified Social Readjustment Rating Scale]. Comparison of two modes of stress measurement: Daily hassles and uplifts versus major life events. The Penn State Worry Questionnaire: Psychometric properties and associated characteristics.
Fragebogen zur Erhebung von Kontrolluberzeugungen zur Krankheit und Gesundheit (KKG) [Questionnaire to assess locus of control regarding illness and health (KKG)]. The aim of this study was to determine and identify as early as possible those factors that play the important role in the prognosis of the condition, to describe the experience, and to suggest a treatment protocol that can be adopted in a tertiary hospital, such as Hamad General Hospital.
Because of its various etiological possibilities and its prognostic characteristics, urgent attention and treatment are required, and the condition may be considered as an emergency. One in every 10,000- 15,000 people experience this condition, with the highest incidence occurring between 50 and 60 years of age.
The prevalence of hearing loss increases with age; most hearing losses develop over a period of 25-30 years.
The aim of this study was to identify patients with ISSNHL as early as possible, to describe their experience, and to suggest a treatment protocol that can be adopted in a tertiary hospital, such as Hamad General Hospital.
Tympanometry showed a type-A curve in all patients, and acoustic reflex results were negative in the affected ear in 13 patients.
Spectacular advances have recently been made in our understanding of hair cell physiology and molecular biology, offering new hope of alleviating ISSNHL [10].
Also, we observed in our study that most patients who had ISSNHL ranged in age from 40 to 60 years, although the highest rate was found among men. Monolateral sensorineural hearing loss, which is not seriously disabling, represents a handicap from the social point of view. The degree of hearing loss may vary from mild to severe and may involve different parts of the hearing frequency range. Suggested causes of ISSNHL include viral infections, immunologic vascular compromise, and intracochlear membrane breaks. Samson, Department of Epidemiology and Medical Statistics, Hamad Medical Cor poration, for her kind help in preparing and typing the manuscript.
Sudden hearing loss due to large vestibular aqueduct syndrome in a child: Should exploratory tympanotomy be performed? In the past, sudden onset hearing loss (occurring within 72 hours) has had very limited treatment options.
Thus, differences in life events and daily "hassles" were expected between groups, as were differences in coping styles, habitual worrying, and social support.
Quite a number of experts and laymen believe that the onset of SHL and TIN is mediated by stress.
However, no standardized measures were applied, and no quantitative statistical analysis of the data was conducted. What must be borne in mind, however, is the existence of various theories of pathogenesis and etiology of these hearing disorders; in general, all lack sound empirical support and somehow differ in their views of the functional role attributed to stress. Furthermore, worrying [24] is an important factor related to the processing of stressful information, a trait variable that has not yet been considered in regard to the onset of hearing disorders.
Additionally, locus of control assessed at the same time is included as a psychological trait variable, which has been studied often in the context of chronic disease [25-28]. For the control group, inpatients suffering from different conservatively treated illnesses of throat, ear, and nose were selected. Life events (LE) were assessed by the German version of the Social Readjustment Rating Scale (retest-reliability after 10 weeks, Pearson's coefficient, r = 0.71) [31,32]. Number and stressfulness of hassles during the last 4 weeks before the onset of the illness were assessed.
Wellbeing showing a significant difference between groups can be considered as a potentially confounding variable.
Worrying had a significantly higher level in the experimental group, but this difference was lost after statistical control for well-being.


Thus, the subjective evaluation of stressful events is more important than is the sum of events. However, the difference in stressfulness of life events and daily hassles were shown to be maintained at a significant level.
Regardless, the fact remains that different coping behaviors, whether positive or negative, are used much more frequently by the experimental group. All subjects reported an extraordinary high degree of social support (high above the average of the norm group). The most powerful predictor both for chronic TIN and for SHL is the state of subjective wellbeing at time of first assessment immediately after the onset of the disorders. Furthermore, what should be mentioned is that the explained variance is higher in the prediction of chronicity than in the discrimination of the different clinical groups. The search for prognostic factors of chronicity must be continued, after this first attempt offering some challenging data. In Bradley WG, Deroff RB, Fenichel GM, Marsden CD (eds), Neurology in Clinical Practice, Vol. However, because of controversies regarding etiology and the need for urgent treatment, various diagnosis and treatment protocols were advocated by different centers.
Many hypotheses have been advanced to explain its etiology: viral inflammation, vascular diseases, allergic reaction, rupture of intralabyrinthine membranes, and autoimmune diseases.
Audiological evaluation, including pure-tone audiometry, tympanometry, speech audiometry, and auditory brainstem-evoked response testing results were included. All patients except one had unilateral ear involvement and revealed almost equal frequency of involvement for both left and right ears.
Only three patients had speech audiometry and, for auditory brainstem response, results in nine patients were normal except for decreased HTL. Six patients of the grade 4 group had flat, basin-shaped or up-turning audiometric curves (Fig.
We observed in our study that some of the causes of sudden or fluctuating sensorineural hearing loss were meningitis, multiple sclerosis, or Friedreich's ataxia.
At one time, it was theorized that a viral componenet was involved, however, treatment with antivirals has shown no benefit. The hypothesis of more frequent and more stressful life events and daily hassles was supported empirically. Because of the abundant clinical evidence for the importance of stress, the simplified model illustrated in Figure 1 and derived from Hoffmeister [1] is used for the conceptualization of the presumed interplay of stressrelated somatic and psychological factors.
Patients were asked whether any of the 42 given life events took place within the last year. It consists of three scales: internality (LOCint), powerful others-externality (LOCpow), and fatalistic externality (LOCfat). The group differences in both aspects of LE and DH, however, remain significant after statistically controlling for well-being (see Table 3).
No difference was registered in the level of social support; both groups showed very high scores (Table 3). Our data show, as is found often in other studies, that life events and daily hassles are not independent of each other but correlate to a large degree. Thus, well-being had some effect on remembering and reporting negative events, especially on the number, but the difference between experimental and control group cannot be explained totally by their different state of well-being.
What might be posited is that the experimental group uses more coping strategies because they meet more life problems, as shown.
Generally, social support may be very high in the special situation to which all subjects were exposed: being in the hospital for their first few days. Also very influential is the degree of disability due to TIN experienced at first assessment. One undesirable aspect of our study is the difference in the number of subjects in the experimental control group, due to the difficulty in recruiting control patients. It was conducted in the ear, nose, and throat outpatient clinics at Hamad General Hospital and the ear, nose, and throat wards at Rumailah Hospital. Recently, increasing interest is centered on the means of diagnosis and treatment, leading to the emergence of quite a variety of protocols adopted by different treatment centers.
With respect to laboratory investigations, results of complete blood cell count, erythrocyte sedimentation rate, blood film for abnormal cells, and coagulation screening were normal in all patients. The dominant role of daily hassles, especially their stressfulness as a risk factor, was shown clearly. In a well-designed but unpublished study by Mtinzel and Sander (oral presentation), however, no differences in stress were found between a group of patients with SHL and those in a clinical control group. Additionally, they had to rate the subjective stressfulness (or strain) of each event on a rating scale from 0 to 100. To assess the relative importance of LE and DH, controls were applied for their common variance.
A further assumption might be that they are trying hard to cope with stress most of the time but are not successful, as the reported strain by the events is higher in the experimental group.
In the prediction of chronic SHL, both disability due to SHL and TIN at onset are important. The task of identification of patients for the study was allotted to the hospital staff, who then informed the psychologists of their potential subjects. Many studies have been carried out to assess the histopathology of the labyrinth in cases of ISSNHL and to provide a better understanding of the etiopathogenesis [10].
In ten of the twelve patients who showed improvement, the duration of onset was less than 14 days and was less than 7 days in six of eight patients in grade 4.
The incidence of tinnitus compares well with that in the literature [11,12]; however, tinnitus did not assist well in determining which patients would suffer hearing loss.
In all the studied cases, patients had an intact tympanic membrane and revealed no other ear, nose, and throat abnormality. Patients with profound hearing loss often do not regain any hearing function with steroid treatment. This selection criterion was used to reduce bias effects of memory on self-report measures [30]. The groups did not differ significantly in any of the sociodemographic variables (Table 2). After controlling for the effect of DH, the difference in LE between groups no longer was significant; on the other hand, after controlling for the effect of LE, the difference in stressfulness of DH was maintained (see Table 4).
After this procedure, the discriminating function of life events, be it number or strain, was lost.
Thus, their potentially exhausting coping endeavors could also contribute to onset of the hearing disorders. Because the identification of potential control group patients was much more difficult than was the identification of SHLITIN patients and because of the fact that pending surgery excluded many patients from the control group, the recruitment of the control subjects was very time-consuming and less successful.
The treatment protocol that was adopted-consisting of high-dose steroid therapy, full-dose antiviral drug (acyclovir), and a histamine analog, betahistine-resulted in hearing improvement in 57.4% of cases.
Finally, most causes of ISSNHL remain unknown; thus the term idiopathic is applied to these cases. In respect to the duration of illness, 33.3% of the studied patients had the complaint for 2 weeks, and 19% had it for more than 4 weeks. However, a high incidence of associated dizziness may be responsible for poor recovery incidence in our series, so it can be considered to indicate a poor prognosis [13-15]. Wellbeing is the only variable differing significantly, with control patients feeling better than did the experimental subjects.
On the other hand, daily hassles (especially their stressfulness) retain their differentiating function. However, the number of subjects lies within the range of statistical demands (number of subjects = 5 × number of variables) [41]. The prospective part of the study aimed at the prediction of chronicity of sudden hearing loss and tinnitus (3 months after onset) by sociodemographic, psychological, and disease-associated variables.
Patients who fulfilled the established criteria were informed about the study and then were given the questionnaires, which they were supposed to complete within 2 days. Thus, what can be concluded is that life events probably give rise to various stressful daily hassles that undermine health status. The results of our study revealed that the steroid therapy protocol practiced in Qatar resulted in hearing improvement in patients with idiopathic sudden sensorineural hearing loss.
The strongest predictor of chronicity was the degree of well-being at the time of first assessment (soon after disease onset). Consequently, our study applying psychological instruments of satisfying reliability and validity in a control group design confirms findings by Hoffmeister [1], Kropp and Rad [10], Stange [11], and Neuser and Knoop [12]. Good prognostic factors include early diagnosis, marked reduction of symptoms, and improved shape of the audiometric curve. Only one person contacted in the experimental group and three in the control group refused to participate (see Table 2).



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Comments Sudden onset tinnitus and hearing loss funciona

  1. DoDaqDan_QelBe
    Naturally my tendency element to the sound intact find any benefit from.
  2. baby_girl
    Hearing loss, we begin to expertise the sinuses are hollow religion for most of my life.
  3. AURELIUS
    External and middle ear result other than water shock.