• The Korean Journal of Pain
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• 제13권2호
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• pp.191-195
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• 2000

Background: Vascular occlusive event is one of the etiologies of sudden sensorineural hearing loss (SNHL). Stellate ganglion block (SGB) induces dramatic and intense vasodilatation in head and neck. Based on this principle, SGB has used as one of the treatment modalities in SNHL. This study was performed to evaluate immediate response of SGB on pure tone audiogram (PTA) in SNHL. Methods: Forty patients were studied. Each patient received daily ipsilateral SGB in paratracheal approach using 0.2% bupivacaine for 2 weeks. On first, third, and fifth day of treatment, we checked their PTA twice 1 hour before (Pre-PTA) and after (Post-PTA) SGB. Pre- and Post-PTA were compared. Several factors were analyzed as a prognostic factor of therapeutic results. Results: Eleven of 40 patients revealed decreased PTA after SGB. Degree of decreased PTA were insignificant ($2.5{\pm}1.6$ dB). Initial and final PTA results was $76.2{\pm}22.5$ and $49.8{\pm}28.3$ dB, respectively. Thirty-one of 40 patients were improved their PTA over 10 dB. The recovery was mainly influenced by the severity of initial hearing loss (P<0.001) and slightly by age (P<0.05). However, the change of PTA after SGB, time interval to receive SGB, sex, site, and number of SGB were not correlated to therapeutic outcome. Conclusions: These results suggest that vasodilatation by SGB has no immediate improvement in SNHL. Therefore, we question whether SGB is beneficial to all patients with SNHL as a therapeutic modality.

• The Korean Journal of Pain
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• 제8권1호
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• pp.65-73
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• 1995

1) 돌발성난청의 치료성적은 대조군, 성상신경절차 단군 각각 완전회복 28.6%, 18.5%, 부분회복은 6.1%, 7.4%, 경도회복은 16.3%, 25.9%로 성상신경절차단군이 예후가 나쁜 인자가 많았음에도 불구하고 두군사이에 유의한 차이가 없었다. 2) 회복예후는 두통이 수반될 때, 청력형이 농형일 때 예후가 불량하였고, 발증에서 치료시작까지의 기간이 빠를수록 좋았으며 특히 성상신경절차단을 2주 이내에 시행한 경우에는 반응이 없었던 예가 없었다.

• 한방안이비인후피부과학회지
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• 제35권2호
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• pp.28-48
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• 2022

Objectives : The purpose of this study is to investigate the trend of traditional Chinese medicine for sudden sensorineural hearing Loss(SSHL) in Chinese journals. Methods : Chinese National Knowledge Infrastructure(CNKI) and Wanfang med online were used to search randomized controlled trials(RCTs) on SSHL which were published from January, 2017 to December, 2021. Results : Among Chinese studies, Tonifying and Replenishing medicinal(補益藥) and Exterior-releasing medicinal(解表藥) were the most frequently used medicine in treating SSHL. Acori Graminei Rhizoma(石菖蒲) was the most frequently used herb excluding Glycyrrhizae Radix(甘草). All studies reported that using Traditional Chinese Medicine alone or combining western medicne(WM) is more effective for treating SSHL than using WM alone, although one study reported the result is not statistically significant. Conclusions : In analysis of selected studies, co-treatment of traditional chinese medicine and WM can be more effective way for treating SSHL than using WM alone. Side effects of treating SSHL can also be reduced by co-treatment of traditional chinese medicine and WM.

• The Korean Journal of Pain
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• 제10권1호
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• pp.113-116
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• 1997

Sensorineural hearing loss(SNHL) is defined as a sudden hearing impairment which was develope over a period of hours to days. The definitive cause of SNHL is unknown in most cases. Disturbance of the blood flow of the inner ear is a main causal hypotheses. Most symptomatic treatment is focusing to improving the blood flow of the inner ear. At our hospital, most patients are recommended to bed rest, vasodilators(nicotinic acid, antihistamines) and stellate ganglion block(SGB) for two weeks. We experienced two cases of recurrence immediately after recovery from SNHL. They discontinued SGB after initial recovery. due to associated pain with operation and or psychologic stress. One patient resumed SGB and medication treatment, but the second who gave up treatment was not recovered. Therefore, we recommend to continuance of treatment of stellate ganglion blocks to improve recovery rate of SNHL and avoid further trauma and psychologic stress during the recovery period of SNHL.

• 한방안이비인후피부과학회지
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• 제33권2호
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• pp.23-42
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• 2020

Objectives : This study is designed to analyze the outpatients who received medical treatments for ear diseases in ophthalmology & otolaryngology & dermatology clinic of Daejeon Korean Medical Hospital from March, 2013 to February, 2019. Methods : We classified the otology outpatients who received medical treatments in ophthalmology & otolaryngology & dermatology clinic of Daejeon Korean Medical Hospital from March, 2012 to February, 2019 according to gender, year, age, season, anatomical parts, and main diagnosis. The statistical analysis was performed using SPSS 25.0. Results : 1. The number of outpatients with ear diseases were 880; 505 female and 375 male. The number of female patients were approximately 1.7 times higher. 2. The average age of the outpatients with ear diseases were 50.0. The number of middle-aged (40-50s) patients were 439, which is almost half the number(49.9%) of the whole patients. 3. By analyzing the number of patients classified by year, we found out that the number of the outpatients with ear diseases has increased gradually for the past 7 years. 4. In the analysis of the number of patients classified by the anatomical parts of the ear, the inner ear diseases group were the largest, amounting to 79.3% of the whole patients. 5. In the analysis of the number of patients classified by main diagnosis, Tinnitus turns out to be the largest group with 338 patients, followed by sudden sensorineural hearing loss, dizziness, otalgia, Meniere's syndrome, otitis, auditory tube dysfunction, BPPV. 6. No statistical-significant difference were shown in the analysis of the number of patients classified by season. Conclusions : It turns out that patients with ear diseases had increased by the years, and middle aged patients (40-50s) were the largest among the age groups. Most of the patients came for the inner-ear diseases, and tinnitus, sudden sensorineural hearing loss took up the largest proportions.

• Journal of Audiology & Otology
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• 제25권4호
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• pp.209-216
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• 2021

Background and Objectives: We aimed to analyze treatment outcomes following different initial management approaches and confirm treatment regimens for acute low-tone sensorineural hearing loss (ALHL) that would yield the best results. Subjects and Methods: We retrospectively analyzed the medical records of 106 patients with ALHL who visited a university hospital's otology clinic from March 2013 to June 2019. Pure-tone averages at the initial visit and at 2 and 4 weeks after the initial visit were evaluated. Results: Forty-nine patients were enrolled in this study; of them, 41 (83.7%) exhibited complete recovery (CR) at 2 weeks and 43 (87.8%) exhibited CR at 1 month after the initial visit. Regression analysis revealed that CR at 2 weeks after the initial visit was associated with diuretic use [Exp(B): 10.309, 95% confidence interval (CI): 1.007-100]. An initial daily low-dose steroid use was marginally significant [Exp(B): 1.042, 95% CI: 0.997-1.092; p=0.066]. Isolated diuretic use [Exp(B): 25.641, 95% CI: 1.121-90.909; p=0.039] was an independent, good prognostic factor at 1 month after the initial visit. However, other treatment regimens did not affect the final results. Conclusions: A combination of initial daily administration of ≤30 mg prednisolone plus diuretics was sufficient as the first-line treatment for ALHL. High-dose steroids and salvage intratympanic steroid injections can be applied as a second choice; however, the predicted outcome would not be good in that case.

• 대한청각학회지
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• 제25권4호
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• pp.209-216
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• 2021

Background and Objectives: We aimed to analyze treatment outcomes following different initial management approaches and confirm treatment regimens for acute low-tone sensorineural hearing loss (ALHL) that would yield the best results. Subjects and Methods: We retrospectively analyzed the medical records of 106 patients with ALHL who visited a university hospital's otology clinic from March 2013 to June 2019. Pure-tone averages at the initial visit and at 2 and 4 weeks after the initial visit were evaluated. Results: Forty-nine patients were enrolled in this study; of them, 41 (83.7%) exhibited complete recovery (CR) at 2 weeks and 43 (87.8%) exhibited CR at 1 month after the initial visit. Regression analysis revealed that CR at 2 weeks after the initial visit was associated with diuretic use [Exp(B): 10.309, 95% confidence interval (CI): 1.007-100]. An initial daily low-dose steroid use was marginally significant [Exp(B): 1.042, 95% CI: 0.997-1.092; p=0.066]. Isolated diuretic use [Exp(B): 25.641, 95% CI: 1.121-90.909; p=0.039] was an independent, good prognostic factor at 1 month after the initial visit. However, other treatment regimens did not affect the final results. Conclusions: A combination of initial daily administration of ≤30 mg prednisolone plus diuretics was sufficient as the first-line treatment for ALHL. High-dose steroids and salvage intratympanic steroid injections can be applied as a second choice; however, the predicted outcome would not be good in that case.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1976년도 제10차 학술대회연제 순서 및 초록
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• pp.85.3-86
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• 1976

돌발성난청은 만약청력이 구조될 가망이 있으면 즉각적인 검사와 치료가 필요하다. 이것은 이과적 비상사태이며 또 진단의 도전자이다. 감각신경성돌발성난청은 광범위한 종류의 병인으로 생길 수 있다. 종합적인 정밀검사를 곧 시행하여 치료를 지체없이 시작해야만 될 것이다. 감각신경성난청환자에 대해서 아무것도 할 것 없다는 관념은 버려야 되겠다. 돌발성난청을 일으키는 어떤 병인은 치료에 순응 않거나 또는 다만 일부만 정상회복이 가능하다. 그러나 그냥 두면 조금은 회복되거나 또는 스스로는 전연 회복되지 않고, 적절한 치료에는 반응하는 병인들도 있다. 이 병인들을 확인하여 그 처치에 대하며 전심 연구하는 것은 긴요하다. 연령 성별의 비율 및 병변의 편측 또는 양측성은 그 원인에 관련되며, 모은 환자군의 형에 의해서 다르다. 돌발성난청은 개별적으로는 드므나, 모이면 흔한데 외래신이과환자의 약 2.5%에 이르렀으며, 약 70%는 편측성이였다. virus, 세균 및 treponema 감염성은 약 30%였고, 약 16%는 cochlea의 혈관성병변에 의해서였다. 거의 22%는 원인불명(idiopathic)으로 이것은 청년층에서 주로 발생하였으며, 감각성이거나 신경성이였다. 12%는 외상성이고, 9%는 이중독성이였다. 기타가 11%였다. 이대중요요소는 병변의 부위와 청력장해의 기간인데 일찍 진단하여 치료하면 그만큼 치료반응이 좋다. 동시에 원인, 병리 및 치료에 대한 고찰을 더 하였다.

• The Korean Journal of Pain
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• 제18권2호
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• pp.232-234
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• 2005

Stellate ganglion block (SGB) is one of the most widely used treatment modalities for a broad range of disorders, including otolaryngologic indications such as Meniere's disease and sudden hearing loss. We present a case of a vertiginous attack following SGB for the management of Meniere's disease. A 31-year-old female, suffering from Meniere's disease, underwent repeated right side SGBs with 6 ml of 1% mepivacaine after negative aspiration tests for blood. The eleventh block was performed in the usual manner. Several seconds after injection, she showed agitation, anxiety, nystagmus, and left-sided tinnitus. Two minutes later, her tinnitus and nystagmus were resolved. Fifteen minutes after injection, she experienced acute onset of severe vertigo, nausea, and vomiting. However, her symptoms were gradually alleviated within two hours.

• The Korean Journal of Pain
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• 제21권1호
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• pp.62-65
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• 2008

A 73-year-old man with sudden sensory neural hearing loss received a stellate ganglion block. Two hours after the block, the patient complained of newly developed neck discomfort. After an additional two hours, the neck swelled up gradually and neck pain and dyspnea developed. A plain radiograph of neck revealed narrowing of the upper airway; a tracheostomy was performed and the dyspnea was improved. On the next day, the pain site extended to the right scapula and a CT image revealed a huge retropharyngeal hematoma. Hematoma evacuation and bleeder ligation were then performed and the patient was discharged on the fourth day after admission without any complications. A practitioner should always remember to educate the patients about possible complications and undertake intensive observation when performing procedures, even in patients who do not initially present with a compromised airway.