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.
Purpose: To develop and evaluate a simple screening tool to assess hearing loss in newborns. A derived score was compared with the standard clinical practice tool. Methods: This cohort study was designed to screen the hearing of newborns using transiently evoked otoacoustic emission and auditory brain stem response, and to determine the risk factors associated with hearing loss of newborns in 3 tertiary hospitals in Northern Thailand. Data were prospectively collected from November 1, 2010 to May 31, 2012. To develop the risk score, clinical-risk indicators were measured by Poisson risk regression. The regression coefficients were transformed into item scores dividing each regression-coefficient with the smallest coefficient in the model, rounding the number to its nearest integer, and adding up to a total score. Results: Five clinical risk factors (Craniofacial anomaly, Ototoxicity, Birth weight, family history [Relative] of congenital sensorineural hearing loss, and Apgar score) were included in our COBRA score. The screening tool detected, by area under the receiver operating characteristic curve, more than 80% of existing hearing loss. The positive-likelihood ratio of hearing loss in patients with scores of 4, 6, and 8 were 25.21 (95% confidence interval [CI], 14.69-43.26), 58.52 (95% CI, 36.26-94.44), and 51.56 (95% CI, 33.74-78.82), respectively. This result was similar to the standard tool (The Joint Committee on Infant Hearing) of 26.72 (95% CI, 20.59-34.66). Conclusion: A simple screening tool of five predictors provides good prediction indices for newborn hearing loss, which may motivate parents to bring children for further appropriate testing and investigations.
Digital hearing aids offer many advantages over conventional analog hearing aids. With the advent of high speed digital signal processing chips, new digital techniques have been introduced to digital hearing aids. In addition, the evaluation of new ideas in hearing aids is necessarily accompanied by intensive subject-based clinical tests which requires much time and cost. In this paper, we present an objective method to evaluate and predict the performance of hearing aid systems without the help of such subject-based tests. In the hearing impairment simulation(HIS) algorithm, a sensorineural hearing impairment medel is established from auditory test data of the impaired subject being simulated. Also, the nonlinear behavior of the loudness recruitment is defined using hearing loss functions generated from the measurements. To transform the natural input sound into the impaired one, a frequency sampling filter is designed. The filter is continuously refreshed with the level-dependent frequency response function provided by the impairment model. To assess the performance, the HIS algorithm was implemented in real-time using a floating-point DSP. Signals processed with the real-time system were presented to normal subjects and their auditory data modified by the system was measured. The sensorineural hearing impairment was simulated and tested. The threshold of hearing and the speech discrimination tests exhibited the efficiency of the system in its use for the hearing impairment simulation. Using the HIS system we evaluated three typical hearing aid algorithms.
This study describes a case of sudden sensorineural hearing loss(SSNHL) accompanied with adjunctive symptoms including tinnitus and aural fullness. In this case, we evaluated the effect of Korean medicine treatment for SSNHL accompanied with adjunctive symptoms including tinnitus and aural fullness. We treated 1 SSNHL patient who had adjunctive symptoms of tinnitus and aural fullness. After Korean medical treatment for 9 days, two approaches were used in order to evaluate the effect of the treatment. The hearing recovery was measured with pure tone audiometry, and the decrease of tinnitus and aural fullness was identified by patient's subjective expression. After Korean medical treatments, clinical symptoms of SSNHL accompanied with adjunctive symptoms including tinnitus and aural fullness were considered improved. This study shows that the Korean medical treatment effects on the SSNHL accompanied with adjunctive symptoms including tinnitus and aural fullness.
With the advent of high speed digital signal processing chips, new digital techniques have been introduced to the hearing instrument. This advanced hearing instrument circuitry has led to the need or and the development of new fitting approach. A number of different fitting approaches have been developed over the past few years, yet there has been little agreement on which approach is the "best" or most appropriate to use. However, when we develop not only new hearing aid, but also its fitting method, the intensive subject-based clinical tests are necessarily accompanied. In this paper, we present an objective method to evaluate and predict the performance of hearing aids without the help of such subject-based tests. In the hearing impairment simulation (HIS) algorithm, a sensorineural hearing impairment model is established from auditory test data of the impaired subject being simulated. Also, in the hearing impairment simulation system the abnormal loudness relationships created by recruitment was transposed to the normal dynamic span of hearing. The nonlinear behavior of the loudness recruitment is defined using hearing loss unctions generated from the measurements. The recruitment simulation is validated by an experiment with two impaired listeners, who compared processed speech in the normal ear with unprocessed speech in the impaired ear. To assess the performance, the HIS algorithm was implemented in real-time using a floating-point DSP.
Kim, Ji-Won;Jeong, Hu-Gyeong;Lee, Joo-Young;Kim, Kwang-Hwi;Kim, Tae-Yeon;Lee, Tae-Geol;Kim, Dong-Eun
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
/
v.30
no.4
/
pp.131-141
/
2017
Objectives : The purpose of this study is to investigate recent clinical studies on the effect of acupuncture on hearing loss. Methods : Based on the PubMed search with the key search terms of 'hearing loss, acupuncture', dated from 2004 to 2017, 1 controlled trials, 3 case reports and 3 case series was found, and were analyzed for this study. Results : 1. The most commonly used acupoints were Shuaigu(GB8) and Fengchi(GB20). 2. The most commonly used meridians were the du channel, the gall bladder meridian of foot-shaoyang, and the triple bunner meridian of hand shaoyang. 3. Acupuncture treatment was effective for conductive and sensorineural hearing loss, especially sudden sensory neural hearing loss. 4. More clinical studies are needed to prove the effectiveness of the acupuncture on hearing loss. To be more objective on the study results, we can measure auditory brainstem response for hearing loss after acupuncture treatment.
Kim, Eun-Sook;Ahn, Seon-Ho;Kim, Shin-Moo;So, Hong-Seob;Park, Rae-Kil
Korean Journal of Clinical Laboratory Science
/
v.38
no.3
/
pp.218-223
/
2006
Sensorineural hearing loss is frequently found in patients with chronic renal failure (CRF). There have been many efforts to elucidate the etiologic factors of hearing loss in patients with CRF. However, there was not any clear identified cause of hearing loss. This study was undertaken to evaluate the activity of mitochondrial respiratory chain (MRC) in CRF patients with hearing impairment. To determine MRC activity, peripheral blood cells were obtained from CRF patients with hearing impairment receiving dialysis and normal subjects without any hearing problems. MRC activity of complex I and complex III was measured by the Trounces method. In MRC activities between the normal subjects group and CRF patients with hearing problems, the complex I and III activities of CRF patients with hearing problems were 63% and 85% compared with normal subjects (p<0.01). These results suggest that the activity of MRC may be implicated in the underlying mechanism of the hearing impairment in CRF patients, through mitochondrial DNA mutations at MRC complex I region with a decrement of MRC activity.
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
/
v.16
no.1
/
pp.141-153
/
2003
Introduction : The causes of sudden sensorineural hearing loss have not been detemined with precision until recently, but viral infections and vascular insufficiencies, such as vascular spasm, occlusion of sludging of erythrocytes were considered as major factors. The treatment has not been determined with precision until recently. It is similar to dizziness(眩暈). sudden dcafncss(暴聾) and congestion-fire deafness(痰火聾) in Oriental Medicine. It is very rare that someone has sudden hearing loss and visit Oriental Medicine Clinic right that time. But we expect if they take a Oriental treatment on thc right time. more effective for their symptom. Subjects : Following conclusions were reached by measuring results of oricntal medical treatments for 40 patients who visited the clinic between January of 2000 and December of 2002, and received treatments continuously for more than 1 months of time. Methods : Among the selected 40 patients. 30 patients belong to Group Ⅰ, which consisted of patients who had already visited a general hospital prior to visiting this clinic, achieved no recovery at all from sudden deafness despite going through more than 5 days of hospitalized treatments of steroidal medications. Group Ⅱ was consisted of 10 patients of sudden deafness who did not experience any steroidal treatments from other hospital prior to the oriental medical treatment. Results and conclusion : According to differentiation of syndrome. among 30 patients of the Group Ⅰ. 21 were categorized as excess syndrome patients and remaining 9 as deficiency syndrome paticnts. Among 10 patients of For Group Ⅱ, 5 were excess syndrome patients and remaining 5 were deficiency syndrome patients. Among Group Ⅰ, recovery ratio of excess syndrome patients was 47.7$\%$ and deficiency syndrome patients was 44.4$\%$ adding up recovery ratio of the group to be 46.1$\%$. Among Group Ⅱ, recovery ratio of excess syndrome patients was 80$\%$ and deficiency syndrome patients was 100$\%$ adding up recovery ratio of the group to be 90$\%$. Oriental medical treatments are generally more effective(90$\%$ recovery ratio) for Sudden Deafness than steroidal treatments. Oriental medical treatments are almost equally effective for both excess syndrome patients and deficiency syndrome patients. However, steroidal treatments for excess syndrom patients(45$\%$ recovery ratio) is much less effective than deficiency syndrome patients(73$\%$ recovery ratio). This indicates that steroidal treatments should be applied selectively to deficiency syndrome patients if applied at all. Even for patients with sudden deafness which hospitalized steroidal treatments did not result in any recovery at all, oriental medical treatments were able to achieve 46.1$\%$ recovery ratio.
Waardenburg syndrome (WS) is a rare genetic disorder, including clinical features of pigmentary abnormalities of irides, skin, hair and sensorineural hearing loss and facial dysmorphism. Among the four types, WS type IV (Waardenburg-Shah syndrome) additionally represents Hirschsprung's disease. Mutations in the SOX10, END3, or EDNRB genes are known to cause WS type IV. Here, we report a 6 year-old girl who was diagnosed as WS type IV by typical clinical manifestations, including skin hypopigmentation, heterochromia of both irides, unilateral sensorineural hearing loss, mild developmental delay and Hirschsprung's disease. The diagnosis was confirmed by molecular genetic analysis of EDNRB. Two novel EDNRB mutations were identified, and each mutation was segregated from each of her parents. During the follow-up period, the patient underwent a surgery for spleen torsion and was medically managed due to recurrent enterocolitis. Also, she suffered from impaired immunity including Hirschsprung's associated enterocolitis.
Cochlea hair cell death is regarded to be responsible for the radiation-induced sensorineural hearing loss (SNHL), which is one of the principal complications of radiotherapy (RT) for head and neck cancers. In this mini-review, we focus on the current progresses trying to unravel mechanisms of radiation-induced hair cell death and find out possible protection. P53, reactive oxygen species (ROS) and c-Jun N-terminal kinase (JNK) pathways have been proposed as pivotal in the processes leading to radiation hair cell death. Potential protectants, such as amifostine, N-acetylcysteine (NAC) and epicatechin (EC), are claimed to be effective at reducing radiation-inducedhair cell death. The RT dosage, selection and application of concurrent chemotherapy should be pre-examined in order to minimize the damage to cochlea hair cells.
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