• The Korean Journal of Pain
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• v.13 no.2
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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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• v.8 no.1
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• pp.65-73
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• 1995

Idiopathic sudden sensorineural hearing loss(SNHL) is defined as a sensorineural hearing loss which develops over a period of hours or few days without a definitive causes. The etiology, prognosis, and treatment of SNHL are uncertain. We reviewed records of 76 patients to investigate the efficacy of the stellate ganglion block(SGB)in SNHL. The control group(40 patients) was managed with the medication such as hypaque, heparin, steroid, nicotinic acid, and vitamine. The SGB group(27 patients) was managed with the same medication and SGB (1~2 times/day). The efficacy of treatment was evaluated by mean dB of 500, 1000, 2000 Hz on follow up pure tone audiogram. Recovery rate above 15dB was not different between SGB and the control group (52.4 v.s. 52.0%), though SGB group has much poor prognostic factors. Recovery rate was higher in a case that was treated early. Especially, the recovery rate was 100% when SGB begins within 2 weeks from the onset. Headache and profound type of audiogram were poor prognostic factors. In conclusion, SGB within 2 weeks from the onset is recommanded to improve the recovery rate.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.35 no.2
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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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• v.10 no.1
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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.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.33 no.2
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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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• v.25 no.4
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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.

• Korean Journal of Audiology
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• v.25 no.4
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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.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1976.06a
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• pp.85.3-86
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• 1976

Sudden deafness requires immediate investigation and treat if there is to be any prospect of salvaging the hearing. It present an otological emergency and a diagnostic challenge. Sn Sudden sensorineural deafness can be caused by a wide variety of pathologies. A battery of tests and investigations must be performed forthwith if treatment is to be started without further delay. The concept that nothing can be done for the patient with sensori-neural deafness must be abandoned. Some pathologies causing sudden deafness are not amenable to therapy or can show only partial reversibility. But there are several causes, showing little or no spontaneous recovery, which do responed to appropriate treatment. It is important to identify them and concentrate on their management. The age and sex ratios and the unilaterral or bilateral nature of the lesion are related to the etiology and depend upon which type of case is included in the series. Though individually rare, collecting for about 2.5 per cent of new otoloical patients. Some 70 per cent of cases are unilateral. Viral, bacterial and treponemal infections accounted for about 30 per cent of the cases. Some 16 per cent were due to vascular lesions of the cochlea. In almost 22 per cent there was no obvious cause (idiopathic), they occurred in young adult and were either sensory or neural. About 12 per cent were traumatic and 9 per cent were ototoxic in origin. The remaining 11 per cent were due to a group of rarities. The two vital factors are the site of the lesion and the duration of the hearing loss. The earlier these are diagnosed and treated the better the response. The etiology, pathology and treatment are reviewed.

• The Korean Journal of Pain
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• v.18 no.2
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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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• v.21 no.1
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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.