Objective. Sudden hearing loss (SHL) is a frightening symptom that often prompts an urgent or emergent visit to a physician. This guideline provides evidence-based recommendations for the diagnosis...

/pdf/clinical-practice-guideline-sudden-hearing-loss-8acwe9fo8a.pdf

Clinical practice guideline: sudden hearing loss.

ObjectiveSudden hearing loss is a frightening symptom that often prompts an urgent or emergent visit to a health care provider. It is frequently but not universally accompanied by tinnitus and/or v...

https://journals.sagepub.com/doi/pdf/10.1177/0194599819859885

Clinical Practice Guideline: Sudden Hearing Loss (Update).

Sudden sensorineural hearing loss (SSNHL) is commonly encountered in audiologic and otolaryngologic practice. SSNHL is most commonly defined as sensorineural hearing loss of 30dB or greater over at least three contiguous audiometric frequencies occurring within a 72-hr period. Although the differential for SSNHL is vast, for the majority of patients an etiologic factor is not identified. Treatment for SSNHL of known etiology is directed toward that agent, with poor hearing outcomes characteristic for discoverable etiologies that cause inner ear hair cell loss. Steroid therapy is the current mainstay of treatment of idiopathic SSNHL in the United States. The prognosis for hearing recovery for idiopathic SSNHL is dependent on a number of factors including the severity of hearing loss, age, presence of vertigo, and shape of the audiogram.

/pdf/sudden-sensorineural-hearing-loss-a-review-of-diagnosis-1y0qilepkr.pdf

Sudden sensorineural hearing loss: a review of diagnosis, treatment, and prognosis.

Radiation therapy is an established modality in the treatment of head and neck cancer patients. Compromised wound healing in irradiated tissues is a common and challenging clinical problem. The pathophysiology and underlying cellular mechanisms including the complex interaction of cytokines and growth factors are still not understood completely. In this review, the current state of research regarding the pathomechanisms of compromised wound healing in irradiated tissues is presented. Current and possible future treatment strategies are critically reviewed.

/pdf/wound-healing-after-radiation-therapy-review-of-the-54wtlmb3ny.pdf

Wound healing after radiation therapy: Review of the literature

Background— The present study was performed to assess the association of prothrombotic risk factors and underlying conditions (infections, vascular trauma, immobilization, malignancies, autoimmune ...

Cerebral Venous Thrombosis in Children A Multifactorial Origin

Intracranial complications of acute and chronic mastoiditis: report of two cases in children

Objectives:We investigated prognostic factors in sudden sensorineural hearing loss (SSNHL).Methods:Our study group consisted of 133 patients with SSNHL who were treated at our department between 19...

Prognostic factors in sudden sensorineural hearing loss : Our experience and a review of the literature

OBJECTIVE We investigated the effect of pharmacologic (steroids, vasodilators, vitamins, and Betaserc) and hyperbaric oxygen therapy on patients with sudden sensorineural hearing loss. METHODS The pharmacologic arm of the study consisted of 52 patients with defined sudden sensorineural hearing loss treated simultaneously in the ENT Department and National Center for Hyperbaric Medicine of the Medical University of Gdansk, Poland, from 1997 to 2000 (Group A). The hyperbaric oxygen therapy consisted of exposure to 100% oxygen at a pressure of 250 kPa for a total of 60 minutes in a multiplace hyperbaric chamber. The control group included 81 patients with defined sudden sensorineural hearing loss treated in the ENT Department, Medical University of Gdansk, from 1980 to 1996 (Group B). Both groups were comparable regarding the age of the patients, season of hearing loss occurrence, tinnitus and vestibular symptom frequency, delay before therapy, and average threshold loss before the start of treatment. The treatment results (hearing gain) were estimated using pure-tone audiometry. We retrospectively analyzed the audiograms of all patients. RESULTS Patients from Group A (blood flow-promoting drugs, glucocorticoids in high doses, betahistine, and hyperbaric oxygen therapy) showed significantly better recovery of hearing levels compared with those from Group B (blood flow-promoting drugs and glucocorticoids in low doses) at seven frequencies (500, 1,000, 2,000, 3,000, 4,000, 6,000, and 8,000 Hz) (p < 0.05) and four groups of frequencies (pure-tone average, high-tone average, pure middle-tone average, and overall average) (p < 0.05). Percentage hearing gain in all investigated frequencies was also better in Group A versus Group B, and the differences were statistically significant (p < 0.05). CONCLUSION We conclude that hyperbaric oxygen therapy with high doses of glucocorticoids improves the results of conventional sudden sensorineural hearing loss treatment and should be recommended. In addition, the best results are achieved if the treatment is started as early as possible.

Usefulness of high doses of glucocorticoids and hyperbaric oxygen therapy in sudden sensorineural hearing loss treatment.

Malignant external otitis (MEO) is an invasive, morbidity, even mortality, mainly pseudomonal infection of the external auditory canal, frequently involving the base of the skull, multiple cranial nerve and the meninges. In many cases conventional therapy has been prolonged, intensive and relatively ineffective, especially in infections other than bacterial (mainly fungal). We presented theoretical principles of hyperbaric oxygen (HBO) treatment in MEO, our own experience and others' experience in applying this treatment method. We treated eight patients with MEO applying pharmacotherapy, topical management, surgery in one case and also adjunct HBO. In six patients, infection was caused by Pseudomonas aeruginosa, in one by Staphylococcus sp. and in one by Aspergillus sp. Complete recovery was achieved in seven patients. In the patient with MEO caused by Aspergillus sp., intracranial complications developed and the patient died. Our experiences in employing HBO in bacterial-caused MEO have confirmed the role of HBO as a valuable, beneficial, supporting classical treatment method. Small number of patients with MEO, especially with non-bacterial infection, and unforeseen clinical course of disease make our experience difficult to objectivize.

Jerzy Kuczkowski

Papers

Intracranial complications of acute and chronic mastoiditis: report of two cases in children

Prognostic factors in sudden sensorineural hearing loss : Our experience and a review of the literature

Usefulness of high doses of glucocorticoids and hyperbaric oxygen therapy in sudden sensorineural hearing loss treatment.

Value of hyperbaric oxygen in bacterial and fungal malignant external otitis treatment

Otitic hydrocephalus associated with lateral sinus thrombosis and acute mastoiditis in children