cardiovascular-agents and Tinnitus

Sensorineural deafness and vertigo have different causes among them immunological, vascular and infectious. Vascular causes of sensorineural hearing loss are unusual and among them are the vertebral artery aneurysms. Knowledge by neurosurgeons, neurointerventional and otolaryngologists aneurysms involving the development of sensorineural hearing loss is critical to establishing and determining a targeted therapeutics. We report the case of an adult handled with endovascular techniques and review the current literature of similar cases.

Topics: Angioplasty, Balloon, Coronary; Cardiovascular Agents; Cerebral Angiography; Combined Modality Therapy; Endovascular Procedures; Hearing Loss, Sensorineural; Hearing Loss, Unilateral; Humans; Imaging, Three-Dimensional; Intracranial Aneurysm; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Male; Middle Aged; Multimodal Imaging; Myocardial Infarction; Risk Factors; Smoking; Stents; Tinnitus; Vertebral Artery; Vertigo

Steroids are currently the most frequently accepted agents for idiopathic sudden sensorineural hearing loss (ISSNHL). However, the therapeutic effect of steroids is not always satisfactory. In this pilot study, we evaluated whether systemic treatment with Ginkgo biloba extract (EGb761) has an additive therapeutic effect in patients receiving a systemic steroid due to ISSNHL. A multicenter, randomized, double-blind clinical trial was performed. Fifty-six patients with ISSNHL were allocated to either EGb761 or placebo. In both groups, methylprednisolone was administered for 14 days. EGb761 was infused intravenously for 5 days in the EGb761 group, while the same amount of normal saline was infused in the placebo group. For the efficacy evaluation, pure-tone audiometry, speech audiometry, tinnitus handicap inventory (THI) and short form-36 health (SF-36) survey outcomes were obtained before administration and on days 3, 5, 14 and 28 of administration. Twenty-four patients in each group completed the study protocol. There was no difference in hearing loss between the two groups before treatment. At day 28, air conduction threshold values in the placebo and EGb761 groups were 34.63 ± 28.90 and 23.84 ± 25.42 dB, respectively (p = 0.082). Speech discrimination scores in the placebo and EGb761 groups were 69.17 ± 40.89 and 87.48 ± 28.65 %, respectively (p = 0.050). THI and SF-36 scores in the placebo and EGb761 groups were similar. Although a combination of steroid and EGb761 for initial treatment did not show better pure tone threshold, compared with steroid alone, speech discrimination was significantly improved in combination therapy. Further studies will be needed to know if addition of EGb761 actually improves the outcome of ISSNHL treatment.

Topics: Administration, Intravenous; Adult; Aged; Audiometry; Cardiovascular Agents; Dexamethasone; Double-Blind Method; Drug Therapy, Combination; Female; Ginkgo biloba; Glucocorticoids; Hearing Loss, Sensorineural; Hearing Loss, Sudden; Humans; Male; Methylprednisolone; Middle Aged; Pilot Projects; Plant Extracts; Speech Perception; Tinnitus; Treatment Outcome

Some patients with sudden sensorineural hearing loss (SSNHL) are frustrated by residual tinnitus even after accomplishment of the treatment for SSNHL. In the present prospective study, we examined patients' backgrounds of sex, laterality and age together with changes in hearing level and the tinnitus score after the onset of SSHNL to determine the prognostic factors of residual tinnitus after the final day of medical treatment for SSNHL.. Forty-four patients with SSNHL were all treated with systemic administration of steroids for 2 weeks and oral intake of vasoactive drugs and vitamin B12 for 6 months before accomplishment of the treatment for SSNHL. The hearing improvement rate (HIR) was determined by comparing the hearing level before and 6 months after the start of treatment. Tinnitus was subjectively evaluated by the tinnitus scoring questionnaire before, 6 and 24 months after the start of treatment. The score of a five-step evaluation of subjective tinnitus feelings, "loudness", "duration" and "annoyance", was recorded.. HIR was significantly correlated with tinnitus score improvement (TSI) in "duration" at 6 months after the start of treatment compared with before treatment. The tinnitus score of all 3 items was significantly improved 6 months after the start of treatment compared with that before treatment but it was not significantly changed between 6 and 24 months after the start of treatment. TSI in "duration" between 6 and 24 months was significantly correlated with the patients' age and HIR using multiple regression analysis.. According to the tinnitus scoring questionnaire, "duration" is the most reliable item for subjective evaluation of tinnitus accompanied by SSNHL. Generally, subjective feelings for residual tinnitus 6 months after the start of treatment for SSNHL are supposed to be almost the same, even at the 24th post-treatment month. Especially, younger patients with better hearing improvement are predicted to achieve further improvement of tinnitus between 6 and 24 months after the start of treatment.

Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Anti-Inflammatory Agents; Audiometry, Pure-Tone; Cardiovascular Agents; Female; Hearing Loss, Sudden; Humans; Hydrocortisone; Male; Middle Aged; Prognosis; Prospective Studies; Recovery of Function; Sex Factors; Surveys and Questionnaires; Tinnitus; Treatment Outcome; Vitamin B 12; Vitamin B Complex; Young Adult

Topics: Cardiovascular Agents; Ergot Alkaloids; Hearing Disorders; Hearing Loss, Sensorineural; Oxytocics; Tinnitus