flunarizine and Hearing-Loss--Sensorineural

To assess the efficacy of the combination of hyperbaric oxygen (HBO) and pharmacological treatment in patients with idiopathic sudden sensorineural hearing loss (ISSNHL) and define patients amenable for HBO therapy.. Prospective, randomized, trial involving 136 cases with unilateral ISSNHL that were randomly divided into 2 groups: the pharmacological treatment (P) group and HBO + pharmacological treatment (HBO+P) group, which received additional HBO for 14 days besides the pharmacological treatments. Pure tone audiometry gain larger than 15 dBHL was defined as success, and the success rate of each group was calculated.. The overall success rate of the HBO+P group and the P group is 60.6% (40/66) and 42.9% (30/70), respectively (p < 0.05). Furthermore, patients with mild-moderate baseline hearing loss, aged ≤50 years, receiving treatment in ≤14 days, or without accompanied dizziness/vertigo in the HBO+P group had higher success rate than the P group (p < 0.05).. HBO combined with pharmacological treatments leads to better hearing recovery than pharmacological treatments alone.

Topics: Adult; Aged; Audiometry, Pure-Tone; Combined Modality Therapy; Drugs, Chinese Herbal; Evoked Potentials, Auditory, Brain Stem; Female; Flunarizine; Glucocorticoids; Hearing Loss, Sensorineural; Hearing Loss, Sudden; Humans; Hyperbaric Oxygenation; Male; Middle Aged; Nerve Growth Factor; Prednisone; Prospective Studies; Thiamine; Treatment Outcome; Vasodilator Agents; Vitamin A; Vitamin B 12; Vitamin E; Vitamins; Young Adult

Changes in intracellular Ca2+ level are involved in a number of intracellular events, including triggering of apoptosis. The role of intracellular calcium mobilization in cisplatin-induced hair cell death, however, is still unknown. In this study, the effect of calcium channel blocker flunarizine (Sibelium), which is used to prescribe for vertigo and tinnitus, on cisplatin-induced hair cell death was investigated in a cochlear organ of Corti-derived cell line, HEI-OC1, and the neonatal (P2) rat organ of Corti explant. Cisplatin induced apoptotic cell death showing nuclear fragmentation, DNA ladder, and TUNEL positive in both HEI-OC1 and primary organ of Corti explant. Flunarizine significantly inhibited the cisplatin-induced apoptosis. Unexpectedly, flunarizine increased the intracellular calcium ([Ca2+]i) levels of HEI-OC1. However, the protective effect of flunarizine against cisplatin was not mediated by modulation of intracellular calcium level. Treatment of cisplatin resulted in ROS generation and lipid peroxidation in HEI-OC1. Flunarizine did not attenuate ROS production but inhibited lipid peroxidation and mitochondrial permeability transition in cisplatin-treated cells. This result suggests that the protective mechanism of flunarizine on cisplatin-induced cytotoxicity is associated with direct inhibition of lipid peroxidation and mitochondrial permeability transition.

Topics: Animals; Antineoplastic Agents; Apoptosis; Calcium Channel Blockers; Calcium Channels, T-Type; Cell Death; Cell Line; Cisplatin; Flunarizine; Hair Cells, Auditory; Hearing Loss, Sensorineural; In Situ Nick-End Labeling; Lipid Peroxidation; Organ Culture Techniques; Organ of Corti; Protective Agents; Rats; Rats, Sprague-Dawley; Reactive Oxygen Species; Treatment Outcome

Vestibular symptoms frequently occur in patients with migraine headache. The common migraine is defined in neurology as a unilateral, pulsating headache, which may be associated with nausea and vomiting, and lasts one or several days. In the classic form patients have visual prodromal symptoms. Focal neurological signs in the migraine complique include, for example, oculomotor palsy and vestibular abnormalities. This so-called vestibular migraine is different from basilar migraine, which involves the irritation of the cervical sympathetic system, and can cause symptoms that resemble transient brainstem ischemia. In order to evaluate vestibular dysfunction electronystagmography (ENG) was used. Patients frequently had abnormal caloric test responses, especially with a directional preponderance, and most had a spontaneous nystagmus. In the migraine attack the patients are presumed to have hypersensitivity of the labyrinth with nausea and vomiting, while in the headache-free period the ENG was almost normal. At present, we have had a high success rate in treating patients with pyracetam. Diazepam was used to treat basilar migraine and flunarizine to prevent vestibular migraine.

Topics: Adolescent; Adult; Aged; Basilar Artery; Calcium Channel Blockers; Caloric Tests; Child; Diazepam; Ear, Inner; Electronystagmography; Female; Flunarizine; Hearing Loss, Sensorineural; Humans; Ischemic Attack, Transient; Male; Middle Aged; Migraine Disorders; Muscle Relaxants, Central; Nausea; Neuroprotective Agents; Nystagmus, Pathologic; Ophthalmoplegia; Piracetam; Sympathetic Nervous System; Vestibular Diseases; Vomiting