prednisolone-hemisuccinate and Hearing-Loss--Sensorineural

Abnormal action potential (AP) recovery from adaptation was manifested as increased recovery (iR) or decreased recovery (dR) relative to the normal recovery range. dR was not analyzed statistically due to the very small number of cases. iR is considered an unfavorable prognostic indicator, whereas a normal AP recovery (nR), enhanced SP/AP ratio (≥0.35), and lower AP threshold are favorable prognostic indicators for idiopathic sudden sensorineural hearing loss (iSSNHL).. This study aimed to determine the prognostic efficacy of AP recovery examinations associated with other electrocochleography (ECochG) findings in iSSNHL.. ECochG was performed transtympanically in 58 iSSNHL ears. AP recovery was measured by a paired-click stimulation paradigm, and hearing outcome was classified into three groups. Additionally, the relationships of other confounding prognostic factors to hearing outcomes were assessed.. iR was significantly more common in the no-recovery group, while nR and an enhanced SP/AP ratio were significantly more common in the cure and improvement groups. The AP threshold was significantly lower in the cure group than in the other two groups. The other confounding prognostic factors generally showed similar trends to those reported previously.

Topics: Action Potentials; Adenosine Triphosphate; Adult; Aged; Alprostadil; Analysis of Variance; Audiometry, Evoked Response; Auditory Threshold; Glucocorticoids; Hearing Loss, Sensorineural; Hearing Loss, Sudden; Humans; Middle Aged; Prednisolone; Prognosis; Recovery of Function; Time Factors; Vasodilator Agents; Vertigo; Young Adult

Neurological impairment during pregnancy is also commonly found in otorhinolaryngology. Cranial nerve palsy, e.g. of the facial nerve or changes in signal processing of the hearing system, are described. Apart from changes in electrolyte balance, these neurological alterations are attributed to hormone fluctuations. The spontaneous remission of the neurological problems after delivery is frequently reported. This case report presents a 34 year pregnant patient suffering from binaural sensorineural hearing loss and tinnitus in the third trimester. Three weeks after delivery there was a spontaneous remission and a measurable improvement of the audiological findings. Although treatment with cortisone and antibiotics remained without effect, a pharmacological treatment during pregnancy has to be carefully and individually coordinated. An interdisciplinary approach in diagnostic and therapeutic measures together with gynaecologists appears obligatory.

Topics: Adult; Ceftriaxone; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Therapy, Combination; Female; Follow-Up Studies; Hearing Loss, Bilateral; Hearing Loss, Sensorineural; Humans; Infant, Newborn; Infusions, Intravenous; Prednisolone; Pregnancy; Pregnancy Complications; Pregnancy Trimester, Third; Puerperal Disorders; Remission, Spontaneous; Tinnitus

The labyrinthine fistula continues to be one of the most common complications in ears with cholesteatoma. Fifty-one patients with labyrinthine fistula were identified in a series of 1243 cases with cholesteatoma operated upon between 1989 and 1993 at the University ENT Clinic Wuerzburg. The surgical management concept comprised of removing the cholesteatoma matrix, categorizing the fistula type, and immediate covering of the labyrinthine capsule defect with bone dust, perichondrium and fibrin glue. The classification system of the fistulae used in the study used the depth of labyrinthine involvement as a criterion and also took into account the possibility of intentional or accidental damage to the labyrinth during surgical manipulation (Fig. 1). From 1991 on, patients were treated with 500 mg of Presnisolon 21 hydrogen succinate in a single intravenous dose, at the time the fistula was corrected. The postoperative hearing results were graded based on the extend of preservation of inner ear function at or near the preoperative level. None of the patients who had corticosteroid therapy suffered a profound sensory neural hearing loss (Fig. 2, 3), whereas five ears without steroids and a deep fistula lost function completely. The study concluded that corticosteroids have a beneficial impact on postoperative outcome in cases with severe injury to the membranous labyrinth.

Topics: Adult; Aged; Anti-Inflammatory Agents; Auditory Threshold; Bone Conduction; Cholesteatoma, Middle Ear; Female; Fistula; Hearing Loss, Sensorineural; Humans; Infusions, Intravenous; Labyrinth Diseases; Male; Middle Aged; Postoperative Complications; Prednisolone; Premedication; Reoperation; Treatment Outcome