Background and ObjectivesThis study aimed to investigate prognostic factors in patients with idiopathic sudden sensorineural hearing loss (ISSNHL).Subjects and MethodsFrom January 2007 to December 2011, a retrospective chart review identified 494 consecutive patients with ISSNHL. Demographic, audiometric, and clinical data were analyzed using a logistic regression test.ResultsHearing recovery from ISSNHL was significantly associated with factors such as age, duration from onset of symptoms to commencement of treatment, severity of the initial pure tone threshold, and the treatment method. Intratympanic (IT) steroid administration alone showed a comparable efficiency to oral steroid administration with or without IT steroid injection. In patients who received IT steroid injection, the duration from onset to treatment, severity of initial hearing loss, and sequential IT steroid injection following systemic steroid administration were statistically associated with hearing improvement.ConclusionsAge, severity of initial pure tone threshold, duration from onset to treatment, initial speech discrimination, and initial pure tone threshold are statistically significant prognostic factors related to hearing improvement in ISSNHL. IT steroid injection as an initial single treatment is comparable to systemic oral steroid administration.

The probability of receiving additional ventilating tube insertion because of recurrent otitis media with effusion significantly increased in younger patients at the time of first ventilating tube insertion. The concurrent adenoidectomy, duration of the ventilating tube, postoperative otorrhea within 1 month, and early extrusion of the ventilating tube also influenced the probability of additional ventilating tube insertion.

Age-related hearing loss (presbycusis) is characterized by an increased hearing threshold and poor speech understanding in a noisy environment, slowed central processing of acoustic information, and impaired localization of sound sources. Presbycusis seriously affects the older people's quality of life. Particularly, hearing loss in the elderly contributes to social isolation, depression, and loss of self-esteem. Current amplification methods related to auditory rehabilitation can provide improved communication ability to users. But, simple auditory rehabilitation is ineffective in managing the central auditory processing disorder and the psychosocial problem of presbycusis. The evaluation of central auditory processing disorder and psychosocial disorder in presbycusis should not be overlooked while providing auditory rehabilitation.

We evaluated the short-term efficacy of Epley, Semont, and sham maneuvers for resolving posterior canal benign paroxysmal positional vertigo (BPPV) in a prospective multicenter randomized double-blind controlled study. Subjects were randomly divided into three groups: Epley (36 patients), Semont (32 patients), and sham (Epley maneuver for the unaffected side, 31 patients). Out of 14 institutes which participated in this study, 5 institutes had previous experience of the Epley but not the Semont maneuver and the other 9 had previous experience of both maneuvers. Each maneuver was repeated twice if there was still positional vertigo or nystagmus on day 0, and the presence of nystagmus and vertigo on positional testing were evaluated immediately, 1 day, and 1 week after treatment. After the first maneuver, the Epley group showed a significantly higher resolution rate of positional nystagmus than the Semont or sham groups (63.9, 37.5, and 38.7%, respectively). After the second maneuver, the resolution rate (83.3%) of the Epley group was significantly higher than that (51.6%) of the sham group. At 1 day and 1 week after treatment, the resolution rate of the Epley group was significantly higher than those of the other groups. Similar results were seen for the resolution of positional vertigo. The Epley maneuver showed persistent resolution rates of positional vertigo and nystagmus without a fatigue phenomenon. The Epley maneuver was significantly more effective per maneuver than Semont or sham maneuvers for the short-term treatment of posterior canal BPPV. The Semont maneuver showed a higher success rate than the sham maneuver, but it was not significantly different.

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.

Our findings show an association between VAT and hearing impairment in women. A reduction in visceral adiposity may help to prevent hearing loss in women.

Abnormal canal paresis was found in 7 patients with MV (23%), 11 with MD (48%), and 37 with VN (100%). An abnormal vestibular ratio in SOT was found in 14 patients with MV (45%), 6 with MD (26%), and 23 with VN (62%). In MV, an abnormal vestibular ratio was more common than canal paresis and an abnormal vestibular ratio was more common than in MD. An abnormal somatosensory ratio (19%) in MV was significantly more common than in VN and MD (3% and 0%). For condition 2, MV showed a significantly higher abnormal rate than VN. An abnormal visual ratio in MV was more common than in VN and MD but this was not significant.

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