Alpha-interferon for the treatment of idiopathic sudden sensorineural hearing loss

Kanemaru, S.; Fukushima, Hideyuki; Nakamura, Hirohiko; Tamaki, Hisanobu; Fukuyama, Yasuhiko; Tamura, Yoshihiro

doi:10.1007/bf02471282

Cited by 18 publications

(12 citation statements)

References 16 publications

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“…There are also some studies showing that 70-80 dB hearing loss is a cut-off level affecting the outcome of SHL therapy (20,21). Not only the severity of hearing loss, but also the configuration of the initial audiograms appears to affect the outcome (20,22). It is suggested that patients with low-frequency hearing losses -upward sloping audiograms -or mid-frequency hearing losses -flat type audiograms -may have a better prognosis (21)(22)(23).…”

Section: Discussionmentioning

confidence: 99%

“…Not only the severity of hearing loss, but also the configuration of the initial audiograms appears to affect the outcome (20,22). It is suggested that patients with low-frequency hearing losses -upward sloping audiograms -or mid-frequency hearing losses -flat type audiograms -may have a better prognosis (21)(22)(23). It was also suggested that low-frequency hearing losses tend to have better recoveries as they have a better tolerance of impairment (24).…”

Section: Discussionmentioning

confidence: 99%

“…The time elapsing from the onset of hearing loss to the initiation of treatment is reported to be another important prognostic factor; the sooner treatment is initiated, the better the outcome (8,22). Treatment should be started as soon as possible and is probably not helpful after 30 days, as active disease may have resolved and damage may be permanent (21).…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Factors in Sudden Sensorineural Hearing Loss

Atay¹,

Kayahan²,

Çınar³

et al. 2016

Balkan Med J

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Background: Sudden sensorineural hearing loss (SSNHL) is still a complex and challenging process which requires clinical evidence regarding its etiology, treatment and prognostic factors. Therefore, determination of prognostic factors might aid in the selection of proper treatment modality. Aims: The aim of this study is to analyze whether there is correlation between SSNHL outcomes and (1) systemic steroid therapy, (2) time gap between onset of symptoms and initiation of therapy and (3) audiological pattern of hearing loss. Study Design: Retrospective chart review. Methods: Patients diagnosed at our clinic with SSNHL between May 2005 and December 2011were reviewed. A detailed history of demographic features, side of hearing loss, previous SSNHL and/or ear surgery, recent upper respiratory tract infection, season of admission, duration of symptoms before admission and the presence of co-morbid diseases was obtained. Radiological and audiological evaluations were recorded and treatment protocol was assessed to determine whether systemic steroids were administered or not. Treatment started ≤5 days was regarded as "early" and >5 days as "delayed". Initial audiological configurations were grouped as "upward sloping", "downward sloping", "flat" and "profound" hearing loss. Significant recovery was defined as thresholds improved to the same level with the unaffected ear or improved ≥30 dB on average. Slight recovery was hearing improvement between 10-30dB on average. Hearing recovery less than 10 dB was accepted as unchanged. Results: Among the 181 patients who met the inclusion criteria, systemic steroid was administered to 122 patients (67.4%), whereas 59 (32.6%) patients did not have steroids. It was found that steroid administration did not have any statistically significant effect in either recovered or unchanged hearing groups. Early treatment was achieved in 105 patients (58%) and 76 patients (42%) had delayed treatment. Recovery rates were no different in these two groups; however, when unchanged hearing rates were compared, it was statistically significantly lower in the early treatment group (p<0.05). When hearing outcomes were compared according to initial audiological pattern, significant recovery and unchanged hearing rates did not differ between groups; however, slight recovery rate was highest in the "flat" type audiological configuration (p<0.05). Conclusion: According to this patient series, oral steroid therapy does not have any influence on the outcomes of SSNHL. However, mid-frequency hearing loss of flat type and initiation of treatment earlier than 5 days from the onset of symptoms, seem to have positive prognostic effects. Further randomized controlled subject groups might contribute to determine prognostic factors of SSNHL.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prognostic Factors in Sudden Sensorineural Hearing Loss

Atay¹,

Kayahan²,

Çınar³

et al. 2016

Balkan Med J

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“…The improvement rate in cases in which hearing recovered more than 30 dB -the marked recovery group by the Japanese standards -was significantly better in the defibrinogenation group [14]. In a nonrandomized control study of ·-interferon, an antiviral agent, complete recovery was found in 27 patients (64.3%) among 42 patients with the average hearing over 70 dB; this suggested the effectiveness of this drug [15].…”

Section: Efficacy Of Treatmentmentioning

confidence: 78%

Sudden Deafness

Kanzaki¹

1999

Otorhinolaryngol Nova

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“…A similar lack of improvement by antiviral therapy was found in a case suspected of having as HSV-related sudden deafness [27]. On the other hand, IFN-·, a broad-spectrum antiviral substance, which was administered to 49 sudden deafness patients showed favorable effects [44]. This study was, however, not placebo controlled and no comparison to the spontaneous cure rate could be done.…”

Section: Antiviral Treatmentmentioning

confidence: 85%

Sudden Deafness and Viral Infections

Pitkäranta

Vasama

Julkunen

1999

Otorhinolaryngol Nova

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Sudden deafness is a dramatic and relatively common otological problem. The etiology in most cases remains unresolved although virus involvement has strong support. Sudden deafness has been associated with mumps, rubella, the respiratory and herpes groups of viruses as well as other more rare ones like hantavirus and Lassa virus. Perhaps the bestknown example of virus-induced sudden deafness is acute unilateral hearing loss associated with mumps virus infection. Mumps virus has also been isolated from the inner ear suggesting a direct virus-induced cytolytic mechanism for deafness. Herpesviruses are neurotropic and they have a tendency to become chronic. Therefore they have been strong candidates for viruses being responsible for acute hearing loss. Although serological associations have been found in certain studies, convincing evidence for the involvement of herpes and varicella-zoster viruses as agents causing direct cochlear damage and hearing loss in humans is missing. A number of case reports have associated sudden deafness to rubella, adeno- and hantavirus infections. Multiple studies showing no association of viruses with sudden deafness may reflect seasonal, geographical or epidemiological differences in this disease. This may also bring up the possibility of other etiological factors such as general inflammatory or autoimmune mechanisms for the disease. Histopathological changes in the affected ears are characterized by abnormal cellular architecture in the inner ear with loss of apical and spiral ganglion cells and destruction of the organ of Corti. Similar histopathological changes have been found in experimental animal models infected with mumps, rubella or herpesviruses. Histopathological observations could favor the theory of viral etiology in idiopathic sudden deafness but do not rule out the possibility of immunological disturbances, which would lead to similar histopathological changes.

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Alpha-interferon for the treatment of idiopathic sudden sensorineural hearing loss

Cited by 18 publications

References 16 publications

Prognostic Factors in Sudden Sensorineural Hearing Loss

Prognostic Factors in Sudden Sensorineural Hearing Loss

Sudden Deafness

Sudden Deafness and Viral Infections

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