Calcium antagonists in the treatment of sudden deafness

Mann, William A.; Beck, Chl.

doi:10.1007/bf00470614

Cited by 25 publications

(16 citation statements)

References 5 publications

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“…Hydroxyethyl starch carrier solution reduces the hematocrit level and platelet aggregation. 187,188 These therapies have considerable side effects. Different types of treatment entail different risks.…”

Section: Supporting Textmentioning

confidence: 99%

Clinical Practice Guideline

Stachler

Chandrasekhar

Archer

et al. 2012

Otolaryngol.--head neck surg.

780

361

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Objective. Sudden hearing loss (SHL) is a frightening symptom that often prompts an urgent or emergent visit to a physician. This guideline provides evidence-based recommendations for the diagnosis, management, and follow-up of patients who present with SHL. The guideline primarily focuses on sudden sensorineural hearing loss (SSNHL) in adult patients (aged 18 and older). Prompt recognition and management of SSNHL may improve hearing recovery and patient quality of life (QOL). Sudden sensorineural hearing loss affects 5 to 20 per 100,000 population, with about 4000 new cases per year in the United States. This guideline is intended for all clinicians who diagnose or manage adult patients who present with SHL.Purpose. The purpose of this guideline is to provide clinicians with evidence-based recommendations in evaluating patients with SHL, with particular emphasis on managing SSNHL. The panel recognized that patients enter the health care system with SHL as a nonspecific, primary complaint. Therefore, the initial recommendations of the guideline deal with efficiently distinguishing SSNHL from other causes of SHL at the time of presentation. By focusing on opportunities for quality improvement, the guideline should improve diagnostic accuracy, facilitate prompt intervention, decrease variations in management, reduce unnecessary tests and imaging procedures, and improve hearing and rehabilitative outcomes for affected patients.Results. The panel made strong recommendations that clinicians should (1) distinguish sensorineural hearing loss from conductive hearing loss in a patient presenting with SHL; (2) educate patients with idiopathic sudden sensorineural hearing loss (ISSNHL) about the natural history of the condition, the benefits and risks of medical interventions, and the limitations of existing evidence regarding efficacy; and (3) counsel patients with incomplete recovery of hearing about the possible benefits of amplification and hearing-assistive technology and other supportive measures. The panel made recommendations that clinicians should (1) assess patients with presumptive SSNHL for bilateral SHL, recurrent episodes of SHL, or focal neurologic findings; (2) diagnose presumptive ISSNHL if audiometry confirms a 30-dB hearing loss at 3 consecutive frequencies and an underlying condition cannot be identified by history and physical examination; (3) evaluate patients with ISSNHL for retrocochlear pathology by obtaining magnetic resonance imaging, auditory brainstem response, or audiometric follow-up; (4) offer intratympanic steroid perfusion when patients have incomplete recovery from ISSNHL after failure of initial management; and (5) obtain follow-up audiometric evaluation within 6 months of diagnosis for patients with ISSNHL. The panel offered as options that clinicians may offer (1) corticosteroids as initial therapy to patients with ISSNHL and (2) hyperbaric oxygen therapy within 3 months of diagnosis of ISSNHL. The panel made a recommendation against clinicians routinely prescribing antivirals,...

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Section: Supporting Textmentioning

confidence: 99%

Clinical Practice Guideline

Stachler

Chandrasekhar

Archer

et al. 2012

Otolaryngol.--head neck surg.

780

361

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“…It is suggested that vasodilators promote cochlear blood flow, reverse presumed vasospasm and increase local oxygenation, but no double-blind randomized clinical work with a vasodilator versus placebo has been performed. Procaine or a calcium antagonist (nifedipine) seems unable to enhance hearing recovery [38,39]. Some studies have suggested that carbogen inhalation (mixture of 5% CO 2 and 95% O 2 ) increases the perilymphatic oxygenation of about 10 mm Hg [40].…”

Section: Which Benefit Can Be Expected From Therapy ?mentioning

confidence: 99%

Management of Idiopathic Sudden Sensorineural Hearing Loss

Mosnier¹,

Bouccara²,

Sterkers³

1999

Otorhinolaryngol Nova

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The cause of sudden sensorineural hearing loss (SHL) remains unknown, even though studies have evidenced two main hypotheses: a latent virus infection due to herpesvirus and a local decrease in cochlear blood flow caused by vasospasm and/or hyperviscosity. Clinical evaluation and diagnostic tests should always be performed, to rule out an acoustic neuroma, revealed in 5–26% of cases by a sudden deafness. The two main major prognostic factors are the severity of hearing loss and the time from onset to treatment, suggesting that two groups of patients are susceptible to benefit from therapy: patients with a hearing loss of less than 40 dB, managed within 2 months from the onset, and patients with a hearing loss of more than 40 dB, treated within 1 month after the onset of deafness. Steroids appear to be the only treatment available with a significant beneficial effect on SHL.

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“…The first trial to treat sudden hearing loss with the calcium channel blocker nimodipine was re ported in 1980, but two subsequent studies have failed to show a positive influence on hearing loss when utilizing calcium antagonist drugs [24][25][26], Histopathologic devel opment of noise trauma and sudden hearing loss are com bined with metabolic damage to the cells of the cochlea, including an intracellular calcium overload [27], Myocar dial cells are known to be less sensitive to ischemic insult in the presence of a sufficient concentration of calcium channel blockers, preventing an elevated calcium influx during reperfusion. The same is possibly true for the hair cells of the cochlea.…”

Section: Discussionmentioning

confidence: 99%

Diltiazem for Prevention of Acoustical Trauma during Otologic Surgery

Maurer¹,

Riechelmann²,

Amedee

et al. 1995

ORL

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100 patients were tested in a prospective, randomized, double-blinded study to assess the perioperative efficacy of a calcium channel blocker (diltiazem) in preventing acoustical trauma during otologic surgery. The patients were randomly divided into a therapy group (diltiazem) and a control group (placebo). Bone conduction hearing thresholds were examined preoperatively and again 1 day and 3 months postoperatively. Frequency-dependent changes in postoperative bone conduction and the number of patients with various degrees of postoperative hearing loss in both groups were statistically analyzed. The results indicated only a small postoperative hearing loss after ear surgery in both groups. There was a tendency for better results in the therapy group, but this was not statistically significant. Despite favorable results in animal trials utilizing different types of noise and the prophylactic application of diltiazem, further studies in humans are needed to determine the role of calcium antagonist drugs in the prophylaxis or treatment of acoustical trauma.

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Calcium antagonists in the treatment of sudden deafness

Cited by 25 publications

References 5 publications

Clinical Practice Guideline

Clinical Practice Guideline

Management of Idiopathic Sudden Sensorineural Hearing Loss

Diltiazem for Prevention of Acoustical Trauma during Otologic Surgery

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