Clinical management and progress in sudden sensorineural hearing loss during pregnancy

Xie, Shaobing; Wu, Xuewen

doi:10.1177/0300060519870718

Cited by 16 publications

(18 citation statements)

References 41 publications

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“…Moreover, all patients gave birth to healthy neonates with normal Apgar scores, which suggested that intratympanic therapy is safe and tolerable for pregnant women. Other recommended therapies include dextran-40 and hyperbaric oxygen therapy[ 24 ]. Wang and Yang[ 18 ] administered 3.5 L of 10% dextran-40 intravenously to six pregnant patients, achieving a success rate (PTAs < 25 dB or mean hearing gains ≥ 30 dB) of 83.3%[ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Intratympanic dexamethasone injection for sudden sensorineural hearing loss in pregnancy

Lyu

Zeng

Zhou

et al. 2020

WJCC

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BACKGROUND As sudden sensorineural hearing loss (SSNHL) rarely occurs in pregnant women, there is a lack of knowledge and relevant research on its management. AIM To investigate the effect of intratympanic dexamethasone injection in the treatment of pregnant patients with SSNHL. METHODS A retrospective chart review was made for the period between June 2017 and August 2019 at our Department of Otorhinolaryngology-Head and Neck Surgery. Pregnant women who met the criteria for SSNHL were included and grouped based on the therapeutic modalities. The treatment group received intratympanic dexamethasone (2.5 mg) q.o.d. for a total of four times, while the control group received no medication other than bed rest and medical observations. All the patients were under close care of obstetricians. Pure-tone audiograms were performed before and after treatment. RESULTS Eleven patients who met the inclusion criteria were assigned to the treatment group ( n = 7) and the control group ( n = 4). The mean age of patients was 31.2 ± 3.8 years; the right ear was affected in seven (63.64%) cases. Two patients (18.2%) suffered from vertigo, 10 (90.9%) suffered from tinnitus and 6 (54.5%) suffered from aural fullness. The time from onset to clinic visit was relatively short, with a mean time of 1.3 ± 0.9 d. All the women were within the second or third trimester; the average gestation period was 26.0 ± 6.2 wk. The pure-tone averages at onset between the two groups were similar. After one wk of therapy, the treatment group had a curative rate of 57.1% and a significantly better hearing threshold and greater improvement compared to the control group (all P < 0.05). Some patients experienced transient discomfort from intratympanic injections that disappeared after getting rest, while none had permanent complications. All patients delivered healthy full-term neonates with an average Apgar score of 9.7 ± 0.5. CONCLUSION Intratympanic dexamethasone injections can be used as a first-line therapy in pregnant women with SSNHL.

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Section: Discussionmentioning

confidence: 99%

Intratympanic dexamethasone injection for sudden sensorineural hearing loss in pregnancy

Lyu

Zeng

Zhou

et al. 2020

WJCC

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“…Hormonal changes in the endolymphatic fluid may alter the homeostasis and enzymatic processes at the cochlea, stria vascularis, spiral ligament, and spiral ganglion neurons, as well as at the afferent terminations of neurons. Moreover, estrogen affects some enzymatic receptors at the sodium-potassium channels throughout the cochlea and membranous labyrinth leading to the presentation of otologic symptoms in pregnant patients [ 16 - 19 ]. Other events described in relation to the inner ear include the fluid retention in endolymph and perilymph and hypercoagulability in the auditory arteries.…”

Section: Reviewmentioning

confidence: 99%

“…The labyrinth vascularization is caused by the labyrinthine artery and its branches [ 16 - 19 ]. These are highly vulnerable to vascular occlusion [ 16 - 19 ].…”

Section: Reviewmentioning

confidence: 99%

“…The labyrinth vascularization is caused by the labyrinthine artery and its branches [ 16 - 19 ]. These are highly vulnerable to vascular occlusion [ 16 - 19 ]. In addition to the probable occlusion, mostly seen during the second month of pregnancy and stabilized in the second or third trimester [ 19 ], an increase in some coagulation factors (VII, VIII, IX, X, XII) and fibrinogen are noted, along with a decrease in factor XI [ 19 ].…”

Section: Reviewmentioning

confidence: 99%

“…These are highly vulnerable to vascular occlusion [ 16 - 19 ]. In addition to the probable occlusion, mostly seen during the second month of pregnancy and stabilized in the second or third trimester [ 19 ], an increase in some coagulation factors (VII, VIII, IX, X, XII) and fibrinogen are noted, along with a decrease in factor XI [ 19 ]. Therefore, pregnancy represents a state of hypercoagulability with greater activation of the blood coagulation and fibrinolysis system, which can increase plasma viscosity and erythrocyte aggregation and decrease deformability.…”

Section: Reviewmentioning

confidence: 99%

See 2 more Smart Citations

Vertigo in Pregnancy: A Narrative Review

Serna-Hoyos¹,

Arango²,

Ortiz-Mesa³

et al. 2022

Cureus

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During pregnancy, physical, hormonal, and psychological changes may occur from conception to labor. Balance is also impacted throughout this time, leading to symptoms such as vertigo and unsteadiness. These symptoms may appear at any time and can cause disability and physical impairment. Little has been published about vertigo in pregnancy. We performed a narrative review of vertigo in pregnant patients. Vertigo in pregnant females may be associated with hormonal changes in peripheral structures and inner ear organs. Meniere’s disease, vestibular migraine, and benign paroxysmal positional vertigo are usually exacerbated during pregnancy. Specific changes to hearing and proprioception in the physical examination are also noted between the second and third trimester of pregnancy. These symptoms are usually seen in pregnant patients throughout this time. Some types of vertigo may be exacerbated and others may present at any time of pregnancy. Further research is needed to understand the clinical and pathological association of audiovestibular symptoms during pregnancy.

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Clinical characteristics of sudden hearing loss during pregnancy

Wu,

Wang,

Zhang

et al. 2023

World j. otorhinolaryngol.-head neck surg.

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ObjectiveThe objective of this study was to explore the clinical characteristics and management of sudden hearing loss (HL) during pregnancy, thus better guiding the clinical practice.MethodsThe clinical and follow‐up data of 17 patients (17 ears) with sudden HL during pregnancy were analyzed retrospectively (the observe group). Twelve nonpregnant female patients (12 ears) with sudden HL of similar clinical characteristics were selected as the control group. The prognosis of the two groups was compared. All the patients were followed up after delivery, and two of them were readmitted to the hospital 1–2 months after delivery.ResultsThe observe group had better improvement in hearing and a higher response rate compared to the control group. The pure tone hearing and speech recognition rate of patients could still be improved after the readmitted treatment, and the hearing could partially recover spontaneously during follow‐up. The laboratory indicators that affect the inflammatory response and coagulation pathway were significantly different between the two groups.ConclusionsThe hearing condition of sudden HL during pregnancy is severe, and the prognosis of these patients is better than nonpregnant patients of similar clinical characteristics. Postpartum treatment is still effective, and some patients showed self‐healing with time during follow‐up. The inflammatory response and coagulation function may affect the hearing of patients through a metabolic pathway.

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Clinical management and progress in sudden sensorineural hearing loss during pregnancy

Cited by 16 publications

References 41 publications

Intratympanic dexamethasone injection for sudden sensorineural hearing loss in pregnancy

Intratympanic dexamethasone injection for sudden sensorineural hearing loss in pregnancy

Vertigo in Pregnancy: A Narrative Review

Clinical characteristics of sudden hearing loss during pregnancy

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