The Pathology Of Sudden Deafness

Schuknecht, Harold F.; Kimura, Robert S.; Naufal, P

doi:10.3109/00016487309121486

Cited by 183 publications

(74 citation statements)

References 14 publications

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“…Sudden unilateral deafness occurring in a young patient is usually due to viral infection of the cochlea [17][18][19] , but the most common causes of sudden unilateral deafness are cerebrovascular diseases or hypercoagulation syndromes, such as polycythemia and macroglobulinemia [20][21][22] . Viirre at al described the sudden hearing loss in 13 migraine patients 11 , all of whom showed a sudden onset of hearing loss and other neurological phenomena that could be attributed to vasospasm, including vertigo, amaurosis fugax, hemiplegia, facial pain, chest pain, and visual aura 11 .…”

Section: Discussionmentioning

confidence: 99%

Oscillucusis and sudden deafness in a migraine patient

Piovesan

Kowacs

Werneck

et al. 2003

Arq. Neuro-Psiquiatr.

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-Migraine is a complex disease that includes neurologic, gastrointestinal and autonomic symptoms, although headache is most common feature. In a portion of cases headache is preceded by focal neurologic symptoms termed auras. Auditory symptoms only rarely occur as part of an aura. We describe a patient whose 13-year migraine history that included the abnormal perception an oscillation of the intensity of ambient sounds (oscillucusis). During a migraine attack immediately after oscillucusis, the patient developed acute and permanent sudden deafness. Clinical and neurologic examinations revealed only profound hearing loss in her left ear. Audiometric testing confirmed the sensorineural nature of the hearing loss. The clinical aspects and physiopathology of auditory symptoms in this case and in patients with migraine is reviewed.KEY WORDS: aura, headache, migraine, oscillucusis, sudden deafness.Oscilucusia e perda auditiva em um paciente com migranea. Oscilucusia e perda auditiva em um paciente com migranea. Oscilucusia e perda auditiva em um paciente com migranea. Oscilucusia e perda auditiva em um paciente com migranea. Oscilucusia e perda auditiva em um paciente com migranea.RESUMO -Migrânea é desordem complexa que inclui sintomas neurológicos, gastrointestinais e autonômicos, na qual a cefaléia é o achado predominante. Em uma parcela de pacientes o quadro álgico pode ser antecipado por sinais neurológicos focais conhecidos como aura. Descrevemos um paciente que iniciou sua historia de migrânea acompanhada por sensações de flutuações nos sons ambientes (oscillucusis) por treze anos. Durante uma crise de cefaléia imediatamente após a oscillucusia o paciente desenvolveu um quadro agudo e permanente de perda auditiva. Exames clínicos e neurológicos revelaram somente uma perda profunda da audição em ouvido esquerdo, cuja natureza sensorioneural foi confirmada por uma avaliação audiométrica. Os aspectos clinicos e fisiopatológicos dos sintomas auditivos encontrados neste caso e em pacientes com migrânea com aura são revisados e comentados. PALAVRAS-CHAVE: aura, cefaléia, migrânea, oscilucusia, perda súbita de audição. , the focal neurological phenomena that precede or accompany an attack are known as aura. These neurological manifestations include visual, somato-sensory, olfactory and less frequently auditory symptoms.The case of a migraine patient with auditory aura followed by hearing loss is revised, and the literature about auditory symptoms in migraine with aura patients are reviewed. CASEA 56-year-old woman started to present migraine episodes at age 40. An year later she perceived ambient sounds to be fluctuating in intensity (oscillucusis). This would last 50 minutes, and was followed by a unilateral (right or left side), throbbing headache associated with nausea and vomiting. These episodes lasted 18 hours, occurred at twice a month and were commonly triggered by stress. At age 53, she had the sudden onset of profound hearing loss in her left ear that was unassociated with vertigo or any other neuro...

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Section: Discussionmentioning

confidence: 99%

Oscillucusis and sudden deafness in a migraine patient

Piovesan

Kowacs

Werneck

et al. 2003

Arq. Neuro-Psiquiatr.

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“…There is contradictory histopathological and clinical evidence against the vascular theory of SSNHL. 12,[184][185][186] Most patients with SSNHL probably do not have a solely ischemic etiology, which is difficult to disprove based on clinical features and testing.…”

Section: Supporting Textmentioning

confidence: 99%

Clinical Practice Guideline

Stachler

Chandrasekhar

Archer

et al. 2012

Otolaryngol.--head neck surg.

782

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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“…Numerous hypotheses of the pathophysiology of idiopathic SSNHL have been proposed. The most widely accepted theories are vascular compromise (Fisch, Nagahara, & Pollak, 1984;Gussen, 1976;Morgenstein & Manace, 1969;Ruben et al, 1969), cochlear membrane rupture (Goodhill, 1971;Harris, 1984;Simmons, 1968), and viral infection (Saunders & Lippy, 1959;Schuknecht et al, 1962) (reviewed in Byl, 1984;Mattox & Simmons, 1977).…”

Section: Theories Of the Etiology Of Idiopathic Ssnhlmentioning

confidence: 99%

“…Potentially as a reflection of the amount of damage and permanence of the hearing loss following occlusion of the cochlear vasculature, cochlear fibrosis occurs over the subsequent weeks (Belal, 1979;Schuknecht & Donovan, 1986;Yoon, Paparella, Schachern, & Alleva, 1990), and this fibrosis can be seen in radiologic studies of patients with hearing loss following known vascular occlusion (Lee et al, 2000). In idiopathic SSNHL, cochlear fibrosis is not typically observed (Albers, Demuynck, & Casselman, 1994;Schuknecht et al, 1962;Schuknecht & Donovan, 1986). Thus, though a vascular etiology may explain a few cases of idiopathic SSNHL, it is not the cause of most cases of this disorder.…”

Section: Theories Of the Etiology Of Idiopathic Ssnhlmentioning

confidence: 99%

Sudden Sensorineural Hearing Loss

Kuhn

Heman‐Ackah

Shaikh

et al. 2011

Trends in Amplification

375

190

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Sudden sensorineural hearing loss (SSNHL) is commonly encountered in audiologic and otolaryngologic practice. SSNHL is most commonly defined as sensorineural hearing loss of 30dB or greater over at least three contiguous audiometric frequencies occurring within a 72-hr period. Although the differential for SSNHL is vast, for the majority of patients an etiologic factor is not identified. Treatment for SSNHL of known etiology is directed toward that agent, with poor hearing outcomes characteristic for discoverable etiologies that cause inner ear hair cell loss. Steroid therapy is the current mainstay of treatment of idiopathic SSNHL in the United States. The prognosis for hearing recovery for idiopathic SSNHL is dependent on a number of factors including the severity of hearing loss, age, presence of vertigo, and shape of the audiogram.

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The Pathology Of Sudden Deafness

Cited by 183 publications

References 14 publications

Oscillucusis and sudden deafness in a migraine patient

Oscillucusis and sudden deafness in a migraine patient

Clinical Practice Guideline

Sudden Sensorineural Hearing Loss

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