Trial of Chinese Medicine Wu-Ling-San for Acute Low-Tone Hearing Loss

Abstract

Purpose: We used new criteria to elucidate the demographics of acute low-tone sensorineural hearing loss (ALHL) and tested the Chinese medicine Wu-Ling-San as a treatment for ALHL. Procedures: We reviewed the medical records of patients with ALHL seen at the outpatient clinic of the Social Insurance Central General Hospital in Tokyo from April 2006 through August 2011. Patients were treated with an oral steroid, a diuretic, or Wu-Ling-San; alone or in combination. Results: We identified 130 definite and 48 probable ALHL cases. The mean age and male-to-female ratio in probable cases were significantly higher than those in definite cases (p < 0.05). The steroid-Wu-Ling-San combination was significantly more effective (100% recovery) than the diuretic alone (59%), Wu-Ling-San alone (62%), or the steroid-diuretic combination (60%, p < 0.05). Conclusions: ALHL can develop in older patients more frequently than we expected. The steroid-Wu-Ling-San combination is a possible new treatment for ALHL.

The Short- and Long-Term Outcome of Intratympanic Steroid Therapy as a Salvage Treatment for Acute Low-Tone Sensorineural Hearing Loss without Episodes of Vertigo

“…We used the diagnostic criteria for ALHL proposed by the Acute Severe Hearing Loss Study Group, Ministry of Health, Labor and Welfare of Japan [Morita et al, 2010;Okada et al, 2012;Shimono et al, 2013], as follows: (1) sensorineural hearing loss of sudden onset without vertigo (but may be accompanied with a slight dizzy sensation); (2) no other known cause; (3) the sum of pure-tone hearing thresholds at low frequencies of 125, 250 and 500 Hz is 70 dB or more; (4) 'definite' ALHL is defined when the sum of pure-tone hearing thresholds at high frequencies of 2,000, 4,000 and 8,000 Hz is 60 dB or less, and (5) 'probable' ALHL is defined when the sum of pure-tone hearing thresholds at high frequencies of 2,000, 4,000 and 8,000 Hz is more than 60 dB but the difference between the affected and contralateral sides is 10 dB or less.…”

“…We used the hearing outcome criteria of ALHL proposed by the Acute Severe Hearing Loss Study Group, Ministry of Health, Labor and Welfare of Japan [Morita et al, 2010;Okada et al, 2012;Shimono et al, 2013], as follows: (1) complete recovery, in which hearing levels at three low frequencies (125, 250 and 500 Hz) returned to within 20 dB of normal; (2) partial recovery, in which average hearing levels at three low frequencies (125, 250 and 500 Hz) improved by 10 dB or more compared to the initial audiogram but were not recovered to within 20 dB of normal; (3) unchanged, in which the average hearing level at three low frequencies (125, 250 and 500 Hz) was within 10 dB of that at the initial audiogram; (4) progression, in which the average hearing level at three low frequencies (125, 250 and 500 Hz) exceeded that at the initial audiogram by 10 dB or more. In this study, complete or partial recovery was defined as recovery from hearing loss.…”

“…Acute low-tone sensorineural hearing loss (ALHL) is defined as hearing impairment confined to the low frequencies with preservation of high-frequency hearing acuity and no episodes of vertigo [Morita et al, 2010;Okada et al, 2012;Shimono et al, 2013]. ALHL appears to partially overlap with the low-tone type of idiopathic sudden sensorineural hearing loss (ISSNHL).…”

“…Although no consensus has been reached regarding the best therapeutic strategy for ALHL, treatments using steroids and/or mild diuretics have been recommended with relatively good hearing outcomes reported [Fuse et al, 2002;Morita et al, 2010;Okada et al, 2012]. Nevertheless, 20-33% of patients respond poorly to conventional therapy, with occasional exacerbation of symptoms and progression to definite MD observed [Fuse et al, 2002;Morita et al, 2010;Okada et al, 2012].…”

“…Nevertheless, 20-33% of patients respond poorly to conventional therapy, with occasional exacerbation of symptoms and progression to definite MD observed [Fuse et al, 2002;Morita et al, 2010;Okada et al, 2012]. Recently, there have been many reports indicating that intratympanic steroid (ITS) administration effectively improves hearing in patients with ISSNHL or MD [Barrs et al, 2001;Li et al, 2015;Martin-Sanz et al, 2015;Selivanova et al, 2005].…”