sudden sensorineural hearing loss

突发性感觉神经性听力损失
  • 文章类型: Journal Article
    背景:虽然已经对突发性感音神经性听力损失(SSNHL)进行了大量研究,关于治疗结果和预后如何因年龄而异的研究仍然不足.本研究旨在调查按年龄组划分的SSNHL患者的康复率差异。方法:对2020年至2023年诊断为SSNHL的177例患者进行回顾性研究。患者分为四个年龄组:20岁以下,30-40岁,50-60岁和70岁以上。比较了这些组的恢复率和相关症状。结果:除70岁以上年龄组外,所有年龄组均观察到显着的康复率(p=0.006,p=0.003,p=0.009)。根据性别(p>0.75)或耳鸣等症状,恢复率没有显着差异。耳朵丰满,头晕(p>0.05)。结论:研究表明,年轻人和中年人在恢复率方面表现出统计学上的显着改善,而老年人的康复率相对较低。
    Background: While numerous studies have been conducted on sudden sensorineural hearing loss (SSNHL), research on how treatment outcomes and prognosis vary by age remains insufficient. This study aims to investigate the differences in recovery rates among SSNHL patients divided by age groups. Methods: A retrospective study was conducted on 177 patients diagnosed with SSNHL from 2020 to 2023. The patients were categorized into four age groups: under 20, 30-40, 50-60, and over 70. Recovery rates and associated symptoms were compared across these groups. Results: Significant recovery rates were observed in all age groups except for those over 70 (p = 0.006, p = 0.003, p = 0.009). No significant differences were found in recovery rates based on gender (p > 0.75) or symptoms such as tinnitus, ear fullness, and dizziness (p > 0.05). Conclusions: The study revealed that younger and middle-aged adults showed statistically significant improvements in recovery rates, while the elderly exhibited relatively lower recovery rates.
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  • 文章类型: Journal Article
    我们的目标是通过对所有现有证据进行总括性审查来探索高压氧在治疗突发性感觉神经性听力损失中的功效。
    我们进行了综述,在PubMed中搜索相关文章,WebofScience,Embase,和Scopus数据库。搜索期从每个数据库开始到2024年4月。我们提取了作者,出版国,出版时间,纳入研究和参与者的数量,干预措施,结果总结,P值,I2,相对风险(95%CI),和结果措施。方法的质量,证据质量,并使用AMSTAR2级评估纳入文章的重叠率,和OVErviews(GROOVE)。
    使用AMSTAR2评估方法学质量。在九篇文章中,两人被评估为“高”,“三如”适度,\“两个为\”低,“剩下的两个”很低。“使用分级系统评估证据质量。结果发现,大多数研究的证据质量并不令人满意。发现所包含的文章之间有轻微的重叠。六项研究报告了阳性结果(OR1.37;95%CI,1.17-1.61;P=0.04),观察到高度异质性(I2=63%)。Egger检验表明存在偏差(P=0.000101)。三项研究报告阴性结果(MD1.49;95%CI,-0.32至3.29;P=0.43;I2=0%),根据Egger检验,没有检测到显著偏差(P=0.106)。
    HBO疗法被证明是SSNHL的有效治疗方法,副作用较少。然而,纳入本研究的系统综述和荟萃分析的方法学质量和证据普遍较低.因此,更高质量,大规模,未来需要多中心随机对照试验来验证HBO治疗SSNHL的疗效.
    https://www.crd.约克。AC.英国/普劳里,标识符[CRD42024523651]。
    UNASSIGNED: Our objective was to explore the efficacy of hyperbaric oxygen in the treatment of sudden sensorineural hearing loss by conducting an umbrella review of all existing evidence.
    UNASSIGNED: We conducted an umbrella review, searching for related articles in the PubMed, Web of Science, Embase, and Scopus databases. The search period covered from the inception of each database until April 2024. We extracted authors, country of publication, time of publication, number of included studies and participants, interventions, summary of results, P-values, I 2, relative risk (95% CI), and outcome measures. The methodological quality, evidence quality, and overlap rate of the included articles were assessed using AMSTAR 2, GRADE, and OVErviews (GROOVE).
    UNASSIGNED: Methodological quality was assessed using AMSTAR 2. Of the nine included articles, two were assessed as \"high,\" three as \"moderate,\" two as \"low,\" and the remaining two as \"very low.\" The quality of evidence was assessed using the GRADE system. It was found that the quality of evidence in most of the studies was unsatisfactory. It was found that there was a slight overlap among the included articles. Six studies reported positive results (OR 1.37; 95% CI, 1.17-1.61; P = 0.04), with high heterogeneity observed (I 2 = 63%). Egger\'s test indicated bias (P = 0.000101). Three studies reported negative results (MD 1.49; 95% CI, -0.32 to 3.29; P = 0.43; I 2 = 0%), with no significant bias detected (P = 0.106) according to Egger\'s test.
    UNASSIGNED: HBO therapy is shown to be an effective treatment for SSNHL with fewer side effects. However, the methodological quality and evidence of the systematic reviews and meta-analysis included in this study were generally low. Therefore, more high-quality, large-scale, multi-center randomized controlled trials are needed in the future to verify the efficacy of HBO therapy for SSNHL.
    UNASSIGNED: https://www.crd.york.ac.uk/prospero, identifier [CRD42024523651].
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  • 文章类型: Journal Article
    突发性感音神经性听力损失(SSNHL)是一种罕见的表现,需要及时诊断和治疗。尽管在临床实践指南中建议不要对头部进行计算机断层扫描(CT)成像,这项调查通常在突发性听力损失患者中完成。这项研究的目的是确定在我们中心接受SSNHL头部CT成像的患者比例,并确定使用CT成像的预测因素。
    在2018年1月至2021年5月期间,对接受SSNHL治疗的成年患者进行回顾性图表审查,并将其转诊至两项学术耳科学/神经医学实践。患者人口统计学,并存的医疗条件,相关症状,初始演示的位置,听力学结果,并收集完成的影像学研究.采用SPSS软件进行统计学分析。
    98例经听力证实的SSNHL患者被纳入。22例(22.4%)患者接受了CT成像检查,以进行SSNHL检查。眩晕的存在(比值比6.90;95%置信区间2.43,19.56)和急诊室的表现(比值比8.71;95%置信区间3.02,25.16)与接受CT成像显着相关。在多变量回归分析中,这两个变量是具有统计学意义的CT成像的独立预测因子(分别为p=0.01,p=0.001)。
    有相当比例的SSNHL患者接受低产量的头部CT成像,特别是出现眩晕的急诊室患者。这些结果突出了集中教育和质量改进举措的机会。证据等级:4。
    UNASSIGNED: Sudden sensorineural hearing loss (SSNHL) is a rare presentation requiring timely diagnosis and treatment. Despite recommendations against obtaining computed tomography (CT) imaging of the head in clinical practice guidelines, this investigation is often completed in patients with sudden hearing loss. The aim of this study was to determine the proportion of patients undergoing CT imaging of the head for SSNHL at our center and identify predictive factors for the use of CT imaging.
    UNASSIGNED: Retrospective chart review of adult patients referred for SSNHL to two academic otology/neurotology practices between January 2018 and May 2021. Patient demographics, comorbid medical conditions, associated symptoms, location of initial presentation, audiologic results, and completed imaging studies were collected. Statistical analysis was performed with SPSS software.
    UNASSIGNED: Ninety-eight patients with audiologically confirmed SSNHL were included. Twenty-two patients (22.4%) underwent CT imaging as an investigation for SSNHL. The presence of vertigo (odds ratio 6.90; 95% confidence interval 2.43, 19.56) and presentation to the emergency room (odds ratio 8.71; 95% confidence interval 3.02, 25.16) were significantly associated with undergoing CT imaging. These two variables were statistically significant independent predictors of CT imaging on multivariate regression analysis (p = .01, p = .001, respectively).
    UNASSIGNED: A significant proportion of patients with SSNHL undergo low-yield CT imaging of the head, particularly patients presenting to the emergency room with vertigo. These results highlight an opportunity for focused education and quality improvement initiatives.Level of evidence: 4.
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  • 文章类型: Journal Article
    这项多中心回顾性队列研究旨在评估乙状窦后手术方法在前庭神经鞘瘤减压中的有效性。专注于肿瘤减压,神经功能保护,术后并发症。一组60名患者,在2016年至2019年期间运营,进行了年龄分析,性别,症状,肿瘤大小,手术持续时间,并发症,死亡率,和使用既定标准的面部/听觉功能。在80%的患者中观察到听力损失,主要是进步,肿瘤大小成为关键的预后因素。术前,10%的患者受到面部无力的影响;术后,35%的患者有影响的面神经功能,10%的人表现出不良或没有面神经功能,与切除程度而不是肿瘤大小有关。较大的肿瘤患者耳鸣更为普遍,而头痛是常见的,无论大小。手术后平衡障碍得到改善,尤其是在肿瘤较大的情况下。功能恢复各不相同,41.67%的患者在4个月内恢复了以前的活动,25%在4-12个月内,和33.33%保持不活跃。死亡率低,为3.3%,手术后60名患者中有2人死亡。这项分析强调了前庭神经鞘瘤的手术风险(例如,面神经衰退,耳鸣,头痛),但也强调改善平衡和低死亡率等益处。许多患者恢复了专业活动,强调对这种情况做出知情治疗决定的重要性。
    This multicenter retrospective cohort study aimed to evaluate the effectiveness of the retrosigmoid surgical approach in decompressing vestibular schwannomas, focusing on tumor decompression, neurological function preservation, and postoperative complications. A cohort of 60 patients, operated between 2016 and 2019, was analyzed for age, sex, symptoms, tumor size, surgery duration, complications, mortality, and facial/auditory functions using established criteria. Hearing loss was observed in 80% of patients, mainly progressive, with tumor size emerging as a critical prognostic factor. Facial weakness affected 10% of patients preoperatively; postoperatively, 35% of patients had affected facial nerve function, with 10% exhibiting poor or no facial nerve function, linked to resection extent rather than tumor size. Tinnitus was more prevalent with larger tumors, whereas headaches were common irrespective of size. Balance disorders improved after surgery, especially in case of larger tumors. Functional recovery varied, with 41.67% of patients returning to their previous activity within 4 months, 25% within 4-12 months, and 33.33% remaining inactive. The mortality rate was low at 3.3 %, with two deaths out of 60 patients after surgery. This analysis highlights surgery risks for vestibular schwannomas (e.g., facial nerve decline, tinnitus, headaches), but also emphasizes benefits like improved balance and low mortality. Many patients regain professional activity, stressing the importance of informed treatment decisions for this condition.
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  • 文章类型: Journal Article
    突发性感音神经性听力损失(SSNHL)是耳鼻喉科常见的紧急症状,需要立即诊断和治疗。SSNHL具有多因素病因,其病理生理机制可能与可能影响耳蜗微环境或其神经成分的炎症和代谢变化有关,从而触发该过程或阻碍听力恢复。因此,本研究的目的是评估代谢和炎症变化,以确定可作为SSNHL患者听力恢复预后因素的全身参数.
    本研究纳入了30名在三个连续频率下突发性听力损失至少30dB的患者。患者随访4个月,在第7天(V1)采集外周血,30天(V2)和120天(V3)。白细胞介素(IL)-1F7,IL-2,IL-4,IL-5,IL-6,IL-10,干扰素γ(IFN-γ),测定血清肿瘤坏死因子α(TNF-α)和脂联素水平。此外,血脂和血糖分布以及肌酐浓度,尿酸,果糖胺,过氧化物,分析总蛋白和白蛋白.患者每周进行针对耳朵的听力测试,标准纯音阈值为250-8,000Hz,语音识别阈值和单词识别得分。
    SSNHL患者被分为一组未达到听力恢复的患者(n=14)和另一组达到完全和显着恢复的患者(n=16)。大多数血清学参数没有显着变化或指示临床变化的值。然而,IFN-γ水平在V1和V2之间下降了36.3%。细胞因子TNF-α从V1到V3显示出统计学上的显着降低(从22.91到10.34pg。/mL)。脂联素显示从V1中的553.7ng/mL降低到V3中的454.4ng/mL。
    我们的结果表明,在SSNHL表现的急性期,血清学细胞因子水平发生变化,并在系统性变化和听力改善之间建立了平行关系,尤其是TNF-α,这显示了听力恢复的差异。IFN-γ的使用,TNF-α和脂联素可以阐明这些患者的临床改善。
    UNASSIGNED: Sudden sensorineural hearing loss (SSNHL) is a common emergency symptom in otolaryngology that requires immediate diagnosis and treatment. SSNHL has a multifactorial etiology, and its pathophysiologic mechanisms may be associated with inflammatory and metabolic changes that may affect the cochlear microenvironment or its nervous component, thus triggering the process or hindering hearing recovery. Therefore, the aim of this study was to assess metabolic and inflammatory changes to identify systemic parameters that could serve as prognostic factors for hearing recovery in patients with SSNHL.
    UNASSIGNED: Thirty patients with a sudden hearing loss of at least 30 dB in three contiguous frequencies were enrolled in this study. Patients were followed up for 4 months and peripheral blood samples were collected at 7 days (V1), 30 days (V2) and 120 days (V3). Interleukins (IL)-1F7, IL-2, IL-4, IL-5, IL-6, IL-10, interferon γ (IFN-γ), tumor necrosis factor α (TNF-α) and adiponectin were quantified in serum. In addition, lipid and glycemic profiles as well as concentration of creatinine, uric acid, fructosamine, peroxide, total proteins and albumin were analyzed. Patients underwent weekly ear-specific hearing tests with standard pure tone thresholds for frequencies of 250-8,000 Hz, speech recognition threshold and word recognition score.
    UNASSIGNED: Patients with SSNHL were divided into a group of patients who did not achieve hearing recovery (n = 14) and another group who achieved complete and significant recovery (n = 16). Most serologic parameters showed no significant changes or values indicating clinical changes. However, IFN-γ levels decreased by 36.3% between V1 and V2. The cytokine TNF-α showed a statistically significant decrease from V1 to V3 (from 22.91 to 10.34 pg./mL). Adiponectin showed a decrease from 553.7 ng/mL in V1 to 454.4 ng/mL in V3.
    UNASSIGNED: Our results show that serologic cytokine levels change in the acute phase of manifestation of SSNHL and establish a parallel between systemic changes and improvements in hearing, especially TNF-α, which showed differences in hearing recovery. The use of IFN-γ, TNF-α and adiponectin may elucidate the clinical improvement in these patients.
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  • 文章类型: Journal Article
    背景:许多研究发现,患有突发性感觉神经性听力损失(SSHL)的患者,伴有或不伴有眩晕,常显示前庭功能受损。然而,缺乏分析不同年龄段SSHL患者前庭诱发肌源性电位(VEMPs)的研究.
    目的:调查不同年龄人口统计学中SSHL患者的前庭状况。
    方法:对84例SSHL患者的临床资料进行回顾性分析。测听法,宫颈前庭诱发肌源性电位(c-VEMPs),并对这些患者进行了眼前庭诱发的肌源性电位(o-VEMPs)。评估的参数包括P1波和N1波的延迟,以及P1-N1波的振幅。此外,该研究评估了性别等因素的影响,患侧,听力损失的配置,并伴有眩晕。
    结果:在84例SSHL患者中,三组在性别方面没有观察到显著差异,患侧,以及是否存在眩晕。II组(年龄41-60岁)的SSHL病例数最高。受影响的耳朵中o-VEMPs的缺失率为20.83%,31.58%,三个年龄组为22.72%,分别,它们之间没有统计学上的显著差异。受影响的耳朵中c-VEMPs的缺失率为8.3%,34.21%,三个年龄组为18.18%,分别,具有显著差异。在未受影响的耳朵里,在未受影响的耳中,o-VEMPs的提取率在各年龄组间存在差异.在三个年龄组中,在三个年龄组中,c-VEMP和o-VEMP的P1和N1波的潜伏期或N1-P1波的振幅没有显着差异,在受影响的一侧或未受影响的一侧,在三个年龄组。
    结论:VEMPs的提取率比参数更有价值。不管是否存在眩晕,前庭器官参与SSHL。值得注意的是,41-60岁的SSHL患者似乎更容易损伤下前庭神经和球囊。
    BACKGROUND: Numerous studies have found that patients experiencing sudden sensorineural hearing loss (SSHL), with or without accompanying vertigo, often show impaired vestibular function. However, there is a dearth of studies analyzing vestibular-evoked myogenic potentials (VEMPs) in SSHL patients across various age groups.
    OBJECTIVE: To investigate vestibular condition in SSHL patients across various age demographics.
    METHODS: Clinical data of 84 SSHL patients were investigated retrospectively. Audiometry, cervical vestibular evoked myogenic potentials (c-VEMPs), and ocular vestibular evoked myogenic potentials (o-VEMPs) were conducted on these patients. Parameters assessed included the latencies of P1 and N1 waves, as well as the amplitudes of P1-N1 waves. Moreover, the study evaluated the influence of factors such as sex, affected side, configuration of hearing loss, and presence of accompanying vertigo.
    RESULTS: Among the 84 SSHL patients, no significant differences were observed among the three groups in terms of gender, affected side, and the presence or absence of vertigo. Group II (aged 41-60 years) had the highest number of SSHL cases. The rates of absent o-VEMPs in the affected ears were 20.83%, 31.58%, and 22.72% for the three age groups, respectively, with no statistically significant difference among them. The rates of absent c-VEMPs in the affected ears were 8.3%, 34.21%, and 18.18% for the three age groups, respectively, with significant differences. In the unaffected ears, there were differences observed in the extraction rates of o-VEMPs in the unaffected ears among the age groups. In the three age groups, no significant differences were noted in the three age groups in the latencies of P1 and N1 waves or in the amplitude of N1-P1 waves for c-VEMPs and o-VEMPs, either on the affected side or on the unaffected side, across the three age groups.
    CONCLUSIONS: The extraction rate of VEMPs is more valuable than parameters. Regardless of the presence of vertigo, vestibular organs are involved in SSHL. Notably, SSHL patients aged 41-60 appear more susceptible to damage to the inferior vestibular nerve and saccule.
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  • 文章类型: Journal Article
    本研究的目的是通过临床数据和先进的分析方法,评估高压氧疗法(HBOT)作为与标准全身性皮质类固醇治疗相结合的方法,与不使用HBOT(非HBOT)的治疗相比,对突发性神经性耳聋(SSNHL)的主要治疗方法的临床疗效。
    病例对照研究。
    在三个日本医疗中心进行,涉及298名在2020年至2023年之间诊断的SSNHL患者。纳入标准包括首次发病和治疗,世卫组织3级或4级初始听力障碍,在症状发作后14天内接受全身性皮质类固醇治疗,并在同一时间段内启动病例组的HBOT。主要结果指标是听力改善的差异(平均听力水平以分贝为单位,dB)在两组之间,在基线和治疗后3个月通过纯音测听法评估,使用针对协变量差异进行调整的治疗加权逆概率(IPTW)方法。
    该研究包括HBOT组67例患者和非HBOT组68例患者。HBOT组表现出明显更大的听力改善(IPTW调节差异:7.6dB,95%CI0.4-14.7;p=0.038)。HBOT组没有眩晕的患者表现出显著的听力改善(11.5dB,95%CI2.3-20.6;p=0.014),而那些患有眩晕的患者没有显着改善(-1.8dB,95%CI-11.8-8.3;p=0.729)。HBOT组与完全恢复的相关性也显着较高(IPTW校正比值比:2.57,95%CI1.13-5.85;p=0.025)。
    在SSHNL中,与非HBOT治疗相比,HBOT联合治疗的听力结果略有改善,但显着改善。
    4.
    UNASSIGNED: The aim of present study was to evaluate the clinical efficacy of hyperbaric oxygen therapy (HBOT) as a primary therapy combined with standard systemic corticosteroid treatment for sudden sensorineural hearing loss (SSNHL) compared to treatment without the use of HBOT (non-HBOT) through clinical data and advanced analytical approaches.
    UNASSIGNED: Case-control study.
    UNASSIGNED: Conducted across three Japanese medical centers involving 298 SSNHL patients diagnosed between 2020 and 2023. Inclusion criteria encompassed first onset and treatment, WHO grade 3 or 4 initial hearing impairment, receipt of systemic corticosteroid therapy within 14 days of symptom onset, and initiation of HBOT within the same timeframe for the case group. The primary outcome measure was the difference in hearing improvement (mean hearing level in decibels, dB) between the two groups, assessed by pure-tone audiometry at baseline and 3 months post-treatment, using the inverse probability of treatment weighting (IPTW) method adjusted for covariate differences.
    UNASSIGNED: The study included 67 patients in the HBOT group and 68 in the non-HBOT group. The HBOT group exhibited significantly greater hearing improvement (IPTW-adjusted difference: 7.6 dB, 95% CI 0.4-14.7; p = 0.038). Patients without vertigo in the HBOT group demonstrated substantial hearing improvement (11.5 dB, 95% CI 2.3-20.6; p = 0.014), whereas those with vertigo showed no significant improvement (-1.8 dB, 95% CI -11.8-8.3; p = 0.729). The HBOT group also had a significantly higher association with complete recovery (IPTW-adjusted odds ratio: 2.57, 95% CI 1.13-5.85; p = 0.025).
    UNASSIGNED: In SSHNL, HBOT combination therapy yielded slightly but significantly improved hearing outcomes compared to non-HBOT treatment.
    UNASSIGNED: 4.
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  • 文章类型: Journal Article
    背景:甘油磷脂(GPL)对于细胞膜的结构和功能至关重要。鞘磷脂及其代谢产物调节细胞生长,凋亡,和应激反应。这项研究旨在调查所有频率(AF-SSNHL)的突发性感觉神经性听力损失患者的脂质代谢。
    方法:该研究包括60例诊断为单侧AF-SSNHL的患者,其中30例患者在随访6个月后听力改善水平≥15dB.使用倾向评分匹配(2:1)的对照组。基于液相色谱-质谱的非靶向脂质组学分析与多变量统计相结合来研究脂质变化。“lipidome”R包和加权基因共表达网络分析(WGCNA)用于评估脂质的结构特征以及脂质与听力之间的关联。
    结果:脂质组学成功地将AF-SSNHL组与对照组区分开,确定17个危险因素,主要包括磷脂酰胆碱(PC),磷脂酰乙醇胺(PE),和相关代谢物。溶血磷脂酰胆碱/PC的比例,溶血磷脂酰乙醇胺/PE,和溶血二甲基磷脂酰乙醇胺/PE上调,而在AF-SSNHL组中,一些甘油磷脂(GPL)-疟原虫表达下调,表明GPL代谢异常。三己糖神经酰胺(d34:1),PE(18:1e_22:5),和鞘磷脂(d40:3)在应答者和无应答者之间显着不同,与听力改善呈正相关。此外,WGCNA的结果还提示部分GPL-疟原虫与听力改善呈正相关.
    结论:AF-SSNHL患者出现异常高血脂和明显的GPL代谢异常。鞘脂和GPL-疟原虫与听力改善水平有关。通过了解脂质变化,临床医生可能能够预测听力恢复的预后和个性化的治疗方法。
    BACKGROUND: Glycerophospholipids (GPLs) are essential for cell membrane structure and function. Sphingomyelin and its metabolites regulate cell growth, apoptosis, and stress responses. This study aimed to investigate lipid metabolism in patients experiencing sudden sensorineural hearing loss across all frequencies (AF-SSNHL).
    METHODS: The study included 60 patients diagnosed with unilateral AF-SSNHL, among whom 30 patients had a level of hearing improvement ≥ 15 dB after 6 months of follow-up. A propensity score-matched (2:1) control group was used. Liquid chromatography‒mass spectrometry based untargeted lipidomics analysis combined with multivariate statistics was performed to investigate the lipids change. The \"lipidome\" R package and weighted gene co-expression network analysis (WGCNA) were utilised to assess the lipids\' structural features and the association between lipids and hearing.
    RESULTS: Lipidomics successfully differentiated the AF-SSNHL group from the control group, identifying 17 risk factors, mainly including phosphatidylcholine (PC), phosphatidylethanolamine (PE), and related metabolites. The ratios of lysophosphatidylcholine/PC, lysophosphatidylethanolamine/PE, and lysodimethylphosphatidylethanolamine/PE were upregulated, while some glycerophospholipid (GPL)-plasmalogens were downregulated in the AF-SSNHL group, indicating abnormal metabolism of GPLs. Trihexosylceramide (d34:1), PE (18:1e_22:5), and sphingomyelin (d40:3) were significantly different between responders and nonresponders, and positively correlated with hearing improvement. Additionally, the results of the WGCNA also suggested that partial GPL-plasmalogens were positively associated with hearing improvement.
    CONCLUSIONS: AF-SSNHL patients exhibited abnormally high blood lipids and pronounced GPLs metabolic abnormalities. Sphingolipids and GPL-plasmalogens had an association with the level of hearing improvement. By understanding the lipid changes, clinicians may be able to predict the prognosis of hearing recovery and personalize treatment approaches.
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  • 文章类型: Journal Article
    目的:比较突发性感音神经性耳聋(SSNHL)患者T2加权磁共振成像(MRI)的白质高强度(WMHs),并分析年龄匹配的对照组的亚群。
    方法:对150例SSNHL患者的T2加权MRI扫描进行WMHs评估,并与148例年龄匹配的健康成年人的数据进行比较。WMHs的评估包括深度白质高信号(DWMHs)和脑室高信号(PVHs)的独立分级。WMH严重程度由两个独立的观察者使用Fazekas和Mirsen量表目测评定。
    结果:发现SSNHL患者的PVHs(p<0.001)和DWMHs(p<0.001)的Fazekas等级明显高于健康参与者。健康和SSNHL患者的DWMHs平均Mirsen等级分别为0.373±0.550和2.140±0.859。发现SSNHL患者的DWMHs的Mirsen等级明显高于健康参与者(p<0.001)。在PVH和DWMHs分级中,Mirsen量表比Fazekas量表具有更高的灵敏度(p<0.001)。两种量表之间的特异性没有发现显着差异(p=0.24)。
    结论:与年龄匹配的对照组相比,突发性听力损失患者发生脑室周围和深部白质高信号的可能性要高得多。这些发现表明,突发性听力损失患者更有可能在大脑中发生微血管变化,这可能表明血管和/或偏头痛的原因是突然的感觉神经性听力损失。
    OBJECTIVE: To compare white matter hyperintensities (WMHs) on T2-weighted magnetic resonance imaging (MRI) of patients with sudden sensorineural hearing loss (SSNHL) and analyze subpopulations with age-matched controls.
    METHODS: T2-weighted MRI scans of 150 patients with SSNHL were assessed for WMHs and compared with the data of 148 healthy age-matched adults. Assessments of WMHs included independent grading of deep white matter hyperintensities (DWMHs) and periventricular hyperintensities (PVHs). WMH severity was visually rated using the Fazekas and Mirsen scales by two independent observers.
    RESULTS: Fazekas grades for PVHs (p < 0.001) and DWMHs (p < 0.001) of SSNHL patients were found to be significantly greater than those of healthy participants. The average Mirsen grades for DWMHs of healthy and SSNHL patients were evaluated to be 0.373 ± 0.550 and 2.140 ± 0.859, respectively. Mirsen grades for DWMHs of SSNHL patients were found to be significantly greater (p < 0.001) than those of healthy participants. The Mirsen scale was found to have higher sensitivity (p < 0.001) than the Fazekas scale in grading PVHs and DWMHs. No significant difference (p = 0.24) was found in specificities between the two scales.
    CONCLUSIONS: Patients with sudden hearing loss have a much higher likelihood of having periventricular and deep white matter hyperintensities compared to age-matched controls. These findings indicate that sudden hearing loss patients are more likely to have microvascular changes in the brain, which may indicate a vascular and/or migraine origin to sudden sensorineural hearing loss.
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  • 文章类型: Journal Article
    目的:本研究的目的是调查15至40岁患者的听力特征和突发性感觉神经性听力损失(SSNHL)的原因,关注诊断后一年的听力学结果。方法:回顾了转诊到我们三级听力学中心的SSNHL患者的病历。所有患者都进行了全面的诊断评估,包括高分辨率3D-FLAIR延迟磁共振成像(MRI),锥形束计算机断层扫描(CBCT),和凝血筛查,传染性,和自身免疫性疾病。结果:总体而言,56名患者(平均年龄28.1±7.6岁)被纳入研究。受影响的耳朵的听力阈值从诊断时的56.0±18.0dB显着提高到一年后的46.9±22.3dB(p=0.02)。听力损失的程度,听力测量配置,听力改善,对听力治疗的依从性在患者中显示出相当大的差异。听觉丰满度,耳鸣,和高音是与SSNHL相关的主要症状,随着时间的推移,他们的患病率显着下降。诊断方案导致在75%(42/56)的患者中确定SSNHL的特定原因。已知病因为耳科(39.3%),传染性(21.4%),自身免疫性(7.1%),血管(5.4%),或肿瘤(1.8%)。特别是,梅尼埃病(n=12),孤立的耳蜗内淋巴积液(n=6),HSV-1(n=5),EBV(n=4)感染是SSNHL的最常见原因。结论:确定SSNHL的特定病因可能有助于更个性化的管理和治疗方法。
    Objectives: The purpose of this study was to investigate the hearing characteristics and causes of sudden sensorineural hearing loss (SSNHL) in patients aged from 15 to 40 years, focusing on audiological outcomes one year after the diagnosis. Methods: The medical records of individuals with SSNHL who were referred to our tertiary-level audiologic center were reviewed. All patients had undergone comprehensive diagnostic evaluations, including high-resolution 3D-FLAIR delayed magnetic resonance imaging (MRI), cone beam computed tomography (CBCT), and screening for coagulation, infectious, and autoimmune diseases. Results: Overall, 56 patients (mean age 28.1 ± 7.6 years) were included in the study. The hearing threshold in the affected ear improved significantly from 56.0 ± 18.0 dB at the diagnosis to 46.9 ± 22.3 dB after one year (p = 0.02). The degree of hearing loss, audiometric configurations, hearing improvements, and adherence to hearing treatments showed considerable variability among patients. Aural fullness, tinnitus, and hyperacusis were the predominant symptoms associated with SSNHL, and their prevalence decreased significantly over time. The diagnostic protocol led to the identification of the specific cause of SSNHL in 75% (42/56) of patients. The known etiology was found to be otological (39.3%), infectious (21.4%), autoimmune (7.1%), vascular (5.4%), or neoplastic (1.8%). In particular, Menière\'s disease (n = 12), isolated cochlear endolymphatic hydrops (n = 6), HSV-1 (n = 5), and EBV (n = 4) infections were the most frequent causes of SSNHL. Conclusions: The identification of the specific etiology of SSNHL may facilitate a more personalized approach to management and treatment.
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