SNHL

SNHL
  • 文章类型: Journal Article
    目的:慢性中耳炎(COM)是一种炎症性疾病,通常表现为耳漏和听力损失。细菌引起的炎症会导致内耳损伤,导致感觉神经性听力损失(SNHL)。这项研究旨在比较革兰氏阴性和革兰氏阳性培养患者中SNHL的患病率和严重程度,并检查循环单核细胞和中性粒细胞的浓度与细菌种类和SNHL之间的关联。
    方法:这是一项回顾性研究。纳入胆脂瘤或慢性化脓性中耳炎伴耳漏患者。在耳镜下使用无菌拭子收集中耳分泌物,30分钟内送细菌检测。记录并分析感染不同病原体的患者的纯音测听和循环白细胞计数。采用Logistic回归分析确定与SNHL相关的危险因素。
    结果:共纳入137例患者,包括45例感染革兰氏阴性菌的病人,41个革兰氏阳性菌,20种微生物感染,和31没有细菌生长。Logistic回归分析显示,细菌培养阳性感染(OR=7.265,95%CI2.219~23.786,p=0.001)是SNHL的独立危险因素。与革兰氏阳性菌患者相比,革兰氏阴性菌患者发生SNHL的风险更高(p<0.0001),听力损失更严重(p=0.005)。感染革兰氏阴性菌的COM患者显示循环单核细胞增加,与SNHL的发生相关(p=0.0343)。
    结论:革兰氏阴性菌与循环单核细胞计数升高相关,并且具有更高的严重SNHL风险。
    方法:4喉镜,2024.
    OBJECTIVE: Chronic otitis media (COM) is an inflammatory disease that commonly presents with otorrhea and hearing loss. Bacteria-induced inflammation can cause inner ear damage, leading to sensorineural hearing loss (SNHL). This study aimed to compare the prevalence and severity of SNHL in patients with gram-negative versus gram-positive cultures and examine associations between the concentrations of circulating monocytes and neutrophils with bacteria species and SNHL.
    METHODS: This was a retrospective study. Cholesteatoma or chronic suppurative otitis media patients with otorrhea were enrolled. Middle ear secretions were collected using sterile swabs under an otoscope, and sent for bacterial detection within 30 min. Pure tone audiometry and circulating leukocyte counts were recorded and analyzed in patients infected with different pathogens. Logistic regression analysis was used to identify the risk factors associated with SNHL.
    RESULTS: A total of 137 patients were enrolled, including 45 patients infected with gram-negative bacteria, 41 with gram-positive bacteria, 20 with polymicrobial infection, and 31 with no bacterial growth. Logistic regression analysis showed that bacterial culture positive infections (OR = 7.265, 95% CI 2.219-23.786, p = 0.001) were an independent risk factor for SNHL. Patients with gram-negative bacteria had higher risks of SNHL (p < 0.0001) and more severe hearing loss (p = 0.005) than those with gram-positive bacteria. COM patients infected with gram-negative bacteria showed an increase in circulating monocytes, which correlated with the occurrence of SNHL (p = 0.0343).
    CONCLUSIONS: Gram-negative bacteria are associated with elevated circulating monocyte counts and have a higher risk of severe SNHL.
    METHODS: 4 Laryngoscope, 134:3335-3341, 2024.
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  • 文章类型: Case Reports
    鉴于越来越多的证据,COVID-19与感音神经性听力损失(SNHL)之间的关系继续巩固。除了明确的COVID-19症状和后遗症,耳鼻喉科医师观察到COVID-19患者和COVID-19免疫后SNHL的发病率增加。尽管这种关联背后的确切机制尚不清楚,在科学文献中讨论了各种假设。本病例报告通过讨论COVID-19免疫后不久的双侧耳鸣和随后的SNHL的独特病例,扩展了COVID-19与SNHL之间的关系。它有助于越来越多的证据将COVID-19与SNHL联系起来,强调进一步研究以了解潜在因果机制的重要性。它强调了监测COVID-19患者和接受免疫接种的患者听力的临床重要性,倡导提高临床医生的认识,以促进对COVID-19相关听力损失的早期识别和适当干预。
    The relationship between COVID-19 and sensorineural hearing loss (SNHL) continues to solidify in light of a growing body of evidence. In addition to the well-established COVID-19 symptoms and sequelae, otolaryngologists have observed an increased incidence of SNHL in patients with COVID-19 and following COVID-19 immunizations. Although the precise mechanisms behind this association remain unclear, various hypotheses are discussed within the scientific literature. This case report expands on the relationship between COVID-19 and SNHL by discussing a unique case of bilateral tinnitus and subsequent SNHL shortly following COVID-19 immunization. It contributes to the growing body of evidence associating COVID-19 with SNHL, underlining the importance of further research to understand potential causal mechanisms. It underscores the clinical importance of monitoring hearing in COVID-19 patients and those receiving immunizations, advocating for increased awareness among clinicians to facilitate early identification and appropriate intervention in cases of COVID-19-related hearing loss.
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  • 文章类型: Journal Article
    背景:流感嗜血杆菌引起的脑膜炎后听力损失(H.流感)越来越多地归因于b型(Hib)和不可分型菌株以外的封装血清型(统称,nHiB流感嗜血杆菌)。nHib流感嗜血杆菌脑膜炎后的儿童听力损失仍然缺乏描述。
    方法:从2000年至2020年科罗拉多州儿童医院的微生物数据库中确定的nHiB流感嗜血杆菌脑膜炎病例的回顾性病例系列。还回顾了有关nHiB流感嗜血杆菌和流感嗜血杆菌脑膜炎后听力损失的文献。
    结果:11例nHib流感嗜血杆菌脑膜炎(中位年龄15.9个月)由于血清型f(36%),血清型a(27%),和不可分型的菌株(36%)。7名(64%)患者为男性,55%是白人,18%是西班牙裔或拉丁裔。最初在4名儿童(40%)中发现了听力损失,两名中度传导性听力损失(CHL)患者和一名单侧中度感音神经性(SNHL)听力损失患者恢复正常听力。一名患有双侧深度感音神经性听力损失和相关骨化性迷路炎的患者需要人工耳蜗植入。所有已确认听力损失的儿童(4名)均有额外的颅内后遗症,其中包括脓胸(2),窦血栓形成(2),和缉获量(2)。在接受类固醇治疗的患者中,25%的人在初始测试中有听力损失,相比之下,66%的人没有接受类固醇治疗。
    结论:nHib流感嗜血杆菌可引起暂时性和永久性脑膜炎后听力损失。类固醇可能在nHib流感嗜血杆菌脑膜炎中提供类似于Hib脑膜炎的耳保护作用。鉴于文献有限,需要进一步研究以更好地表征nHib流感嗜血杆菌脑膜炎后的听力结果.
    BACKGROUND: Postmeningitic hearing loss from Haemophilus influenzae (H. influenzae) is increasingly due to encapsulated serotypes other than type b (Hib) and nontypeable strains (collectively, nHiB H. influenzae). Pediatric hearing loss after nHib H. influenzae meningitis remains poorly described.
    METHODS: Retrospecive case series of nHiB H. influenzae meningitis cases identified from a microbiologic database at Children\'s Hospital Colorado from 2000 to 2020. Literature regarding nHiB H. influenzae and H. influenzae postmeningitic hearing loss was also reviewed.
    RESULTS: Eleven cases of nHib H. influenzae meningitis (median age 15.9 months) were identified due to serotype f (36 %), serotype a (27 %), and nontypable strains (36 %). Seven (64 %) patients were male, 55 % were white and 18 % were Hispanic or Latino. Hearing loss was initially identified in 4 children (40 %), with two patients with moderate conductive hearing loss (CHL) and one child with unilateral moderate sensorineural (SNHL) hearing loss patients recovering normal hearing. One patient with bilateral profound sensorineural hearing loss and associated labyrinthitis ossificans required cochlear implantation. All children (4) with identified hearing loss were noted to have additional intracranial sequelae, which included empyema (2), sinus thrombosis (2), and seizures (2). Of patients receiving steroids, 25 % had hearing loss on initial testing, compared to 66 % of those who did not receive steroids.
    CONCLUSIONS: nHib H. influenzae can cause both transient and permanent postmeningitic hearing loss. Steroids may offer otoprotection in nHib H. influenzae meningitis similar to Hib meningitis. Given the limited literature, further study is needed to better characterize hearing outcomes after nHib H. influenzae meningitis.
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  • 文章类型: Journal Article
    这项研究旨在了解北方邦东部三级护理中心疑似听力损失儿童的听力筛查经验,印度使用畸变产物耳声发射(DPOAE)作为筛查方式。这项研究是在7月期间在北方邦东部的三级护理中心进行的,2021年6月,2022年由96名儿童组成,他们被转诊为疑似听力损失。他们进行了畸变产物耳声发射(DPOAE)测试。在96名接受DPOAE测试的儿童中,25(26.04%)通过测试,55(57.29%)在双侧耳中出现“参考”结果,而16(16.67%)在任一耳中出现“参考”结果。OAE是一个简单的,尽管存在一些局限性,但具有成本效益且方便的听力筛查工具。通用新生儿听力筛查可以使用OAE实施。
    This study aims to comprehend the experience of hearing screening in children with suspected hearing loss at a tertiary care centre of eastern Uttar Pradesh, India using distortion product otoacoustic emission (DPOAE) as a screening modality. This study was conducted at a tertiary care centre of eastern Uttar Pradesh during the period of July, 2021to June, 2022 consisting of 96 children who were referred with suspected hearing loss. They underwent distortion product otoacoustic emissions (DPOAE) testing. Out of 96 children who underwent DPOAE testing, 25 (26.04%) passed the test, 55(57.29%) had \"refer\" result in bilateral ears whereas 16 (16.67%) had \"refer\" result in either ear. OAE is a simple, cost-effective and convenient tool for hearing screening in spite of some limitations. Universal new-born hearing screening can be implemented using OAE.
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  • 文章类型: Journal Article
    目的:研究放化疗对头颈部恶性肿瘤患者听力的影响。
    方法:接受顺铂以外药物治疗的患者以及有任何耳科相关病理或异常的患者被排除在研究之外。经活检证实为鼻咽部恶性肿瘤的患者,口咽喉,鼻旁窦,口腔,腮腺顺铂放化疗和不同放射方式均符合条件。在CT图像上显示感兴趣区域和OAR。所有患者的听力在治疗开始时使用纯音测听法进行评估,在它的结论,六个月后.纯音阈值与基线和CTCAE的差异-不良事件分级的通用术语标准与耳蜗剂量有关。
    结果:该研究涉及75名患者。在超过40Gy的耳蜗剂量水平下,观察到显著的SNHL(>10dB损耗)。绝对PTA阈值在任何频率下从基线到完成都没有统计学差异。对于4000和8000Hz,从基线到随访,绝对PTA阈值不同,但仅在8000Hz随访6个月后差异有统计学意义.治疗后,64%的患者有I级CTCAE评分,16%和12%,分别,有渗出性中耳炎和咽鼓管功能障碍。
    结论:接受头颈部辐射的患者可能会损害内耳。辐射诱导的SNHL通常在常规临床实践中没有报道,因为它具有长期性质。在具有高风险部位的头颈部肿瘤组中,近90%的SNHL患者受到影响.因此,减少这些患者人群的耳蜗剂量至关重要。需要更多的调查来区分耳蜗和后耳蜗类型的感觉神经性听力损失。
    OBJECTIVE: To study effects of chemoradiation therapy on hearing in patients with malignancy of head and neck.
    METHODS: Patients receiving drugs other than cisplatin as well as those with any otology-related pathology or abnormalities were excluded from the study. Patients with primary biopsy-proven malignancy of the Nasopharynx, Oropharynx, Paranasal Sinuses, Oral Cavity, and Parotid with chemoradiation by cisplatin and different radiation modalities were all eligible. Areas of interest and OARs are indicated on CT images. All patients\' hearing was assessed using pure tone audiometry at the beginning of treatment, at its conclusion, and six months later. Variations in pure tone thresholds from baseline and CTCAE - Common Terminology Criteria for Adverse Events grading are related to cochlear dose.
    RESULTS:  The study involves 75 patients. At cochlear dosage levels of more than 40 Gy, significant SNHL (>10 dB loss) is seen. Absolute PTA threshold values do not statistically differ from baseline to completion at any frequency. For 4000 and 8000 Hz, the absolute PTA threshold values differed from baseline to follow-up, but only for 8000 Hz was the difference statistically significant after six months of follow-up. Following treatment, 64% of patients had grade I CTCAE scoring and 16% and 12%, respectively, had otitis media with effusion and Eustachian tube dysfunction.
    CONCLUSIONS:  The inner ear may be harmed in patients receiving radiation to the head and neck. Radiation-induced SNHL typically goes unreported in routine clinical practise because of its long-term nature. In the group of head and neck tumours with high-risk locations, nearly 90% of patients with SNHL were affected. Therefore, it\'s critical to reduce cochlear dosage in these patient populations. More investigation is needed to distinguish between cochlear and retro-cochlear types of sensorineural hearing loss.
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  • 文章类型: Journal Article
    耳鸣是耳蜗功能障碍的症状,这会在情感和身体上打扰病人。由于焦虑和耳鸣同时存在,某些苯二氮卓类药物已作为可能的耳鸣治疗选择.除了药物,某些研究已经研究了使用维生素来治疗耳鸣。鼓室类固醇也已成功用于各种研究,用于治疗耳鸣。在访问州立医学院和医院的ENTOPD的患者中进行了基于临床的介入研究。通过方便的抽样法将160名受试者纳入研究,考虑纳入和排除标准。在他们当中,80例受试者给予鼓室内注射地塞米松,其余80例给予阿普唑仑和维生素B复合物等口服药物。在接受鼓室内地塞米松治疗的患者中,其中36个有显著改善,与接受口服药物的人相比,p值为0.00,其中只有10人表现出改善,p值为0.32。在我们的研究中,症状的改善与症状的持续时间显着相关。表现为严重SNHL的患者是最常见的表现,但改善最少(29.6%)。出现症状后一年内出现的患者有最大的改善。鼓室内地塞米松可以被认为是改善耳鸣症状的良好替代品。
    Tinnitus is a symptom of cochlear dysfunction, which can disturb the patient emotionally and physically. As anxiety and tinnitus persist concurrently, certain benzodiazepines have been administered as possible tinnitus treatment options. In addition to pharmacological medications, certain studies have looked at the use of vitamins to treat tinnitus. Intratympanic steroids have been successfully used in various studies as well, for the treatment of tinnitus. A clinical based interventional study was taken up among the patients visiting the ENT OPD of a State Medical College and Hospital. 160 subjects were included in the study by convenient sampling method, taking the inclusion and the exclusion criteria into consideration. Out of them, 80 subjects were given an intratympanic injection of dexamethasone and rest 80 were given oral drugs like alprazolam and vitamin B complex. Among the patients who were treated with intratympanic dexamethasone, significant improvement was seen in 36 of them, with a p value of 0.00 as compared to those who were given oral drugs, in which only 10 showed improvement, with a p value of 0.32. The improvement of the symptoms is significantly related with the duration of the symptoms in our study. Patients presenting with severe SNHL was the commonest presentation but had the least improvement (29.6%). Patients presenting within one year of occurrence of the symptoms had maximum improvement. Intratympanic dexamethasone can be considered as a good alternative for improvement of symptoms of tinnitus.
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  • 文章类型: Journal Article
    背景:巨细胞病毒(CMV)是人类先天性感染的最常见病原体。它是婴儿期神经发育迟缓和感觉神经性听力损失的主要原因。自2000年以来,许多研究已将伐更昔洛韦用作先天性CMV感染儿童的治疗方法.
    方法:为了评估伐更昔洛韦预防临床后遗症的疗效及其可能的副作用,我们对已发表的文献进行了回顾.这项搜索是通过PubMed完成的,内容是2007年1月至2021年12月出版的手稿,结合了MeSH单词“Valganciclovir”,\"先天性\",和“巨细胞病毒”。
    结果:共纳入27篇文献(12篇回顾性研究,4个前瞻性研究,1项随机对照试验,和10例病例报告)。临床特征与文献中已经描述的相似。所使用的治疗方案在所包括的各种研究之间非常不同,并且新生儿抗病毒治疗仅中等有效。该疗法被证明具有良好的耐受性。
    结论:纳入研究的质量和样本量由于疾病的稀有性而受到限制。在开始日期方面使用不同的治疗方案,剂量,和持续时间使得无法比较和正确评估治疗的疗效。需要随机对照试验来确定正确的有效剂量,副作用最少,治疗持续时间最有效。
    BACKGROUND: Cytomegalovirus (CMV) is the most common agent of congenital infection in humans. It is a main cause of neurodevelopmental delay and sensorineural hearing loss in infancy. Since the 2000s, a number of studies have used Valganciclovir as a therapy for children with congenital CMV infection.
    METHODS: In order to evaluate the efficacy of Valganciclovir in preventing clinical sequelae and its possible side effects, we performed a review of the published literature. This search was completed via PubMed for manuscripts published from January 2007 to December 2021, combining the MeSH words \"Valganciclovir\", \"Congenital\", and \"Cytomegalovirus\".
    RESULTS: A total of 27 articles were included (12 retrospective studies, 4 prospective studies, 1 randomized controlled trial, and 10 case reports). The clinical features were similar to those already described in the literature. The therapeutic protocols used were very different between the various studies included and neonatal antiviral treatments were only moderately effective. The therapy proved to be well-tolerated.
    CONCLUSIONS: The quality of the included studies and the sample size were limited due to the rarity of the disease. The use of different therapeutic protocols in terms of starting dates, doses, and durations made it impossible to compare and correctly evaluate the efficacy of the treatments. Randomized controlled trials are needed to establish the correct effective dose with the fewest side effects and the most efficient duration of therapy.
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  • 文章类型: Journal Article
    该研究的目的是筛选新生儿以进行早期诊断的感觉神经性听力损失,并评估新生儿听力损失与高危因素之间的关系。一个潜在的,队列,在耳鼻喉科进行的观察性分析研究,MGMMC&MYHINDORE(M.P.)在2018-2019年期间进行了200多名新生儿,这些新生儿在出院前和稳定高危新生儿后由OAE&BERA随机筛选。200个新生儿中,发现4例新生儿(2%)的感觉神经性听力损失,与低危新生儿相比,高危新生儿的听力障碍增加了13.8倍。这项研究的核心目标是强调普遍的新生儿听力筛查对于新生儿和新生儿的早期诊断和干预在听觉康复方面的重要性,因为每个孩子都是宝贵的,听力是他们的基本权利。
    The aim of the study to screen the neonates for earlier diagnosis of sensorineural hearing loss and to assess the relationship between the hearing loss in newborns along with the high risk factors. A prospective, cohort, observational analytical study done at department of ENT,MGMMC & MYH INDORE (M.P.) carried out during 2018-2019 over 200 neonates who were randomly selected screened by OAE & BERA before their discharge from the hospital and after stabilizing high risk neonates. Out of 200 neonates, sensorineural hearing loss found to be in 4 neonates (2%) and hearing impairment seen 13.8 times more in high risk neonates as compare to the low risk neonates. The core goal of the study was to emphasize the importance of universal newborn hearing screening for early diagnosis & intervention in newborns & Neonates in terms of auditory rehabilitation as every child is precious and hearing is their fundamental right.
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  • 文章类型: Journal Article
    现代生活方式对人体正常的生理机制提出了新的挑战。药物滥用,吸烟,饮酒,以及缺乏锻炼也可能增加患某些疾病的风险,尤其是年龄较大。研究感音神经性耳聋程度与血脂水平(总胆固醇、甘油三酯,低密度脂蛋白,高密度脂蛋白)。对150名年龄在15至60岁之间的患者进行了横断面研究,这些患者在SirSunderLal医院的耳鼻咽喉科门诊部被诊断为感音神经性听力损失,IMS,BHU.所有150名患者均为2019年8月至2021年7月登记的15至60岁年龄组。血清总胆固醇水平,甘油三酯和低密度脂蛋白与感音神经性耳聋的严重程度显著相关(p<0.05),而血清高密度脂蛋白水平与感音神经性耳聋的严重程度无直接相关.高脂血症状态是SNHL的主要危险因素。定期筛查和监测血脂可能会预防SNHL病态,并长期改善患者的生活质量。
    The modern life style poses new challenges on the normal physiological mechanisms of the human body. Drug abuse, tobacco smoking, and alcohol drinking, as well as lack of exercise may also increase the risk of developing certain diseases, especially older age.To study the relationship between degree of sensorineural hearing loss and serum lipid level (total cholesterol, triglyceride, low density lipoproteins, high density lipoproteins).A cross-sectional study was conducted in 150 patients aged between 15 to 60 years diagnosed with sensorineural hearing loss at Otorhinolaryngology outpatient department at Sir Sunder Lal hospital, IMS, BHU. All the 150 patients were amongst age group of 15 to 60 years who were registered from August 2019 to July 2021.The serum levels of total cholesterol, triglyceride and low-density lipoprotein directly correlate with the severity of sensorineural hearing loss significantly (p < 0.05) whereas the serum levels of high-density lipoprotein had no direct co-relation with the severity of sensorineural hearing loss. Hyperlipidemic state is a major risk factor for SNHL. Regular screening and monitoring of serum lipid might prevent morbid SNHL and improve patients\' quality of life in long term.
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  • 文章类型: Journal Article
    感音神经性听力损失是世界上最常见的问题,也是最被忽视的疾病。因此,了解SNHL的病因和病理生理学至关重要。该研究的主要目的是确定血清脂质参数是否与SNHL相关。本研究包括68名20-60岁年龄段的临床诊断为感觉神经性听力损失的患者。知情书面同意,耳镜检查,对所有患者进行纯音测听。对受试者进行血清脂质分布。本研究中受试者的平均年龄为53.25±13.78岁,男女比例为1.125:1。血清总胆固醇和血清甘油三酯与听力损失程度也有显著关系(p值<0.001)。随着血清LDL的增加,听力损失的严重程度增加,这是统计学上显著的(p值<0.001),其中血清HDL水平显示与听力损失的严重程度在统计学上不显著和负相关。血清脂质谱可用作评估听力损失严重程度的重要生物标志物。血脂参数紊乱的受试者听力障碍较高。
    Sensorineural hearing loss is the most frequent problem worldwide and is the most neglected condition. Thus, it is essential to understand the etiology and pathophysiology of SNHL. The main objective of the study is to find whether serum lipid parameters have any correlation with SNHL. 68 patients within the age group of 20-60 years with clinically diagnosed sensorineural hearing loss were included in this study. Informed written consent, otoscopy, pure tone audiometry were done on all patients. The subjects were subjected to Serum lipid profile. The mean age of subjects in this study was 53.25 ± 13.78 years and male to female ratio was found to be 1.125:1. The serum total cholesterol and serum triglyceride also showed significant relationship with the degree of hearing loss (p value < 0.001). With an increase in the serum LDL there was increase in the severity of hearing loss which was statistically significant (p value < 0.001) where as serum HDL level showed statistically insignificant and negative correlation with severity of hearing loss. Serum lipid profile can be used as important biomarker for assessing the severity of hearing loss. Subjects with deranged lipid parameters had higher degress of hearing impairement.
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