Navegando por Palavras-chave "Sudden Hearing Loss"

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    Avaliação vestibular na surdez súbita
    (Universidade Federal de São Paulo (UNIFESP), 2021) Maia, Nathalia De Paula Doyle [UNIFESP]; Gananca, Fernando Freitas [UNIFESP]; Universidade Federal de São Paulo
    Purpose: To evaluate vestibular function in patients with sudden hearing loss (SS) using cervical and ocular vestibular evoked myogenic potential (respectively, cVEMP and oVEMP), video head impulse test (vHIT), and caloric test. In addition, this study aims to assess the correlation between dizziness with vestibular tests and the correlation between vestibular tests and hearing recovery. Methods: This is an observational, longitudinal, prospective study comprising consecutive patients with SS who attended the emergency room and the outpatient clinic of the Otorhinolaryngology and Head and Neck Surgery Department of the Universidade Federal de São Paulo (UNIFESP) and met the eligible criteria, from November 2019 to March 2021. An otorhinolaryngologic assessment was performed, including audiometry, cVEMP, oVEMP, vHIT and caloric test. Audiometry was performed at the presentation and at the end of follow-up. A p-value ≤ 0,05 was considered statistically significant. Results: Seventeen patients were included in the study, 9 (52.94%) males and 8 (47.06%) females, with a mean age of 45.4 ± 11.1 years. The right side was affected in 9 patients (52.94%) and the left side in 8 (47.06%). Five patients (29,41%) presented dizziness and 15 (88,23%) tinnitus. All participants underwent vestibular assessment through cervical and ocular VEMP and vHIT, and 13 of them were evaluated by caloric test. cVEMP was abnormal in 5 (29.41%) patients, while oVEMP was abnormal in eleven (64.71%). vHIT and caloric test were abnormal in 7 (41.18%) and 5 (38.46%) patients, respectively. There was no statistically significant correlation between clinical data and vestibular tests or hearing recovery, neither between vestibular tests and hearing recovery. Conclusion: oVEMP, cVEMP, vHIT and caloric test revealed vestibular involvement in some patients. However, abnormal vestibular tests or its combination were not correlated with hearing recovery in SS.
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    Caracteristicas clínicas e biomarcadores da perda auditiva sensorioneural súbita: papel no prognóstico
    (Universidade Federal de São Paulo (UNIFESP), 2021) Elias, Thais Gomes Abrahao [UNIFESP]; Penido, Norma De Oliveira [UNIFESP]; Universidade Federal de São Paulo
    Introduction: Sudden sensorineural hearing loss (SSHL) is a heterogeneous inflammatory disease, involving multiple causes and different inflammatory responses. We need to incorporate the concept of individualization and better classification of patients with SSHL, aiming to establish the endotypes of this pathology, offer the best therapeutic modality and be able to predict the hearing recovery and therapeutic response of each patient. Objective: To investigate the clinical and molecular characteristics and prognosis of hearing recovery in patients with sudden sensorineural hearing loss. Methods: A multicenter study was carried out, including patients diagnosed with SSHL from the Universidade Federal de São Paulo and Massachusetts Eye and Ear, Harvard Medical School, to compare clinical and molecular characteristics (Interleukin-6, Interleukin-10, Tumor-Necrosis Factor-Alpha, antioxidant enzymes and malondialdehyde activity). Results: It was possible to identify the etiology of SSHL in 45.6% of patients with unilateral SSHL (USSHL), 22.7% of patients with bilateral SSHL (BSSHL) non-simultaneous or sequential and 88.8% of patients with BSSHL simultaneous. 77.8% of patients with BSSHL simultaneous had severe or profound hearing loss even after treatment. The differences in the prevalence of severe to profound hearing loss in BSSHL simultaneous compared to unilateral USSHL and BSSHL non-simultaneous or sequential were statistically significant (P = 0.002). No statistically significant association was found between the concentration of interleukins, TNF-alpha, antioxidant enzymes and MDA and hearing recovery among patients with SSHL. As for the performance of patients with SSHL after cochlear implant surgery, there was also no statistically significant difference when compared with a group of patients with idiopathic bilateral sensorineural hearing loss. Discussion: It can be suggested that the involvement of the inner ear is worse in BSSHL simultaneous and is probably related to systemic diseases, mainly autoimmune diseases. The plasma concentration of cytokines and oxidative stress activity do not reliably represent possible elevations of these inflammatory products in the intracochlear environment, which is inaccessible for clinical studies to date. Patients with SSHL experience significant performance improvement after cochlear implant surgery regardless of the etiology of hearing loss. Conclusion: Simultaneous BSSHL should be considered as a distinct clinical entity, when compared to unilateral SSHL and nonsimultaneous or sequential BSSHL, with greater involvement of the inner ear and greater chance of having a worse recovery from hearing loss. We found no difference between hearing gain after cochlear implant surgery in patients with SSHL and patients with idiopathic progressive hearing loss. The plasma concentration of IL-6, IL-10, TNF-alpha, oxidative stress activity and concentrations of TBARS (MDA activity) and TLR 4 do not correlate with the prognosis of hearing recovery after SSHL.