What Is Sudden Deafness?

Sudden deafness or "idiopathic sudden deafness", referred to as "sudden deafness" or "abrupt deafness", refers to sudden, unexplained sensorineural hearing loss. The main clinical manifestations are unilateral hearing loss, which can be accompanied by tinnitus, a sense of ear blockage, dizziness, nausea, and vomiting.

Basic Information

nickname: Sudden and sudden deafness
English name: sudden deafness
Visiting department: ENT
Multiple groups: 30 to 40 years old

Common causes: unknown
Common symptoms: Unilateral hearing loss, tinnitus, a sense of ear blockage, dizziness, nausea, vomiting
Contagious: no

Causes of sudden deafness

The etiology of sudden deafness is unknown, and many causative factors may cause sudden deafness. At present, the widely accepted theories include viral infection theory, circulation disorder theory, autoimmune theory, and membrane labyrinth rupture theory.

Clinical manifestations of sudden deafness

Deafness

Most of them are unilateral deafness, and there is no threat before the onset. A few patients have a history of mild cold, fatigue or emotional excitement. Deafness occurs suddenly. Patients' hearing generally drops to the lowest point within minutes or hours. A few patients can reach the lowest point within 3 days.

2. Tinnitus

It can be an initial symptom. Most patients can develop tinnitus when they are deaf, but tinnitus can also occur after deafness. After treatment, hearing can improve in most patients, but tinnitus can persist.

3. Vertigo

Some patients may be accompanied by varying degrees of vertigo, mostly rotary vertigo, with nausea and vomiting. It can occur at the same time as deafness, or before and after deafness.

4. Other

A small number of patients may have a sense of earplugs, oppression, or numbness.

Sudden Deafness Examination

Check-up

No obvious lesions were found on the eardrum. Tuning fork tests suggest sensorineural hearing loss.

2. Auxiliary inspection

(1) Hearing test pure tone audiometry: The hearing curve generally shows sensorineural hearing loss above moderate to severe, and most of them show a high-frequency decline. Acoustic impedance detection: The tympanic pressure curve is normal. Otoacoustic emissions and cochlear electrograms suggest snail damage.

(2) Vestibular function tests are generally performed during the period of remission of vertigo. The alternate cold and hot test combined with electronysm tracing is used. The test results may be normal, diminished or completely disappeared.

(3) CT imaging of the temporal bone and MR of the internal auditory canal revealed no significant organic lesions in the internal auditory canal and craniocerebral.

Diagnosis of sudden deafness

A clinical diagnosis can be made based on clinical symptoms, physical examination, and audiological results, except for hearing loss caused by other diseases.

Sudden Deafness Treatment

Sudden deafness is currently treated by comprehensive treatment, with an effective rate of about 70%. The time to start treatment has a certain relationship with the prognosis, so it should be treated as early as possible within 7 to 10 days after the onset of disease.

Glucocorticoid

With anti-inflammatory, anti-viral and immunosuppressive effects, it can relieve vascular endothelial edema and increase blood supply to the inner ear. It is currently an important treatment for sudden deafness.

2. Thrombolytic and anticoagulant drugs

Plasma fibrinogen levels in patients with sudden deafness are significantly higher than in normal people, and red blood cell aggregation and plasma viscosity are also significantly increased, suggesting that blood viscosity plays an important role in the pathogenesis of sudden deafness.

3. Neurotrophic drugs

Commonly used neurotrophic drugs include adenosine triphosphate (ATP) and vitamins. ATP is a coenzyme and the main source of energy for the body. Because it has the effect of improving body metabolism, it has become one of the main drugs for treating sudden deafness.

4. Hyperbaric oxygen therapy

Capillary cell edema, reduced cochlear blood flow leads to cochlear hypoxia, and in some patients with sudden deafness, oxygen pressure in the external lymphocytes decreases. Therefore, the ultimate goal of treatment is to restore the oxygen pressure in the cochlea. Hyperbaric oxygen treatment can reduce inner ear edema and ischemia and hypoxia damage, improve inner ear circulation, and also significantly increase the partial pressure of oxygen in blood and tissue cells, the volume of blood in plasma and the diffusion radius in tissues, and accelerate inner ear hair cells and Vestibular nerve fiber repair can also reduce platelet aggregation and reduce blood viscosity, so it can be used for the treatment of sudden deafness. The effect of treatment is related to the time of illness. With the accumulation of treatment experience, the efficacy of hyperbaric oxygen combined drugs and other treatments is better than that of single hyperbaric oxygen therapy. After clinical observation, hyperbaric oxygen therapy combined with certain psychological nursing measures is more effective. Individualized psychological counseling is adopted for patients with sudden deafness. The patient's psychological pressure is reduced. It can cooperate well with the treatment and allow the treatment to proceed smoothly. Get better clinical results.

5. Efficacy evaluation

Chinese Medical Association Otolaryngology Branch and Chinese Journal of Otolaryngology Head and Neck Surgery Editorial Board (1996)

Healing threshold of each frequency from 0.25-4kHz recovered to normal, or reached healthy ear level, or reached the level before the illness. The average hearing of the above frequency is improved by more than 30dB. The average hearing of the above effective frequency is improved by 15-30dB. Ineffective The average hearing improvement at the above frequencies is less than 15dB.

Prognosis of sudden deafness

Sudden deafness has a tendency to heal itself, and some patients can recover to varying degrees on their own. Serious hearing loss and dizziness before treatment are poor prognostic factors. Hearing recovery in children and the elderly is worse than in other age groups. The time to start treatment also has an impact on the prognosis. Generally, those who start treatment within 7 to 10 days have better results.

Sudden Deafness Prevention

As the cause of sudden deafness is unclear, there are no targeted preventive measures. As a general precaution, pay attention to the following points in daily life:

1. Strengthen exercise, enhance physical fitness, avoid colds, and prevent viral infections.

2. Don't be overworked, pay attention to the combination of work and rest, and keep your body and mind happy.

3. Maintain a balanced diet and eat more fresh fruits and vegetables. Reduce the irritation caused by smoke, alcohol, coffee, etc.

4. Control systemic chronic diseases such as hypertension, hyperlipidemia and diabetes.

5. For patients who have suffered from sudden deafness and their ears still do not have a practical hearing level after treatment, in addition to the above recommendations, it is also recommended that the healthy ear should be protected in particular: avoid contact noise; avoid ototoxic drugs; avoid ear injuries And ear infections.

References

1. Huang Zhaoxuan, Wang Jibao, Kong Weijia. Practical Otolaryngology Head and Neck Surgery. Beijing: People's Medical Publishing House, 2007: 988-992.

2. Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery, Otolaryngology Head and Neck Surgery Branch of Chinese Medical Association. Guidelines for the diagnosis and treatment of sudden deafness: Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2006: 41: 569.

3. GordinA, GoldenbergD, GolzA, etal. Magnesium: anewtherapy foridiopathicsuddensensorineural hearing loss: Otol Neuroto, 2002: 23 (4): 447-451.