CATEGORY:
Research
SCREENSHOT:
TITLE:
Treatment of Long-term Sudden Sensorineural Hearing Loss as an Otologic Migraine Phenomenon
CONTENT:
Otol Neurotol. 2021 Mar 5. doi: 10.1097/MAO.0000000000003111. Online ahead of print.
ABSTRACT
OBJECTIVES: To describe a cohort of patients presenting with long-term sudden sensorineural hearing loss (SSNHL) treated with prophylactic migraine and intratympanic steroid therapy.
METHODS: Patients presenting to a neurotology clinic at least 6 weeks from SSNHL onset were included. All patients received migraine prophylactic medication (nortriptyline, topiramate, and/or verapamil) and lifestyle changes for at least 6 weeks, as well as intratympanic steroid injections, if appropriate.
RESULTS: Twenty-one patients (43% female) with a mean age of 64 ± 11 years who presented 9 ± 8 months (median = 5) from symptom onset were included. Posttreatment hearing thresholds were significantly improved compared with pretreatment thresholds at 500 Hz (49 ± 19 dB versus 55 ± 20 dB, p = 0.01), 1000 Hz (52 ± 19 dB versus 57 ± 21 dB, p = 0.03), low-frequency pure-tone average (53 ± 15 dB versus 57 ± 17 dB, p = 0.01), and speech-frequency pure-tone average (57 ± 13 dB versus 60 ± 15 dB, p = 0.02). Posttreatment word-recognition-score (WRS) and speech-recognition-threshold (SRT) were also significantly improved (45 ± 28% versus 70 ± 28% and 57 ± 18 dB versus 50 ± 16 dB, respectively, both p < 0.01). Notably, ≥15% improvement in WRS and ≥10 dB improvement in SRT was observed in 13 (68%) and 8 (40%) patients, respectively. Of the 11 patients who presented with initial < 50% WRS, 8 (73%) had improved posttreatment >50% WRS with an average improvement of 39 ± 9%.
CONCLUSIONS: Migraine medications in addition to intratympanic steroid injections significantly improved SRT and hearing frequencies in 40% and 29% of SSNHL patients, respectively, while significant WRS recovery was observed in most (68%) patients. This suggests SSNHL may be an otologic migraine phenomenon, which may be at least partially reversible even after the traditional 30-day postonset window.
PMID:33710150 | DOI:10.1097/MAO.0000000000003111
SOURCE:
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
PUBLISHER:
PMID:
pubmed:33710150
ID:
0b58ea4968e09ff10f4e1238c494f316pubmed:33710150
DOI:
10.1097/MAO.0000000000003111
DATE – PUBLISHED:
Fri, 12 Mar 2021 06:00:00 -0500
DATE – DOI:
2021-03-12T14:03:36Z
DATE – ADDED:
03/12/21 01:58PM
LINK – PUBMED:
https://pubmed.ncbi.nlm.nih.gov/33710150/
LINK – DOI:
https://doi.org/10.1097/MAO.0000000000003111
LINK – PUBLISHER:
https://journals.lww.com/10.1097/MAO.0000000000003111?utm_source=hearinglosstreatmentreport.com
IMAGE:
REFERENCE:
Hearing Loss Treatment Report, Urgent Research, 2021-03-12T18:58:06+00:00, https://www.hearinglosstreatmentreport.com.