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tinnitus

Sudden Sensorineural Hearing Loss—A Medical Emergency

Teaser: 

Dr. Pradeep Shenoy, MD, FRCS, FACS, DLO,1 Stéphanie Bellemare-Gagnon, MPA, Aud (C)2

1ENT & Neck Surgeon, Campbellton Regional Hospital, Campbellton, New Brunswick, Canada.
2Entendre Plus Hearing, Hearing and Balance Clinics.

CLINICAL TOOLS

Abstract: Sudden hearing loss—usually unilateral and rarely bilateral—can be associated with tinnitus and vertigo. In most cases it is idiopathic, although various explanations such as infective, vascular, and immune causes have been postulated. We have reviewed the literature and what follows is a survey of current research and suggested treatments for sudden hearing loss.
Key Words: sudden sensorineural hearing loss (SSNHL), tinnitus, pure tone audiogram (PTA), acoustic brainstem response audiometry (ABRA), viral neuritis, vascular insufficiency, oral steroids, intratympanic steroids, antiviral treatment, hyperbaric oxygen therapy (HBOT), MRI brain, acoustic neuroma.
All patients with SSNHL should be assessed by taking a thorough history and performing a complete examination to identify any specific disease.
PTA should be performed in all patients.
Targeted laboratory investigations should be performed after the initial assessment.
All patients should have an MRI of the brain if a CT SCAN of the brain is contraindicated; ABR testing should also be considered.
If a specific cause for SSNHL is found, the patient should be managed accordingly.
If SSNHL is idiopathic in nature, patients may be offered a course of oral steroids.
If oral steroids are contraindicated, IT steroid therapy could be considered as a primary or salvage therapy.
Use of antivirals, HBOT, vasodilators, and vasoactive agents are not currently supported by the research.
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The Management of Tinnitus

The Management of Tinnitus

Teaser: 

 

John P. Preece, PhD, Department of Communicative Disorders, University of Rhode Island, Kingston, RI.
Richard S. Tyler, PhD, Department of Otolaryngology-Head & Neck Surgery, Department of Speech Pathology & Audiology, University of Iowa, Iowa City, IA.
William Noble, PhD, School of Psychology, University of New England, Armidale, NSW, Australia.

Hearing loss in the elderly is a frequently acknowledged problem. Prevalence of hearing loss clearly increases with age, to as high as 50% of persons older than 70 years. Less recognised is an often-related problem, tinnitus. We are concerned here about pathological tinnitus: that which lasts more than five minutes more than once a week. In this article we review the prevalence of tinnitus as a function of age, and its causes and mechanisms. We also describe problems commonly associated with chronic tinnitus and some treatment options. We conclude with some special considerations for the elderly patient.
Key words: tinnitus, prevalence, counseling, sound therapy.

Hearing Loss and the Aging Ear

Hearing Loss and the Aging Ear

Teaser: 

 

Christopher J. Danner, MD, Fellow Otology/Neurotology/Skull Base Surgery and Jeffery P. Harris, MD, PhD, Departmental Chairman, Department of Otolaryngology, Head and Neck Surgery, University of California--San Diego, San Diego, CA, USA.

Multiple factors lead to the cause and progression of presbycusis or hearing loss secondary to increased age. Noise trauma, genetic predisposition and oxidative damage all have been implicated in its development. Tinnitus, a frequent side effect of hearing loss, often has its origin within the central auditory system. A classification scheme for hearing loss and treatment options for tinnitus are discussed.
Key words: hearing loss, presbycusis, tinnitus, free radicals, central auditory system.