Rheopheresis in treatment of idiopathic sensorineural sudden hearing loss
Abstract Backround Only few therapeutic options exist for patients with refractory sudden idiopathic sensorineural hearing loss (SISHL). Little is known about the efficacy of second-line therapies. Rheopheresis seems to be an effective therapeutic possibility. Methods Between 2012 and 2015, 106 pati...
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SAGE Publishing
2017-06-01
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| Series: | Journal of Otolaryngology - Head and Neck Surgery |
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| Online Access: | http://link.springer.com/article/10.1186/s40463-017-0228-9 |
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| author | Milan Kostal Jakub Drsata Milan Bláha Miriam Lánská Viktor Chrobok |
| author_facet | Milan Kostal Jakub Drsata Milan Bláha Miriam Lánská Viktor Chrobok |
| author_sort | Milan Kostal |
| collection | DOAJ |
| description | Abstract Backround Only few therapeutic options exist for patients with refractory sudden idiopathic sensorineural hearing loss (SISHL). Little is known about the efficacy of second-line therapies. Rheopheresis seems to be an effective therapeutic possibility. Methods Between 2012 and 2015, 106 patients with SISHL were enrolled in the study, of whom 52 were refractory to initial treatment. As salvage therapy, these patients were offered either 3 sessions of rheopheresis (33 pts) or intratympanic steroid treatment through MicroWick application (19 pts). Pure tone audiometry was performed at diagnosis, at the 1st month and the 1st year during the follow-up. Results Patients in the rheopheretic arm had higher hearing loss than in the MicroWick arm (81% vs. 52%, p = 0.04). In spite of this, there was a significant improvement for patients in the rheopheretic arm (27% of hearing loss reduction, p < 0.001) after the 1st month and this remained unchanged during the 1st year, while no improvement was seen in the MicroWick arm (0% of hearing loss reduction, p = 0.424). We found no predictive factor for steroid-failure in first-line therapy. Older age (p = 0.003), presence of vertigo (p = 0.006) and more profound initial hearing loss (p < 0.001) were identified as negative prognostic markers. Conclusion Rheopheresis can be used as a potentially effective and safe salvage therapy for patients with cortico-refractory SISHL. |
| format | Article |
| id | doaj-art-47c77209f15247eab5ba400f8d1ca884 |
| institution | Kabale University |
| issn | 1916-0216 |
| language | English |
| publishDate | 2017-06-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Otolaryngology - Head and Neck Surgery |
| spelling | doaj-art-47c77209f15247eab5ba400f8d1ca8842025-02-03T10:54:10ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162017-06-014611710.1186/s40463-017-0228-9Rheopheresis in treatment of idiopathic sensorineural sudden hearing lossMilan Kostal0Jakub Drsata1Milan Bláha2Miriam Lánská3Viktor Chrobok44th Department of Internal Medicine, University Hospital Hradec Kralove Charles University, Faculty of Medicine in Hradec KraloveDepartment of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove Charles University, Faculty of Medicine in Hradec Kralove4th Department of Internal Medicine, University Hospital Hradec Kralove Charles University, Faculty of Medicine in Hradec Kralove4th Department of Internal Medicine, University Hospital Hradec Kralove Charles University, Faculty of Medicine in Hradec KraloveDepartment of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove Charles University, Faculty of Medicine in Hradec KraloveAbstract Backround Only few therapeutic options exist for patients with refractory sudden idiopathic sensorineural hearing loss (SISHL). Little is known about the efficacy of second-line therapies. Rheopheresis seems to be an effective therapeutic possibility. Methods Between 2012 and 2015, 106 patients with SISHL were enrolled in the study, of whom 52 were refractory to initial treatment. As salvage therapy, these patients were offered either 3 sessions of rheopheresis (33 pts) or intratympanic steroid treatment through MicroWick application (19 pts). Pure tone audiometry was performed at diagnosis, at the 1st month and the 1st year during the follow-up. Results Patients in the rheopheretic arm had higher hearing loss than in the MicroWick arm (81% vs. 52%, p = 0.04). In spite of this, there was a significant improvement for patients in the rheopheretic arm (27% of hearing loss reduction, p < 0.001) after the 1st month and this remained unchanged during the 1st year, while no improvement was seen in the MicroWick arm (0% of hearing loss reduction, p = 0.424). We found no predictive factor for steroid-failure in first-line therapy. Older age (p = 0.003), presence of vertigo (p = 0.006) and more profound initial hearing loss (p < 0.001) were identified as negative prognostic markers. Conclusion Rheopheresis can be used as a potentially effective and safe salvage therapy for patients with cortico-refractory SISHL.http://link.springer.com/article/10.1186/s40463-017-0228-9RheopheresisSudden idiopathic hearing lossMicroWick |
| spellingShingle | Milan Kostal Jakub Drsata Milan Bláha Miriam Lánská Viktor Chrobok Rheopheresis in treatment of idiopathic sensorineural sudden hearing loss Journal of Otolaryngology - Head and Neck Surgery Rheopheresis Sudden idiopathic hearing loss MicroWick |
| title | Rheopheresis in treatment of idiopathic sensorineural sudden hearing loss |
| title_full | Rheopheresis in treatment of idiopathic sensorineural sudden hearing loss |
| title_fullStr | Rheopheresis in treatment of idiopathic sensorineural sudden hearing loss |
| title_full_unstemmed | Rheopheresis in treatment of idiopathic sensorineural sudden hearing loss |
| title_short | Rheopheresis in treatment of idiopathic sensorineural sudden hearing loss |
| title_sort | rheopheresis in treatment of idiopathic sensorineural sudden hearing loss |
| topic | Rheopheresis Sudden idiopathic hearing loss MicroWick |
| url | http://link.springer.com/article/10.1186/s40463-017-0228-9 |
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