Journal Tht Aries

8/11/2019 Journal Tht Aries

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PROGNOSTIC IMPAC

STANDARD LABORAT

VALUES ON OUTCOMPATIENTS WITH SUD

SENSORINEU

HEARING LCREATED BY MUHAMMAD


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BACKGROUND

Defines as unexplained unilateral sensorineural heraling loss of 30 dB

greater over 3 frequencies with onset over period less than 72 hours

marked verstibular symptom

Incidences between 160 to 400 in 100.000 person per year.

Multifactorial causes such as cardiovascular disease, cigarette smokin

hypertension (the most common risk factors), age, severe hearing los

audiogram shape, vertigo (negative factors).

While cardiovasular disease were disccused as a common risk factorssurprising that so far prgnostic impact of the entire range routine labo

values hasnt been evaluated systematically.


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METHODS

Retospective analysis was perform in germany, all adult with unilateral idiopathic sensorineu

between 2006 to 2009. The number of the pastient that followed in this reasearch were 173

Prequisite was DD evaluation excluding a spesific etiology ( head trauma, vestibular schwano

patient was received brain electrical response audiometry. If BERA pathologic the patient wi

by MRI of the head and cerebellopontine angle.

Inclusion criteria was at least 2 pure tone audiograms were available (the first at presentatio

symptoms before the therapy and second after the therapy)

Exclusion criteria was hearing loss 4 weeks, acute bilateral hearing loss, combination with acute vestibular hypofunct

chronic ear disease


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METHODS

This reasearch present the audigram test with 6 frequencies ( 250,500,1000,2000,4000 dan

The severity of hearing loss dB

Mild 15-39

Moderate 40-59

Severe 60-79

Profound 80-100

Deaf >100 db


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Pattern audiogram Criteria Image

Low frequency Ascending

pattern, 500 Hz

or less

Mid frequency U-shaped,

greater 500 hz

and 2000 hz.

High frequency Descending,

greater 2000 hz,

8000 or less

Flat

Total deafness Hearing loss

>100 dB in 500

Hz,1000 Hz, 2000Hz, 4000 Hz


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LABORATORY VALUES


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RESULT

Patient and disease characteristic

Median age was 64 and 4 of 5 patient complained also of the tinnitus in affected ear.

14% were smokers

Half of the patient showed cardiovascular risk

3 patient were reported deaf on contralateral ear

Overall recovery

81 patients had a final hearing gain >10 dB

29 patients had a relative hearing gain of >50%

72 patients has a relative hearing gain in relation to contralateral ears of >50 %


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RESULT

Prognostic impact od clinical and laboratory parameters

A blood test showed half patients had a elevated glucose values.

1/3 had elevated cholesterol and 1/4 had a elevated trygliceride

showed a hyperfibrinogenemia.

Low frequency hearing loss had a better outcome than other audiogram pattern

Start of inpatient treatment 4 days after onset

First SSNHL had a better outcome than reccurent SSNHL

Initial hearing loss >60 dB had a better outcome than initial hearing loss < 60 dB

Quick values lower than references

Hyperbrinogenemia


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DISCUSSION

Those result was showed in previous study. Treatment using corcicosteroids with in 1-2 weegive a better outcome.

Low frequencies hearing loss had better outcome than high frequencies

Hypercholesterolemia were found in 38% patient and hyperglycemia were found in 58% pat

of diagnosis.

Erytrocite sedimentation values rate was correlated to better outcome.

CRP values had no influence on outcome and CRP values only play role in underlying implamnot related to at least most cases of SSNHL not play role in prognostic.


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RESULT

The quick prothrombin time test still is the basis for monitoring anticoagulant therapy in ma

But there are effect on this theraphy that affect on quick laboratory value.

Thsi study believe that combination of anticoagulant therapy and SSNHL therapy significantl

microcircularity in inner ear.

Hyperfibrinogenemia is independent risk factor to SSNHL in half patient in this study and we

therapy regime for anticoagulant can be used for improvement of rheological blood perform


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CONCLUSION

The presented cohort study on 173 patient with SSNHL revealed that beside clinical and audio

factors also the laboratory markers decreased a quick test value and hyperfibrinogenemia wer

prognostic marker for better outcome using treatment regime mainly intending to improve co

microcirculation.

Hyperfibrinogenemia is a positive prognostic marker on outcome when using rheological regimtreat SSNHL.

Fibrinogen can be used as a biomarker for better patient selection for treatment regime of SS

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