Toshihiro Tachi

Sudden Deafness and Right-to-Left Shunts

Purpose: One of the etiologies for idiopathic sudden deafness is considered to be ischemia of the inner ear. Cryptogenic stroke is caused by a right-to-left shunt (RLS). The present study investigated whether RLS is associated with the occurrence of sudden deafness. Methods: Contrast saline transcranial Doppler ultrasonography was performed to detect RLS. Subjects comprised 23 consecutive sudden deafness patients and 46 age- and gender-matched controls. Clinical characteristics, including vascular risk factors, were compared between sudden deafness and control groups. Results: RLS was more frequent in the sudden deafness group than in controls (48 vs. 17%, p = 0.011). No significant differences in other clinical characteristics were seen between groups. Conclusion: RLS may be a potential cause of sudden deafness.

Prognostic Factors in Sudden Sensorineural Hearing Loss

Objective: 1) Assess the prognostic factors possibly affecting hearing recovery, such as age, severity of hearing loss, definitive episode of vertigo, tinnitus, and ear fullness. 2) Assess the effect of corticosteroids in sudden sensorineural hearing loss (SSHL). Method: We reviewed the medical records of 117 patients seen at the outpatient clinic of Kawasaki Medical School Hospital between 2004 and 2008. Hearing loss was graded from 1 to 4 according to the grading system by the Research Committee on acute profound deafness of the Japanese Ministry of Health and Welfare. Results: Eighty-five patients were Grade-1 (under 40 dB hearing thresholds at the average of 0.25, 0.5, 1, 2, and 4 KHz), 22 were Grade-2 (40 to 60 dB), 9 were Grade-3 (60 to 90 dB), and one was Grade-4 (90 dB and over). The recovery rates after the treatment of hydrocortisone (300 mg/d for 3 days, 100 mg/d for 3 days) were 88.2% in Grade-1, 50% in Grade-2, and 30% in Grade-3 and -4. The recovery rate was significantly higher in Grade-1 and in cases in which that treatment was started within 7 days from the onset. Conclusion: Our study indicates that the prognostic factors affecting hearing recovery are the severity of hearing loss and the duration of disease between the onset and the initial treatment of corticosteroid. The age, presence of vertigo, tinnitus, and ear fullness did not influence the recovery rate.

Sudden Sensorineural Hearing Loss: Effective Steroid Dose

has a correlation with the air-volume of temporal bone. In other words, for a bad-development temporal bone, the second genu of facial nerve presents also with underdevelopment, with a short tympanic segment and an anteriorly located mastoid segment. 2) There is no doubt that the CT of temporal bone is very important in diagnosis of facial nerve abnormalities in congenital aural malformation. The theory is confirmed by surgery that the more serious the congenital aural malformation, the worse the course of the facial nerve is.