A Subjective Rating Scale for Initial Assessment of Sudden Unilateral Sensorineural Hearing Loss

2017 ◽  
Vol 22 (3) ◽  
pp. 154-159
Author(s):  
Omer J. Ungar ◽  
Oren Cavel ◽  
Yahav Oron ◽  
Anat Wengier ◽  
Oshri Wasserzug ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Physical Examination ◽  
Sensorineural Hearing Loss ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Sensorineural Hearing ◽  
Initial Assessment ◽  
Subjective Rating ◽  
Numerical Rating ◽  
Subjective Rating Scale

Objective: To examine the value of a subjective numerical rating scale (NRS) in the initial evaluation of patients suspected of suffering from unilateral sudden sensorineural hearing loss (SSNHL) until a formal audiogram is available. Study Design: Prospective noncontrolled clinical study. Methods: Thirty-one consecutive patients referred to the emergency department due to suspected unilateral SSNHL and with no other aural pathology by history or physical examination were enrolled. Patients were asked to characterize the severity of their hearing loss using an NRS of 1 (normal hearing) to 6 (complete deafness). SSNHL was defined as an SNHL of at least 30 dB over 3 consecutive frequencies that occurred in 3 days or less. A formal audiogram was obtained subsequently as soon as available. Results: Twenty-four patients were treated with steroids and met the audiometric criteria of SSNHL. All scored their NRS as 3 or more. None of the 7 patients whose NRS grades were ≤2.5 met the criteria for SSNHL. Two patients were treated with steroids although their hearing did not meet the audiometric criteria for SSNHL as the hearing loss was limited to 2 consecutive frequencies. The NRS score for both was <3. Conclusion: In addition to the patient's history and physical examination, a NRS can be a useful tool in the preliminary assessment of patients suspected of having SSNHL until audiometry becomes available. In the scale of 1-6, an NRS score of 3 or more reliably predicts the need to treat the patient with steroids according to the accepted criteria.

Efficacy of serologic testing in asymmetric sensorineural hearing loss

2000 ◽  
Vol 122 (4) ◽  
pp. 469-476
Author(s):  
Paul Sabini ◽  
Anthony P. Sclafani
Keyword(s):  
Hearing Loss ◽  
Physical Examination ◽  
Sensorineural Hearing Loss ◽  
Sedimentation Rate ◽  
Glycosylated Hemoglobin ◽  
Antibody Test ◽  
Sensorineural Hearing ◽  
Serologic Testing ◽  
Antibody Titers ◽  
Asymmetric Sensorineural Hearing Loss

PURPOSE The goal of this study was to determine the efficacy of a detailed questionnaire, auditory brain stem response testing (ABR), MRI, and an extensive battery of serologic tests in diagnosing asymmetric sensorineural hearing loss (ASNHL). METHODS AND MATERIAL Patients with audiograms demonstrating ASNHL of 10 dB or greater in 2 consecutive frequencies or 15 dB in any 1 frequency between 250 and 6000 Hz were asked to participate. Patients underwent MRI scanning of the cerebellopontine angle, internal auditory canals, and posterior fossa with gadolinium contrast, ABR, and an extensive battery of tests. The causative diagnosis was made by the individual clinician based on each patient's history, physical examination, and test results. RESULTS Forty-five patients completed the study. A review of the data confirmed the utility of a detailed history and physical examination, MRI, and fluorescent treponemal antibody test in all cases. Erythrocyte sedimentation rate, glycosylated hemoglobin, Lyme antibody titers, and total hemolytic component (CH50) were helpful in selected cases. Thyroid function testing, complete blood count, Sequential Multiple Analysis-7, prothrombin time/partial thromboplastin time, lipid profile, and ABR were of no value in these patients. CONCLUSION A careful history and physical examination, MRI, and fluorescent treponemal antibody test should be performed for the evaluation of all patients with ASNHL; however, more extensive serologic testing, including sedimentation rate, glycosylated hemoglobin, Lyme antibody titers, and CH50, should be selectively performed, based on a suggestive history or suspicious physical findings.

scholarly journals Granulomatosis with Polyangiitis as a Cause of Sudden-Onset Bilateral Sensorineural Hearing Loss: Case Report and Recommendations for Initial Assessment

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Paul R. Ratmeyer ◽  
Benjamin R. Johnson ◽  
Luis P. Roldan ◽  
Tania L. Kraai
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Granulomatosis With Polyangiitis ◽  
Early Recognition ◽  
Sensorineural Hearing ◽  
Initial Assessment ◽  
Laboratory Evaluation ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Granulomatosis with polyangiitis (GPA) is a severe systemic vasculitis that commonly affects the paranasal sinuses, upper and lower respiratory tracts, and kidneys. GPA has also been associated with sensorineural hearing loss (SNHL), through inflammation of the cochlear apparatus. Early recognition, diagnostic laboratory evaluation, and appropriate treatment are essential to improve outcomes and achieve remission for patients with GPA. Here, we present a case of bilateral sudden sensorineural hearing loss (SSNHL) and distal symmetric polyneuropathy as the first presenting signs of GPA. A specific diagnostic work-up to rule out autoimmune inner-ear disease in patients with bilateral SSNHL is not clearly stated in the clinical practice guidelines from the American Academy of Otolaryngology-Head and Neck Surgery. The aim of this paper is to delineate an appropriate diagnostic work-up for patients with bilateral SSNHL when there is concern for autoimmune disease.

scholarly journals Treatment of Neuropathic Pain with 5% Lidocaine-Medicated Plaster: Five Years of Clinical Experience

2011 ◽  
Vol 16 (4) ◽  
pp. 259-263 ◽  
Author(s):  
Claire Delorme ◽  
Marie L Navez ◽  
Valérie Legout ◽  
Rodrigue Deleens ◽  
Dominique Moyse
Keyword(s):  
Neuropathic Pain ◽  
General Population ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Initial Assessment ◽  
Experienced Pain ◽  
Numerical Rating ◽  
Numerical Rating Scale Score ◽  
Excellent Safety Profile ◽  
One Year

BACKGROUND: Neuropathic pain is often severe and adversely affects patients’ quality of life.OBJECTIVE: To perform a retrospective, observational study investigating the efficacy and safety of treating refractory chronic neuropathic pain with 5% lidocaine-medicated plaster, in patients attending pain centres.METHODS: Medical records from 467 patients treated with 5% lidocaine-medicated plaster were evaluated for efficacy (maximum and minimum pain intensities and coanalgesic consumption) and adverse events. Data from an initial assessment and at least one follow-up visit had to be available, and separate analyses were conducted for the general population and the subpopulation older than 70 years of age.RESULTS: Of the patients enrolled, 25.0% were older than 70 years of age. While 20.6% had postherpetic neuralgia, 76.3% had other types of peripheral pain. Approximately 78.1% of cases of peripheral neuropathic pain followed surgery, and 23% were post-traumatic pain. The time from onset to referral was more than one year in two-thirds of cases. All patients experienced pain of at least moderate severity (mean [± SD] 11-point numerical rating scale score 5.2±2.4 to 8.2±1.6). Treatment with 5% lidocaine-medicated plaster reduced pain intensity by more than 50% in 45.5% of patients, and by at least 30% in 82.2%. Of note, the consumption of analgesics and coanalgesics was significantly reduced. Results were similar in both the general population and the subpopulation older than 70 years of age, at high risk and often receiving multiple medications.CONCLUSIONS: Treatment of refractory neuropathic pain with 5% lidocaine-medicated plaster clearly demonstrated efficacy and an excellent safety profile in patients with refractory neuropathic pain.

Hearing Loss Associated with Xylene Exposure in a Laboratory Worker

2012 ◽  
Vol 23 (10) ◽  
pp. 824-830 ◽  
Author(s):  
Adrian Fuente ◽  
Bradley McPherson ◽  
Linda J. Hood
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Otoacoustic Emissions ◽  
Outer Hair Cell ◽  
Cell Damage ◽  
Auditory Brainstem ◽  
Sensorineural Hearing ◽  
Auditory Brainstem Responses ◽  
Initial Assessment ◽  
Laboratory Worker

Background: Xylene is an organic solvent, widely used in histology laboratories and other occupational settings. Research in animals has demonstrated that xylene induces outer hair cell damage. Evidence regarding the effects of xylene in humans is only available from studies investigating workers exposed to mixtures of solvents containing xylene. These data indicate that mixtures of solvents containing xylene may induce hearing loss and central auditory dysfunction. Purpose: To comprehensively evaluate the peripheral and central auditory system of a histology laboratory worker exposed to xylene, who had presented with bilateral mild sensorineural hearing loss at an initial assessment. Research Design: A case report of a male histology laboratory worker who has been exposed to xylene for over 20 yr. Results: A diagnosis of bilateral mild sensorineural hearing loss of cochlear origin was made on the basis of otological, neuroimaging, and audiological examinations. Results indicating the absence of transient-evoked otoacoustic emissions, and auditory brainstem responses as expected for a mild cochlear hearing loss, were obtained. Conclusions: The observed bilateral mild sensorineural hearing loss was considered to have been induced by xylene exposure, due to the absence of any other etiological factors related to the onset of hearing loss. The results found in this patient are in agreement with animal data indicating xylene-induced ototoxicity. Xylene-exposed individuals should be audiologically monitored on a regular basis.

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