Clinical issues regarding diagnostic criteria, retractable cases, and treatment of acute low-tone sensorineural hearing loss

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  • 急性低音障害型感音難聴をめぐる諸問題

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In 2000, the Acute Profound Deafness Research Committee of the Ministry of Health, Labour and Welfare of Japan proposed diagnostic criteria for acute low-tone sensorineural hearing loss (ALHL). Based on these criteria, elderly people with high-tone loss resulting from presbycusis are not included in the ALHL category. This situation has produced a bias in the epidemiological features of ALHL. Therefore, the criteria should include these cases as probable ALHL. The short-term outcome of ALHL is generally good, but the long-term prognosis is not necessary good, as recurrences occur in 20-30% of patients and 5-10% of patients develop Méniére disease. In addition, some patients develop hearing deterioration across the frequencies. Among these intractable cases, the possibility of an acoustic tumor exists. An imaging study is required in such intractable cases to rule out such rare diseases. Steroids and isosorbide are the standard medications for the treatment of ALHL; however, reliable evidence of their efficacies has not been obtained to date. A prospective randomized controlled study examining the use of these drugs is needed in the future.

Journal

  • AUDIOLOGY JAPAN

    AUDIOLOGY JAPAN 53 (4), 241-250, 2010

    Japan Audiological Society

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