Clinical Approach for Sudden Deafness

Abstract

Recent our observation on patients with sudden deafness indicates that the treatment must be done as soon as possible. If the treatment is started on the 5th to 14th day after the onset of deafness, the recovery of hearing can be expected, but chronic cases show poor prognosis.
In order to obtain a further information concerning this sickness, several biochemical and physiological observations were made: 1) the dètermination of pH, Po₂ Pco₂ and electrolytes in cerebrospinal fruid, 2) the vestibular function test, and 3) study of the recovery of hearing.
As far as the biochemical study of cerebrospinal fluid is concerned, the pH tended to decrease without the alternation of the levels of Po₂, Pco₂ and electrolytes. The relationship between the clinical picture and the pH of cerebrospinal fluid may be useful to evaluate this deafness. Follow up study of the vestibular function is also useful for the evaluation of the clinical picture.
Finally, the recovery rate of hearing must be carefully studied. Follow up observation of the sudden deafness's hearing in some cases show some difference between the recovery of tonal acuity and the improvement of supra-threshold tests. In some cases, initial low score of SISI test gradually gained high score with the recovery of tonal acuity. Unilateral cases sometimes showed high SISI score in the contralateral normal ear.
Follow up study of these factors are very useful to assess the clinical picture and the prognosis of this disease.