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Abstract: A 60-year-old male patient came to the clinic with a complaint of hearing loss in the left ear with tinnitus for 3 days. He started to think that it was due to fire and did not improve after taking self-medication to clear fire, so he came to the clinic. After 14 days of drug treatment, the patient’s condition improved and his hearing basically returned to normal.
Basic information】Male, 60 years old
Disease Type】Sudden deafness
Hospital】Northern War Zone General Hospital
Date of consultation】August 2021
Treatment plan】Medication (methylprednisolone tablets, prostaglandin injection, bactrim injection, methylcobalamin dispersible tablets)
Treatment Period】Hospitalization for 2 weeks, review after half a month
Treatment effect】The patient’s hearing was basically normalized.
I. Initial consultation
A 60-year-old male patient came to see us, complaining of hearing loss in the left ear with tinnitus for 3 days. Through careful questioning, we learned that the patient’s family had died half a month ago due to illness, poor rest and depression. After taking the medicine, the patient’s hearing loss and tinnitus did not improve, so he came to the clinic. The pure tone audiometry indicated total deafness and severe hearing loss in the left ear, while the hearing in the right ear was approximately normal. CT examination of the middle ear showed no abnormalities in the middle ear anatomy.
II. Treatment history
Because of the patient’s severe hearing loss, the patient was informed that he needed to be hospitalized for infusion treatment in a timely manner, and was given psychological comfort at the same time. After hospitalization, the patient was given oral hormone methylprednisolone tablets, intravenous infusion of prostaglandin injection and bactrim injection, as well as oral metocobalamin dispersible tablets for nutritional nerve therapy. The patient was excluded from contraindications to hormone use before hormone administration. During the course of treatment, we communicate with the patient daily about the changes of the disease and adjust the medication when necessary.
III. Treatment effect
After 1 week of treatment, the patient’s hearing was restored to moderate deafness, and after 14 days of treatment, the patient’s hearing was basically restored to normal, but occasional tinnitus still existed. Therefore, the patient was instructed to continue to take methylcobalamin dispersible tablets orally for half a month after discharge, and at the same time, the patient needed to adjust his emotions and maintain a positive attitude.
IV. Notes
We are glad that the patient’s hearing has basically returned to normal after treatment, but the patient still needs to avoid stress and strain, avoid emotional excitement, and ensure good sleep and proper exercise. Patients need to avoid contact with noise after discharge to reduce the stimulation to the ear. In terms of diet, they need to eat a light diet and avoid overly salty foods as well as avoiding refreshing drinks such as tea and coffee. After discharge, the patient should continue to take oral methylcobalamin dispersible tablets to consolidate treatment for half a month, and repeat pure tone audiometry after half a month.
V. Personal insight
Sudden deafness is a relatively common disease in ENT clinics. Generally, most of the symptoms will improve when treated promptly at the early stage of onset. Therefore, if a patient suddenly develops hearing loss in the ear, he or she must go to the hospital for examination in time to avoid delaying the best time for treatment. Patients should decide whether to take oral medication in the outpatient clinic or to be hospitalized for infusion treatment according to the severity of symptoms after consultation. In addition, patients need to maintain a good state of mind, because hearing loss and tinnitus symptoms can significantly affect the patient’s work and life, and may even lead to depression. Therefore, it is recommended to communicate more with friends and family members, and if necessary, to channel through a psychiatrist, so that a good mood is conducive to the recovery of sudden deafness.