Diagnostic criteria and treatment principles of iron deficiency deafness

  Iron deficiency deafness is a clinically common form of sensorineural deafness, a disease of iron deficiency in the inner ear tissues, and currently the only deafness that can be completely restored or improved to varying degrees by appropriate treatment. Clinical epidemiological surveys have shown that iron deficiency deafness accounts for approximately 10-15% of all sensorineural deafness. The groups at high risk of iron deficiency deafness are, in order of prevalence: infants and children under 3 years of age (recent experimental studies in Guangdong Trace Element Science, 2011;18:29-33 confirmed that iron deficiency during pregnancy and lactation may adversely affect the development of cochlear auditory hair cells in offspring, leading to iron deficiency deafness), preschool children, women of childbearing age, growing adolescents, iron deficiency anemia Patients with iron deficiency anemia, vegetarians, those with a partial diet or aversion to black or red foods or a long-term loss of appetite, patients with repeated small amounts of blood loss (e.g., nosebleeds, bleeding hemorrhoids, gastrointestinal bleeding, etc.), those with a history of massive blood loss from trauma, those with repeated mouth ulcers or frequent weakness, adolescents during the growth period, and the elderly over 60 years of age. The occurrence of iron deficiency deafness is mainly related to excessive long-term iron loss, insufficient supplementation or reduced absorption. However, iron deficiency deafness can also be caused by a large loss of iron in a short period of time and sudden metabolic disorders.  Acute iron deficiency deafness is characterized by sudden unilateral or bilateral sensorineural deafness with moderate, severe or profound deafness, which can occur simultaneously or sequentially in both ears. Bilateral acute iron deficiency deafness can cause rapid decline or loss of speech and language skills in preschool children. Chronic iron deficiency deafness is characterized by a slowly developing non-fluctuating sensorineural deafness of varying degrees, mostly in both ears, with a mild degree of deafness at the beginning of the disease and gradually increasing in severity, with symmetrical or asymmetrical hearing loss on both sides.  Both acute and chronic forms of iron deficiency deafness can be associated with intermittent or persistent tinnitus, which can be mild or severe; vertigo is rare.  Diagnostic criteria: clinical manifestation of sudden or slow onset sensorineural deafness with: 1. history of iron deficiency anemia; 2. hemoglobin level <130g/L in adult males, <120g/L in adult females, and <106g/L in children under 13 years of age; 3. serum ferritin <0.70nmol/L (80ng/ml); 4. erythrocyte basic ferritin <11.38 The deafness should be diagnosed as iron deficiency deafness if there is no other clear deafness-causing factor to explain the sudden or slow onset of unilateral or bilateral sensorineural deafness, and the clinical and laboratory tests meet 3 or more of the above conditions; if 2 or more of the above conditions are met, the deafness should be classified as iron deficiency deafness Suspicious.  Treatment principle: Once iron deficiency deafness is diagnosed, it should be treated as soon as possible with a combination of Chinese and Western medicine and iron therapy, while attention should be paid to correct the causes of iron deficiency that have been clearly identified. The shorter the duration of the disease, the shorter the treatment course, the greater the possibility of restoring hearing.  Prognosis: The results of our previous study showed that the treatment efficiency of iron deficiency deafness is 76.57%, the apparent efficiency is 58.86%, and the cure rate is 35.43%.  Treatment course: 3 months is one course of treatment. Acute type of iron deficiency deafness mostly requires 1 course of treatment, while chronic type of iron deficiency deafness requires 1-10 courses of treatment, or even longer.