Sudden deafness
Sudden deafness, also known as idiopathic blast deafness, is a sudden loss of hearing that can reach its peak or even total deafness in 1 to 3 days. Most of them have monaural onset and are caused by systemic or local factors.
[Clinical manifestations]
1. Deafness: sudden and obvious hearing loss (mostly unilateral), most patients have tinnitus, and some patients have stuffiness, fullness and obstruction in the ear.
2. Causes: Most patients have no obvious causes for the onset of deafness, many of them occur during sleep and feel tinnitus and deafness when they wake up. Some patients have obvious history of exertion, emotional excitement, mental tension and cold, which may be related to the onset of the disease.
3. Vertigo: A small number of patients have deafness and vertigo at the same time, with a spinning sensation, often accompanied by nausea and vomiting, and most of the vertigo is reduced in about a week after the onset of the disease, and the tinnitus and deafness do not improve.
[Diagnosis]
1.Sudden and obvious hearing loss, unilateral deafness is common, some patients can be accompanied by vertigo, electrical audiometric examination is sensorineural deafness.
2. Differentiation: Simple sudden deafness is easy to diagnose, because of the sudden onset of symptoms, hearing loss is obvious, most of them are monaural, so it is not easy to be confused with other deafness; but if the patient is accompanied by vertigo, it should be differentiated from many diseases, at this time, you should go to the hospital to ask a specialist for examination, because to identify the symptoms of vertigo, you need to use various instruments, so it is not something that the patient can do by himself.
[Treatment]
The earlier the treatment of sudden deafness, the better the effect. More than 80% of those who start treatment within one week after the onset of the disease can recover or partially recover their hearing, while the effect of treatment after two weeks after the onset of the disease is poor. Some data show that when the onset of the disease is more than one month, the hearing has already been basically fixed, and the effect of treatment will be greatly reduced. Some patients become permanently deaf because they are not treated in time. Therefore, sudden deafness should be treated as an emergency.
Medications: low molecular dextran, vasodilators (calcium channel blockers, histamine derivatives, herbs for blood circulation), anti-thrombotic and fibrinolytic agents (dongling thrombin, urokinase), vitamins, drugs to improve inner ear metabolism (Ducoxib, etc.), glucocorticoids, etc.; TCM herbs such as compound salvia. Sedation should be given to patients with tinnitus and vertigo.
Physiotherapy and acupuncture: hyperbaric oxygen, peri-auricular acupuncture point injection, etc.
Surgical treatment: intra-dural drug injection, inner ear nourishment with temporal muscle flap, etc.
Drug-related deafness
Treatment should be carried out early, with neurotrophic drugs such as vitamin A, vitamin B complex, ATP, coenzyme A and hyperbaric oxygen. In early stage of mild intoxication, hearing can be restored. For deafness that has been poisoned for a long time, general treatment methods have no obvious effect. In terms of prevention, genetic testing of ototoxic drug-sensitive individuals is feasible to screen ototoxic drug-sensitive people; avoid the use of ototoxic drugs.
Noise Deafness
There is no effective treatment for noise deafness in Western medicine. The application of vasodilators followed by neurotropic drugs and drugs to promote cell metabolism may be helpful, but the effect is generally not obvious. Hearing impairment can be treated with hearing aids. Most importantly, once diagnosed, transfer away from the noisy working environment as soon as possible, or improve the noise pollution of the working environment, wear anti-noise ear plugs and noise detector.
Age-related deafness
Hearing aids can be worn, and conservative treatment is based on nourishing nerves and improving microcirculation.
Deafness caused by systemic diseases and infectious deafness
We can treat the cause of deafness and maintain the residual hearing, and we can treat the dilation of blood vessels and improve the metabolism of the inner ear with drugs.
Traumatic deafness
Most of them are conductive deafness. We should try to restore and reconstruct the sound conduction system, and we can treat them with tympanoplasty hearing reconstruction surgery.
Autoimmune deafness
Immunosuppressive drugs such as cyclophosphamide and prednisolone are effective, but can be relapsed after stopping. Re-dosing remains effective.