MODERN THERAPEUTIC PERSPECTIVES IN THE TREATMENT OF SUDDENLY INSTALLED DEAFNESS

Abstract

Introduction. Sudden hearing loss constitutes a medical emergency requiring immediate clinical and laboratory tests, as well as an adequate and quickly established treatment. According to literature data, sudden hearing loss is a major health problem because of the urban noise exposure, but especially by increasing the number of cardiovascular diseases, metabolic diseases, immune diseases and neurological diseases. In the literature are cited multiple causes of disease, but studies show that the pathogenesis is determined only in 10-15% of cases. The diagnosis of sudden hearing loss is one of exclusion, that can't be set until after the elimination of the causal factors possible. The main theories aetio-pathogenic include vascular cause and noise exposure. Matherial and method. A significant number of studies support the idea that inflammatory responses are intimately associated with vascular trauma and noise exposure. Inflammation, however, is a normal adaptive response aimed at restoring tissue functionality and homeostasis after infection, tissue injury and even stress under sterile conditions, and suppressing it could have unintended negative consequences. Therefore, an appropriate approach to prevent or ameliorate hearing loss should involve improving the resolution of the inflammatory process in the cochlea rather than inhibiting this phenomenon. Results and conclusions. The resolution of inflammation is not a passive response but rather an active, highly controlled and coordinated process. Inflammation by itself produces specialized pro-resolving mediators with critical functions, including essential fatty acid derivatives (lipoxins, resolvins, protectins and maresins), proteins and peptides such as annexin A1 and galectins, purines (adenosine), gaseous mediators (NO, H2S and CO), as well as neuromodulators like acetylcholine and netrin-1. In this review article, the authors describe recent advances in the understanding of the resolution phase of inflammation and highlight therapeutic strategies that might be useful in preventing inflammation-induced cochlear damage.

Keywords

• sudden hearing loss
• resolution of inflammation
• lipid mediators
• essential fatty acid
• adenosin
• annexin a1
• cohlear damage