Window Coverage and Liquid Biopsy in the First-Line Therapy of Severe Sudden Sensorineural Hearing Loss

Alexander Kilgue; Rayoung Kim; Lars-Uwe Scholtz; Conrad Riemann; Christoph J. Pfeiffer; Matthias Schürmann; Ingo Todt

doi:10.3390/brainsci14111154

Brain Sciences (Nov 2024)

Window Coverage and Liquid Biopsy in the First-Line Therapy of Severe Sudden Sensorineural Hearing Loss

Alexander Kilgue,
Rayoung Kim,
Lars-Uwe Scholtz,
Conrad Riemann,
Christoph J. Pfeiffer,
Matthias Schürmann,
Ingo Todt

Affiliations

Alexander Kilgue: Department of Otolaryngology, Head and Neck Surgery, Campus Klinikum Bielefeld Mitte, Medical School OWL, Bielefeld University, Teutoburger Str. 50, 33604 Bielefeld, Germany
Rayoung Kim: Department of Otolaryngology, Head and Neck Surgery, Campus Klinikum Bielefeld Mitte, Medical School OWL, Bielefeld University, Teutoburger Str. 50, 33604 Bielefeld, Germany
Lars-Uwe Scholtz: Department of Otolaryngology, Head and Neck Surgery, Campus Klinikum Bielefeld Mitte, Medical School OWL, Bielefeld University, Teutoburger Str. 50, 33604 Bielefeld, Germany
Conrad Riemann: Department of Otolaryngology, Head and Neck Surgery, Campus Klinikum Bielefeld Mitte, Medical School OWL, Bielefeld University, Teutoburger Str. 50, 33604 Bielefeld, Germany
Christoph J. Pfeiffer: Department of Otolaryngology, Head and Neck Surgery, Campus Klinikum Bielefeld Mitte, Medical School OWL, Bielefeld University, Teutoburger Str. 50, 33604 Bielefeld, Germany
Matthias Schürmann: Department of Otolaryngology, Head and Neck Surgery, Campus Klinikum Bielefeld Mitte, Medical School OWL, Bielefeld University, Teutoburger Str. 50, 33604 Bielefeld, Germany
Ingo Todt: Department of Otolaryngology, Head and Neck Surgery, Campus Klinikum Bielefeld Mitte, Medical School OWL, Bielefeld University, Teutoburger Str. 50, 33604 Bielefeld, Germany

DOI: https://doi.org/10.3390/brainsci14111154
Journal volume & issue: Vol. 14, no. 11
p. 1154

Abstract

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Introduction: Based on clinical practice guidelines, the application of corticosteroids as a first-line therapy is common. Although sudden sensorineural hearing loss (SSHL) etiology is primarily idiopathic, hearing loss can result from a perilymphatic fistula (PLF). Recent findings show evidence of a specific rate of PLF based on a cochlin-tomoprotein (CTP) detection test. Based on this rate of PLF treatment, the concepts of SSNHL need to be re-evaluated. The present study aimed to evaluate CTP in SSNHL patients and compare pre-surgical and post-surgical pure tone hearing thresholds after round and oval window sealing as first-line treatment. Material and Methods: A total of 30 patients with unilateral SSNHL with a pure tone average (PTA) (4 Freq. of 60 dB or more were enrolled in a prospective study. All patients underwent tympanoscopy for middle ear exploration as a first-line treatment. After intraoperative observation of a possible PLF, all patients obtained middle ear lavage to gain CTP samples for following ELISA-based CTP detection tests. All patients received round window and oval window sealing with fascia. PTA hearing thresholds were analyzed post-surgically 3 weeks after treatment based on 4-frequency bone conduction (BC). Results: The average preoperative pure tone BC threshold was 97.7 dB compared with the 69 dB postoperative BC threshold. Mean BC improved by 20.3 dB after middle ear exploration and window sealing. A total of 56% (17 of 30) of patients recovered at least 10 dB. The middle ear cochlin-tomoprotein detection rate was 70% positive. Conclusions: The combination of early tympanoscopy and inner ear-specific cochlin-tomoprotein as a detection tool for suspected PLF showed evidence of PLF as a key causative in SSNHL.

Published in Brain Sciences

ISSN: 2076-3425 (Online)
Publisher: MDPI AG
Country of publisher: Switzerland
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry
Website: https://www.mdpi.com/journal/brainsci/

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