Abstract
Sudden hearing loss (sudden idiopathic sensorineural hearing loss, SISHL) is a major medical, social and economic problem. The etiology is not fully understood; the problem is arising presumably by the action of heterogeneous factors (viral infections, immunologic or vascular disorders etc.).
Treatment of SISHL is generally not satisfactory, both in terms of corticosteroids or other options. Rheohemapheresis (RHF) offers a possibility of a rescue treatment.
It is based on a rapid improvement of rheologic properties of blood that can favorably affect the viscosity and thus the flow of the microcirculation, coagulation or activity of the endothelium. In the years 2012 - 2013, we treated 16 patients in the age 34 - 72 years by means of our own modification of RHF, after treatment failure with corticoid infusion therapy.
Hearing improvement was achieved significantly in 11 patients according to WHO rating, respectively in 12 diseased according to Fowler counting. 5 patients did not improve significantly, at one patient the hearing worsened. Most patients achieved an improvement at a frequency of 0.5 kHz.
Tinnitus disappeared in two patients, and average tinnitus reduction was achieved 15.25 dB. Unfavorable prognostic factor showed to be the severity of hearing loss and age of the patient and the time of the incident.
RHF side effects were not significant (two short-term non-serious reactions). RHF in our study showed a beneficial therapeutic effect even after a failed conventional therapy and subsequent initiation of treatment and was not associated with significant adverse risks.
Treatment results of our group support the hypothesis that RHF may be an alternative rescue therapy in SISHL, especially in case of a vascular etiology, even after a failure of a standard therapy.