PMID- 11192894
OWN - NLM
STAT- MEDLINE
DCOM- 20010201
LR  - 20051117
IS  - 0023-852X (Print)
IS  - 0023-852X (Linking)
VI  - 111
IP  - 1
DP  - 2001 Jan
TI  - Pediatric fluctuating sensorineural hearing loss: problems in medical management.
PG  - 21-5
AB  - OBJECTIVES: To discuss the diagnosis and management of children with fluctuating 
      sensorineural hearing loss, especially focusing on those problems dealing with 
      autoimmune inner ear disease. STUDY DESIGN: A retrospective chart review of a 
      large pediatric otolaryngology practice. A series of 40 children with progressive 
      hearing losses was identified. Of that group, 22 children, aged 1.5 to 12.2 years 
      at first audiogram, were considered to have fluctuating sensorineural hearing 
      loss (FSNHL). Criteria for inclusion in the FSNHL group were threshold variations 
      of 15 dB or more in at least one ear at two or more of the standard audiometric 
      frequencies on at least 2 testing days. METHODS: Charts were reviewed for age, 
      sex, otologic history, laboratory evaluations, medical or surgical treatments, 
      significant medical history, and family medical history. RESULTS: Twenty-two 
      children met the criteria for fluctuating sensorineural hearing loss. Of those 
      with fluctuating hearing loss, 15 were idiopathic, 3 had positive lymphocyte 
      transformation tests (LTT) suggestive of autoimmune inner ear disease (AIED), and 
      4 had fistula on middle ear exploration. Average fluctuation for all groups was 
      29.1 dB. Average duration of fluctuations was 4.95 years. CONCLUSIONS: The 
      majority of pediatric FSNHL cases (15 of 22) were idiopathic in nature. Of those 
      FSNHL children with positive LTTs, only one was treated with steroid therapy. In 
      the other patients with positive LTTs, parents or other physicians were often 
      reluctant to treat, or the patient was lost to follow-up. Mean fluctuations 
      varied substantially across all standard audiometric frequencies for all groups.
FAU - Dinces, E A
AU  - Dinces EA
AD  - Department of Otolaryngology, Montefiore Medical Center, Albert Einstein College 
      of Medicine, Bronx, New York 10467, USA.
FAU - Yang, S
AU  - Yang S
FAU - Balogun, A O
AU  - Balogun AO
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Laryngoscope
JT  - The Laryngoscope
JID - 8607378
RN  - 0 (HSP70 Heat-Shock Proteins)
RN  - 0 (Steroids)
SB  - IM
MH  - Adolescent
MH  - Audiometry
MH  - Auditory Threshold/physiology
MH  - Autoimmune Diseases/complications
MH  - Blotting, Western
MH  - Bone Conduction/physiology
MH  - Child
MH  - Child, Preschool
MH  - Disease Progression
MH  - Ear Diseases/complications
MH  - Ear, Middle/pathology
MH  - Fistula/complications
MH  - Follow-Up Studies
MH  - HSP70 Heat-Shock Proteins/analysis
MH  - Hearing Loss, Sensorineural/*drug therapy/etiology/immunology/therapy
MH  - Humans
MH  - Infant
MH  - Labyrinth Diseases/complications
MH  - Lymphocyte Activation/immunology
MH  - Perilymph
MH  - Retrospective Studies
MH  - Speech Perception/physiology
MH  - Steroids/therapeutic use
MH  - Treatment Outcome
EDAT- 2001/02/24 12:00
MHDA- 2001/02/28 10:01
CRDT- 2001/02/24 12:00
PHST- 2001/02/24 12:00 [pubmed]
PHST- 2001/02/28 10:01 [medline]
PHST- 2001/02/24 12:00 [entrez]
AID - 10.1097/00005537-200101000-00004 [doi]
PST - ppublish
SO  - Laryngoscope. 2001 Jan;111(1):21-5. doi: 10.1097/00005537-200101000-00004.