Fibrinolytic therapy for idiopathic sudden sensorineural hearing loss.

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The etiology of idiopathic sudden sensorineural hearing loss (sudden deafness) is often difficult to determine. One of the presumed etiologies is microembolism of the inner ear vessels. This article describes the efficacy of fibrinolytic therapy with urokinase.Initially, all of 66 patients with sudden deafness were treated with a course of intravenous hydrocortisone (250mg/day for 5 days, then 100mg/day for 5 days). On the 3rd to 5th day after the beginning of therapy, audiometry was performed. In 28 patients hearing improved, and steroid therapy was continued. However, the other 38 patients, whose hearing showed no improvement, received additional intravenous administration of high doses of urokinase (240, 000 Units/day for 3 days, then 120, 000 Units/day for 3 days).The results in this series of 66 patients treated with steroid alone or a combination of steroid and urokinase are reviewed. Pure-tone threshold at 250, 500, 1 k, 2k, and 4 kHz better than 30 dB in the ISO hearing level or equal to that ofthe uninvolved ear was regarded as an index of complete recovery. Thirty-six patients (54.5%) were in this categoly. At least 30 dB improvement of pure-tone average threshold at the above 5 frequencies was regarded as good recovery. Twenty-two patients(18.2%)were this group. Nine patients(13.6%)had fair recovery with improvement of 10-29dB pure-tone average threshold. Nine patients(13.6%)had no change in hearing. A relatively high recovery rate(64.7%)was noted in the patients with hearing levels more than 70 dB. There were no complications during the course of fibrinolytic therapy.The authors conclude that urokinase is an additional therapeutic modality for patients with sudden deafness.
耳鼻咽喉科臨床学会の論文

Fibrinolytic therapy for idiopathic sudden sensorineural hearing loss.

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