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Hearing Disorders: HELP
Articles by Sujana S. Chandrasekhar
Based on 12 articles published since 2009
(Why 12 articles?)
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Between 2009 and 2019, S. S. Chandrasekhar wrote the following 12 articles about Hearing Disorders.
 
+ Citations + Abstracts
1 Guideline Clinical practice guideline: tinnitus executive summary. 2014

Tunkel, David E / Bauer, Carol A / Sun, Gordon H / Rosenfeld, Richard M / Chandrasekhar, Sujana S / Cunningham, Eugene R / Archer, Sanford M / Blakley, Brian W / Carter, John M / Granieri, Evelyn C / Henry, James A / Hollingsworth, Deena / Khan, Fawad A / Mitchell, Scott / Monfared, Ashkan / Newman, Craig W / Omole, Folashade S / Phillips, C Douglas / Robinson, Shannon K / Taw, Malcolm B / Tyler, Richard S / Waguespack, Richard / Whamond, Elizabeth J. ·Otolaryngology-Head and Neck Surgery, Johns Hopkins Outpatient Center, Baltimore, Maryland, USA dtunkel@jhmi.edu. · Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois, USA. · Partnership for Health Analytic Research, LLC, Los Angeles, California, USA. · Department of Otolaryngology, State University of New York Downstate Medical Center, Brooklyn, New York, USA. · New York Otology, New York, New York, USA. · Department of Research and Quality Improvement, American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA. · Divisions of Rhinology & Sinus Surgery and Facial Plastic & Reconstructive Surgery, University of Kentucky, Lexington, Kentucky, USA. · Department of Otolaryngology, University of Manitoba, Winnipeg, MB, Canada. · Department of Otolaryngology, Tulane University, New Orleans, Louisiana, USA. · Division of Geriatric Medicine and Aging, Columbia University, New York, New York, USA. · National Center for Rehabilitative Auditory Research, Portland VA Medical Center, Portland, Oregon, USA. · ENT Specialists of Northern Virginia, Falls Church, Virginia, USA. · Ochsner Health System, Kenner, Louisiana, USA. · Mitchell & Cavallo, P.C., Houston, Texas, USA. · Department of Otology and Neurotology, The George Washington University, Washington, DC, USA. · Department of Surgery, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA. · Morehouse School of Medicine, East Point, Georgia, USA. · Department of Head and Neck Imaging, Weill Cornell Medical Center, NewYork-Presbyterian Hospital, New York, New York, USA. · Department of Psychiatry, University of California, San Diego, La Jolla, California, USA. · Department of Medicine, UCLA Center for East-West Medicine, Los Angeles, California, USA. · Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, USA. · Department of Surgery, University of Alabama School of Medicine, Birmingham, Alabama, USA. · Consumers United for Evidence-based Healthcare, Fredericton, New Brunswick, Canada. ·Otolaryngol Head Neck Surg · Pubmed #25274374.

ABSTRACT: The American Academy of Otolaryngology--Head and Neck Surgery Foundation (AAO-HNSF) has published a supplement to this issue featuring the new Clinical Practice Guideline: Tinnitus. To assist in implementing the guideline recommendations, this article summarizes the rationale, purpose, and key action statements. The 13 recommendations developed address the evaluation of patients with tinnitus, including selection and timing of diagnostic testing and specialty referral to identify potential underlying treatable pathology. It will then focus on the evaluation and treatment of patients with persistent primary tinnitus, with recommendations to guide the evaluation and measurement of the impact of tinnitus and to determine the most appropriate interventions to improve symptoms and quality of life for tinnitus sufferers.

2 Guideline Clinical practice guideline: sudden hearing loss. 2012

Stachler, Robert J / Chandrasekhar, Sujana S / Archer, Sanford M / Rosenfeld, Richard M / Schwartz, Seth R / Barrs, David M / Brown, Steven R / Fife, Terry D / Ford, Peg / Ganiats, Theodore G / Hollingsworth, Deena B / Lewandowski, Christopher A / Montano, Joseph J / Saunders, James E / Tucci, Debara L / Valente, Michael / Warren, Barbara E / Yaremchuk, Kathleen L / Robertson, Peter J / Anonymous4970719. ·Department of Otolaryngology, Henry Ford Hospital, Detroit, Michigan 48202, USA. rstachl1@hfhs.org ·Otolaryngol Head Neck Surg · Pubmed #22383545.

ABSTRACT: OBJECTIVE: Sudden hearing loss (SHL) is a frightening symptom that often prompts an urgent or emergent visit to a physician. This guideline provides evidence-based recommendations for the diagnosis, management, and follow-up of patients who present with SHL. The guideline primarily focuses on sudden sensorineural hearing loss (SSNHL) in adult patients (aged 18 and older). Prompt recognition and management of SSNHL may improve hearing recovery and patient quality of life (QOL). Sudden sensorineural hearing loss affects 5 to 20 per 100,000 population, with about 4000 new cases per year in the United States. This guideline is intended for all clinicians who diagnose or manage adult patients who present with SHL. PURPOSE: The purpose of this guideline is to provide clinicians with evidence-based recommendations in evaluating patients with SHL, with particular emphasis on managing SSNHL. The panel recognized that patients enter the health care system with SHL as a nonspecific, primary complaint. Therefore, the initial recommendations of the guideline deal with efficiently distinguishing SSNHL from other causes of SHL at the time of presentation. By focusing on opportunities for quality improvement, the guideline should improve diagnostic accuracy, facilitate prompt intervention, decrease variations in management, reduce unnecessary tests and imaging procedures, and improve hearing and rehabilitative outcomes for affected patients. RESULTS: The panel made strong recommendations that clinicians should (1) distinguish sensorineural hearing loss from conductive hearing loss in a patient presenting with SHL; (2) educate patients with idiopathic sudden sensorineural hearing loss (ISSNHL) about the natural history of the condition, the benefits and risks of medical interventions, and the limitations of existing evidence regarding efficacy; and (3) counsel patients with incomplete recovery of hearing about the possible benefits of amplification and hearing-assistive technology and other supportive measures. The panel made recommendations that clinicians should (1) assess patients with presumptive SSNHL for bilateral SHL, recurrent episodes of SHL, or focal neurologic findings; (2) diagnose presumptive ISSNHL if audiometry confirms a 30-dB hearing loss at 3 consecutive frequencies and an underlying condition cannot be identified by history and physical examination; (3) evaluate patients with ISSNHL for retrocochlear pathology by obtaining magnetic resonance imaging, auditory brainstem response, or audiometric follow-up; (4) offer intratympanic steroid perfusion when patients have incomplete recovery from ISSNHL after failure of initial management; and (5) obtain follow-up audiometric evaluation within 6 months of diagnosis for patients with ISSNHL. The panel offered as options that clinicians may offer (1) corticosteroids as initial therapy to patients with ISSNHL and (2) hyperbaric oxygen therapy within 3 months of diagnosis of ISSNHL. The panel made a recommendation against clinicians routinely prescribing antivirals, thrombolytics, vasodilators, vasoactive substances, or antioxidants to patients with ISSNHL. The panel made strong recommendations against clinicians (1) ordering computerized tomography of the head/brain in the initial evaluation of a patient with presumptive SSNHL and (2) obtaining routine laboratory tests in patients with ISSNHL.

3 Editorial Implantable Auditory Devices: Bridging the Gap Between Conventional Hearing Aids and Cochlear Implants. 2019

Kohan, Darius / Chandrasekhar, Sujana S. ·Lenox Hill Hospital/, Manhattan Eye Ear Nose Throat Hospital -Northwell Health System, NYU School of Medicine, 863 Park Avenue, Suite 1East, New York, NY 10016, USA. Electronic address: earmaven@aol.com. · ENT and Allergy Associates, LLP, 18 East 48th Street, 2nd Floor, New York, NY 10017, USA. Electronic address: ssc@nyotology.com. ·Otolaryngol Clin North Am · Pubmed #30827364.

ABSTRACT: -- No abstract --

4 Editorial A Significant Treatable Cause of Hearing Loss in Our Time. 2018

Chandrasekhar, Sujana S. ·New York Otology, 210 East 64th Street, New York, NY 10065, USA; Department of Otolaryngology-Head and Neck Surgery, Zucker School of Medicine at Hofstra-Northwell, Hempstead, NY, USA; Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: ssc@nyotology.com. ·Otolaryngol Clin North Am · Pubmed #29352571.

ABSTRACT: -- No abstract --

5 Review Traumatic wound breakdown following baha™ implant. 2010

Sambur, Ian M / Chandrasekhar, Sujana S / Govindaraj, Satish. ·Department of Otolaryngology-Head and Neck Surgery, Mount Sinai School of Medicine, New York, NY 10021, USA. ·Laryngoscope · Pubmed #21225816.

ABSTRACT: OBJECTIVES: To highlight the importance of recognizing and managing severe peri-operative and post-operative soft tissue complications of baha™ osseointegrated implants. To discuss a patient with severe post-traumatic peri-operative and post-operative scalp complications following baha™ surgery, including management options. STUDY DESIGN: Case report and literature review of post-operative soft tissue complications of baha™ osseointegrated implants. METHODS (CASE SUMMARY): A patient presented with a severe right sided mixed hearing loss and was treated with a baha™ osseointegrated implant. Post-operatively, the patient suffered trauma to the site and developed a severe traumatic wound infection, with complete dehiscence of the split thickness skin graft. The patient was treated with oral antibiotics and meticulous, aggressive local wound care. Operative management was considered but not implemented. Full healing with ability to use the device successfully was achieved. RESULTS: The patient healed completely and did not require revision surgery. He now has serviceable hearing after benefiting from the baha™ implant. CONCLUSIONS: Although post-operative complications following baha™ surgery are infrequent and commonly mild, the surgeon will rarely be encountered by a severe soft tissue complication as described. Aggressive local wound care included culture-guided antibiotic therapy is indicated prior to performing revision surgery.

6 Article International consensus (ICON) on treatment of sudden sensorineural hearing loss. 2018

Marx, M / Younes, E / Chandrasekhar, S S / Ito, J / Plontke, S / O'Leary, S / Sterkers, O. ·Department of otology and neurotology, Purpan hospital, CHU de Toulouse, 1, place du Dr-Baylac, 31059 Toulouse, France; Paul-Sabatier Toulouse 3 University, 31062 Toulouse, France. Electronic address: marx.m@chu-toulouse.fr. · Department of otology and neurotology, Purpan hospital, CHU de Toulouse, 1, place du Dr-Baylac, 31059 Toulouse, France; Paul-Sabatier Toulouse 3 University, 31062 Toulouse, France. · New York otology, New York, NY, USA. · Department of otolaryngology, head & neck surgery, graduate school of medicine, Kyoto university, Kyoto, Japan. · Department of otorhinolaryngology, head and neck surgery, university hospital Halle (Saale), Martin Luther university Halle-Wittenberg, Halle (Saale), Germany. · Department of otolaryngology, university of Melbourne, Royal Victorian eye and ear hospital, East Melbourne, Australia. · Unité otologie, implants auditifs et chirurgie de la base du crâne, groupe hospitalier Pitié-Salpêtrière, 75651 Paris cedex 13, France; UMR-S 1159 Inserm, université Paris 6 Pierre-et-Marie-Curie, 78890 Paris cedex 18, France. ·Eur Ann Otorhinolaryngol Head Neck Dis · Pubmed #29396226.

ABSTRACT: Sudden sensorineural hearing loss (SSNHL) is a common and alarming symptom that often prompts an urgent visit to an ENT specialist. Treatment of SSNHL remains one of the most problematic issues for contemporary otorhinolaryngology: although many meta-analyses and national guidelines have been issued, management is not standardized in terms of medical treatment, and duration and route of administration. We present several methodological suggestions for the study of treatments for SSNHL. These were developed from the existing level of evidence of the main treatments used in SSNHL by experts who convened at the IFOS 2017 ENT World Congress in Paris, France. All panelists agreed that one of the main limitations present in studies on SSNHL is related to the wide heterogeneity, which characterizes both the initial hearing deficit and the amount of hearing recovery. Although evidence of the efficacy of systemic steroids cannot be considered as strong enough to recommend their use, it is still the most widespread primary therapy and can be considered as the current standard of care. Therefore, systemic steroids stand as an adequate control for any innovative treatment. To reduce the number of subjects we suggest that the inclusion criteria should be restricted to moderate to profound levels of hearing loss. The efficacy of trans-tympanic steroids as a salvage therapy was suggested in several reports on small populations and needs to be confirmed with larger randomized controlled trials.

7 Article Clinical practice guideline: tinnitus. 2014

Tunkel, David E / Bauer, Carol A / Sun, Gordon H / Rosenfeld, Richard M / Chandrasekhar, Sujana S / Cunningham, Eugene R / Archer, Sanford M / Blakley, Brian W / Carter, John M / Granieri, Evelyn C / Henry, James A / Hollingsworth, Deena / Khan, Fawad A / Mitchell, Scott / Monfared, Ashkan / Newman, Craig W / Omole, Folashade S / Phillips, C Douglas / Robinson, Shannon K / Taw, Malcolm B / Tyler, Richard S / Waguespack, Richard / Whamond, Elizabeth J. ·Otolaryngology-Head and Neck Surgery, Johns Hopkins Outpatient Center, Baltimore, Maryland, USA dtunkel@jhmi.edu. · Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois, USA. · Partnership for Health Analytic Research, LLC, Los Angeles, California, USA. · Department of Otolaryngology, State University of New York at Downstate Medical Center, Brooklyn, New York, USA. · New York Otology, New York, New York, USA. · Department of Research and Quality Improvement, American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA. · Divisions of Rhinology & Sinus Surgery and Facial Plastic & Reconstructive Surgery, University of Kentucky, Lexington, Kentucky, USA. · Department of Otolaryngology, University of Manitoba, Winnipeg, Manitoba, Canada. · Department of Otolaryngology, Tulane University, New Orleans, Louisiana, USA. · Division of Geriatric Medicine and Aging, Columbia University, New York, New York, USA. · National Center for Rehabilitative Auditory Research, Portland VA Medical Center, Portland, Oregon, USA. · ENT Specialists of Northern Virginia, Falls Church, Virginia, USA. · Ochsner Health System, Kenner, Louisiana, USA. · Mitchell & Cavallo, P.C., Houston, Texas, USA. · Department of Otology and Neurotology, The George Washington University, Washington, DC, USA. · Department of Surgery, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA. · Morehouse School of Medicine, East Point, Georgia, USA. · Department of Head and Neck Imaging, Weill Cornell Medical Center, New York-Presbyterian Hospital, New York, New York, USA. · Department of Psychiatry, University of California, San Diego, La Jolla, California, USA. · Department of Medicine, UCLA Center for East-West Medicine, Los Angeles, California, USA. · Department of Otolaryngology-Head and Neck Surgery, The University of Iowa, Iowa City, Iowa, USA. · Department of Surgery, University of Alabama School of Medicine, Birmingham, Alabama, USA. · Consumers United for Evidence-Based Healthcare, Fredericton, New Brunswick, Canada. ·Otolaryngol Head Neck Surg · Pubmed #25273878.

ABSTRACT: OBJECTIVE: Tinnitus is the perception of sound without an external source. More than 50 million people in the United States have reported experiencing tinnitus, resulting in an estimated prevalence of 10% to 15% in adults. Despite the high prevalence of tinnitus and its potential significant effect on quality of life, there are no evidence-based, multidisciplinary clinical practice guidelines to assist clinicians with management. The focus of this guideline is on tinnitus that is both bothersome and persistent (lasting 6 months or longer), which often negatively affects the patient's quality of life. The target audience for the guideline is any clinician, including nonphysicians, involved in managing patients with tinnitus. The target patient population is limited to adults (18 years and older) with primary tinnitus that is persistent and bothersome. PURPOSE: The purpose of this guideline is to provide evidence-based recommendations for clinicians managing patients with tinnitus. This guideline provides clinicians with a logical framework to improve patient care and mitigate the personal and social effects of persistent, bothersome tinnitus. It will discuss the evaluation of patients with tinnitus, including selection and timing of diagnostic testing and specialty referral to identify potential underlying treatable pathology. It will then focus on the evaluation and treatment of patients with persistent primary tinnitus, with recommendations to guide the evaluation and measurement of the effect of tinnitus and to determine the most appropriate interventions to improve symptoms and quality of life for tinnitus sufferers. ACTION STATEMENTS: The development group made a strong recommendation that clinicians distinguish patients with bothersome tinnitus from patients with nonbothersome tinnitus. The development group made a strong recommendation against obtaining imaging studies of the head and neck in patients with tinnitus, specifically to evaluate tinnitus that does not localize to 1 ear, is nonpulsatile, and is not associated with focal neurologic abnormalities or an asymmetric hearing loss. The panel made the following recommendations: Clinicians should (a) perform a targeted history and physical examination at the initial evaluation of a patient with presumed primary tinnitus to identify conditions that if promptly identified and managed may relieve tinnitus; (b) obtain a prompt, comprehensive audiologic examination in patients with tinnitus that is unilateral, persistent (≥ 6 months), or associated with hearing difficulties; (c) distinguish patients with bothersome tinnitus of recent onset from those with persistent symptoms (≥ 6 months) to prioritize intervention and facilitate discussions about natural history and follow-up care; (d) educate patients with persistent, bothersome tinnitus about management strategies; (e) recommend a hearing aid evaluation for patients who have persistent, bothersome tinnitus associated with documented hearing loss; and (f) recommend cognitive behavioral therapy to patients with persistent, bothersome tinnitus. The panel recommended against (a) antidepressants, anticonvulsants, anxiolytics, or intratympanic medications for the routine treatment of patients with persistent, bothersome tinnitus; (b) Ginkgo biloba, melatonin, zinc, or other dietary supplements for treating patients with persistent, bothersome tinnitus; and (c) transcranial magnetic stimulation for the routine treatment of patients with persistent, bothersome tinnitus. The development group provided the following options: Clinicians may (a) obtain an initial comprehensive audiologic examination in patients who present with tinnitus (regardless of laterality, duration, or perceived hearing status); and (b) recommend sound therapy to patients with persistent, bothersome tinnitus. The development group provided no recommendation regarding the effect of acupuncture in patients with persistent, bothersome tinnitus.

8 Article Diagnostic and prognostic utility of measuring tumor necrosis factor in the peripheral circulation of patients with immune-mediated sensorineural hearing loss. 2012

Svrakic, Maja / Pathak, Shresh / Goldofsky, Eliot / Hoffman, Ronald / Chandrasekhar, Sujana S / Sperling, Neil / Alexiades, George / Ashbach, Matthew / Vambutas, Andrea. · ·Arch Otolaryngol Head Neck Surg · Pubmed #23165380.

ABSTRACT: OBJECTIVES: To characterize levels of tumor necrosis factor (TNF; formerly known as tumor necrosis factor α), a well-established proinflammatory cytokine, in patients with immune-mediated sensorineural hearing loss (IM-SNHL) and to determine the role of this cytokine in identifying steroid-responsive hearing loss. DESIGN: Prospective case-control study. SETTING: Tertiary care academic medical center. PATIENTS: A total of 11 control subjects and 85 patients with clinical and audiometric characteristics of IM-SNHL (autoimmune inner ear disease and sudden SNHL combined) treated with corticosteroids were enrolled in the study. Patients were categorized as steroid responders (n = 47) and steroid nonresponders (n = 38). Peripheral venous blood was used to determine the total amount of plasma TNF by enzyme-linked immunosorbent assay. Peripheral blood mononuclear cells (PBMCs) were isolated and treated with in vitro dexamethasone. Treated and untreated PBMCs were then analyzed for release of soluble TNF protein into conditioned supernatants as well as expression of TNF messenger RNA (mRNA). MAIN OUTCOME MEASURES: Mean plasma levels of TNF, unstimulated and dexamethasone-stimulated PBMC-secreted levels of TNF, and TNF mRNA levels in unstimulated and dexamethasone-stimulated PBMCs. RESULTS: Steroid nonresponders had the highest mean baseline plasma levels of TNF compared with steroid responders and control subjects (27.6, 24.1, and 14.4 pg/mL, respectively) (P = .03). For patients with IM-SNHL with a high baseline plasma levels of TNF (>14.4 pg/mL), the mean TNF secreted by PBMCs was 59.1 pg/mL, which decreased to 7.2 pg/mL with in vitro dexamethasone stimulation in the responder group, while the mean TNF secreted by PBMCs was 11.2 pg/mL, which slightly increased to 11.7 pg/mL with in vitro dexamethasone stimulation in the nonresponder group (P = .04). CONCLUSIONS: The level of TNF can be used as both a diagnostic and prognostic cytokine for IM-SNHL. For patients presenting with a sudden change in hearing threshold, a high baseline plasma TNF from the peripheral circulation is supportive of the diagnosis if it is greater than 18.8 pg/mL, with a positive predictive value higher than 97%. In addition, this study demonstrates that for patients with IM-SNHL and high plasma levels of TNF, their clinical response to oral glucocorticoids can be predicted by their in vitro PBMC response to dexamethasone. This algorithm may further guide optimal medical treatment and possibly avoid the deleterious adverse effects of administering glucocorticoids to those patients who would not benefit from their effect.

9 Article Intratympanic steroid use for hearing salvage in Vogt-Koyanagi-Harada syndrome. 2011

Pelosi, Stanley / Chandrasekhar, Sujana S. ·Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, 7209 Medical Center East, South Tower, 1215 21st Ave. South, Nashville, TN 37232, USA. Stanley.Pelosi@gmail.com ·Ear Nose Throat J · Pubmed #22180111.

ABSTRACT: We discuss the rare case of a 68-year-old woman with Vogt-Koyanagi-Harada (VKH) syndrome and sensorineural hearing loss (SNHL) who was successfully treated with intratympanic corticosteroid injections. The patient had presented with bilaterally asymmetric (i.e., moderate and moderate to severe) SNHL, tinnitus, vertigo, and vitiligo. She received two intratympanic injections in her worse-hearing ear over the course of 1 month. Subsequent audiometry showed an immediate 5- to 10-dB improvement in her hearing across multiple frequencies, as well as a long-term improvement to near-normal thresholds. The hearing thresholds in her untreated ear remained stable. To the best of our knowledge, this is the first report of a patient with VKH syndrome who was successfully treated with intratympanic steroid application.

10 Article Neuromonics™ Tinnitus Treatment: preliminary experience in a private practice setting. 2010

Jang, David W / Johnson, Erika / Chandrasekhar, Sujana S. ·Mount Sinai School of Medicine, New York, NY, USA. david.jang@mssm.edu ·Laryngoscope · Pubmed #21225806.

ABSTRACT: EDUCATIONAL OBJECTIVE: At the conclusion of this presentation, the participants should be able to identify the principles behind the Neuromonics™ Tinnitus Treatment (NTT) and understand its strengths and potential shortfalls. OBJECTIVES: To describe the preliminary experience and efficacy of the NTT in an independent, non-industry sponsored private otology practice clinical study. STUDY DESIGN: Case series with retrospective chart review and post-intervention quality of life questionnaire. METHODS: Tinnitus Reaction Questionnaire (TRQ) scores, and awareness and disturbance scores, were obtained pre- and post-treatment. A posttreatment questionnaire based on the Glasgow Benefit Inventory (GBI) was conducted over the telephone. RESULTS: Eleven patients had completed the six-month program at the time of the study. Nine of the eleven patients completing therapy were considered "highly suitable". TRQ scores were universally improved (ranging from a 3 to 78% decrease in the TRQ score). However, only two of the seven (29%) had achieved a decrease in the TRQ score by 40% or more. Seven of ten patients (70%), and four of ten (40%) patients reported a reduction in the percentage of the time they were aware of and disturbed by their tinnitus, respectively. Eight of ten patients (80%) exhibited positive scores on the GBI (mean 17.39, median 7.81, range -3.1 to 67.6). When asked whether they thought the device was worth the cost, responses were divided equally between positive and negative responses. CONCLUSION: Neuromonics ™ Tinnitus Treatment appears to be a practical and promising treatment for tinnitus.

11 Article Sudden hearing loss from PDE-5 inhibitors: A possible cellular stress etiology. 2009

Maddox, Patrick T / Saunders, James / Chandrasekhar, Sujana S. ·Department of Surgery, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA. ptm@hitchcock.org ·Laryngoscope · Pubmed #19507217.

ABSTRACT: OBJECTIVES: Phosphodiesterase-5 (PDE) inhibitors are a relatively new class of drugs introduced in 1998 for the treatment of erectile dysfunction and pulmonary artery hypertension. Recent concerns regarding these drugs and sudden sensorineural hearing loss (SSHL) have resulted in an FDA requirement for more stringent labeling. In this report, we further investigate the potential link between SSHL and use of these drugs. STUDY DESIGN: Report of two cases and review of FDA postmarketing data. METHODS: Retrospective review. RESULTS: Twenty-five patients were evaluated in our study with a variable amount of information available on each patient. Fifteen patients (88%) experienced the event within 24 hours of taking a PDE-5 inhibitor. Eight patients (32%) had associated vertigo concurrently with their hearing loss. Ninety-six percent of reported cases were unilateral. Complete resolution of hearing was noted in five patients (20%), whereas three other patients (12%) had at least partial improvement. Therefore, eight patients (32%) had documented improvement in their hearing from initial presentation. CONCLUSIONS: Although the data are inconclusive, there is a potential link between PDE-5 inhibitor use and SSHL. Otolaryngologists should, therefore, inquire regarding PDE-5 inhibitor use as a potential cause of SSHL. Although there is currently no direct evidence for a mechanism of this side effect, we postulate that it is related to the prolonged effects of intracellular cyclic guanosine monophosphate (cGMP) within the cochlea.

12 Minor In reference to Intratympanic dexamethasone injection for refractory tinnitus: prospective placebo-controlled study. 2014

Chandrasekhar, Sujana S. ·New York Otology, New York, New York. ·Laryngoscope · Pubmed #24089258.

ABSTRACT: -- No abstract --