Hypothermia Facilitates Hearing Restoration in the Treatment of Severe Sudden Deafness

  • Kiyofumi Gyo
  • Nobuhiro Hakuba
  • Kenichiro Koga


Idiopathic sudden sensorineural hearing loss (sudden deafness) that occurs in 27,000 cases a year in Japan, mainly involves adults in 50 and 60 years in age and devastates their quality of life. Although it is supposed to have many different origins, including disturbance of vascular circulation, viral infection, rupture of the membranous labyrinth and immune-mediated disorder, the exact etiology remains undetermined. We think disturbance of vascular circulation is the basic cause of this disease, since it occurs suddenly without preceding any sign or symptom. At present, management of sudden deafness is controversial. Various therapeutic agents such as steroid, vasodilators, diuretics, anticoagulants, contrast agents, and carbogen inhalation, have been attempted as a single therapy or as a combination therapy, aiming to alleviate cellular ischemia to the inner ear. According to recent double blind randomized control studies [1-5], there is no specific agent or treatment, which might dramatically restore hearing. Sudden deafness is thought to heal spontaneously in two thirds of the patients as a natural history, however, complete recovery rate remains in the range of 24-63% by a single therapy [6], when hearing impairment is more than 40 dB in pure tone average in speech frequencies and the treatment starts within 14 days after the onset.


Hearing Loss Pure Tone Average Tympanic Temperature Hair Cell Loss Ginkgo Biloba Extract 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Kronenberg J, Almagor M, Bendet E, et al. (1992) Vasoactive therapy versus placebo in the treatment of sudden hearing loss: A double-blind clinical study. Laryngoscope 102; 65–68PubMedCrossRefGoogle Scholar
  2. 2.
    Probst R, Tschopp K, Ludin E, et al. (1992) A randomized, double-blind, placebo- controlled study of dextran/ pentoxifylline medication in acute acoustic trauma and sudden hearing loss. Acta Otolaryngol (Stockh) 112; 435–443CrossRefGoogle Scholar
  3. 3.
    Reisser CH and Wedauer H (2001) Ginkgo biloba extract Egb761 or pentoxifylline for the treatment of sudden deafness: A randomized, reference-controlled, double blind study. Acta Otolaryngol (Stockh) 121; 579–584CrossRefGoogle Scholar
  4. 4.
    Tucci DL, Farmer JC, Kitch RD, et al. (2002) Treatment of sudden sensorineural hearing loss with systemic steroids and valacyclovir. Otology Neurotol 23; 301–308CrossRefGoogle Scholar
  5. 5.
    Ogawa K, Takei S, Inoue Y, et al. (2002) Effect of prostaglandin El on idiopathic sudden sensorineural hearing loss: a double-blinded clinical study. Otol Neurotol 23; 665–668,PubMedCrossRefGoogle Scholar
  6. 6.
    Kanzaki J, Inoue Y, Ogawa K, et al. (2003) Effect of single-drug treatment on idiopathic sudden sensorineural hearing loss. Auris Nasus Larynx 30; 123–7PubMedCrossRefGoogle Scholar
  7. 7.
    Busto R, Dietrich WD, Globus MYT, et al. (1987) Small differences in intraischemic brain temperature critically determine the extent of ischemic neuronal injury. J Cerebr Blood Flow Metab 7; 729–738CrossRefGoogle Scholar
  8. 8.
    Welsh FA, Sims RE, Harris VA (1990) Mild hypothermia prevents ischemic injury in gerbil hippocampus. J Cerebr Blood Flow Metab 10; 557–563CrossRefGoogle Scholar
  9. 9.
    Watanabe F, Koga K, Hakuba N, et al. (2001) Hypothermia prevents hearing loss and progressive hair cell loss after transient cochlear ischemia in gerbils. Neuroscience 102; 639–645PubMedCrossRefGoogle Scholar
  10. 10.
    Rothman S (1984) Synaptic release of excitatory amino acid neurotransmitter mediates anoxic neuronal death. Neuroscience 4; 1884–1891PubMedGoogle Scholar
  11. 11.
    Taniguchi M, Hakuba N, Koga K, et al. (2002) Apoptotic hair cell death after transient cochlear ischemia in gerbils. Neuroreport 13; 245–262CrossRefGoogle Scholar
  12. 12.
    Koga K, Hakuba N, Watanabe F, et al. (2003) Transient cochlear ischemia causes delayed cell death in the organ of Corti: An experimental study in gerbils. J Comp Neurol 456; 105–111PubMedCrossRefGoogle Scholar
  13. 13.
    Hakuba N, Matsubara A, Hyodo J, et al. (2003) AMPA/kainate-type glutamate receptor antagonist reduces progressive inner hair cell loss after transient cochlear ischemia. Brain Res 25: 979; 194–202CrossRefGoogle Scholar
  14. 14.
    Hyodo J, Hakuba N, Koga K, et al. (2001) Hypothermia reduces glutamate efflux in perilymph following transient cochlear ischemia. Neuroreport 12; 1983–1987PubMedCrossRefGoogle Scholar
  15. 15.
    Kawabata A and Tokura H (1996) Effects of two kinds of pillow on thermoregulatory responses during night sleep. Appl Human Sci 15; 155–159PubMedCrossRefGoogle Scholar
  16. 16.
    Okamoto-Mizuno K, Tsuzuki K, Mizuno K (2003) Effects of head cooling on human sleep stages and body temperature. Int J Biometeorol 48; 98–102PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Tokyo 2004

Authors and Affiliations

  • Kiyofumi Gyo
    • 1
  • Nobuhiro Hakuba
    • 1
  • Kenichiro Koga
    • 1
  1. 1.Department of OtolaryngologyEhime UniversityEhimeJapan

Personalised recommendations