Sudden Sensorineural Hearing Loss During Pregnancy:A 21 cases report

ZENG Xiangli; HE Jiancheng; LI Peng; LI Yongqi; CEN Jintian; LI Zhicheng; ZHANG Gehua

doi:10.3969/j.issn.1672-2922.2014.02.05

Abstract：Objectives To report clinical characteristics of sudden sensorineural hearing loss in pregnant women and dis-cuss on safe and effective treatments for this special population. Methods This is a retrospective analysis of characteristics, treatment procedures and effectiveness in 21 pregnant women with sudden deafness seen from June 2005 to December 2013. The criteria of 2005 Jinan conference was used for diagnosis of sudden deafness. The treatment effectiveness and hearing recov-ery were recorded during the treatment. Treatment protocols:Careful watching in the outpatient office with no treatment was the approach in 2 cases with only low-mid frequency hearing loss of 3 days or less. The rest 19 cases received either daily intrave-nous injection of low molecular dextran-40 (500 ml for a course of 14 days) with oral prednisone (starting at 1 mg/kg to a maxi-mum of 60 mg/day followed by a 10 mg reduction every 3 days), or puerarin injectable (250 ml daily) and same oral prednisone as above for those who were allergic to low molecular dextran-40. The treatment would be stopped upon determination of hear-ing recovery. Ultrasound was used to monitor for fetal deformity, hypoevolutism or low body weight during treatment by an ob-stetrician. The conditions of the mother and baby were followed up for more than 6 months, including the mother’s liver and re-nal functions and hearing, and the growth development, intelligence and hearing of the baby. Results Hearing evaluation before treatment showed low-mid frequency sloping loss (n=6), flat loss (n=7), total loss (n=5), basin shaped loss (n=1), peak shaped loss (n=1), and groove shaped low (n=1). Post-treatment hearing showed complete recovery in 13 cases, significant recovery in 3 cases, partial recovery in 2 cases, and no recovery in 3 cases. All mothers and babies were in excellent health after a period of 6 months to 5 years follow-up. Conclusions Treatment in pregnant women with sudden deafness must be individualized. Low molecular dextran-40, prednisone and puerarin are effective and safe in these patients with little adverse reactions in either the mother or the fetus. Mild and moderate low-mid frequency sudden deafness is prone to recover spontaneously. Careful observa-tion and follow-up on an outpatient basis is the first choice for the patients whose sudden deafness is less than 3 days.