Fibrinogen/LDL apheresis as successful second-line treatment of sudden hearing loss: a retrospective study on 217 patients.
BACKGROUND
Sudden sensorineural hearing loss (SSHL) may be caused by a reduction of cochlear perfusion. Cholesterol and fibrinogen negatively influence rheological properties of blood thus leading to alteration of microcirculation. Fibrinogen/LDL apheresis improves cochlear blood flow by acutely decreasing plasma cholesterol and fibrinogen.


METHODS
Remission rates of 217 patients with SSHL were analysed retrospectively after single apheresis. All patients had been treated otherwise before without any improvement of hearing. We investigated data in regard to frequency of hearing loss and time between onset of symptoms and apheresis.


RESULTS
15% of all patients had complete remissions, whereas partial remissions were seen in 46%. No change of hearing threshold was seen in 33%, 2% worsened. Remission rates decreased from 70% for a time of 2 weeks between onset of SSHL and apheresis to 63% and 21% for 6 weeks and 3 months.


CONCLUSIONS
The present study shows that apheresis was followed by complete or partial remissions in 61% of patients even as second line therapy. The window for good therapeutic success is approximately 6 weeks.
Heigl
Franz
F
Hettich & Partner, Medizinisches Versorgungszentrum Kempten-Allgäu, Kempten, Germany. heigl@mvz-kempten.de
Hettich
Reinhard
R
Suckfuell
Markus
M
Luebbers
Christian W
CW
Osterkorn
D
D
Osterkorn
K
K
Canis
Martin
M
D000158:Acoustic Impedance Tests; D000161:Acoustic Stimulation; D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D015415:Biomarkers / Q000097:blood; D001781:Blood Component Removal; D003051:Cochlea / Q000098:blood supply / Q000503:physiopathology*; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D005858:Germany; D006319:Hearing Loss, Sensorineural / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D003639:Hearing Loss, Sudden / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D018056:Hemorheology; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers; D008077:Lipoproteins, LDL; D005340:Fibrinogen