title: High fibrinogen in peripheral blood correlates with poorer hearing recovery in idiopathic sudden sensorineural hearing loss.
abstract: OBJECTIVE
  We used hearing tests and peripheral blood sample analyses to characterize the pathology of idiopathic sudden sensorineural hearing loss (ISSNHL) and to identify possible prognostic factors for predicting recovery of hearing loss.
  
  
  METHODS
  A retrospective, multicenter trial was conducted.
  
  
  METHODS
  Two hundred three patients examined within 7 days after the onset of ISSNHL received prednisone with lipo-prostaglandin E1. Pure-tone auditory tests were performed before and after treatment with these drugs. Blood tests were performed on blood samples collected during the patients' initial visit to our clinic.
  
  
  RESULTS
  In all patients, elevated white blood cell (WBC) counts, fasting blood sugar levels, HgbA1c, and erythrocyte sedimentation rate (ESR) significantly correlated with high hearing threshold measurements obtained on the initial visit. High fibrinogen levels, WBC counts, ESR, and low concentrations of fibrinogen degradation products (FDP) were associated with lower hearing recovery rates. Additionally, different audiogram shapes correlated with different blood test factors, indicating that different pathologies were involved.
  
  
  CONCLUSIONS
  High fibrinogen levels measured within seven days after ISSNHL onset correlated with poorer hearing recovery. This may be a consequence of ischemia or infections in the inner ear. The high WBC counts also observed may therefore reflect an immune response to inner ear damage induced by ischemic changes or infections. Our data indicate that therapeutic strategies should be selected based on the timing of initial treatment relative to ISSNHL onset.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Keio University, School of Medicine, Shinjuku, Tokyo, Japan.
authors.forename: Sho
authors.initials: S
authors.lastname: Kanzaki
authors.affiliation: Department of Otorhinolaryngology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Sakagami
authors.affiliation: Department of Otorhinolaryngology, Nara Medical University, Kashihara, Nara, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hosoi
authors.affiliation: Department of Otorhinolaryngology, Graduate School of Medical Sciences, Nagoya City University, Mizuho, Nagoya, Aichi, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Murakami
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Keio University, School of Medicine, Shinjuku, Tokyo, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Ogawa
mesh_terms: D000527:Alprostadil / Q000627:therapeutic use; D001301:Audiometry, Pure-Tone; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D005938:Glucocorticoids / Q000627:therapeutic use; D006319:Hearing Loss, Sensorineural / Q000097:blood* / Q000188:drug therapy; D003639:Hearing Loss, Sudden / Q000097:blood* / Q000188:drug therapy; D006801:Humans; D008297:Male; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D020127:Recovery of Function / Q000502:physiology*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D005340:Fibrinogen; D000527:Alprostadil; D011241:Prednisone