title: Prognostic predictors of sudden sensorineural hearing loss in defibrinogenation therapy.
abstract: CONCLUSIONS
  Defibrinogenation therapy rather than corticosteroids therapy should be chosen for patients specifically with profound hearing loss and with initial high fibrinogen.
  
  
  OBJECTIVE
  Corticosteroids therapy is the standard treatment for sudden sensorineural hearing loss (SSNHL) and prognostic factors by this therapy were reported. Defibrinogenation therapy is one of the treatment options for SSNHL. Aims of this study were to identify prognostic factors and correlative markers with hearing improvement in treating SSNHL by defibrinogenation therapy.
  
  
  METHODS
  During the early phase of the study, consecutive 61 patients were treated by defibrinogenation therapy with batroxobin (50 units), whereas corticosteroids (500 mg/day of hydrocortisone tapered by 9 days) were used for consecutive 64 patients during the late phase. Blood data that could predict a complete recovery were identified. Coagulation/fibrinolysis markers correlated with hearing improvement by defibrinogenation therapy were investigated.
  
  
  RESULTS
  Although there were no overall differences in hearing improvement between the two therapies, recovery rate in profound hearing loss patients was better in defibrinogenation therapy. In patients who showed complete recovery, serum fibrinogen level before treatment was significantly higher in the defibrinogenation group than the corticosteroid group. Responses of several fibrinolysis markers to defibrinogenation therapy evaluated by post-/pre-values were negatively correlated with hearing improvement.
authors.affiliation: a Department of Otorhinolaryngology Head and Neck Surgery , Osaka University Graduate School of Medicine , Osaka , Japan.
authors.forename: Ryohei
authors.initials: R
authors.lastname: Oya
authors.affiliation: b Department of Otolaryngology Head and Neck Surgery , Niigata University Graduate School of Medical and Dental Sciences , Niigata , Japan.
authors.forename: Arata
authors.initials: A
authors.lastname: Horii
authors.affiliation: c Department of Otolaryngology , Higashiosaka City General Hospital , Higashiosaka , Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Akazawa
authors.affiliation: d Department of Otolaryngology , Suita Municipal Hospital , Suita , Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Osaki
authors.affiliation: a Department of Otorhinolaryngology Head and Neck Surgery , Osaka University Graduate School of Medicine , Osaka , Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Inohara
mesh_terms: D000305:Adrenal Cortex Hormones / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D012103:Batroxobin / Q000494:pharmacology / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D005260:Female; D005343:Fibrinolytic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D006309:Hearing / Q000187:drug effects; D006319:Hearing Loss, Sensorineural / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D003639:Hearing Loss, Sudden / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D015415:Biomarkers; D005343:Fibrinolytic Agents; D012103:Batroxobin
keywords: Sudden sensorineural hearing loss; coagulation; corticosteroids; defibrinogenation; fibrinolysis; prognostic factor