title: Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss.
abstract: Sudden sensorineural hearing loss (SSHL) is characterized by acute, idiopathic hearing loss. The estimated incidence rate is 5-30 cases per 100,000 people per year. The causes of SSHL and the mechanisms underlying SSHL currently remain unknown. Based on several hypotheses such as a circulatory disturbance to the cochlea, viral infection, and autoimmune disease, pharmaco-therapeutic approaches have been applied to treat SSHL patients; however, the efficacy of the standard treatment, corticosteroid therapy, is still under debate. Exposure to intense sounds has been shown to cause permanent damage to the auditory system; however, exposure to a moderate level enriched acoustic environment after noise trauma may reduce hearing impairments. Several neuroimaging studies recently suggested that the onset of SSHL induced maladaptive cortical reorganization in the human auditory cortex, and that the degree of cortical reorganization in the acute SSHL phase negatively correlated with the recovery rate from hearing loss. This article reports the development of a novel neuro-rehabilitation approach for SSHL, "constraint-induced sound therapy (CIST)". The aim of the CIST protocol is to prevent or reduce maladaptive cortical reorganization by using an enriched acoustic environment. The canal of the intact ear of SSHL patients is plugged in order to motivate them to actively use the affected ear and thereby prevent progress of maladaptive cortical reorganization. The affected ear is also exposed to music via a headphone for 6 hr per day during hospitalization. The CIST protocol appears to be a safe, easy, inexpensive, and effective treatment for SSHL.
authors: Department of Integrative Physiology, National Institute for Physiological Sciences; Department of Otolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences and Medical School.
authors: Kenichi
authors: K
authors: Sekiya
authors: Department of Otorhinolaryngology, Kansai Rosai Hospital.
authors: Munehisa
authors: M
authors: Fukushima
authors: Institute for Biomagnetism and Biosignalanalysis, University of Muenster; Institute for Epidemiology and Social Medicine, University of Muenster.
authors: Henning
authors: H
authors: Teismann
authors: Institute for Biomagnetism and Biosignalanalysis, University of Muenster.
authors: Lothar
authors: L
authors: Lagemann
authors: Department of Integrative Physiology, National Institute for Physiological Sciences; Sokendai Graduate University for Advanced Studies.
authors: Ryusuke
authors: R
authors: Kakigi
authors: Institute for Biomagnetism and Biosignalanalysis, University of Muenster.
authors: Christo
authors: C
authors: Pantev
authors: Department of Integrative Physiology, National Institute for Physiological Sciences; Institute for Biomagnetism and Biosignalanalysis, University of Muenster; Sokendai Graduate University for Advanced Studies; hokamoto@nips.ac.jp.
authors: Hidehiko
authors: H
authors: Okamoto
mesh_terms: D001303:Auditory Cortex / Q000503:physiopathology*; D003051:Cochlea / Q000503:physiopathology*; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000503:physiopathology / Q000534:rehabilitation*; D003639:Hearing Loss, Sudden / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D013016:Sound; D016896:Treatment Outcome