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A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery
Indexed/Abstracted in: EMBASE, Scopus
Otorinolaringologia 2004 December;54(4):185-92
The role of improved blood viscosity after fibrinogen adsorption in the treatment of sudden hearing loss
Kleinjung T. 1, Ullrich H. 2,3, Steffens T. 1, Jacob P. 1, Strutz J. 1
1 Department of Otorhinolaryngology University of Regensburg, Germany
2 Institute for Clinical Chemistry and Laboratory Medicine University of Regensburg, Germany
3 Institute of Transfusion Medicine University of Hamburg, Germany
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Aim. The pathology of sudden sensorineural hearing loss (SSNHL) is still controversial. Several studies suggest microcirculatory disturbances as main underlying factors. The aim of our study was to investigate the effect of fibrinogen adsorption in patients with unilateral sudden sensorineural hearing loss. Lowering of the plasma fibrinogen level leads to a decreased plasma and whole blood viscosity.
Methods. Extracorporeal selective adsorption of fibrinogen from plasma using the TheraSorb™-Rheo Fibrinogen Adsorber (Miltenyi Biotec, Bergisch-Gladbach, Germany) was performed on a maximum of 3 sessions, depending on the recovery of auditory function. Treatments were scheduled to take place on days 1, 3 and 5. Fibrinogen concentration in plasma was measured before and after each apheresis session. Auditory function was documented by pure tone audiometry before and after each treatment. All the patients were followed up at 2 weeks, 4 weeks and 3 months.
Results. The mean plasma fibrinogen concentration of the 20 patients before the first apheresis session was 308.1±51.5 mg/dL. After the first treatment session the fibrinogen concentration was lowered to 100.7±25.3 mg/dL (p<0.001). Primary endpoint was the improvement of pure tone threshold. Directly after the end of treatment the relative mean hearing loss with reference to the non-affected ear showed an improvement from 35.2 dB to 11.8 dB (p<0.001). During follow-up measurements the complete recovery rate increased to 80% after 4 weeks.
Conclusion. Our findings indicate that selective fibrinogen adsorption can be an effective method in the treatment of sudden sensorineural hearing loss.