[otorri.] =?iso-8859-1?Q?Re:_=5Botorri.=5D_SURDEZ_S=DABITA_-_PROTOCOLO_de_TRATAMENTO?=

Wed, 25 Oct 2000 20:30:33 -0700

Caro Aur�lio,
 
    Encontrei os seguintes resumos sobre acyclovir X surdez s�bita. Infelizmente acho que n�o ser�o de grande ajuda em rela��o � unimed... 
 
   

Id: 99266731 Autor: Stokroos RJ; Albers FW; Schirm J Endere�o: Department of Otorhinolaryngology, University Hospital Groningen, The Netherlands T�tulo: Therapy of idiopathic sudden sensorineural hearing loss: antiviral treatment of experimental herpes simplex virus infection of the inner ear Fonte: Ann Otol Rhinol Laryngol; 108(5):423-8, 1999 May. ISSN: 0003-4894 Pa�s de publica��o: UNITED STATES Idioma: Eng Resumo: Experimental herpes simplex virus type 1 (HSV-1) labyrinthitis provides a model of idiopathic sudden sensorineural hearing loss (ISSHL). Corticosteroids improve the prognosis for hearing recovery in ISSHL, but the effects of acyclovir are unknown. To establish the therapeutic efficacy of acyclovir (Zovirax) and prednisolone in experimental HSV-1 viral labyrinthitis, we induced HSV-1 labyrinthitis in 12 guinea pigs. Three animals received no treatment, 3 received prednisolone, 3 received acyclovir, and 3 received both. Four other animals served as controls, receiving culture medium only. Hearing, HSV-1 antibody titers, and cochlear damage were evaluated. The HSV-1 labyrinthitis caused hearing loss within 24 hours. Combination treatment consisting of prednisolone and acyclovir resulted in earlier hearing recovery and less extensive cochlear destruction compared to prednisolone or acyclovir as a monotherapy. The beneficial effect of this treatment modality remains to be demonstrated in ISSHL (Au) Tipo de publica��o: JOURNAL ARTICLE Nome de subst�ncia: 0 (Antiviral Agents); 0 (Glucocorticoids, Synthetic); 50-24-8 (Prednisolone); 59277-89-3 (Acyclovir)

Id: 96336727 Autor: Hughes GB; Freedman MA; Haberkamp TJ; Guay ME Endere�o: Department of Otolaryngology and Communicative Disorders, Cleveland Clinic Foundation, Ohio 44195, USA T�tulo: Sudden sensorineural hearing loss Fonte: Otolaryngol Clin North Am; 29(3):393-405, 1996 Jun. ISSN: 0030-6665 Pa�s de publica��o: UNITED STATES Idioma: Eng Resumo: Approximately 4000 new cases of sudden hearing loss (SHL) occur annually in the United States, and 15,000 annually worldwide, accounting for approximately 1% of all cases of SHL. Although prevalence studies do not necessarily distinguish between idiopathic and acquired SHL, most cases of spontaneous SHL have no identifiable cause. In this article, the authors assess the cause, history, diagnosis, and treatment of SHL (Au) Tipo de publica��o: JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL Nome de subst�ncia: 396-01-0 (Triamterene); 53-03-2 (Prednisone); 58-93-5 (Hydrochlorothiazide); 59277-89-3 (Acyclovir)

93245811 Autor: Chand RP; Jan A; Vyas H T�tulo: Acute sensorineural deafness following herpes simplex infection [letter] Fonte: Eur J Pediatr; 152(4):379, 1993 Apr. ISSN: 0340-6199 Pa�s de publica��o: GERMANY Idioma: Eng Tipo de publica��o: LETTER Nome de subst�ncia: 59277-89-3 (Acyclovir)

Id:

98393272

Autor:

Stokroos RJ; Albers FW; Tenvergert EM

Endere�o:

Department of Otorhinolaryngology, University Hospital, Groningen, The Netherlands

T�tulo:

Antiviral treatment of idiopathic sudden sensorineural hearing loss: a prospective, randomized, double-blind clinical trial

Fonte:

Acta Otolaryngol; 118(4):488-95, 1998 Jul.

ISSN:

0001-6489

Pa�s de publica��o:

NORWAY

Idioma:

Eng

Resumo:

A subclinical viral labyrinthitis has been postulated in the literature to elicit Idiopathic Sudden Sensorineural Hearing Loss. An etiological role for the herpes virus family is assumed. Corticosteroids possess a limited beneficial effect on hearing recovery in ISSHL. In this study, the therapeutic value of the antiherpetic drug aciclovir (Zovirax) on hearing recovery in 44 ISSHL patients receiving prednisolone is evaluated in a multicentre clinical trial. The study is designed prospectively, randomized, double-blind and placebo-controlled. Subjective parameters include hearing recovery, a pressure sensation on the affected ear, disequilibrium or vertigo and tinnitus. Audiometric parameters include pure tone and speech audiometry. A one-year follow up is obtained. Both the pressure sensation and disequilibrium or vertigo have a good prognosis, but tinnitus, occurring in most patients, has a poor prognosis. Hearing recovery prognosis depends on the severity of initial hearing loss, and not on vestibular involvement. No beneficial effect from combining aciclovir with prednisolone can be established in ISSHL (Au)

Tipo de publica��o:

CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL

Nome de subst�ncia:

0 (Anti-Inflammatory Agents, Steroidal); 0 (Antiviral Agents); 50-24-8 (Prednisolone); 59277-89-3 (Acyclovir)

Sauda��es,

Jorge Pierre, Crato-CE

 

----- Original Message -----
 
 
 
Sent: Wednesday, October 25, 2000 3:49 PM
Subject: [otorri.] SURDEZ S�BITA - PROTOCOLO de TRATAMENTO

Caros colegas gostaria de receber refer�ncias bibliogr�ficas sobre condutas em SURDEZ S�BITA.
 
H� cerca de 1 ano internei um paciente com Surdez S�bita e fiz o PROTOCOLO ensinado aqui pelo Prof. Ricardo Bento [ DEXTRAN + DECADRON + ZOVIRAX ] e me recordo bem que n�o havia nada ainda confirmado sobre o uso do acyclovir em casos iniciais onde n�o houvesse suspeita de acometimento viral, mas que pela experi�ncia pessoal do Prof. poderia haver uma melhora do quadro se iniciado at� o 5 � dia .
 
O problema que enfrento no momento � com a auditoria da UNIMED , pois segundo os mesmos a conta ficou car�ssima e n�o h� nenhuma REFER�NCIA BIBLIOGR�FICA que respalde a minha prescri��o.  CONCLUS�O : GLOSARAM a CONTA .
 
Passo no momento por uma situa��o vexat�ria  no hospital ,  na unimed e com o paciente e seus familiares.
 
Agrade�o antecipadamente a ajuda de todos.
Aur�lio 
 

Responder a