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Syphilitic labyrinthitis--an update

Y M Chan1, D A Adams, A G Kerr

  • 1Department of Otolaryngology, Royal Victoria Hospital, Belfast, Northern Ireland.

The Journal of Laryngology and Otology
|August 1, 1995
PubMed
Summary
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Combined ampicillin and prednisone treatment effectively preserves hearing in patients with syphilitic labyrinthitis. This combination therapy, sometimes with ACTH, significantly reduces the progression to profound deafness.

Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Neurology

Background:

  • Syphilitic labyrinthitis can lead to progressive hearing loss and profound deafness.
  • Understanding the natural history of syphilitic labyrinthitis is crucial for interpreting treatment outcomes.

Purpose of the Study:

  • To evaluate the effectiveness of different treatment regimens for syphilitic labyrinthitis.
  • To assess the impact of ampicillin, prednisone, and ACTH on hearing preservation.

Main Methods:

  • Retrospective analysis of 48 patients with syphilitic labyrinthitis.
  • Follow-up periods ranging from six months to 25 years.
  • Comparison of hearing outcomes based on treatment with ampicillin alone, ampicillin plus prednisone, and ampicillin plus prednisone with ACTH injections.

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Main Results:

  • Ampicillin alone maintained useful hearing in 11 out of 11 ears.
  • Combined ampicillin and prednisone treatment preserved useful hearing in 28 out of 29 ears.
  • Addition of ACTH to ampicillin and prednisone maintained hearing in 16 out of 17 ears.
  • While some ears progressed to profound deafness, no patient with initial useful hearing became completely deaf.

Conclusions:

  • Combined ampicillin and prednisone therapy is superior to ampicillin alone for preserving hearing in syphilitic labyrinthitis.
  • Adjunctive ACTH may further enhance hearing preservation.
  • Treatment strategies should aim to prevent the progression to profound deafness in affected patients.