Sodium enoxaparin and venovenous hemofiltration for treatment of sudden sensorineural hearing loss and tinnitus.
Abstract
The pathogenesis of sudden sensorineural hearing loss (SNHL) and tinnitus are still not well understood. Prompted by such observations, we implemented a protocol using sodium enoxaparin associated with a venovenous hemofiltration for treatment of sudden hearing loss and tinnitus.
The venovenous hemofiltration selectively eliminates fibrinogen, low-density lipoprotein, cholesterol, triglycerides, lipoprotein and complement from the blood plasma by means of extracorporal circulation. The reduction of these macromolecules immediately improves the hemorheological situation and leads to a significant decrease of plasma viscosity and red cell transmission time.
Patients, who had suffered from SNHL and tinnitus, have been analysed. Hemofiltration was performed at the first and last day of the protocol while, to begin since the second day of the protocol, sodium enoxaparin was administered subcutaneously at a dose of 4000 I.U. once a day for 10 days.
Every day all patients underwent the following instrumental examinations: liminar tonal audiometry; otoacoustic emission; otoacoustic products of distortion. Blood tests where performed at the beginning, after the fist day and at the end of the treatment.
After the first hemofiltration, all the patients with complete auditive recovery have been discharged without receiving the treatment with sodium enoxaparin.
Specifically excluded were patients with abnormal known coagulation.
