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Considerations on anatomy and pathophysiological notions concerning the inner ear

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ABSTRACT

Sudden hearing loss is a medical emergency requiring immediate clinical and laboratory tests, as well as an adequate and quickly established treatment. Sudden hearing loss is disabling for the patient and its perma- nence has implications on the patient’s quality of life. According to literature data, the earliness of treatment initiation is directly correlated to therapeutic results. An individual response to therapy exists, which is due to anatomical particularities: individual vascular pat- tern, poor vascularity and fragility of cochlear vascular- ization, as well as the existence of some malformations. The knowledge of the pathophysiological mechanisms of brain ischemia led to a new paradigm in the modern therapeutic protocols for acute and aggravated stroke: the neural growth factors. Nerve growth factors are a modern and advanced therapeutic approach through multimodal effects: neuroprotector, neurotrophic and neuroregenerative effects.

Key words: cochlear vasculature, nerve growth factor, cochlear ischemia, sudden hearing loss treatment.

Abbreviations: NGF Nerve growth factor, SHL – Sudden hearing loss, BDNF – Brain-derived neurotrophic factor, AICA – anterior-inferior cerebel- lar artery, LTP/LDP – long-term potentiation/depres- sion, Ang 1 – Angiopoietin 1, tPA – tissue plasminogen activator, Shh – Sonic Hedgehog, miRs – microRNAs.

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Iulia Burghiu-Hobeanu and Viorel Zainea

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