Heparin-induced extracorporal low-density-lipoprotein precipitation (HELP)to improve the recovery of hearing in patients with sudden idiopathic hearing loss

The pathogenesis of sudden hearing loss (SHL) is still not well understood. Possible causes include increased blood viscosity, microthrombosis or alte red blood flow. Hypercholesterolemia, hyperfibrinogenemia and increased pla telet aggregation are frequently observed in patients with SHL. The aim of this study was to investigate whether drastic lowering of plasma cholestero l and fibrinogen by selective extracorporal apheresis could have a benefici al effect on hearing recovery in these patients. Seven patients with SHL we re treated with an extracorporal procedure removing fibrinogen and choleste rol from plasma. Six of the seven patients showed an immediate improvement in auditory thresholds following a single treatment of heparin-induced low- density lipoprotein precipitation. These findings indicate for the first ti me that acute and drastic removal of plasma fibrinogen and low-density lipo proteins may be an effective clinical method for the treatment of patients with SHL.