{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:21:09Z","timestamp":1760955669495},"reference-count":81,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2009,10,20]],"date-time":"2009-10-20T00:00:00Z","timestamp":1255996800000},"content-version":"vor","delay-in-days":11038,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[1979,8]]},"abstract":"<jats:p>Cochleovestibular dysfunction may occur as the only manifestation of late syphilis. It may occur singly, in combination, and be unilateral or bilateral. A presumptive diagnosis may be made on the basis of excluding other known etiologies of inner ear dysfunction and on a positive serological test for syphilis. The combined experience of the author and a literature review suggests that a combination of penicillin and prednisone is the treatment of choice. Since no controlled clinical trials have been reported, antibiotic and corticosteroid dosage, timing and route of administration are conjectural. All patients with a presumptive diagnosis of late otitic syphilis should be treated regardless of previous syphilitic treatment. Duration of symptoms and magnitude of functional loss are not contraindications. Penicillin is the antibiotic of choice and the minimal treatment should be the United States Public Health Service schedule for late syphilis, i.e., benzathine penicillin G, 2.4 million units by intramuscular injection weekly for three successive weeks. Since penicillin acts on dividing cells only and since treponemes probably divide very slowly in late syphilis, prolonged penicillinemia is desirable. This may be maintained with injectable depo\u2010penicillin (benzathine penicillin G) or penicillin by mouth, depending upon patient compliance. Duration of treatment of one year is suggested. Prednisone, 40 to 60 mgm\/day by mouth is started and continued for at least two weeks. If symptomatic improvement occurs the dose is tapered to a level which will maintain this improvement.<\/jats:p>","DOI":"10.1002\/lary.1979.89.8.1273","type":"journal-article","created":{"date-parts":[[2017,2,27]],"date-time":"2017-02-27T12:10:36Z","timestamp":1488197436000},"page":"1273-1288","source":"Crossref","is-referenced-by-count":34,"title":["Late Syphilitic Hearing Loss: A Diagnostic and Therapeutic Dilemma"],"prefix":"10.1002","volume":"89","author":[{"given":"Gary D.","family":"Becker","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2009,10,20]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1966.00760020020008"},{"key":"e_1_2_1_3_1","first-page":"262","volume-title":"Pathology of the Ear","author":"Schuknecht H. 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