Classification and hearing evolution of patients with sudden sensorineural hearing loss

Abstract

The aim of this study was to analyze clinical aspects, hearing evolution and efficacy of clinical treatment of patients with sudden sensorineural hearing loss (SSNHL). This was a prospective clinical study of 136 consecutive patients with SSNHL divided into three groups after diagnostic evaluation: patients with defined etiology (DE, N = 13, 10%), concurrent diseases (CD, N = 63, 46.04%) and idiopathic sudden sensorineural hearing loss (ISSHL, N = 60, 43.9%). Initial treatment consisted of prednisone and pentoxifylline. Clinical aspects and hearing evolution for up to 6 months were evaluated. Group CD comprised 73% of patients with metabolic decompensation in the initial evaluation and was significantly older (53.80 years) than groups DE (41.93 years) and ISSHL (39.13 years). Comparison of the mean initial and final hearing loss of the three groups revealed a significant hearing improvement for group CD (P = 0.001) and group ISSHL (P = 0.001). Group DE did not present a significant difference in thresholds. The clinical classification for SSNHL allows the identification of significant differences regarding age, initial and final hearing impairment and likelihood of response to therapy. Elevated age and presence of coexisting disease were associated with a greater initial hearing impact and poorer hearing recovery after 6 months. Patients with defined etiology presented a much more limited response to therapy. The occurrence of decompensated metabolic and cardiovascular diseases and the possibility of first manifestation of auto-immune disease and cerebello-pontine angle tumors justify an adequate protocol for investigation of SSNHL.

Sudden Sensorioneural Hearing Loss and Autoimmune Systemic Diseases

“…Whereas this systemic immune-mediated change is a possible cause of hearing loss in such patients, according to the literature, only 10 to 29% of sudden SNHL have a defined etiology. 12 24 Given the difficulty to confirm the diagnosis, and mainly the lack of criteria for this diagnosis, we chose not to include possible immune-mediated hearing loss, which are not associated with SAD but confirmed with rheumatologic criteria and laboratory tests in this analysis. This way, the prevalence of sudden sensorineural hearing loss with immune-mediated etiology should be even greater.…”

Acupuncture in Treating Sudden Sensorineural Hearing Loss: A Report of 2 Cases

“…Only about 10% of cases have an identifiable cause [4]. Besides hearing loss, most patients have tinnitus and fullness of the ear [5].…”

Constraint-induced sound therapy for sudden sensorineural hearing loss – behavioral and neurophysiological outcomes

“…In around 10% of SSHL patients8 an identifiable cause can be defined, such as Ménière's disease9, head trauma, autoimmune inner ear disease1011, Cogan's syndrome1213, genetic diseases14, ototoxic drugs15, retrocochlear disorders related to vestibular schwannoma16, auditory neuropathy17, or stroke18. The remaining 90% of cases are often classified as suffering from idiopathic SSHL.…”