Prognostic factors in sudden sensorineural hearing loss: a retrospective study using interaction effects

Cho, Chin-Saeng; Choi, Young–Jin

doi:10.5935/1808-8694.20130083

Cited by 26 publications

(21 citation statements)

References 17 publications

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“…In our study, 55 patients (26.8%) had accompanying vestibular symptoms, but no significant correlation to prognosis was noted. This result was also supported by some previous reports [15,17,23,25,26] .…”

Section: Discussionsupporting

confidence: 91%

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Recovery of Idiopathic Sudden Sensorineural Hearing Loss

Edızer¹,

Çelebi²,

Hamit³

et al. 2015

Int Adv Otol

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OBJECTIVE:The objective was to identify and evaluate factors that may influence the recovery rate in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). MATERIALS and METHODS:A retrospective analysis was performed for patients with sudden sensorineural hearing loss between 2009 and 2013. Those with an identified etiology were excluded. The patients were divided into four treatment groups: (i) systemic corticosteroids (SC) only, (ii) SC+low-molecular-weight heparin (LMWH), (iii) SC+hyperbaric oxygen (HBO), and (iv) SC+LMWH+HBO. Recovery was evaluated according to Siegel's criteria. Age, initial hearing level, onset, treatment and audiogram types, comorbidities, and associated tinnitus and vestibular symptoms were investigated for their impact on prognosis. RESULTS:Two hundred five patients with ISSNHL were included. Recovery was seen in 59% of the patients. The complete recovery rate was significantly lower in patients older than 60 years and in patients presenting with profound hearing loss. Different audiogram curves had no significant effect on recovery. Sudden hearing loss was accompanied by tinnitus in 107 (52.1%) patients and vestibular symptoms in 55 (26.8%); however, neither was noted to affect prognosis. Different treatment combinations did not significantly affect prognosis. However, hypertension and a delay in treatment by more than 10 days from the onset of hearing loss were associated with a worse prognosis. CONCLUSION:Profound hearing loss, older than 60 years, a delay in treatment by more than 10 days, and hypertension were negative prognostic factors in this study, whereas, the type of audiogram curve and addition of HBO to SC did not affect prognosis.

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Section: Discussionsupporting

confidence: 91%

“…The correlation between the degree of initial hearing loss and recovery has been well established [1,2,16,22,23] . In the present study, patients presenting profound hearing loss had the highest rate of no recovery (45.9%) compared with a complete recovery rate of 6.6%.…”

Section: Discussionmentioning

confidence: 99%

Recovery of Idiopathic Sudden Sensorineural Hearing Loss

Edızer¹,

Çelebi²,

Hamit³

et al. 2015

Int Adv Otol

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“…24 Cho reported that the clinical characteristics of patients with vertigo do no directly affect hearing improvement in cases of SSNHL; however, vertigo influences SSNHL via an interaction with the initial hearing levels. 34 Our research results also supported this association; we observed greater recovery among patients without vertigo.…”

Section: Vertigosupporting

confidence: 84%

Sudden sensorineural hearing loss: role of hyperbaric oxygen therapy

et al. 2017

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Sudden sensorineural hearing loss is defined as an acute hearing reduction of 30 dB or more, in at least three consecutive frequencies, occurring within 3 days of symptom onset. There is no consensus on the best treatment option. The aims of this paper were to evaluate the effectiveness of a treatment protocol based on medical therapy combined with hyperbaric oxygen therapy and to examine the factors that influence the recovery of hearing (age, gender, the amount of time between the onset of symptoms and the initiation of treatment -time since onset -, audiometric curve type and objective vertigo). Audiometric results were evaluated according to Siegel's criteria. In patients treated also with hyperbaric oxygen therapy we observed complete resolution in 44.1% of the patients, partial resolution in 37.2%, slight improvement in 10.5% and no improvement in 8.2% of the patients. This resolution pattern was significantly different from that observed in the patients treated only with medical therapy. The factors associated with a better prognosis were young age, rapid intervention, upward sloping or pantonal audiometric patterns and the absence of objective vertigo. Gender appeared to be an insignificant factor. Medical treatment associated with hyperbaric oxygen therapy gives better results in terms of hearing gain compared to exclusive medical treatment.

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“…Its mechanism of action in sudden hearing loss is not thoroughly understood. It is known to reduce inflammation and edema, but its role on mineralocorticoid receptors and regulation of ion homeostasis of inner ear fluids might be even more significant [18] . Mineralocorticoids regulate ion homeostasis in endolymph, which is required for endocochlear membrane potential and thus normal cochlear function [19] .…”

Section: Introductionmentioning

confidence: 99%

“…Mineralocorticoids regulate ion homeostasis in endolymph, which is required for endocochlear membrane potential and thus normal cochlear function [19] . Glucocorticoids help to restore ion homeostasis, since they have a strong affinity to mineralocorticoid receptors in the inner ear [18] .…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Two Vasoactive/Vasodilative Agents in Combination with Corticosteroid for Treatment of Sudden Sensorineural Hearing Loss

Kordiš¹,

Žargi²,

Battelino³

2015

Int Adv Otol

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OBJECTIVE:Idiopathic sudden sensorineural hearing loss (ISSNHL) or sudden deafness is considered an otologic emergency. In spite of numerous investigations, its cause and treatment remain uncertain. Vascular hypothesis is one of the accepted etiologic theories, and vasodilator agents have been used to treat this medical condition. MATERIALS and METHODS:We conducted a retrospective study in which we have compared the efficiency of two vasoactive/vasodilative agents-pentoxifylline and betahistine-separately and together for treatment of sudden deafness in 59 patients. Methylprednisolone was used in all three groups. Hearing threshold (HT) was measured, and pure tone average (PTA) was calculated on admission, after 1 week, and after 3 months. RESULTS:Hearing improvement was noticed in 33 out of 59 patients (56%) at the second follow-up with a mean PTA improvement of 20 dB. The best recovery rate was seen in the pentoxifylline + steroid group (69%) versus the pentoxifylline + betahistine + steroid group (55%) and betahistine + steroid group (48%). There was no statistically significant difference in treatment outcome (p=0.433) between all three groups. Methylprednisolone dosage was 32, 48, or 64 mg/day. The amount of steroid given was not statistically significant for recovery of hearing loss (HL) (p=0.418). CONCLUSION:The pentoxifylline with methylprednisolone group achieved the best results. In that group, 67% of patients improved at the first follow-up versus 69% after 3 months. Statistically, there was no significant difference in treatment outcome between all three groups (p=0.433). Greater PTA improvement was seen at higher doses of steroid. The amount of steroid given was not found to have a statistically significant influence on hearing recovery (p=0.418).

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Prognostic factors in sudden sensorineural hearing loss: a retrospective study using interaction effects

Abstract: The clinical characteristics of patients with vertigo did not directly affect hearing improvement with SSNHL; however, vertigo had an influence on SSNHL though its interaction with the initial hearing levels.

Cited by 26 publications

References 17 publications

Recovery of Idiopathic Sudden Sensorineural Hearing Loss

Recovery of Idiopathic Sudden Sensorineural Hearing Loss

Sudden sensorineural hearing loss: role of hyperbaric oxygen therapy

A Comparison of Two Vasoactive/Vasodilative Agents in Combination with Corticosteroid for Treatment of Sudden Sensorineural Hearing Loss

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