Prognostic Factors for the Hearing Outcome in Patients with Profound Idiopathic Sudden Sensorineural Hearing Loss (ISSHL) Receiving the Triple Combined Therapy

Abstract

The aim of this study was to identify prognostic factors for the hearing outcome in patients with profound ISSHL pure tone average : PTA !90dB receiving triple combined therapy, namely, intravenous steroid IVS , hyperbaric oxygen HBO , and intratympanic steroid ITS. Between August , 2010 and September , 2017, 136 patients 72 men and 64 women with profound ISSHL were started on the triple combined therapy within days from the onset. The hearing outcome was assessed based on the Ministry of Health, Labour and Welfare of Japan Study. The prognostic factors for the hearing outcome were retrospectively examined by multivariate analyses. Complete recovery, significant recovery, slight recovery, and no change were observed in 21 patients 15.4% , 71 patients 52.2% , 31 patients 22.8% , and 13 patients 9.6% , respectively. Hearing recovery from ISSNHL was significantly associated with the initial pure tone threshold p 0.05 , but not with the age p 0.05 or interval to the start of treatment p 0.05. Receiver operating characteristic ROC curve analysis revealed a cut off level of the initial pure tone threshold of 104dB. Better overall hearing improvement was observed in the group with an initial pure tone threshold of under 104dB as compared to the group with a threshold of over 105dB p 0.05. Furthermore, hearing improvement in all the frequencies examined was significantly better in the group with an initial threshold of under 104dB p 0.05. Hearing recovery from ISSNHL was significantly associated with the initial pure tone threshold. The cut off level for this threshold was determined to be 104dB.