Recovery of Idiopathic Sudden Sensorineural Hearing Loss

Abstract

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.

Oral and intratympanic steroid therapy for idiopathic sudden sensorineural hearing loss

“…In a similar regression analysis for patients receiving combined oral1IT having greater than 30 dB improvement in PTA, age was not statistically correlated with outcomes. 8 In earlier literature, older age in treated ISSNHL patients tends to be associated with a worse prognosis [12][13][14][15] or no change in hearing improvement. [16][17][18] One prospective, longitudinal cohort study of 127 ISSNHL patients found no significant difference in PTA recovery rates in the various age groups studied (30, 31-50, 51-70, 71 years old), but did note a trend in poorer results in the more extreme age groups (30, 71 years old) 19 Attanasio et al 20 found increased age was associated with worse hearing outcomes in their study of 496 patients; on subgroup analysis divided by age >65 years old, patients in the older subgroup had a statistically significant higher PTA both pre-and posttreatment.…”

Idiopathic Sudden Sensorineural Hearing Loss: Relatedness with Stress Perception, Coping Styles and Temperament and Personality Traits

“…In ISSHL, patients reported higher stress levels and more stressful life-events before the sudden hearing loss occurred when comparied with healthy controls. While certain single-case studies have reported the association between stress and ISSHL which used qualitative interviews as assessment instruments (14)(15)(16) . However, any standardized assesment methods were not found, and quantitative statistical analysis of the collected data was not performed Two other studies, which limited by method and design, had similar results (14,16) .…”

Does the addition of hyperbaric oxygen therapy to conventional treatment modalities influence the outcome of soldiers with idiopathic sudden sensorineural hearing loss?

“…Most patients with ISSNHL improve in hearing within 1 month after the beginning of hearing loss, but some patients improve within 4 months 4. Around 32%–65% of patients with ISSNHL may spontaneously recover their hearing,5 but treatment is still suggested because of the uncertainty of the outcome and the effects of hearing impairment on the quality of life. The aim in ISSNHL treatment is to decrease the inflammatory response and increase the blood supply and oxygen saturation 5.…”

“…Around 32%–65% of patients with ISSNHL may spontaneously recover their hearing,5 but treatment is still suggested because of the uncertainty of the outcome and the effects of hearing impairment on the quality of life. The aim in ISSNHL treatment is to decrease the inflammatory response and increase the blood supply and oxygen saturation 5. Despite there were being many possible treatment policies in current clinical practice nowadays, there is a lack of consensus about the definitive treatment for ISSNHL.…”