Early hearing improvement predicts the prognosis of idiopathic sudden sensorineural hearing loss.

Abstract

PURPOSE:

To determine pre- and post-treatment factors that are useful for predicting the prognosis of hearing improvement in idiopathic sudden sensorineural hearing loss (ISSHL).

METHODS:

This retrospective study included 332 patients with ISSHL. Patients received intravenous steroid treatment (prednisolone sodium succinate; 120 mg/day followed by dose tapering). Complete recovery of hearing levels was defined as a final pure-tone audiometry of ≤ 20 dB HL or the same level as the contralateral ear. Patients' age; sex; side of hearing loss; initial hearing level; days from onset to treatment; presence of vertigo, diabetes, and hypertension; and hearing improvement on days 3-4 and 6-7 after treatment initiation were analyzed as potential prognostic factors.

RESULTS:

Overall, 109 patients (32%) had complete recovery. Results of the multivariate logistic regression model identified age (odds ratio [OR] = 0.974), initial hearing level (OR = 0.949), vertigo (OR = 0.409), and hearing improvement on days 6-7 after treatment initiation (OR = 1.11) as significant independent predictors of complete recovery. Age ≥ 60 years, initial hearing level ≥ 72.5 dB HL, and vertigo contributed to poor prognosis. Patients without these three factors and a hearing improvement of ≥ 10 dB HL on days 6-7 post-treatment had a complete recovery rate of 80%. Only 1.5% of the patients with 2-3 of these factors and a hearing improvement of < 10 dB HL on days 6-7 after treatment initiation achieved complete recovery.

CONCLUSION:

Age, initial hearing level, vertigo, and hearing improvement on days 6-7 after treatment initiation were independent predictors of hearing recovery in ISSHL.

• Authors: Marie N Shimanuki, Seiichi Shinden, Naoki Oishi, Noriomi Suzuki, Kaho Iwabu, Tsubasa Kitama, Amina Kida, Koji Sakamoto, Kaoru Ogawa
• Journal: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (Eur Arch Otorhinolaryngol) Vol. 278 Issue 11 Pg. 4251-4258 (Nov 2021) ISSN: 1434-4726 [Electronic] Germany
• PMID: 33389010 (Publication Type: Journal Article)
• Copyright: © 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.

Chemical References

• Glucocorticoids

Topics

• Audiometry, Pure-Tone
• Glucocorticoids
• Hearing
• Hearing Loss, Sensorineural (diagnosis, drug therapy)
• Hearing Loss, Sudden (diagnosis, drug therapy)
• Humans
• Middle Aged
• Prognosis
• Retrospective Studies
• Treatment Outcome
• Vertigo (diagnosis, drug therapy)