Abstract
The purpose of this retrospective study was to analyze the clinical characteristics and document hearing recovery in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). 122 patients diagnosed with unilateral ISSNHL, from March 2009 to December 2014, were treated with oral steroids and pentoxifylline. Hearing change was evaluated by comparing pre-treatment and post-treatment pure-tone average (PTA) (500, 1K, and 2K Hz), and categorized into complete, partial, and no recovery of hearing. T-test, Wilcoxon Signed Rank test and Regression analysis were employed to analyze the statistical significance. Of the 122 patients, seventy-one (58%) had complete recovery and 34 (28%) had partial recovery. The average pre-treatment PTA was 78.3±16.9 dB whereas post-treatment average was 47.0±20.8 dB, showing statistically significant improvement (t=24.89, P≤0.001). The factors such as presence of tinnitus (P=0.005) and initial milder hearing loss (P=0.005) were found to be significant predictors for hearing recovery. Conventional steroid regimes produced a recovery rate in ISSNHL, which exceeds the spontaneous recovery rate. The current study results highlight the importance of medical treatment in the management of ISSNHL.
Highlights
Idiopathic sudden sensorineural hearing loss (ISSNHL) is an often under-recognized medical emergency that the Otolaryngologists and Audiologists come across frequently
Presentation to a physician and early initiation of treatment improves the prognosis for hearing recovery.[3] analysis, manuscript preparation; PPK, concept, study design, The incidence of ISSNHL has been estimated to range data acquisition, manuscript revision; SS, study design, data between 5 and 20 cases per 100,000 people per year.[4]
Academy of Otolaryngology-Head and Neck Surgery Foundation ly (AAO-HNSF) guidelines recommends that clinicians may offer corticosteroids as initial therapy to patients with ISSNHL.[4] n Several prognostic factors have been investigated in various o studies, including age of the patient, presence of concomitant vestibular symptoms, degree of hearing loss, audiometric configue ration, and time between the onset of hearing loss and initiation of s treatment.[3,13]
Summary
Idiopathic sudden sensorineural hearing loss (ISSNHL) is an often under-recognized medical emergency that the Otolaryngologists and Audiologists come across frequently. Academy of Otolaryngology-Head and Neck Surgery Foundation ly (AAO-HNSF) guidelines recommends that clinicians may offer corticosteroids as initial therapy to patients with ISSNHL.[4] n Several prognostic factors have been investigated in various o studies, including age of the patient, presence of concomitant vestibular symptoms, degree of hearing loss, audiometric configue ration, and time between the onset of hearing loss and initiation of s treatment.[3,13] There is no consensus regarding the actual influence u of these factors on the clinical outcome.[14,15,16,17,18] Since ISSNHL is still l a medical dilemma, in terms of its associated symptoms, prognosia tic indicators and hearing recovery following treatment, there is a need to study these characteristics, for better understanding and c management of this condition. Tapering dose of prednisolone for fourteen days was administered, which is consistent with the AAO-HNSF clinical practice guidelines.[4]
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