Abstract
ObjectivesWe used hearing tests and peripheral blood sample analyses to characterize the pathology of idiopathic sudden sensorineural hearing loss (ISSNHL) and to identify possible prognostic factors for predicting recovery of hearing loss.Study DesignA retrospective, multicenter trial was conducted.MethodsTwo hundred three patients examined within 7 days after the onset of ISSNHL received prednisone with lipo-prostaglandin E1. Pure-tone auditory tests were performed before and after treatment with these drugs. Blood tests were performed on blood samples collected during the patients’ initial visit to our clinic.ResultsIn all patients, elevated white blood cell (WBC) counts, fasting blood sugar levels, HgbA1c, and erythrocyte sedimentation rate (ESR) significantly correlated with high hearing threshold measurements obtained on the initial visit. High fibrinogen levels, WBC counts, ESR, and low concentrations of fibrinogen degradation products (FDP) were associated with lower hearing recovery rates. Additionally, different audiogram shapes correlated with different blood test factors, indicating that different pathologies were involved.ConclusionsHigh fibrinogen levels measured within seven days after ISSNHL onset correlated with poorer hearing recovery. This may be a consequence of ischemia or infections in the inner ear. The high WBC counts also observed may therefore reflect an immune response to inner ear damage induced by ischemic changes or infections. Our data indicate that therapeutic strategies should be selected based on the timing of initial treatment relative to ISSNHL onset.
Highlights
Idiopathic sudden sensorineural hearing loss (ISSNHL) is characterized by a sudden onset of hearing loss and generally presents unilaterally [1]
High fibrinogen levels measured within seven days after ISSNHL onset correlated with poorer hearing recovery
The high white blood cell (WBC) counts observed may reflect an immune response to inner ear damage induced by ischemic changes or infections
Summary
Idiopathic sudden sensorineural hearing loss (ISSNHL) is characterized by a sudden onset of hearing loss and generally presents unilaterally [1]. Little is known about the pathogenesis of ISSNHL. Many studies have identified factors that predict which patients possess a favorable prognosis and require minimal or no treatment. Only a few studies have determined the probability of whether a patient’s hearing will recover by using prognostic models that incorporate probability data [4]. Several reports have investigated the prognostic value of certain factors, such as the timing of initial treatment, initial hearing levels, absence or presence of accompanying vertigo, and audiogram profiles [4,5,6,7,8]. Audiogram profiles may indicate different pathologies that lead to cochlear lesions as well as different prognoses
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