Impact of prognostic factors on recovery from sudden hearing loss

AbstractObjective:To define the impact of patient-related and audiovestibular parameters on the prognosis of sudden hearing loss.Methods:Eighty-three patients were included in this retrospective study. All were treated medically. We recorded the patients' demographic parameters, systemic diseases, time elapsed between onset of sudden hearing loss and initiation of treatment, tinnitus, vestibular symptoms, type of initial audiogram, pure tone averages and speech discrimination scores. For all patients, audiological measurements were performed on initial admission and at the completion of treatment on the 10th day.Results:There was no correlation between the hearing gain and recovery rate scores and patients' gender or age (p>0.05). However, a correlation was found between gender and relative hearing gain. Vertigo was not correlated with hearing gain and recovery rate scores (p<0.05). However, relative hearing gain correlated negatively with the presence of vertigo (−r=0.05, 81 degrees of freedom,p=0.043). Patients with <40 dB hearing loss on admission showed a better relative hearing gain (r=0.55, 81 degrees of freedom,p=0.03). Relative hearing gain correlated positively with better pre-treatment speech discrimination scores (r=0.82, 81 degrees of freedom,p=0.009) and negatively with poorer pre-treatment pure tone averages (−r=0.082, 81 degrees of freedom,p=0.009). There was no correlation between the scores for hearing gain, relative hearing gain and recovery rate and: systemic diseases (p>0.05); time elapsed between onset of sudden hearing loss and initiation of treatment (p>0.05); type of audiogram on initial admission (p>0.05), except for midfrequency type of audiogram; and tinnitus (p>0.05).Conclusions:The outcome of sudden hearing loss was unaffected by systemic disease, tinnitus or type of audiogram (except for midfrequency type). The following were poor prognostic factors in the outcome of sudden hearing loss: female gender, presence of vertigo, initiation of treatment more than seven days after onset of hearing loss, and >40 dB hearing loss on admission.

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Intratympanic Steroid Injection for Treatment of Idiopathic Sudden Hearing Loss

Otolaryngology ◽

10.1016/j.otohns.2005.05.015 ◽

2005 ◽

Vol 133 (2) ◽

pp. 251-259 ◽

Cited By ~ 81

Author(s):

William H. Slattery ◽

Laurel M. Fisher ◽

Zarina Iqbal ◽

Rick A. Friedman ◽

Nancy Liu

Keyword(s):

Clinical Trial ◽

Hearing Loss ◽

Adverse Events ◽

Pure Tone ◽

Steroid Injection ◽

Sudden Hearing Loss ◽

Oral Steroid ◽

Speech Discrimination ◽

Open Label ◽

Pure Tone Average

Objective. To conduct a clinical trial of intratympanic steroid injection for idiopathic sudden sensorineural hearing loss in subjects who failed oral steroid therapy. Study Design and Setting. Open-label methylprednisolone injection clinical trial in a tertiary neurotologic referral center. Twenty subjects (14 males; 6 females) received 4 injections within a 2-week period (4 days apart). Hearing, dizziness/p, and tinnitus were evaluated before and after treatment. Results. There were no serious unexpected adverse events and 2 types of expected adverse events (tympanic membrane perforation, nausea after injection). No increases in dizziness or tinnitus lasting longer than 24 hours were observed after injections. One of 20 (5%) improved to near-normal hearing. In addition, there was statistically significant improvement in 4-frequency pure-tone average and speech discrimination score at 1 month after treatment. Conclusion. Four intratympanic injections of methylprednisolone improved pure-tone average or speech discrimination scores for a subset of sudden hearing loss subjects that failed to benefit from oral steroids. Significance. A clinical trial of intratympanic injections for idiopathic sudden hearing loss was successfully completed and promising results were found.

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Effectiveness of hyperbaric oxygen therapy in idiopathic sudden hearing loss

The Journal of Laryngology & Otology ◽

10.1017/s0022215106001769 ◽

2006 ◽

Vol 120 (8) ◽

pp. 665-669 ◽

Cited By ~ 13

Author(s):

B Satar ◽

Y Hidir ◽

S Yetiser

Keyword(s):

Hearing Loss ◽

Hyperbaric Oxygen ◽

Pure Tone ◽

Sudden Hearing Loss ◽

Sudden Sensorineural Hearing Loss ◽

Improvement Rate ◽

Hearing Gain ◽

Pure Tone Average ◽

Number Of Patients ◽

Age Stratification

The aim of this study was to investigate the efficacy of hyperbaric oxygen (HBO) therapy in idiopathic sudden sensorineural hearing loss (ISSHL) by comparing hearing gain and improvement rate in patients who have been placed on both HBO and medical treatment (MT) (37 patients), and patients who have received MT only (17 patients). Both groups were compared with reference to pure tone average (PTA) and the number of patients who experienced hearing gain. Of 37 patients (40 ears) who received HBO + MT, 24 (60 per cent) experienced ≥ 10 decibels (dB) improvement in PTA compared to 13 (76.4 per cent) of 17 patients who were placed on MT only. Inter- or intra-group comparison of age stratification (<50 and ≥50 ages) did not produce significant differences in PTA and in the number of patients who experienced hearing gain.Although there are numerous studies showing efficacy of HBO therapy; this study did not reveal a trend in favour of HBO therapy.

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Clinical features and prognostic factors of pediatric idiopathic sudden hearing loss from moderate to profound degree

American Journal of Otolaryngology ◽

10.1016/j.amjoto.2021.103027 ◽

2021 ◽

Vol 42 (5) ◽

pp. 103027

Author(s):

Yi Wang ◽

Tongli Ren ◽

Jianghua Jing ◽

Na Gao ◽

Hui Zhao ◽

...

Keyword(s):

Hearing Loss ◽

Prognostic Factors ◽

Clinical Features ◽

Sudden Hearing Loss

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Early Posttreatment Audiometry Underestimates Hearing Recovery after Intratympanic Steroid Treatment of Sudden Sensorineural Hearing Loss

International Journal of Otolaryngology ◽

10.1155/2011/465831 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Benjamin J. Wycherly ◽

Jared J. Thompkins ◽

H. Jeffrey Kim

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Sudden Hearing Loss ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Speech Discrimination ◽

Case Review ◽

Retrospective Case ◽

Hearing Recovery ◽

History Of

Objective. To review our experience with intratympanic steroids (ITSs) for the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL), emphasizing the ideal time to perform follow-up audiograms.Methods. Retrospective case review of patients diagnosed with ISSNHL treated with intratympanic methylprednisolone. Injections were repeated weekly with a total of 3 injections. Improvement was defined as an improved pure-tone average ≥20 dB or speech-discrimination score ≥20%.Results. Forty patients met the inclusion criteria with a recovery rate of 45% (18/40). A significantly increased response rate was found in patients having an audiogram >5 weeks after the first dose of ITS (9/13) over those tested ≤5 weeks after the first dose of ITS (9/27) ().Conclusions. Recovery from ISSNHL after ITS injections occurs more frequently >5 weeks after initiating ITS. This may be due to the natural history of sudden hearing loss or the prolonged effect of steroid in the inner ear.

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Comparison of Pure-Tone Audiometry Analysis in Sudden Hearing Loss Studies

Otology & Neurotology ◽

10.1097/mao.0b013e31811515ae ◽

2007 ◽

Vol 28 (6) ◽

pp. 753-763 ◽

Cited By ~ 32

Author(s):

Stefan K. Plontke ◽

Michael Bauer ◽

Christoph Meisner

Keyword(s):

Hearing Loss ◽

Pure Tone ◽

Pure Tone Audiometry ◽

Sudden Hearing Loss

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Characteristics of Presbycusis in A Super-Aged Society

Otolaryngology Open Access Journal ◽

10.23880/ooaj-16000216 ◽

2021 ◽

Vol 6 (2) ◽

Author(s):

Hajime Sano

Keyword(s):

Hearing Loss ◽

High Frequency ◽

Pure Tone ◽

The Elderly ◽

Elderly Group ◽

Hearing Level ◽

Speech Discrimination ◽

Frequency Range ◽

Female Patients ◽

Male Patients

Objectives: To estimate presbycusis' characteristics and investigate whether any changes have occurred in the pathophysiology of presbycusis over the decades. Methods: This was a retrospective cross-sectional observational study. A total of 186 patients aged ≥ 65 years were selected for the elderly group; they included patients with mild-to-moderate sensorineural hearing loss of unknown cause. For the middle age group, 56 patients aged 30–50 years who had positive results for the recruitment phenomenon were selected as controls. The participants’ age, sex, pure-tone hearing levels of air conduction (125–8000 Hz), maximum speech discrimination score (SDSmax), and the presence or absence of the recruitment phenomenon were investigated based on medical records. Results: Sixty-one patients in the elderly group were aged ≥ 80 years. Hearing levels were significantly better in male patients in the low-frequency range and significantly better in female patients in the high-frequency range (p < 0.01). In the elderly group, the proportion of patients with poor speech discrimination was 52.4–70.2%. The SDSmax was significantly higher in female patients than in male patients (p < 0.01). The proportion of patients with the recruitment phenomenon was 93.5%. The audiometric hearing pattern was dominated by a gradual-down slope, high-frequency-impaired, and flat patterns. There were significantly more female patients with a flat pattern and significantly more male patients with a gradual-downslope pattern and U-shaped pattern (p < 0.01). Age, sex, mean pure-tone hearing level, and audiometric hearing pattern significantly affected the SDSmax (all, p < 0.05), as evaluated with multiple regression analysis. Conclusion: More than half of the elderly patients with mild or moderate hearing loss were estimated to have retrocochlear damage. The age of hospital visitors for presbycusis was found to have increased over time. However, the distribution of pathophysiologies was not different from that in previous studies performed with relatively younger patients. This suggests a shift of patients presenting with presbycusis toward an older age range.

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“Clinical Profile & Prognostic Factors In Patients with Sudden Sensorineural Hearing Loss”

International Journal Of Medical Science And Clinical Invention ◽

10.18535/ijmsci/v8i12.01 ◽

2021 ◽

Vol 8 (12) ◽

pp. 5830-5835

Author(s):

Md. Feroz Hossen ◽

Mahbubul Alam Choudhury

Keyword(s):

Hearing Loss ◽

Prognostic Factors ◽

Sensorineural Hearing Loss ◽

Pure Tone ◽

Winter Season ◽

Hearing Threshold ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Clinical Profile ◽

Pure Tone Audiogram

Introduction: Idiopathic sudden sensorineural hearing loss (ISSNHL) is an emergency disease requiring immediate diagnosis and treatment. The incidence of ISSNHL in the Western countries’ population was estimated to 5–20 per 100,000 inhabitants. The etiology of ISSNHL remains unknown. Its pathogenesis is most often suggested to be due to a disturbed microcirculation and infection. Objective: To study the clinical profile & prognostic factors in patients with sudden sensorineural hearing loss. Material and Methods: A retrospective study was carried out from patients of sudden sensineural hearing loss (SSNHL) presenting to ENT Department ofNorthern Private Medical College, Rangpur, Bangladesh from January to June-2020. All patients were given intravenous steroids as treatment modality for 14 days and pure tone audiogram was done every 3 days during hospital admission. It was followed by oral steroids in tapering dose for further 14 days. After 1 month, audiogram was done again. After 1 month if hearing threshold was decreased by more than 50% of presenting one, then it was labeled as improved. Results:Total 51 patients (55ears) with age ranging from 6-70 years (average-38.5 years) were included. Three fourth were male. Presentation was 1-14days after onset of hearing loss (average- 3.7days) with pure tone audiogram (PTA) of 38-117dB (average 83.1dB). The flat audiogram (62.3%) was most common type. Smoking was present in 14 patients and tinnitus in 30 ears. Hemoglobin ranged from 7.3-18.7gm %( average- 15.3gm/dl). PTA post treatment was 8-73dB (average- 56dB). Average age of improved patient was 39.8years which was lower than non-improved patients (42.3years). In improved patients, average PTA at presentation was 77.9dB while it was 86.6dB in non-improved patients. Conclusion: Our study demonstrates that the age distribution and clinical characteristics of ISSNHL patients vary according to levels of hearing loss. Moreover, ISSNHL patients with vertigo tend to sufer from a more severe hearing loss. Further studies are needed to obtain better knowledge about the etiopathogenesis of SSNHL. SSNHL is more commonly seen in male patients with polycythaemia and is commonly presented in winter season and is frequently associated with tinnitus. Young age and lower audiogram threshold at presentation favor prognosis.

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Audiometric Characteristics of Presbycusis: A Hospital-Based Study

Journal of Islamabad Medical & Dental College ◽

10.35787/jimdc.v10i3.543 ◽

2021 ◽

Vol 10 (3) ◽

pp. 169-175

Author(s):

Ghulam Saqulain ◽

Gul Zahra ◽

Nazia Mumtaz

Keyword(s):

Hearing Loss ◽

High Frequency ◽

Pure Tone ◽

Noise Exposure ◽

Pure Tone Audiometry ◽

Sampling Technique ◽

Rehabilitation Medicine ◽

Speech Discrimination ◽

Chi Square ◽

Severe Hearing Loss

Background: Presbycusis is related to degenerative changes of aging resulting from deficient cochlear microcirculation. It is characterized by bilateral, symmetrical, sensorineural hearing loss (SNHL) in which recruitment and speech discrimination is affected in the absence of noise exposure. The objective of this study was to analyze the pure tone audiogram characteristics in Presbycusis. Methods: This descriptive study recruited n=192 cases of presbycusis of both genders, aged 50 to 80 years with convenience sampling technique. The study was conducted at Yusra General Hospital and the National Institute of Rehabilitation Medicine, Islamabad from1st July 2017 to 30th September 2017. Pure tone audiometry was used to collect audiometric data. SPSS-24 was used for data analysis. Chi-square and Pearson’s correlation were used to determine association between variables with p < 0.05 taken as significant. Results: Pure tone audiometry revealed 58 (30.2%) right and 65 (33.9%) left ears with high frequency gently sloping audiogram, while the second commonest configuration being high frequency steeply sloping curve in 51(26.6%) right and 52(27.1%) left ears. There was a significant correlation between the configuration of the audiogram and age with p=0.000, while no significant correlation with gender (p=0.71). The majority,77 (40.10%) right and 71(36.98%) of left ears had moderately severe hearing loss, while severe hearing loss was second commonest with 60(31.25%) right and 70(36.46%) left ears affected. The severity of hearing loss had a significant (P=0.000) positive correlation with age but no significant relationship with gender. Conclusion: High frequency gently sloping audiogram was the commonest configuration followed by high frequency steeply sloping curve. Moderately severe hearing loss was most commonly seen followed by severe hearing loss.

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A Study of Prognostic Factors in Sudden Hearing Loss

Ear Nose & Throat Journal ◽

10.1177/014556130508401012 ◽

2005 ◽

Vol 84 (10) ◽

pp. 641-644 ◽

Cited By ~ 20

Author(s):

Aydin Mamak ◽

Süleyman Yilmaz ◽

Harun Cansiz ◽

Ender Inci ◽

Ender Güçlü ◽

...

Keyword(s):

Hearing Loss ◽

Prognostic Factors ◽

Prognostic Significance ◽

Sudden Hearing Loss ◽

Low Frequencies ◽

Factors Associated

We investigated the prognostic significance of the presence or absence of vertigo and tinnitus, the timing of the initiation of treatment, the type and severity of hearing loss, and age in 72 patients who had experienced sudden hearing loss. We found that the factors associated with a positive prognosis were the absence of vertigo, the presence of tinnitus, initiation of treatment within 7 days, a greater degree of hearing loss in the low frequencies, and a hearing loss of less than 45 dB. Age had no effect on prognosis.

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