The Effects of Prognostic Factors in Idiopathic Sudden Hearing Loss

Introduction Sudden hearing loss is one of the otologic emergencies. The treatment of this disease is affected negatively by some prognostic factors. Objective In this study, the effects of early treatment initiation in patients with idiopathic sudden hearing loss and of prognostic factors in early treated patients were investigated. Methods Out of the 216 patients admitted between September 2007 and September 2015, 154 were identified as having idiopathic sudden hearing loss; they were followed-up for a mean time of 7.4 months, and evaluated retrospectively. The effects of several parameters on the success of the treatment were statistically evaluated, such as the time the treatment was initiated, being of the female gender, the severity of the hearing loss, having descending type audiogram patterns, being older than 60 years old, and the co-presence of vertigo. Results Success rates were found to be significantly higher in idiopathic hearing loss patients that were admitted within the first week (p < 0.05) of the onset of the hearing loss. However, the outcomes were found to be similar when patients admitted within the first 3 days and 4–7 days after the occurrence of the hearing loss were compared (p > 0.05). Parameters such as female gender, severe hearing loss, descending type audiogram, being older than 60 years old, and co-presence of vertigo didn't reveal statistically significant effects on the outcome (p >0.05). Conclusion The aforementioned prognostic factors, which are well-known in the literature, did not have significant effects when the idiopathic sudden hearing loss treatment was initiated within the first 7 days of the onset of the hearing loss.

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A hirtelen halláscsökkenés javulásában szerepet játszó prognosztikai faktorok vizsgálata

Orvosi Hetilap ◽

10.1556/650.2019.31368 ◽

2019 ◽

Vol 160 (18) ◽

pp. 687-693

Author(s):

Márton Kovács ◽

János Uzsaly ◽

Gréta Bodzai ◽

Kinga Harmat ◽

Adrienne Németh ◽

...

Keyword(s):

Cardiovascular Disease ◽

Hearing Loss ◽

Prognostic Factors ◽

Sensorineural Hearing Loss ◽

High Frequency ◽

Epidemiological Data ◽

Sudden Hearing Loss ◽

Sudden Sensorineural Hearing Loss ◽

Older Age ◽

Severe Hearing Loss

Abstract: Sudden sensorineural hearing loss is defined as a greater than 30 dB deterioration in at least 3 consecutive frequencies occurring within 72 hours. The disease is mostly idiopathic and needs an urgent treatment. Between 01. 01. 2015 and 31. 12. 2016, 149 patients with sudden hearing loss were admitted to the Department of Otorhinolaryngology, University of Pécs. The epidemiological data, the prognostic factors and the outcome of the treatment were retrospectively analyzed. Isolated high frequency (p = 0.012) and less severe hearing loss (p<0.001), older age (p = 0.005), comorbodities like cardiovascular disease (p = 0.009) and diabetes (p = 0.029) were found as negative prognostic factors. Time of introduction of the treatment, gender, and side of the affected ear did not influence the outcome. Our finding was mainly congruent to the literature. Orv Hetil. 2019; 160(18): 687–693.

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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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Impact of prognostic factors on recovery from sudden hearing loss

The Journal of Laryngology & Otology ◽

10.1017/s0022215107005683 ◽

2007 ◽

Vol 121 (11) ◽

pp. 1035-1040 ◽

Cited By ~ 34

Author(s):

A Ceylan ◽

F Çelenk ◽

Y K Kemaloğlu ◽

Y A Bayazıt ◽

N Göksu ◽

...

Keyword(s):

Hearing Loss ◽

Prognostic Factors ◽

Recovery Rate ◽

Pure Tone ◽

Degrees Of Freedom ◽

Sudden Hearing Loss ◽

Systemic Diseases ◽

Speech Discrimination ◽

Hearing Gain ◽

Pre Treatment

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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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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Development, Prediction, and Treatment of Anemia in Patients (pts) with Lymphoma/Multiple Myeloma (L/M): Findings of Two European Surveys (ECAS and BEPOS).

Blood ◽

10.1182/blood.v104.11.3133.3133 ◽

2004 ◽

Vol 104 (11) ◽

pp. 3133-3133

Author(s):

Heinz Ludwig ◽

Simon Van Belle ◽

Pere Gascón

Keyword(s):

At Risk ◽

Multiple Myeloma ◽

Treatment Initiation ◽

Risk Model ◽

Predictive Accuracy ◽

Hematologic Malignancy ◽

Performance Status ◽

Female Gender ◽

Mean Time ◽

Anemia Treatment

Abstract Quality of life (QOL) in cancer pts is adversely affected by several factors, including disease- or treatment-related anemia. Between January 2001 and February 2002, the European Cancer Anaemia Survey (ECAS) was conducted to provide information on pervasiveness of cancer-related anemia, impact of anemia on WHO performance status, risk factors for its development, and anemia treatment practices in Europe. Briefly, a total of 15,370 pts were enrolled, of whom 2,360 had L/M. Data analysis showed 53% of L/M pts were anemic (hemoglobin [Hb] <12 g/dL) at enrollment and 73% were anemic at some time during the survey. Low Hb levels correlated significantly with WHO performance scores of 3 or 4 (P <0.001, R =.352). The ECAS data were additionally analyzed to determine patient and disease characteristics that predicted anemia development and to construct a model for identifying pts at risk. Using logistic regression on the L/M incidence group (pts who were not anemic and not being treated for cancer at enrollment, started chemotherapy [CT] during ECAS, and had at least 2 CT cycles during the survey), 4 variables were found to significantly predict anemia development. Initial Hb, persistent/recurrent disease, female gender, and intent to treat or treatment with platinum-based CT were found to independently predict anemia (P <0.001), with an area under the ROC curve of 0.821 (95% CI; 0.763–0.878), indicating acceptable predictive accuracy of the model. Three levels of risk (low [24%], moderate [51%], and high [72%]) for developing anemia were calculated from the model (χ2(2) = 112.6, P <0.001). Mean time required for anemia development was 9.0 wks to reach Hb of <12 g/dL, 11.1 wks to reach Hb of <11 g/dL, and 13.3 wks to reach Hb of <10 g/dL. Notably, only 46% of anemic L/M pts received anemia treatment. Subsequently, a recent (2003) survey, the Belgian Erythropoietin Survey (BEPOS), extended the information gained through ECAS by examining use of recombinant human erythropoietin (rHuEPO) in pts receiving CT. Specifically, BEPOS documented when rHuEPO treatment was started, dosing schedules and dosage adjustments, length of treatment, impact of iron supplementation on rHuEPO treatment, and outcomes. Patients enrolled had either solid tumors (non-small-cell lung cancer, breast cancer) or hematologic malignancies (multiple myeloma [MM], Hodgkin’s disease [HD], non-Hodgkin’s lymphoma [NHL]). Interim results suggest that 72% of BEPOS pts began rHuEPO during the first 2 CT cycles, with an overall median Hb value of 10.1 g/dL at treatment initiation. For hematologic malignancy pts, the median Hb at treatment initiation was ~10 g/dL for HD; in NHL and MM, the median Hb was >9 to <10 g/dL. Mean time for all pts to achieve a 2-g/dL increase in Hb in the absence of transfusion was 6.4 wks; mean time for NHL pts (6.3 wks) was similar, while mean time for MM pts (9.1 wks) was longer, more in line with that seen in clinical trials. Achievement of the 2-g/dL increase in Hb after 6.4 wks determined in BEPOS is consistent with increases of ~1 g/dL after 4 wks and ~2 g/dL after 8 wks noted in studies of epoetin alfa (Demetri 1998, Gabrilove 2001, Littlewood 2001). Using the large ECAS database, an anemia risk model has been established that should help identify pts at risk for anemia, so that administration of rHuEPO can be initiated expeditiously, before Hb declines to considerably lower levels and/or anemia symptoms, including impaired QOL, develop.

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