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

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.

Download Full-text

Analysis of hearing improvement in patients with severe to profound sudden sensorineural hearing loss according to the level of pure tone hearing threshold

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-011-1864-8 ◽

2011 ◽

Vol 269 (9) ◽

pp. 2057-2060 ◽

Cited By ~ 7

Author(s):

Seok Min Hong ◽

Young Gil Ko ◽

Chan Hum Park ◽

Jun Ho Lee ◽

Ji Heui Kim

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Pure Tone ◽

Hearing Threshold ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Hearing Improvement

Download Full-text

Effect of intratympanic dexamethasone injection in sudden idiopathic sensorineural hearing loss

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20163477 ◽

2016 ◽

Vol 2 (4) ◽

pp. 258

Author(s):

K. Mallikarjuna Swamy ◽

Arati Ganiger

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Pure Tone ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Hearing Improvement ◽

Pure Tone Audiogram ◽

Intravenous Steroid ◽

A Prospective Study ◽

Intratympanic Dexamethasone

Background: The aim of this study is to assess the effect of intratympanic dexamethasone injection (ITDI) in patients with idiopathic sudden sensorineural hearing loss (ISSNHL).Methods: A prospective study was conducted on 40 patients refractory to intravenous steroid therapy between May 2012 to March 2014. Intratympanic dexamethasone injection was given every week for 3 consecutive weeks. Hearing was assessed by performing pure tone audiogram before every ITDI and also 1 week after the completion of treatment.Results: Hearing improvement was seen in 27 out of the 40 cases (68%).Conclusions: Intratympanic dexamethasone significantly improves the prognosis of ISSNHL and is a safe, inexpensive and effective treatment in ISSNHL.

Download Full-text

Comparison of 2 Different Intratympanic Methylprednisolone Injection Schedules in Combination With Intravenous Dexamethasone for Unilateral Sudden Sensorineural Hearing Loss

Ear Nose & Throat Journal ◽

10.1177/0145561320904816 ◽

2020 ◽

pp. 014556132090481

Author(s):

Yanlu Lyu ◽

Fanqian Zeng ◽

Min Yan ◽

Zhou Zhou ◽

Wei Zhang ◽

...

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Pure Tone ◽

Hearing Threshold ◽

Retrospective Chart Review ◽

Neck Surgery ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Systemic Steroid ◽

Once Daily

Sudden sensorineural hearing loss is a common otologic disease in clinic. Systemic and intratympanic steroid treatment have been proved to be effective, but the regimens vary from center to center. The purpose of the study is to analyze the effects of the combined application of intravenous dexamethasone and intratympanic methylprednisolone injection in different time strategies for the treatment of unilateral sudden sensorineural hearing loss. A retrospective chart review was performed for the period from March 2016 to June 2018 at our Department of Otorhinolaryngology—Head and Neck Surgery. A total number of 61 patients who met the academy criteria for unilateral sudden hearing loss were included and grouped based on the time to introduce intratympanic methylprednisolone. All the patients received intravenous dexamethasone 10 mg once daily for 5 days, followed 5 mg once daily for the next 7 days. Intratympanic methylprednisolone (40 mg) was injected every other day 4 times into all patients. This regimen was commenced on day 1 in group 1 and on day 6 in group 2. The pre and posttreatment pure-tone audiograms were analyzed. Sixty-one patients met our inclusion criteria. No significant differences were observed between patients’ demographics or pretreatment hearing thresholds. In the 3 months posttreatment pure-tone audiogram assessment, the mean hearing threshold improvement were similar between groups with no frequency specificity. The curative rate in both groups were similar and satisfying. Two patients with diabetes mellitus had persistent small perforations. Some patients had other transient discomfort that disappeared before discharge. The different timing of initiation of intratympanic methylprednisolone injection does not significantly affect the outcome of the treatment for sudden sensorineural hearing loss. Thus, we suggest that intratympanic steroid injection should not be applied as a first-line method except for patients who do not respond early to systemic steroid therapy.

Download Full-text

A study of clinical and audiometric profile in patients presenting with sudden sensorineural hearing loss

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20171189 ◽

2017 ◽

Vol 3 (2) ◽

pp. 336

Author(s):

Vinod M. K. ◽

Amanjot Kaur ◽

Jagdeepak Singh ◽

Jatinder Singh ◽

Kulwinder Singh Sandhu ◽

...

Keyword(s):

Hearing Loss ◽

Prognostic Factors ◽

Sensorineural Hearing Loss ◽

Pure Tone ◽

Randomized Study ◽

Pure Tone Audiometry ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Unknown Etiology ◽

Maximum Improvement

Background: To assess the clinical and audiometric profile in patients presenting with sudden sensorineural hearing loss (SSNHL).The study also aimed to find out any possible etiology of SSNHL, prognostic factors and effectiveness of treatment. Prospective, open label, randomized study conducted in department of ENT at the Ram Lal eye and ENT hospital attached to Government medical college, Amritsar, Punjab, India.Methods: 50 patients of either sex aged between 18 to 50 years suffering from unilateral or bilateral onset SSNHL included in the study on the basis of predetermined clinical criteria. The hearing assessments of patients were done before and after the treatment with tuning fork tests, pure-tone and impedance audiometry. Results: Most of the patients of SSNHL presented with unknown etiology. Steroid treatment gave a statistically significant improvement in pure tone averages. Maximum improvement is observed in patients who started treatment within one month of developing SSNHL. Post-treatment outcomes were not influenced by age of the patient and type of the pure tone audiometry graph. The presence of vertigo and diabetes are bad prognostic factors for hearing outcome in SSNHL.Conclusions: Most of the cases of sudden sensorineural hearing loss have unknown etiology. Patients with associated DM and vertigo are having poor recovery of hearing. Early starting of treatment gives maximum improvement of hearing.

Download Full-text

A Smartphone-Based Approach to Screening for Sudden Sensorineural Hearing Loss: Cross-Sectional Validity Study

JMIR mhealth and uhealth ◽

10.2196/23047 ◽

2020 ◽

Vol 8 (11) ◽

pp. e23047

Author(s):

Heng-Yu Haley Lin ◽

Yuan-Chia Chu ◽

Ying-Hui Lai ◽

Hsiu-Lien Cheng ◽

Feipei Lai ◽

...

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Gold Standard ◽

Pure Tone ◽

Pure Tone Audiometry ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Clinical Settings ◽

Cross Sectional ◽

Scale Difference

Background Sudden sensorineural hearing loss (SSNHL) is an otologic emergency that warrants urgent management. Pure-tone audiometry remains the gold standard for definitively diagnosing SSNHL. However, in clinical settings such as primary care practices and urgent care facilities, conventional pure-tone audiometry is often unavailable. Objective This study aimed to determine the correlation between hearing outcomes measured by conventional pure-tone audiometry and those measured by the proposed smartphone-based Ear Scale app and determine the diagnostic validity of the hearing scale differences between the two ears as obtained by the Ear Scale app for SSNHL. Methods This cross-sectional study included a cohort of 88 participants with possible SSNHL who were referred to an otolaryngology clinic or emergency department at a tertiary medical center in Taipei, Taiwan, between January 2018 and June 2019. All participants underwent hearing assessments with conventional pure-tone audiometry and the proposed smartphone-based Ear Scale app consecutively. The gold standard for diagnosing SSNHL was defined as the pure-tone average (PTA) difference between the two ears being ≥30 dB HL. The hearing results measured by the Ear Scale app were presented as 20 stratified hearing scales. The hearing scale difference between the two ears was estimated to detect SSNHL. Results The study sample comprised 88 adults with a mean age of 46 years, and 50% (44/88) were females. PTA measured by conventional pure-tone audiometry was strongly correlated with the hearing scale assessed by the Ear Scale app, with a Pearson correlation coefficient of .88 (95% CI .82-.92). The sensitivity of the 5–hearing scale difference (25 dB HL difference) between the impaired ear and the contralateral ear in diagnosing SSNHL was 95.5% (95% CI 87.5%-99.1%), with a specificity of 66.7% (95% CI 43.0%-85.4%). Conclusions Our findings suggest that the proposed smartphone-based Ear Scale app can be useful in the evaluation of SSNHL in clinical settings where conventional pure-tone audiometry is not available.

Download Full-text