Tran Ba Huy P, Sauvaget E
Service d'ORL, Hôpital Lariboisière, 75010 Paris cedex, France.
Ann Otolaryngol Chir Cervicofac. 2007 Jun;124(2):66-71. doi: 10.1016/j.aorl.2006.12.003.
To evaluate the influence of the treatment delay for sudden sensorineural hearing loss (SSHL) on the final hearing recovery and the prognostic value of the audiometric shapes and the hearing recovery at the end of treatment.
Prospective study including 321 patients admitted in the emergency care center for a recent idiopathic SSHL. Classification according to the audiometric shape in 5 types. All patients received steroids (1 mg/kg per day) and, in case of ascending shape, steroids and mannitol during 6 days. Hearing recovery was evaluated according to the following parameters: 1) hearing recovery (initial PTA-PTA at D6 or D30); 2) incidence of hearing recovery (initial PTA-PTA at D6 or D30)/initial PTA x 100%).
Whatever the audiometric type, delay in initiating treatment did not have any influence on the final outcome. Audiometric classification had a good prognostic value, since the ascending shape had a better hearing recovery than descending shape or the sub or total anacusis. Hearing recovery at D6 is a prognostic factor on the final outcome.
Idiopathic SSHL cannot be considered, nowadays, as an otologic emergency.
评估突发性感音神经性听力损失（SSHL）治疗延迟对最终听力恢复的影响，以及听力图形状和治疗结束时听力恢复的预后价值。
前瞻性研究，纳入321例因近期特发性SSHL入住急诊护理中心的患者。根据听力图形状分为5种类型。所有患者均接受类固醇治疗（每天1mg/kg），对于听力图呈上升型的患者，在6天内同时给予类固醇和甘露醇治疗。根据以下参数评估听力恢复情况：1）听力恢复（第6天或第30天的初始纯音平均听阈 - 纯音平均听阈）；2）听力恢复发生率（（第6天或第30天的初始纯音平均听阈 - 纯音平均听阈）/初始纯音平均听阈×100%）。
无论听力图类型如何，开始治疗的延迟对最终结果均无任何影响。听力图分类具有良好的预后价值，因为上升型的听力恢复优于下降型或部分或完全失聪型。第6天的听力恢复是最终结果的一个预后因素。
如今，特发性SSHL不能被视为耳科急症。
