Handzel Ophir, Ben-Ari Oded, Damian Doris, Priel Maayan M, Cohen Jacob, Himmelfarb Mordechai
The Cochlear Implant Program, Department of Otolaryngology/Head, Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
Audiol Neurootol. 2013;18(4):201-7. doi: 10.1159/000349913. Epub 2013 May 14.
Sudden sensorineural hearing loss (SSNHL) can cause significant morbidity. Treatment with steroids can improve outcome. Delay in initiation of treatment reduces the chance to regain hearing. For this reason SSNHL is considered an emergency. Diagnosis is based on history, physical examination and a standard audiogram, the latter requiring specialized equipment and personnel. Standard audiogram may not be available at the time and place of patient presentation. A smartphone or tablet computer-based hearing test may aid in the decision to prescribe steroids in this setting. In this study the uHear™ hearing test application was utilized. The output of this ear-level air conduction hearing test is reported in hearing grades for 6 frequencies ranging from 250 to 6000 Hz. A total of 32 patients with unilateral SSNHL proven by a standard audiogram were tested. The results of standard and iPod hearing tests were compared. Based on the accepted criterion of SSNHL (at least 30 dB loss - or 2 hearing grades - in 3 consecutive frequencies) the test had a sensitivity of 0.76 and specificity of 0.91. Using a less stringent criterion of a loss of 2 hearing grades over at least 2 frequencies the sensitivity was 0.96 and specificity 0.86. The correlation coefficient for the comparison of the average hearing grade across the 6 measured frequencies of the study and standard audiogram was 0.83. uHear more accurately reflected hearing thresholds at mid and high tones. Similarly to previously published data, low frequency thresholds could be artificially elevated. In conclusion, uHear can be useful in the initial evaluation of patients with single-sided SSNHL by providing important information guiding the decision to initiate treatment before a standard audiogram is available.
突发性感音神经性听力损失（SSNHL）可导致严重的发病率。使用类固醇治疗可改善预后。延迟开始治疗会降低听力恢复的机会。因此，SSNHL被视为一种急症。诊断基于病史、体格检查和标准听力图，后者需要专门的设备和人员。在患者就诊时和就诊地点可能无法进行标准听力图检查。基于智能手机或平板电脑的听力测试可能有助于在这种情况下决定是否使用类固醇进行治疗。在本研究中，使用了uHear™听力测试应用程序。这种耳级气导听力测试的结果以250至6000赫兹范围内6个频率的听力等级报告。共有32例经标准听力图证实为单侧SSNHL的患者接受了测试。比较了标准听力测试和iPod听力测试的结果。根据公认的SSNHL标准（在连续3个频率中至少有30分贝的听力损失——或2个听力等级），该测试的灵敏度为0.76，特异性为0.91。使用不太严格的标准，即至少在2个频率上有2个听力等级的损失，灵敏度为0.96，特异性为0.86。在该研究的6个测量频率上的平均听力等级与标准听力图比较的相关系数为0.83。uHear能更准确地反映中高频的听力阈值。与先前发表的数据类似，低频阈值可能会被人为提高。总之，在标准听力图可用之前，uHear可为单侧SSNHL患者的初始评估提供重要信息，有助于指导治疗决策，因此具有实用性。
