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儿童特发性突发性感音神经性听力损失预后因素的多变量分析

Multivariate analysis of prognostic factors for idiopathic sudden sensorineural hearing loss in children.

作者信息

Chung Jae Ho, Cho Seok Hyun, Jeong Jin Hyeok, Park Chul Won, Lee Seung Hwan

机构信息

Departments of Otolaryngology-Head and Neck Surgery, School of Medicine, Hanyang University, Seoul, South Korea.

出版信息

Laryngoscope. 2015 Sep;125(9):2209-15. doi: 10.1002/lary.25196. Epub 2015 Feb 17.

Abstract

OBJECTIVES/HYPOTHESIS: To evaluate clinical characteristics and possible associated factors of idiopathic sudden sensorineural hearing loss (ISSNHL) in children using univariate and multivariate analyses.

STUDY DESIGN

A retrospective case series with comparisons.

METHODS

From January 2007 to December 2013, medical records of 37 pediatric ISSNHL patients were reviewed to assess hearing recovery rate and examine factors associated with prognosis (gender; side of hearing loss; opposite side hearing loss; treatment onset; presence of vertigo, tinnitus, and ear fullness; initial hearing threshold), using univariate and multivariate analysis, and compare them with 276 adult ISSNHL patients.

RESULTS

Pediatric patients comprised only 6.6% of pediatric/adult cases of ISSNHL, and those below 10 years old were only 0.7%. The overall recovery rates (complete and partial) of the pediatric and adult patients were 57.4% and 47.2%, respectively. The complete recovery rate of the pediatric group (46.6%) was higher than that of the adult group (30.8%, P = .040). According to multivariate analysis, absence of tinnitus, later onset of treatment, and higher hearing threshold at initial presentation were associated with a poor prognosis in pediatric ISSNHL.

CONCLUSIONS

The recovery rate of ISSNHL in pediatric patients is higher than in adults, and the presence of tinnitus and earlier treatment onset is associated with favorable outcomes.

LEVEL OF EVIDENCE

摘要

目的/假设:采用单因素和多因素分析评估儿童特发性突发性感音神经性听力损失(ISSNHL)的临床特征及可能的相关因素。

研究设计

一项有对照的回顾性病例系列研究。

方法

回顾2007年1月至2013年12月期间37例儿童ISSNHL患者的病历,通过单因素和多因素分析评估听力恢复率,并检查与预后相关的因素(性别;听力损失侧;对侧听力损失;治疗开始时间;是否存在眩晕、耳鸣和耳闷;初始听力阈值),并与276例成人ISSNHL患者进行比较。

结果

儿童患者仅占儿童/成人ISSNHL病例的6.6%,10岁以下儿童仅占0.7%。儿童和成人患者的总体恢复率(完全恢复和部分恢复)分别为57.4%和47.2%。儿童组的完全恢复率(46.6%)高于成人组(30.8%,P = 0.040)。多因素分析显示,儿童ISSNHL患者无耳鸣、治疗开始时间较晚以及初始就诊时听力阈值较高与预后不良相关。

结论

儿童ISSNHL的恢复率高于成人,耳鸣的存在和较早开始治疗与良好预后相关。

证据级别

4级。

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