Liang H, Zhong S X
Department of Otorhinolaryngology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Sep 7;51(9):691-694. doi: 10.3760/cma.j.issn.1673-0860.2016.09.011.
To investigate the possible factors related to recurrence and prognosis of sudden sensorineural hearing loss(SSNHL). Four hundred and ninety-five patients with unilateral sudden sensorineural hearing loss between January 2013 to April 2014 were analyzed retrospectively(34 patients lost to follow-up with a dropout rate of 6.87%). Twenty of the 495 patients were diagnosed as recurrent SSNHL and treated again in the same hospital. The data of the patients were summarized to analyze the related factors which might influence the recurrence and prognosis of SSNHL. In the 20 patients with recurrent SSNHL, 19 had the second attack in same ear as the first attack, and the other one had in both ears. There were seven male patients, and thirteen female patients. Patients ranged in age from 24 to 77years, with a median age of 39.5 years. Types of hearing loss: low frequency in eight patients, high frequency in two patients, flat frequency in eight patients, total deafness in two patients, the types of the second attack in 17 patients were same as the first attack, only one patient was changed from total deafness to flat frequency, one case was changed from flat frequency to high frequency, one case changed from flat frequency to total deafness. The intervals between of the first attack time and the second attack time were 1-36 months with the median time of 3.5 months. After systemic oral and (or) transtympanic steroid treatment, recovered in three cases, effective in three cases and 14 cases invalid, the cure rate was 15%, and the total effective rate was 30%. There were statistically significant differences in the recovery rate(χ=8.640, <0.05) and the overall response rate(χ=12.379, <0.01)between the first and the second treatments. For the patients with vertigo and/or dizziness, with a history more than seven days, with hypertension or diabetes mellitus, and with a type of hearing loss except low frequency type, the treatment effect was invalid. The patients with hearing loss at low frequency had the best outcomes. The total effective rates were significant different between patients younger and old than 34 years old(<0.05). There was no difference in the total effective rate between genders, and patients with or without tinnitus and/or aural fullness in the recurrent SSNHL(>0.05). The recurrence rates of patients with various types of hearing loss were different(=7.744, <0.05), with a highest recurrence rate in patients with hearing loss at low frequency. Other factors such as gender, age, accompanied diseases (hypertension or diabetes mellitus), associated symptoms, interval from onset to treatment had no effects on the recurrence rate. Recurrence of SSNHL is more likely to be found in patients with hearing loss of low frequency and flat type. The prognosis of recurrent SSNHL is poorer than that of the first episode, and may be related to the age and type of hearing loss.
探讨与突发性聋(SSNHL)复发及预后相关的可能因素。回顾性分析2013年1月至2014年4月期间495例单侧突发性聋患者(34例失访,失访率为6.87%)。495例患者中有20例被诊断为复发性SSNHL,并在同一家医院再次接受治疗。汇总患者数据,分析可能影响SSNHL复发及预后的相关因素。在20例复发性SSNHL患者中,19例第二次发作发生在与首次发作相同的耳,另1例双耳均发作。男性患者7例,女性患者13例。患者年龄范围为24至77岁,中位年龄为39.5岁。听力损失类型:低频型8例,高频型2例,平坦型8例,全聋型2例,17例第二次发作的类型与首次发作相同,仅1例从全聋型变为平坦型,1例从平坦型变为高频型,1例从平坦型变为全聋型。首次发作时间与第二次发作时间间隔为1至36个月,中位时间为3.5个月。经全身口服和(或)鼓室内注射类固醇治疗后,3例痊愈,3例有效,14例无效,治愈率为15%,总有效率为30%。首次治疗与第二次治疗的治愈率(χ=8.640,P<0.05)和总有效率(χ=12.379,P<0.01)差异有统计学意义。对于有眩晕和/或头晕、病史超过7天、患有高血压或糖尿病以及听力损失类型为非低频型的患者,治疗效果不佳。低频听力损失患者的预后最佳。年龄小于34岁和大于34岁的患者总有效率差异有统计学意义(P<0.05)。复发性SSNHL患者中,性别、有无耳鸣和/或耳闷胀感的患者总有效率无差异(P>0.05)。不同听力损失类型患者的复发率不同(χ=7.744,P<0.05),低频听力损失患者的复发率最高。性别、年龄、伴发疾病(高血压或糖尿病)、相关症状、发病至治疗间隔等其他因素对复发率无影响。SSNHL复发更常见于低频型和平坦型听力损失患者。复发性SSNHL的预后比首次发作时更差,可能与年龄和听力损失类型有关。