Weiss Daniel, Böcker Armin Julius, Koopmann Mario, Savvas Eleftherios, Borowski Matthias, Rudack Claudia
Department of Otorhinolaryngology, Head and Neck Surgery, University of Münster, Kardinal-von-Galen-Ring 10, Münster, 48149, Germany.
Practice for Otorhinolaryngology, Head and Neck Surgery, Meckenemstrasse 26, Bocholt, 46395, Germany.
J Otolaryngol Head Neck Surg. 2017 Apr 4;46(1):27. doi: 10.1186/s40463-017-0207-1.
Sudden sensorineural hearing loss (SSHL) is a disease, which severely affects the patient's social and relational life. The underlying pathomechanisms have not been finally clarified yet and outcome is not predictable.
We conducted a retrospective study in order to identify parameters that influence hearing recovery. The data base contains results of basic otoneurological tests and clinical parameters of 198 patients with idiopathic SSHL of at least 60 dB in at least four frequencies, diagnosed and treated at the University Hospital of Münster, Germany, between 1999 and 2015. Hearing recovery was measured by pure tone audiometry.
Multivariate linear and logistic regression analyses indicate that the chance as well as the magnitude of hearing recovery is higher for patients with normal caloric testing than for patients with pathological caloric testing. However, for the subgroup of patients who attained a hearing recovery, the caloric testing result was not found to influence the magnitude. Instead, the magnitude was noticeably lower for patients within this subgroup who had a previous hearing loss. Furthermore, we found indications that the magnitude is higher for men than for women and that receiving a high-dose steroid therapy is associated with a higher chance and magnitude of a hearing recovery.
We conclude that SSHL associated with disorders of the vestibular system or previous hearing loss represent special sub-entities of SSHL that may be caused by unique pathophysiological mechanisms and are associated with worse outcome. Furthermore, our data support the importance of elevated dosage of steroids in SSHL therapy.
突发性感音神经性听力损失（SSHL）是一种严重影响患者社交和人际关系生活的疾病。其潜在的病理机制尚未最终明确，预后也不可预测。
我们进行了一项回顾性研究，以确定影响听力恢复的参数。数据库包含了1999年至2015年间在德国明斯特大学医院诊断和治疗的198例特发性SSHL患者的基本耳神经学检查结果和临床参数，这些患者至少在四个频率上听力损失至少60分贝。通过纯音听力测定法测量听力恢复情况。
多变量线性和逻辑回归分析表明，冷热试验正常的患者听力恢复的机会和程度高于冷热试验异常的患者。然而，对于听力恢复的患者亚组，未发现冷热试验结果会影响恢复程度。相反，该亚组中有过听力损失的患者恢复程度明显较低。此外，我们发现有迹象表明男性的恢复程度高于女性，接受高剂量类固醇治疗与听力恢复的机会和程度更高相关。
我们得出结论，与前庭系统疾病或既往听力损失相关的SSHL代表了SSHL的特殊亚实体，可能由独特的病理生理机制引起，且预后较差。此外，我们的数据支持了在SSHL治疗中增加类固醇剂量的重要性。
