Rossini Bruno Almeida Antunes, Penido Norma de Oliveira, Munhoz Mario Sergio Lei, Bogaz Eduardo Amaro, Curi Renata Souza
Department of ENT, Universidade Federal de São Paulo, São Paulo, Brazil.
Int Arch Otorhinolaryngol. 2017 Jul;21(3):213-223. doi: 10.1055/s-0036-1586162. Epub 2016 Jul 26.
Several authors have demonstrated the relationship between sudden sensorineural hearing loss (SNHL) and systemic autoimmune diseases (SAD). Immune-mediated SNHL can rarely present as unilateral sudden SNHL and manifests itself in the contralateral ear only after years. It presents clinical relevance for being one of the few SNHL that may be reversible given that early and appropriate treatment is applied. The objective of this study is to describe the clinical presentations and audiological findings from patients with idiopathic sudden SNHL and SAD associated with a probable diagnosis of immune-mediated SNHL. Furthermore, we strive to estimate the prevalence of SAD in patients with sudden SNHL. This is an observational retrospective cohort. We have selected and studied patients with SAD. Revision of available literature on scientific repositories. We evaluated 339 patients with sudden SNHL. Among them, 13 (3.83%) patients suffered from SAD. Three patients had bilateral involvement, a total of 16 ears. We evaluate and describe various clinical, epidemiological, and audiological aspects of this sample. In our sample of patients with sudden SNHL, the prevalence of SAD was found relevant. The majority had tinnitus and dizziness concomitant hearing loss, unilateral involvement and had experienced profound hearing loss at the time of the installation. In spite of instituted treatment, most cases showed no improvement in audiometric thresholds. Apparently, patients with sudden SNHL and SAD have a more severe initial impairment, higher percentage of bilateral, lower response to treatment, and worse prognosis than patients with sudden SNHL of unknown etiology.
几位作者已经证明了突发性感音神经性听力损失（SNHL）与全身性自身免疫性疾病（SAD）之间的关系。免疫介导的SNHL很少表现为单侧突发性SNHL，仅在数年之后才会在对侧耳出现症状。鉴于早期和适当的治疗可以使其可逆，它作为少数几种SNHL之一具有临床相关性。
本研究的目的是描述特发性突发性SNHL和与可能诊断为免疫介导的SNHL相关的SAD患者的临床表现和听力学检查结果。此外，我们努力估计突发性SNHL患者中SAD的患病率。
这是一项观察性回顾性队列研究。我们选择并研究了患有SAD的患者。对科学数据库中现有文献进行了修订。
我们评估了339例突发性SNHL患者。其中，13例（3.83%）患有SAD。3例为双侧受累，共16只耳。我们评估并描述了该样本的各种临床、流行病学和听力学方面的情况。
在我们的突发性SNHL患者样本中，发现SAD的患病率具有相关性。大多数患者伴有耳鸣和头晕，听力损失为单侧受累，且在发病时经历了重度听力损失。尽管进行了治疗，但大多数病例的听力阈值没有改善。显然，与病因不明的突发性SNHL患者相比，突发性SNHL和SAD患者的初始损伤更严重，双侧受累的比例更高，对治疗的反应更低，预后更差。
