Ungar Omer J, Cavel Oren, Oron Yahav, Wengier Anat, Wasserzug Oshri, Handzel Ophir
Department of Otolaryngology, Head and Neck Surgery, and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Audiol Neurootol. 2017;22(3):154-159. doi: 10.1159/000479723. Epub 2017 Oct 10.
To examine the value of a subjective numerical rating scale (NRS) in the initial evaluation of patients suspected of suffering from unilateral sudden sensorineural hearing loss (SSNHL) until a formal audiogram is available.
Prospective noncontrolled clinical study.
Thirty-one consecutive patients referred to the emergency department due to suspected unilateral SSNHL and with no other aural pathology by history or physical examination were enrolled. Patients were asked to characterize the severity of their hearing loss using an NRS of 1 (normal hearing) to 6 (complete deafness). SSNHL was defined as an SNHL of at least 30 dB over 3 consecutive frequencies that occurred in 3 days or less. A formal audiogram was obtained subsequently as soon as available.
Twenty-four patients were treated with steroids and met the audiometric criteria of SSNHL. All scored their NRS as 3 or more. None of the 7 patients whose NRS grades were ≤2.5 met the criteria for SSNHL. Two patients were treated with steroids although their hearing did not meet the audiometric criteria for SSNHL as the hearing loss was limited to 2 consecutive frequencies. The NRS score for both was <3.
In addition to the patient's history and physical examination, a NRS can be a useful tool in the preliminary assessment of patients suspected of having SSNHL until audiometry becomes available. In the scale of 1-6, an NRS score of 3 or more reliably predicts the need to treat the patient with steroids according to the accepted criteria.
探讨主观数字评定量表（NRS）在疑似单侧突发性感音神经性听力损失（SSNHL）患者初始评估中的价值，直至获得正式听力图。
前瞻性非对照临床研究。
纳入31例因疑似单侧SSNHL转诊至急诊科且经病史或体格检查无其他耳部病变的连续患者。要求患者使用1（正常听力）至6（完全失聪）的NRS对听力损失的严重程度进行描述。SSNHL定义为在3天或更短时间内连续3个频率至少30 dB的感音神经性听力损失。随后尽快获得正式听力图。
24例患者接受了类固醇治疗并符合SSNHL的听力测定标准。所有患者的NRS评分均为3或更高。NRS评分≤2.5的7例患者中无一例符合SSNHL标准。2例患者接受了类固醇治疗，尽管其听力不符合SSNHL的听力测定标准，但听力损失仅限于连续2个频率。两者的NRS评分均<3。
除患者病史和体格检查外，在获得听力测定结果之前，NRS可作为疑似SSNHL患者初步评估的有用工具。在1-6的量表中，NRS评分3或更高可可靠地预测根据公认标准对患者进行类固醇治疗的必要性。
