Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Otolaryngology-Head and Neck Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC.
Information Management Office, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Graduate Institute of Biomedical Electronics &Bioinformatics, National Taiwan University, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2018 Nov;81(11):1008-1012. doi: 10.1016/j.jcma.2018.03.012. Epub 2018 Jun 19.
Sudden sensorineural hearing loss (SSNHL) is an emergency clinical otology condition defined as hearing loss greater than 30 dB over three consecutive frequencies within 72 h. We aimed to integrate pretreatment hearing grades with reports of treatment recovery outcomes of SSNHL using the modified Siegel's criteria.
This was a retrospective cohort study comprising 110 patients with SSNHL seen between January 2014 and January 2015. The patients were treated with combined systemic and intra-tympanic steroid therapy. The audiometric results were recorded using the modified Siegel's criteria, including pretreatment hearing grades 1-5 (grade 1: hearing threshold under 25 dB, grade 2: hearing threshold 26-45 dB, grade 3: hearing threshold 46-70 dB, grade 4: hearing threshold 71-90 dB, grade 5: hearing threshold over 90 dB) and hearing recovery outcomes, consisting of complete recovery (CR), partial recovery (PR), slight improvement (SI), no improvement (NI) or non-serviceable ears (NS). Patients were further assessed based on the treatment modality (initial or salvage treatment) and duration of the treatment delay.
Hearing improvements (CR + PR + SI) were seen in 56 patients. Patients with pretreatment hearing grade 3 had the highest improvement rate (88.2% or 30/34). Patients who received the combined steroid therapy as the initial modality had a better overall hearing improvement rate than did the salvage group. Treatment within the first 14 days yielded a better hearing improvement rate than did late treatments of more than 14 days, especially in patients with a pretreatment hearing grade of 5.
Using the modified Siegel's criteria, we report the hearing recovery outcomes with matched pretreatment hearing grades of patients with SSNHL treated with combined intra-tympanic steroid therapy. Our results show the prognostic significance of pretreatment hearing grades in patients with SSNHL.
突发性聋（SSNHL）是一种紧急的临床耳科学病症，定义为在 72 小时内连续三个频率上听力损失超过 30dB。我们旨在使用改良的 Siegel 标准将治疗前听力分级与 SSNHL 的治疗恢复结果报告相结合。
这是一项回顾性队列研究，纳入了 2014 年 1 月至 2015 年 1 月期间就诊的 110 例 SSNHL 患者。患者接受了联合全身和鼓室内类固醇治疗。使用改良的 Siegel 标准记录听力结果，包括治疗前听力分级 1-5 级（1 级：听力阈值<25dB，2 级：听力阈值 26-45dB，3 级：听力阈值 46-70dB，4 级：听力阈值 71-90dB，5 级：听力阈值>90dB）和听力恢复结果，包括完全恢复（CR）、部分恢复（PR）、轻度改善（SI）、无改善（NI）或失能耳（NS）。根据治疗方式（初始或挽救性治疗）和治疗延迟时间对患者进一步进行评估。
56 例患者听力改善（CR+PR+SI）。治疗前听力分级 3 级的患者改善率最高（88.2%，30/34）。作为初始治疗方式接受联合类固醇治疗的患者总体听力改善率优于挽救性治疗组。在 14 天内治疗的患者听力改善率优于 14 天以上的延迟治疗患者，尤其是治疗前听力分级为 5 级的患者。
我们使用改良的 Siegel 标准报告了接受联合鼓室内类固醇治疗的 SSNHL 患者的听力恢复结果，并与治疗前听力分级相匹配。我们的结果表明，治疗前听力分级对 SSNHL 患者具有预后意义。
