Department of Otolaryngology, Saiseikai Utsunomiya Hospital, Tochigi, Japan.
Department of Otorhinolaryngology, Head and Neck Surgery, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo, 160-8582, Japan.
Eur Arch Otorhinolaryngol. 2021 Nov;278(11):4251-4258. doi: 10.1007/s00405-020-06532-4. Epub 2021 Jan 2.
To determine pre- and post-treatment factors that are useful for predicting the prognosis of hearing improvement in idiopathic sudden sensorineural hearing loss (ISSHL).
This retrospective study included 332 patients with ISSHL. Patients received intravenous steroid treatment (prednisolone sodium succinate; 120 mg/day followed by dose tapering). Complete recovery of hearing levels was defined as a final pure-tone audiometry of ≤ 20 dB HL or the same level as the contralateral ear. Patients' age; sex; side of hearing loss; initial hearing level; days from onset to treatment; presence of vertigo, diabetes, and hypertension; and hearing improvement on days 3-4 and 6-7 after treatment initiation were analyzed as potential prognostic factors.
Overall, 109 patients (32%) had complete recovery. Results of the multivariate logistic regression model identified age (odds ratio [OR] = 0.974), initial hearing level (OR = 0.949), vertigo (OR = 0.409), and hearing improvement on days 6-7 after treatment initiation (OR = 1.11) as significant independent predictors of complete recovery. Age ≥ 60 years, initial hearing level ≥ 72.5 dB HL, and vertigo contributed to poor prognosis. Patients without these three factors and a hearing improvement of ≥ 10 dB HL on days 6-7 post-treatment had a complete recovery rate of 80%. Only 1.5% of the patients with 2-3 of these factors and a hearing improvement of < 10 dB HL on days 6-7 after treatment initiation achieved complete recovery.
Age, initial hearing level, vertigo, and hearing improvement on days 6-7 after treatment initiation were independent predictors of hearing recovery in ISSHL.
确定有助于预测特发性突发性聋（ISSHL）听力改善预后的治疗前后因素。
本回顾性研究纳入了 332 例 ISSHL 患者。患者接受静脉类固醇治疗（琥珀酸钠泼尼松龙；120mg/天，然后逐渐减少剂量）。听力水平完全恢复定义为最终纯音测听的≤20dB HL 或与对侧耳相同水平。分析患者年龄、性别、听力损失侧、初始听力水平、发病至治疗的天数、眩晕、糖尿病和高血压的存在以及治疗开始后第 3-4 天和第 6-7 天的听力改善情况，作为潜在的预后因素。
共有 109 例（32%）患者完全恢复。多变量逻辑回归模型的结果确定年龄（比值比 [OR] = 0.974）、初始听力水平（OR = 0.949）、眩晕（OR = 0.409）和治疗开始后第 6-7 天的听力改善（OR = 1.11）是完全恢复的显著独立预测因素。年龄≥60 岁、初始听力水平≥72.5dB HL 和眩晕提示预后不良。没有这三个因素且治疗开始后第 6-7 天听力改善≥10dB HL 的患者完全恢复率为 80%。只有 1.5%的患者有 2-3 个因素且治疗开始后第 6-7 天听力改善<10dB HL 完全恢复。
年龄、初始听力水平、眩晕和治疗开始后第 6-7 天的听力改善是 ISSHL 听力恢复的独立预测因素。
