Department of Otorhinolaryngology-Head and Neck Surgery, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil.
Otolaryngol Head Neck Surg. 2021 Oct;165(4):563-570. doi: 10.1177/0194599820986571. Epub 2021 Feb 9.
To characterize, with a standard systematic protocol, the clinical and audiometric profile of patients with idiopathic sudden sensorineural hearing loss (ISSNHL) and to correlate the findings with hearing recovery prognosis.
Retrospective cohort of patients with ISSNHL.
Outpatients of a tertiary referral center followed for 20 years.
We collected clinical information, including the presence of tinnitus, vertigo, and comorbidities, as well as initial pure tone averages, degree of hearing loss, audiogram curves, and time between hearing loss onset and treatment. These variables were statistically analyzed for their impact on hearing recovery prognosis. All patients were treated with oral corticosteroids, following a standard treatment protocol. Hearing recovery was defined according to the criteria of the American Academy of Otolaryngology-Head and Neck Surgery Foundation, and hearing outcomes were reported via a standardized method (scattergrams).
Our final study group comprised 186 patients. Most patients were between 41 and 60 years of age. Univariate analysis revealed that vertigo; presence of severe or profound initial hearing loss; flat, U-shaped, and descending audiogram curves; and initiating treatment ≥15 days were correlated with worse hearing recovery. However, the multivariate logistic model revealed that only the presence of severe or profound hearing loss (odds ratio, 6.634; 95% CI, 2.714-16.216; < .001) and initiating treatment ≥15 days (odds ratio, 0.250; 95% CI, 0.102-0.610; = .008) were independent risk factors for worse hearing recovery prognosis.
This study demonstrated that the presence of severe or profound hearing loss at the first audiogram and initiating treatment after 14 days from ISSNHL onset were independent risk factors associated with a worse hearing recovery prognosis.
采用标准系统方案对特发性突发性聋（ISSNHL）患者的临床和听力学特征进行描述，并将这些发现与听力恢复预后相关联。
特发性突发性聋患者的回顾性队列研究。
在一家三级转诊中心的门诊患者，随访了 20 年。
我们收集了临床信息，包括耳鸣、眩晕和合并症的存在，以及初始纯音平均值、听力损失程度、听力图曲线和听力损失发作与治疗之间的时间。这些变量进行了统计学分析，以评估其对听力恢复预后的影响。所有患者均采用口服皮质类固醇激素，按照标准治疗方案进行治疗。根据美国耳鼻喉科学-头颈外科学会基金会的标准，将听力恢复定义为，并通过标准化方法（散点图）报告听力结果。
我们的最终研究组包括 186 例患者。大多数患者年龄在 41 至 60 岁之间。单因素分析显示，眩晕、初始严重或极重度听力损失、平坦、U 形和下降型听力图曲线以及开始治疗≥15 天与听力恢复较差相关。然而，多变量逻辑模型显示，仅严重或极重度听力损失的存在（比值比，6.634；95%置信区间，2.714-16.216；<0.001）和开始治疗≥15 天（比值比，0.250；95%置信区间，0.102-0.610；=0.008）是听力恢复预后较差的独立危险因素。
本研究表明，首次听力图中存在严重或极重度听力损失以及 ISSNHL 发病后 14 天开始治疗是与听力恢复预后较差相关的独立危险因素。
