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儿童中重度特发性突发性聋的临床特征及预后因素。

Clinical features and prognostic factors of pediatric idiopathic sudden hearing loss from moderate to profound degree.

机构信息

ENT institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China.

ENT institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China.

出版信息

Am J Otolaryngol. 2021 Sep-Oct;42(5):103027. doi: 10.1016/j.amjoto.2021.103027. Epub 2021 Apr 16.

Abstract

BACKGROUND

The pediatric idiopathic sudden sensorineural hearing loss (PISSNHL) is not rare in the clinics, however, the prognostic factors of PISSNHL are still unclear.

OBJECTIVES

To investigate the clinical and audiologic characteristics associated with prognosis in PISSNHL.

MATERIAL AND METHODS

Clinical and audiological characteristics and possible prognostic factors were retrospectively evaluated in 76 PISSNHL patients aged less than 19 years.

RESULTS

Hearing loss was moderate in nine patients, severe in 21 patients, profound in 46 patients. Among five types of audiogram, 3.9% were classified as ascending, 11.8% as descending, 25.0% as flat, 55.3% as profound, and 3.9% as concave. The recovery rate according to Siegel's criteria was 55.3%. There was no significant difference between the recovery group and the poor recovery group in terms of age, sex, laterality of hearing loss, the onset of treatment, and accompanying symptoms (p > 0.05). The initial hearing levels and the audiogram type were significantly different in the two groups (p < 0.001) according to univariate analysis, while only the initial hearing level was significantly different (p = 0.046) according to multivariate analysis.

CONCLUSIONS AND SIGNIFICANCE

Prognosis of PISSNHL was mainly related to initial hearing at onset. An initial hearing level greater than 80 dB was a poor prognostic factor.

摘要

背景

儿科特发性突发性感觉神经性听力损失(PISSNHL)在临床上并不少见,但 PISSNHL 的预后因素仍不清楚。

目的

探讨与 PISSNHL 预后相关的临床和听力学特征。

材料与方法

回顾性评估了 76 例年龄小于 19 岁的 PISSNHL 患者的临床和听力学特征及可能的预后因素。

结果

9 例患者听力损失为中度,21 例为重度,46 例为极重度。5 种听力图类型中,3.9%为上升型,11.8%为下降型,25.0%为平坦型,55.3%为极重度,3.9%为凹型。根据 Siegel 标准,恢复率为 55.3%。根据单因素分析,恢复组与恢复不良组在年龄、性别、听力损失的侧别、治疗开始时间和伴随症状方面无显著差异(p>0.05)。两组间初始听力水平和听力图类型差异有统计学意义(p<0.001),但多因素分析仅初始听力水平有统计学意义(p=0.046)。

结论与意义

PISSNHL 的预后主要与发病时的初始听力有关。初始听力水平大于 80dB 是预后不良的因素。

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