Waissbluth Sofia, Sepúlveda Valeria, Urzúa Pablo
Department of Otorhinolaryngology, Pontificia Universidad Católica de Chile, Santiago, Chile.
Department of Otorhinolaryngology, Pontificia Universidad Católica de Chile, Santiago, Chile.
Acta Otorrinolaringol Esp (Engl Ed). 2022 Nov-Dec;73(6):346-355. doi: 10.1016/j.otoeng.2021.07.005.
The aim of this study was to evaluate the different audiometric patterns in sudden sensorineural hearing loss (SSNHL), assess recovery rates based on the initial pattern and also, analyse the impact on speech discrimination scores (SDS).
A retrospective, descriptive, study was completed for patients with SSNHL from January 2010 until June 2020. Outcome measures included audiometric patterns, recovery rates, improvements over time for hearing loss as well as for SDS at 14 days and 3 months follow-up. The Kruskal-Wallis test and Mann-Whitney U test were used to compare differences between the different groups. Post-hoc testing involved the Wilcoxon signed-rank test. A P<0.05 was considered statistically significant.
We included 211 patients, 64.3% showed downward-sloping or flat audiometric curves. Overall, 40% of the patients had recovered 50% or more of their hearing by day 14. We observed that hearing did improve over time, and this was more common for the upward-sloping cases, with 65% recovering to at least 50% of the maximum possible recovery by 3 months follow-up. Thirty percent had concomitant vertigo and/or dizziness; these patients had worse initial speech PTAs (pure tone average) (P≤0.0001) and inferior recovery rates (P=0.0007) as compared to patients without vertigo and/or dizziness.
SSNHL is still a controversial topic. Variability was observed with regards to audiometric curves, recovery rates and SDS recovery. We provide a table with recovery rates based on audiometric patterns that may help guide clinicians when explaining this condition to their patients.
本研究旨在评估突发性感音神经性听力损失（SSNHL）的不同听力图模式，根据初始模式评估恢复率，并分析其对言语辨别得分（SDS）的影响。
对2010年1月至2020年6月期间患有SSNHL的患者进行了一项回顾性描述性研究。结果测量包括听力图模式、恢复率、随访14天和3个月时听力损失以及SDS随时间的改善情况。采用Kruskal-Wallis检验和Mann-Whitney U检验比较不同组之间的差异。事后检验采用Wilcoxon符号秩检验。P<0.05被认为具有统计学意义。
我们纳入了211例患者，64.3%表现为下降型或平坦型听力图曲线。总体而言，40%的患者在第14天时听力恢复了50%或更多。我们观察到听力确实随时间有所改善，这在上升型病例中更为常见，65%的患者在3个月随访时恢复到至少最大可能恢复量的50%。30%的患者伴有眩晕和/或头晕；与没有眩晕和/或头晕的患者相比，这些患者的初始言语PTA（纯音平均）更差（P≤0.0001），恢复率更低（P=0.0007）。
SSNHL仍然是一个有争议的话题。在听力图曲线、恢复率和SDS恢复方面观察到了变异性。我们提供了一个基于听力图模式恢复率的表格，这可能有助于临床医生在向患者解释这种情况时提供指导。
