Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina, U.S.A.
Duke Center for the Study of Aging and Human Development, Durham, North Carolina, U.S.A.
Laryngoscope. 2023 Oct;133(10):2457-2469. doi: 10.1002/lary.30630. Epub 2023 Mar 7.
Despite its relatively high prevalence, our understanding of the natural clinical course of acute low-tone hearing loss (ALHL) without vertigo remains incomplete. The purpose of this study is to summarize the findings of studies that evaluated recovery from hearing loss (HL), recurrence and/or fluctuation of HL, and progression to Meniere's Disease (MD) of patients presenting with ALHL without vertigo.
A scoping review of the English literature was performed. On May 14, 2020 and July 6, 2022, MEDLINE, Embase, and Scopus were searched to identify articles related to the prognosis of ALHL. To be included, articles had to present outcomes that were clearly distinguishable for patients with ALHL without vertigo. Two reviewers evaluated articles for inclusion and extracted data. Disagreements were adjudicated by a third reviewer.
Forty-one studies were included. There was extensive heterogeneity between studies in regard to defining ALHL, treatment methods, and time of follow-up. Most of the cohorts (39 out of 40) reported partial or complete recovery of hearing in the majority (>50%) of patients, although reports of recurrence were relatively common. Progression to MD was infrequently reported. Shorter time from onset of symptoms to treatment predicted better hearing outcomes in 6 of 8 studies.
The literature suggests that although the majority of patients with ALHL experience hearing improvement, recurrence and/or fluctuation are common, and progression to MD occurs in a minority of patients. Additional trials utilizing standardized inclusion and outcome criteria are needed to determine the ideal treatment for ALHL.
NA Laryngoscope, 133:2457-2469, 2023.
尽管急性低频感音神经性听力损失（ALHL）伴眩晕的发病率相对较高，但我们对其自然临床病程的了解仍不完整。本研究的目的是总结评估无眩晕的 ALHL 患者听力损失（HL）恢复、HL 复发和/或波动以及进展为梅尼埃病（MD）的研究结果。
对英文文献进行了范围综述。于 2020 年 5 月 14 日和 2022 年 7 月 6 日，检索了 MEDLINE、Embase 和 Scopus，以确定与无眩晕的 ALHL 预后相关的文章。纳入标准为：文章必须明确区分无眩晕的 ALHL 患者的结局。两名评审员评估文章的纳入情况并提取数据。意见分歧由第三名评审员裁决。
共纳入 41 项研究。关于定义 ALHL、治疗方法和随访时间，各项研究之间存在广泛的异质性。尽管复发报告相对常见，但大多数队列（40 项中的 39 项）报告大多数 (>50%)患者的听力部分或完全恢复。MD 的进展很少报道。8 项研究中有 6 项研究表明，从症状发作到治疗的时间越短，听力预后越好。
文献表明，尽管大多数 ALHL 患者的听力有所改善，但复发和/或波动较为常见，且仅有少数患者进展为 MD。需要更多的临床试验，利用标准化的纳入和结局标准来确定 ALHL 的理想治疗方法。
无。Laryngoscope, 133:2457-2469, 2023.
