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儿童特发性突发性感音神经性听力损失的临床特征与预后:一项双中心回顾性研究。

Clinical features and prognosis of pediatric idiopathic sudden sensorineural hearing loss: A bi-center retrospective study.

作者信息

Li Yingqiang, Zhou Xiaowei, Dou Zhiyong, Deng Dongzhou, Bing Dan

机构信息

Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Otological Department, The First People's Hospital of Foshan, Foshan, China.

出版信息

Front Neurol. 2023 Mar 15;14:1121656. doi: 10.3389/fneur.2023.1121656. eCollection 2023.

Abstract

OBJECTIVE

Limited research has focused on the clinical features of sudden sensorineural hearing loss (SSNHL) in pediatric patients. This study is aimed to investigate the relationship between clinical features and the baseline hearing severity and outcomes of SSNHL in the pediatric population.

METHOD

We conducted a bi-center retrospective observational study in 145 SSNHL patients aged no more than 18 years who were recruited between November 2013 and October 2022. Data extracted from medical records, audiograms, complete blood count (CBC) and coagulation tests have been assessed for the relationship with the severity (the thresholds of the initial hearing) and outcomes (recovery rate, hearing gain and the thresholds of the final hearing).

RESULTS

A lower lymphocyte count ( = 0.004) and a higher platelet-to-lymphocyte ratio (PLR) ( = 0.041) were found in the patient group with profound initial hearing than in the less severe group. Vertigo (β = 13.932, 95%CI: 4.082-23.782, = 0.007) and lymphocyte count (β = -6.686, 95%CI: -10.919 to -2.454, = 0.003) showed significant associations with the threshold of the initial hearing. In the multivariate logistic model, the probability of recovery was higher for patients with ascending and flat audiograms compared to those with descending audiograms (ascending: OR 8.168, 95% CI 1.450-70.143, = 0.029; flat: OR 3.966, 95% CI 1.341-12.651, = 0.015). Patients with tinnitus had a 3.2-fold increase in the probability of recovery (OR 3.222, 95% CI 1.241-8.907, = 0.019), while the baseline hearing threshold (OR 0.968, 95% CI 0.936-0.998, = 0.047) and duration to the onset of therapy (OR 0.942, 95% CI 0.890-0.977, = 0.010) were negatively associated with the odds of recovery.

CONCLUSIONS

The present study showed that accompanying tinnitus, the severity of initial hearing loss, the time elapse and the audiogram configuration might be related to the prognosis of pediatric SSNHL. Meanwhile, the presence of vertigo, lower lymphocytes and higher PLR were associated with worse severity.

摘要

目的

针对小儿突发性感音神经性听力损失(SSNHL)临床特征的研究有限。本研究旨在探讨小儿SSNHL临床特征与基线听力严重程度及预后之间的关系。

方法

我们对2013年11月至2022年10月期间招募的145例年龄不超过18岁的SSNHL患者进行了一项双中心回顾性观察研究。从病历、听力图、全血细胞计数(CBC)和凝血试验中提取的数据已被评估与严重程度(初始听力阈值)和预后(恢复率、听力增益和最终听力阈值)的关系。

结果

初始听力重度的患者组淋巴细胞计数较低(P = 0.004),血小板与淋巴细胞比值(PLR)较高(P = 0.041),而初始听力较轻的患者组则相反。眩晕(β = 13.932,95%CI:4.082 - 23.782,P = 0.007)和淋巴细胞计数(β = -6.686,95%CI:-10.919至-2.454,P = 0.003)与初始听力阈值显著相关。在多因素逻辑模型中,听力图呈上升型和平坦型的患者恢复概率高于下降型患者(上升型:OR 8.168,95%CI 1.450 - 70.143,P = 0.029;平坦型:OR 3.966,95%CI 1.341 - 12.651,P = 0.015)。耳鸣患者恢复概率增加3.2倍(OR 3.222,95%CI 1.241 - 8.907,P = 0.019),而基线听力阈值(OR 0.968,95%CI 0.936 - 0.998,P = 0.047)和开始治疗的时长(OR 0.942,95%CI 0.890 - 0.977,P = 0.010)与恢复几率呈负相关。

结论

本研究表明,小儿SSNHL的预后可能与耳鸣、初始听力损失的严重程度、时间推移以及听力图形态有关。同时,眩晕、淋巴细胞减少和PLR升高与更严重的病情相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6568/10050692/cc6adef4f9f6/fneur-14-1121656-g0001.jpg

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