Department of Speech, Language, and Hearing Sciences, University of Colorado Boulder.
Department of Otolaryngology - Head & Neck Surgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora.
Am J Audiol. 2023 Dec 4;32(4):865-877. doi: 10.1044/2023_AJA-22-00135. Epub 2023 Sep 25.
The purpose of this study is to investigate the association between cardiovascular disease (CVD) risk factors and idiopathic sudden sensorineural hearing loss (ISSNHL) disease severity and recovery.
A retrospective medical chart review was performed on 90 patients ( = 48 men; = 59.8 years, = 15.8) evaluated for ISSNHL. Major CVD risk factors (current tobacco smoking, diabetes, total cholesterol ≥ 240 mg/dl or treatment, and hypertension [systolic blood pressure [BP]/diastolic BP ≥ 140/ ≥ 90 mmHg or treatment]) determined two CVD risk groups: lower (no major risk factors) and higher (one or more risk factors). Two pure-tone averages (PTAs) were computed: PTA and PTA. Complete recovery of ISSNHL was defined as PTA - PTA ≥ 10 dB. Logistic regression estimated the odds of ISSNHL recovery by CVD risk status adjusting for age, sex, body mass index, noise exposure, and treatment.
Most patients (67.8%) had one or more CVD risk factors. Severity of initial low- and high-frequency hearing loss was similar between CVD risk groups. Recovery was 53.2% for PTA and 32.9% for PTA. With multivariable adjustment, current/former smoking was associated with lower odds of PTA recovery ( = 0.27; 95% CI [0.08, 0.92]). Neither higher CVD risk status nor individual CVD risk factors had a significant association with recovery. For every one-unit increase in Framingham Risk Score, odds of PTA recovery were 0.95 times lower (95% CI [0.90, 1.00]) after accounting for age, sex, body mass index, noise exposure, and treatment/time-to-treatment grouping ( = .056).
The prognosis of low-frequency ISSNHL recovery is worse among current/former smokers than nonsmokers. Other CVD risk factors and aggregate risk are not significantly related to recovery.
本研究旨在探讨心血管疾病（CVD）危险因素与特发性突发性聋（ISSNHL）疾病严重程度和恢复之间的关系。
对 90 例（男性 48 例；平均年龄 59.8 岁，标准差 15.8 岁）接受 ISSNHL 评估的患者进行回顾性病历回顾。根据主要 CVD 危险因素（当前吸烟、糖尿病、总胆固醇≥240mg/dl 或治疗、高血压[收缩压/舒张压≥140/≥90mmHg 或治疗]）将 CVD 风险分为两组：低风险（无主要危险因素）和高风险（一个或多个危险因素）。计算了两个纯音平均值（PTA）：PTA 和 PTA。将 ISSNHL 完全恢复定义为 PTA-PTA≥10dB。使用 logistic 回归在调整年龄、性别、体重指数、噪声暴露和治疗的情况下，根据 CVD 风险状况估计 ISSNHL 恢复的可能性。
大多数患者（67.8%）有一个或多个 CVD 危险因素。低、高频听力损失初始严重程度在 CVD 风险组之间相似。PTA 的恢复率为 53.2%，PTA 的恢复率为 32.9%。经多变量调整后，当前/以前吸烟与 PTA 恢复的可能性较低相关（ = 0.27；95%置信区间[0.08，0.92]）。较高的 CVD 风险状况或个别 CVD 危险因素与恢复均无显著相关性。在考虑年龄、性别、体重指数、噪声暴露和治疗/治疗时间分组后，Framingham 风险评分每增加一个单位，PTA 恢复的可能性降低 0.95 倍（95%置信区间[0.90，1.00]）（ =.056）。
与不吸烟者相比，当前/以前吸烟者低频 ISSNHL 恢复的预后更差。其他 CVD 危险因素和总体风险与恢复无显著关系。
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