Aldè Mirko, Ambrosetti Umberto, Piatti Gioia, Romanini Camilla, Filipponi Eliana, Di Berardino Federica, Zanetti Diego, Pignataro Lorenzo, Cantarella Giovanna, Barozzi Stefania
Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
J Clin Med. 2024 Jun 4;13(11):3303. doi: 10.3390/jcm13113303.
The purpose of this study was to investigate the hearing characteristics and causes of sudden sensorineural hearing loss (SSNHL) in patients aged from 15 to 40 years, focusing on audiological outcomes one year after the diagnosis. The medical records of individuals with SSNHL who were referred to our tertiary-level audiologic center were reviewed. All patients had undergone comprehensive diagnostic evaluations, including high-resolution 3D-FLAIR delayed magnetic resonance imaging (MRI), cone beam computed tomography (CBCT), and screening for coagulation, infectious, and autoimmune diseases. Overall, 56 patients (mean age 28.1 ± 7.6 years) were included in the study. The hearing threshold in the affected ear improved significantly from 56.0 ± 18.0 dB at the diagnosis to 46.9 ± 22.3 dB after one year ( = 0.02). The degree of hearing loss, audiometric configurations, hearing improvements, and adherence to hearing treatments showed considerable variability among patients. Aural fullness, tinnitus, and hyperacusis were the predominant symptoms associated with SSNHL, and their prevalence decreased significantly over time. The diagnostic protocol led to the identification of the specific cause of SSNHL in 75% (42/56) of patients. The known etiology was found to be otological (39.3%), infectious (21.4%), autoimmune (7.1%), vascular (5.4%), or neoplastic (1.8%). In particular, Menière's disease (n = 12), isolated cochlear endolymphatic hydrops (n = 6), HSV-1 (n = 5), and EBV (n = 4) infections were the most frequent causes of SSNHL. The identification of the specific etiology of SSNHL may facilitate a more personalized approach to management and treatment.
本研究旨在调查15至40岁突发性感音神经性听力损失(SSNHL)患者的听力特征及病因,重点关注诊断后一年的听力学结果。回顾了转诊至我们三级听力中心的SSNHL患者的病历。所有患者均接受了全面的诊断评估,包括高分辨率3D-FLAIR延迟磁共振成像(MRI)、锥形束计算机断层扫描(CBCT)以及凝血、感染和自身免疫性疾病筛查。总体而言,56例患者(平均年龄28.1±7.6岁)纳入本研究。患耳听力阈值从诊断时的56.0±18.0 dB显著改善至一年后的46.9±22.3 dB( = 0.02)。患者之间的听力损失程度、听力图形态、听力改善情况以及听力治疗依从性存在很大差异。耳闷、耳鸣和听觉过敏是与SSNHL相关的主要症状,其患病率随时间显著下降。诊断方案使75%(42/56)的患者明确了SSNHL的具体病因。已知病因包括耳科疾病(39.3%)、感染性疾病(21.4%)、自身免疫性疾病(7.1%)、血管性疾病(5.4%)或肿瘤性疾病(1.8%)。特别是,梅尼埃病(n = 12)、孤立性耳蜗内淋巴积水(n = 6)、单纯疱疹病毒1型(HSV-1,n = 5)和EB病毒(EBV,n = 4)感染是SSNHL最常见的病因。明确SSNHL的具体病因可能有助于采取更个性化的管理和治疗方法。