Klein Linor, Vass Roni, Oron Yahav, Abu-Eta Rani, Shilo Shahaf, Shapira Udi, Handzel Ophir, Chaushu Hen, Muhanna Nidal, Ziv Oren, Ungar Omer J
Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Laryngoscope. 2025 Feb;135(2):889-893. doi: 10.1002/lary.31785. Epub 2024 Sep 20.
To study predictors of delayed presentation, diagnosis, and treatment of idiopathic sudden sensorineural hearing loss (ISSNHL).
Retrospective medical chart review and patient telephone survey.
Tertiary medical center.
All patients who initially presented or referred with unilateral ISSNHL between 2016 and 2020 were included. Associations between epidemiological, demographic, and socioeconomic profiles and delays in presentation, diagnosis and treatment were studied.
A total of 518 patients were suitable for study inclusion. The total delay in the emergency department (ED) setup was a median (interquartile range, IQR) of 1 (0-1) day, 7 (6-12) days in a community otolaryngologist setup, and 15 (8-25) days in a general practitioner setup. Patients who presented to the ED first also had fewer diagnostic and treatment delays. Those who presented to a community otolaryngologist first had significantly longer presentation delay (5 [4-8] days p < 0.001) and significantly longer treatment delays (1 [1-3] days p < 0.001). Patients who presented to a general practitioner first had significantly longer presentation delays compared with ED presentation, and the longest diagnostic and treatment delays (3 [2-5], 8 [4-12] days, and 4 [2-7] days, p = < 0.01, p = <0.01, and p < 0.001, respectively). There was no association between socioeconomic status or demography and presentation, diagnostic, or treatment delays.
Total delay in ISSNHL management is affected by the venue of the first medical encounter. General practitioners' level of awareness of the need for empiric steroidal treatment of ISSNHL without delay should be raised.
3 Laryngoscope, 135:889-893, 2025.
研究特发性突发性感音神经性听力损失（ISSNHL）延迟就诊、诊断及治疗的预测因素。
回顾性病历审查及患者电话调查。
三级医疗中心。
纳入2016年至2020年间首次因单侧ISSNHL就诊或转诊的所有患者。研究流行病学、人口统计学及社会经济特征与就诊、诊断及治疗延迟之间的关联。
共有518例患者适合纳入研究。在急诊科就诊时的总延迟时间中位数（四分位间距，IQR）为1（0 - 1）天，在社区耳鼻喉科医生处为7（6 - 12）天，在全科医生处为15（8 - 25）天。首先在急诊科就诊的患者诊断和治疗延迟也较少。首先在社区耳鼻喉科医生处就诊的患者就诊延迟显著更长（5 [4 - 8]天，p < 0.001），治疗延迟也显著更长（1 [1 - 3]天，p < 0.001）。与在急诊科就诊相比，首先在全科医生处就诊的患者就诊延迟显著更长，且诊断和治疗延迟最长（分别为3 [2 - 5]天、8 [4 - 12]天和4 [2 - 7]天，p = < 0.01、p = < 0.01和p < 0.001）。社会经济状况或人口统计学与就诊、诊断或治疗延迟之间无关联。
ISSNHL治疗的总延迟受首次医疗接触地点的影响。应提高全科医生对ISSNHL立即进行经验性类固醇治疗必要性的认识。
3 喉镜，135:889 - 893，2025年。
