Sofer Harel, Fisher Ran, Tarnovsky Yehuda, Vofo Gaelle, Kaufmann Michal, Stern Shavit Sagit
Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Department of Otolaryngology Head and Neck Surgery, Hadassah Medical Center, Jerusalem, Israel.
Otolaryngol Head Neck Surg. 2025 Feb;172(2):509-516. doi: 10.1002/ohn.1009. Epub 2024 Oct 13.
This study aimed to assess the prognostic value of early posttreatment initiation audiometry findings in patients with idiopathic sudden sensorineural hearing loss (ISSHL).
A retrospective cohort study.
The study was conducted at a single tertiary medical center.
A review was conducted on 299 ISSHL patients treated between 2007 and 2023. Patients underwent audiometry on Days 2 to 3 and 5 to 7 posttreatment initiation. Data on demographics, medical history, audiometry results, and prognosis were collected. Prognosis was categorized based on hearing recovery at 1 year postdiagnosis.
Older age, worse initial speech reception threshold (SRT), ischemic heart disease, cerebrovascular accidents/transient ischemic attacks, hypertension, and diabetes were associated with a poorer prognosis. Posttreatment initiation audiometry findings on Days 2 to 3 and 5 to 7 significantly correlated with prognosis. Patients with a ≥30% improvement had substantial or complete recovery in over 80% of cases, while those with <10% had <30% recovery. Multivariate analysis identified a significant improvement on days 5 to 7 as an independent predictor of complete recovery (odds ratio = 4.25 [95% confidence interval 1.96-9.23], P = .0002).
Posttreatment initiation audiometry findings, particularly on Days 5 to 7, hold significant prognostic value in ISSHL patients. A substantial improvement during this timeframe is strongly associated with favorable outcomes. These findings emphasize the potential of posttreatment initiation audiometry as a valuable tool for clinicians in counseling patients with ISSHL.
本研究旨在评估特发性突发性感音神经性听力损失（ISSHL）患者治疗后早期听力测定结果的预后价值。
一项回顾性队列研究。
该研究在一家单一的三级医疗中心进行。
对2007年至2023年期间接受治疗的299例ISSHL患者进行了回顾性研究。患者在治疗开始后的第2至3天和第5至7天接受听力测定。收集了人口统计学、病史、听力测定结果和预后的数据。根据诊断后1年的听力恢复情况对预后进行分类。
年龄较大、初始言语接受阈值（SRT）较差、缺血性心脏病、脑血管意外/短暂性脑缺血发作、高血压和糖尿病与预后较差相关。治疗开始后第2至3天和第5至7天的听力测定结果与预后显著相关。改善≥30%的患者在超过80%的病例中实现了显著或完全恢复，而改善<10%的患者恢复率<30%。多变量分析确定治疗后第5至7天的显著改善是完全恢复的独立预测因素（优势比=4.25[95%置信区间1.96 - 9.23]，P = 0.0002）。
治疗开始后的听力测定结果，尤其是第5至7天的结果，对ISSHL患者具有重要的预后价值。在此时间段内的显著改善与良好的预后密切相关。这些发现强调了治疗开始后听力测定作为临床医生为ISSHL患者提供咨询的有价值工具的潜力。
