Of 300 patients, 208 were considered to have idiopathic SSNHL; 50% were treated with corticosteroids, 44% did not receive any treatment. The treated patients had the same outcome as the non-treated patients. The time interval from onset of SSNHL to start of treatment was of importance for the outcome irrespective of type of audiogram or results from laboratory tests. Higher age and heredity for hearing loss gave a significantly lower chance of improvement.
Methods:The first 400 patients submitted to the Swedish national database for SSNHL were analyzed. Information was collected at the first visit about the patient's past medical history, potential precipitating events traumata, family medical history, hearing loss, current disease, diagnostic protocol and treatment using questionnaires as well as two audiograms for each patient, one at the first visit to the ENT-clinic and one three months later.Results: 65% of these 400 patients underwent hematological tests and 40% had an MRI/CT.22/160 MRI investigated had pathological findings: five acoustic neuromas, one subdural hematoma, one pons infarction, five vascular abnormalities and ten patients had accidental findings not connected to the hearing tracts. 300 of these 400 patients were evaluated as idiopathic sudden sensorineural hearing loss (ISSNHL); 24% of them had one or more pathological tests. No significant correlation was found between either the MRI findings or the laboratory findings with regard to either treatment or hearing recovery in patients with ISSNHL.
Conclusion:Results from a database for SSNHL demonstrate no correlation between laboratory findings, treatment and outcome in 400 patients. The patients with pathological tests were not treated differently from those with normal tests or no tests taken. The value of laboratory findings and MRI might increase if the results are categorized to more specific diagnoses.
A randomized placebo-controlled study has demonstrated no effect of prednisolone in customary dosage on idiopathic sudden sensorineural hearing loss (ISSNHL). The aim of the present paper is to analyse a larger patient group by meta-analysis of data from the RCT together with a corresponding material drawn from the Swedish national database for ISSNHL. Data from 192 patients, 18-80 years with ISSNHL, were available. All had an acute hearing loss of at least 30 dB measured as PTA in the three most affected contiguous frequencies. All patients had been enrolled within one week after onset and evaluated by audiograms after 3 months. 45/99 (RCT) and 54/99 (the database) had been treated with prednisolone in tapering doses from 60 mg daily and 42/93 with placebo (RCT) or 51/93 with no treatment (the database). Primary outcome was the mean hearing improvement on day 90 for the different groups. A mean difference of >10 dB improvement was required to demonstrate a treatment effect for prednisolone compared to placebo/no treatment. No significant difference was seen between the prednisolone group and placebo/no treatment (p = 0.06). Total recovery was 38% in prednisolone group, 40% in the placebo and 14% in the no treatment group. Vertigo at the onset of hearing loss and age at onset had an equal negative prognostic value in all groups and signs of inflammation had a positive effect. Prednisolone in customary dosage does not influence recovery after ISSNHL.
Methods:The first 400 patients submitted to the Swedish national database for SSNHL were analyzed. Information was collected at the first visit about the patient's past medical history, potential precipitating events traumata, family medical history, hearing loss, current disease, diagnostic protocol and treatment using questionnaires as well as two audiograms for each patient, one at the first visit to the ENT-clinic and one three months later.Results: 65% of these 400 patients underwent hematological tests and 40% had an MRI/CT.22/160 MRI investigated had pathological findings: five acoustic neuromas, one subdural hematoma, one pons infarction, five vascular abnormalities and ten patients had accidental findings not connected to the hearing tracts. 300 of these 400 patients were evaluated as idiopathic sudden sensorineural hearing loss (ISSNHL); 24% of them had one or more pathological tests. No significant correlation was found between either the MRI findings or the laboratory findings with regard to either treatment or hearing recovery in patients with ISSNHL.
Conclusion:Results from a database for SSNHL demonstrate no correlation between laboratory findings, treatment and outcome in 400 patients. The patients with pathological tests were not treated differently from those with normal tests or no tests taken. The value of laboratory findings and MRI might increase if the results are categorized to more specific diagnoses.
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