Idiopathic Sudden Sensorineural Hearing Loss With Minimal Hearing Impairment

Abstract

ObjectivesThe aim of the study was to determine the characteristics of patients who did not match the audiometric criteria of idiopathic sudden sensorineural hearing loss (SSNHL) but complained of acute hearing loss.MethodsBy thorough medical chart reviews, historical cohort study was performed with consecutive data of 589 patients complaining of acute unilateral sensorineural hearing loss without identifiable causes between 2005 and 2013. Those patients demonstrating a hearing loss of at least 30 dB at three consecutive frequencies based on pure tone audiometry were classified as group I; the others were classified as group II. Patients' characteristics, final hearing, and hearing improvement rate (HIR) between the two groups were compared.ResultsGroup II exhibited distinctive characteristics, including an early age of onset of the hearing loss (P<0.01), an absence of accompanying diabetes (P<0.01) and hypertension (P<0.01), and better unaffected hearing and final hearing compared with group I (P<0.001). However, the HIR of the patients in the two groups was not significantly different (P>0.05).ConclusionPatients who did not meet the audiological criteria of SSNHL exhibited distinctive characteristics compared to SSNHL patients.

Idiopathic Sudden Sensorineural Hearing Loss, But Not Compatible With the Classical Definition

“…SSNHL, which is also known as sudden deafness, is defined as a sudden onset of hearing loss frequently without a detectable pathology. SSNHL, a disease of unknown etiology in about 90% of cases, is defined as more than 30 dB sensorineural hearing loss occurring at least three consecutive frequencies within 72 hours or less [1][2][3][4]. It is one of the otolaryngological emergencies, and its incidence is not so uncommon.…”

“…Studies concerning SSNHL focused on patients with classical hearing loss, an early onset within three days, in a sensorineural pattern of at least 30 dB over three consecutive frequencies. Patients who did not meet these criteria tended to be excluded from most studies [1][2][3][4][5]. These patients had minimal hearing impairment, which was compatible with the complaint.…”

“…Sudden sensorineural hearing loss (SSNHL) is defined as a hearing impairment in one or both ears with an early onset within three days, in the sensorineural pattern of at least 30 dB over three consecutive frequencies [1,2]. SSNHL with no organic pathology through investigation is defined as idiopathic SSNHL [1][2][3]. The most common theories include viral infection, rupture of the cochlear membrane, and vascular etiologies.…”

“…Nevertheless, there have been many cases that have atypical audiograms with a history of SSNHL, less than 30 dB HL compared to the other ear, or have HL only in one or two consecutive frequencies, or have both conditions. The treatment options for these patients are more controversial, having acute onset of complaints, but the audiograms do not fit in the classical knowledge [3,5]. In the literature, there have been some studies concerning these patients but not enough to determine an acceptable treatment schedule.…”

Easing the Burden of Tinnitus: A Narrative Review for Exploring Effective Pharmacological Strategies

“…Although tinnitus commonly accompanies the substantial hearing loss of 30 dB or more, most cases seeking medical attention primarily complain of hearing impairment. However, in instances where the degree of hearing loss is smaller than this criterion or if the loss occurs only in three or fewer frequencies, patients may present with tinnitus rather than emphasizing hearing impairment [ 57 , 58 ]. Tinnitus can also be the primary complaint even in low-frequency limited losses [ 59 ].…”