Outcomes of unilateral idiopathic sudden sensorineural hearing loss: Two decades of experience

Abstract

Objectives(a) Determine the demographic and medical risk factors for patients who presented with unilateral idiopathic sudden sensorineural hearing loss (ISSNHL); (b) identify treatments that patients underwent; (c) evaluate the adequacy of follow‐up and compliance with long‐term hearing rehabilitation.MethodsRetrospective review of patients who presented with unilateral ISSNHL between January 1998 and December 2017 at a tertiary care academic medical center.ResultsTwo hundred‐four patients met inclusion criteria. Of these, 129 (63.2%) did not undergo treatment at an outside hospital prior to our evaluation. In this subgroup, the average pretreatment pure tone average (PTA) was 61.9 ± 2.5 dB (dB). The most common treatment was oral steroids and was recommended in 76 patients (59.9%). Patients also underwent intratympanic (IT) steroid injections (7.2%) or oral steroids followed by salvage IT injections (19.4%). Mean follow‐up duration was 17.9 (±29.2) months, and posttreatment PTA (45.6 ± 2.6 dB) was significantly better than baseline (P < .001). In this cohort, hearing amplification was infrequently recommended. Less than 20% of patients reported active hearing amplification use at their most recent visit. At follow‐up, 90 patients (69.8%) reported subjective improvement in hearing after treatment. Only 55 patients (42.6%) showed improvement in PTA compared to their pretreatment audiograms.ConclusionMany patients with ISSNHL experienced audiometric improvement after treatments, but most had persistent hearing loss. The duration of follow‐up was short. Most patients did not use long‐term hearing amplification. Future studies are needed to identify factors that contribute to reduced follow‐up and low compliance with hearing amplification use in ISSNHL.Level of Evidence2c.

Magnitude of Diabetes Mellitus in Patients of Sudden Sensorineural Hearing Loss and Its Effect on Corticosteroid Therapy

“…3,9,11,13 Other factors which have been implicated in the pathogenesis of sudden sensorineural hearing loss like viral inflammatory conditions of the labyrinth, autoimmune conditions damaging the cochlear apparatus or any degree of compromise in the blood flow due to microvascular diseases respond well to corticosteroid therapy. 14,15 Systemic administration of corticosteroids has been shown to have very good efficacy especially if given early in the course of the disease as has been shown in the studies done by a number of researchers. 4,5,14 We assessed the different parameters of the disease in patients who had DM as compared to the patients who were not suffering from DM at presentation to our department.…”

Diagnostic value and prognostic significance of MRI findings in sudden sensorineural hearing loss

“…The mean hearing threshold was measured at V0 and V1, the difference being expressed in decibels (∆dB). Hearing recovery was deemed present if ∆dB of mean hearing thresholds were ≥15 or if final mean hearing threshold was <25 dB 20 . Initial and final hearing loss severity was classified as mild (26–40 dB HL), moderate (41–55 dB HL), moderately severe (56–70 dB HL), severe (71–90 dB HL), and profound (>90 dB) using Siegel's criteria 21 …”

“…Hearing recovery was deemed present if ΔdB of mean hearing thresholds were ≥15 or if final mean hearing threshold was <25 dB. 20 Initial and final hearing loss severity was classified as mild (26-40 dB HL), moderate (41-55 dB HL), moderately severe (56-70 dB HL), severe (71-90 dB HL), and profound (>90 dB) using Siegel's criteria. 21 All MRI examinations comprised brain and dedicated temporal bone imaging at 1.5 or 3 T, with MRI scans interpreted by experienced radiologists.…”

Imaging Parameters of the Ipsilateral Medial Geniculate Body May Predict Prognosis of Patients with Idiopathic Unilateral Sudden Sensorineural Hearing Loss on the Basis of Diffusion Spectrum Imaging

“…The audiogram shapes were classified into 4 subtypes: low-frequency type, high-frequency type, flat type, and profound type. 13 Hearing recovery was classified according to the Siegel criteria, as follows: 1…”

“…Idiopathic sudden sensorineural hearing loss (ISSHL) is an acute unexplained onset of hearing loss from a cochlear or retrocochlear origin. 1,2 Sudden sensorineural hearing loss affects approximately 5À27 per 100,000 people annually, and the incidence has increased across recent decades. 3,4 Viral infections, cochlear ischemia, autoimmune processes, and metabolic derangement have been proposed as potential etiologies.…”