The prognostic value of the otoacoustic emission test in low frequency sudden hearing loss

Abstract

Low frequency sudden hearing loss (LFSHL) is a frequent finding in the otological practice. Several prognostic indicators have been suggested concerning the prediction of the outcome of sudden hearing loss, but so far there are no proven factors to establish the prognosis. The aim of this study was to assess whether OAEs could be considered as a reliable prognostic test in LFSHL. The study group consisted of 20 patients presenting with a unilateral LFSHL. Each patient was submitted to spontaneous otoacoustic emissions (SOAEs), transient otoacoustic emissions (TEOAEs) and distortion products (DPOAEs) recording and then treated with glycerol administrated intravenously in 3-h intervals for 4 days. Pure tone audiometry (PTA) threshold was evaluated again 1 h after the last administration of glycerol. After osmotic therapy 12 patients (60%) showed a significant PTA improvement with a mean improvement of 11 dB; modifications were significant at the Student's t test for paired data (P<0.0001). The relationship between the pretherapy presence or absence of SOAEs, TEOAEs and DPOAEs and PTA modification was not significant at the exact Fisher's test. In conclusion, even if our study supports that OAEs could be an indicator of the inner ear functional state, they cannot be utilized as a prognostic test in LFSHL in relation to the efficacy of osmotic therapy. Among the other parameters evaluated, only the precocity of therapy seems to be related to prognosis in LFSHL.

Audiologic results in patients with Moebiüs sequence

“…In contrast, from the results of this test, 65% of the Type A tympanogram showed TEOA, indicating good hair cell function and generally indicates that the hearing thresholds should be better than 30 dB HL [26,30,31]. For the DPOAE, it was seen a greater percentage of presence, due to the possibility of having response in individuals with hearing loss up to 50 dB HL [32].…”

Long‐term prognosis of low‐frequency hearing loss and predictive factors for the 10‐year outcome

“…3 Additionally, otoacoustic emission testing is not a suitable prognostic test for LFHL. 19 On the basis of our current findings, we propose that the clinical course is important for predicting the prognosis of LFHL.…”

Otoacoustic Emissions in the Prediction of Sudden Sensorineural Hearing Loss Outcome

“…Some studies report only on the presence or absence of OAEs (2,35,37), whereas others also detail the response strength albeit employing different and non-comparable outcome measures (response thresholdsV33; absolute amplitudesV34, 36; DPOAEs sumV39; SNRV40).…”

“…Follow-up is not specified in some studies (33), whereas others report inconsistent follow-up in regard with the duration, frequency, and tests that have been performed (2,34,35,38), variable intervals between reexaminations (2,34,36,38), or short-term follow-up of several days only (36,37,39).…”

“…These include prolonged delay from onset of ISSNHL to patients' presentation (35,38), variability in the severity and audiometry patterns of the initial hearing loss (35,37,38), a history of previous episodes of hearing loss (37), differences in treatment protocols and the time to commencement of treatment (2,33Y38,40), vagueness in the selection of study participants (33,34,36,37) or biased selection (37Y39), and patient evaluation without an appropriate MRI study to exclude inner ear or cerebellopontine angle space-occupying lesions in some or all patients (33,34,36,38,40). These include prolonged delay from onset of ISSNHL to patients' presentation (35,38), variability in the severity and audiometry patterns of the initial hearing loss (35,37,38), a history of previous episodes of hearing loss (37), differences in treatment protocols and the time to commencement of treatment (2,33Y38,40), vagueness in the selection of study participants (33,34,36,37) or biased selection (37Y39), and patient evaluation without an appropriate MRI study to exclude inner ear or cerebellopontine angle space-occupying lesions in some or all patients (33,34,36,38,40).…”