Prognostic Factors in Idiopathic Sudden Sensorineural Hearing Loss: The Experience of Two Audiology Tertiary Referral Centres
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Diagnostic and Therapeutic Work-Up
- Complete recovery (CR): Final hearing level ≤ 25 dB;
- Partial recovery (PR): More than 15 dB hearing gain and final hearing level 26–45 dB;
- Slight improvement (SI): More than 15 dB hearing gain and final hearing level 46–75 dB;
- No improvement (NI): Less than 15 dB hearing gain or final hearing level 76–90 dB;
- Non-serviceable ear (NS): Final hearing level > 90 dB. For the statistical analysis, the outcomes were dichotomized as CR vs. non-complete recovery (including PR, SI, NI, and NS).
2.3. Statistical Analysis
3. Results
3.1. General Clinical Features and Outcomes
3.2. Clinical Prognostic Factors
3.3. Prognostic Value of Audiometric Findings at Diagnosis: Logistic Regression-Based Estimations
4. Discussion
4.1. Demographics, Comorbidities and Prognosis
4.2. Pre-Treatment Audiological Variables and Prognosis
4.3. Weaknesses and Strengths of the Investigation
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Variable | Overall N = 86 | Complete Recovery N = 21 | Non-Complete Recovery N = 65 | p-Value |
---|---|---|---|---|
Age (years) Median (IQR) | 58.00 (47.00–69.00) | 54.00 (50.00–60.00) | 60.00 (46.00–63.00) | 0.165 * |
Age < 65 years N (%) | 54 (62.79) | 17 (80.95) | 37 (56.92) | 0.040 ** |
Age ≥ 65 years N (%) | 32 (37.21) | 4 (19.05) | 28 (43.08) | |
Female N (%) | 38 (44.19) | 11 (52.38) | 27 (41.54) | 0.268 ** |
Male N (%) | 48 (55.81) | 10 (47.62) | 38 (58.46) | |
Time-to-diagnosis (days) Median (IQR) | 7.00 (1.50–20.00) | 5.00 (1.00–7.00) | 7.00 (2.00–20.00) | 0.102 * |
Time-to-diagnosis ≤ 7 days N (%) | 49 (56.98) | 16 (76.19) | 33 (50.77) | 0.035 ** |
Time-to-diagnosis > 7 days N (%) | 37 (43.02) | 5 (23.81) | 32 (49.23) | |
No hypertension N (%) | 43 (53.09) | 13 (65.00) | 30 (49.18) | 0.166 ** |
Hypertension N (%) | 38 (46.91) | 7 (35.00) | 31 (50.82) | |
No diabetes N (%) | 71 (87.65) | 20 (100.00) | 51 (83.61) | 0.048 ** |
Diabetes N (%) | 10 (12.39) | 0 (0.00) | 10 (16.39) | |
No vascular disease N (%) | 70 (86.42) | 16 (80.00) | 54 (88.52) | 0.268 ** |
Vascular disease N (%) | 11 (13.58) | 4 (20.00) | 7 (11.48) | |
No dyslipidemia N (%) | 61 (75.31) | 17 (85.00) | 44 (72.13) | 0.197 ** |
Dyslipidemia N (%) | 20 (24.69) | 3 (15.00) | 17 (27.87) | |
No kidney failure N (%) | 79 (97.53) | 20 (100.00) | 59 (96.72) | 0.565 ** |
Kidney failure N (%) | 2 (2.47) | 0 (0.00) | 2 83.28) | |
No autoimmune disorders N (%) | 74 (92.50) | 10 (90.00) | 56 (93.33) | 0.470 ** |
Autoimmune disorders N (%) | 4 (7.50) | 2 (10.00) | 4 (6.67) | |
No subjective hypoacusis N (%) | 2 (2.38) | 0 (0.00) | 2 (3.17) | 0.560 ** |
Subjective hypoacusis N (%) | 82 (97.62) | 21 (100.00) | 61 (96.83) | |
No fullness N (%) | 46 (55.42) | 13 (61.90) | 33 (53.23) | 0.333 ** |
Fullness N (%) | 37 (44.58) | 8 (38.10) | 29 (46.77) | |
No tinnitus N (%) | 26 (32.10) | 6 (28.57) | 20 (33.33) | 0.454 ** |
Tinnitus N (%) | 55 (67.90) | 15 (71.43) | 40 (66.67) | |
No vestibular symptoms N (%) | 57 (68.67) | 18 (85.71) | 39 (62.90) | 0.043 ** |
Vestibular symptoms N (%) | 26 (31.33) | 3 (14.29) | 23 (37.10) | |
No spontaneous nystagmus N (%) | 50 (89.29) | 14 (93.33) | 36 (87.80) | 0.485 ** |
Spontaneous nystagmus N (%) | 6 (10.71) | 1 (6.67) | 5 (12.20) | |
No positional nystagmus N (%) | 44 (86.27) | 13 (92.86) | 31 (83.78) | 0.370 ** |
Positional nystagmus N (%) | 7 (13.73) | 1 (7.14) | 6 (16.22) | |
No asymmetric vestibular reflectivity N (%) | 38 (86.36) | 12 (92.31) | 26 (83.87) | 0.417 ** |
Asymmetric vestibular reflectivity N (%) | 6 (13.64) | 1 (7.69) | 5 816.13) | |
Oral Steroid dose (mg) Median (IQR) | 30 (25-50) | 40 (25-50) | 25 (25-37.5) | 0.0249 * |
PTA affected side (dB) Median (IQR) | 48.13 (36.25–73.75) | 36.25 (30.00–37.50) | 58.75 (42.50–76.25) | <0.0001 * |
Threshold 250 Hz affected side (dB) Median (IQR) | 45.00 (30.00–65.00) | 35.00 (15.00–45.00) | 50.00 (35.00–70.00) | 0.0038 * |
Threshold 500 Hz affected side (dB) Median (IQR) | 50.00 (35.00–70.00) | 40.00 (25.00–45.0) | 55.00 (40.00–75.00) | 0.0012 * |
Threshold 1000 Hz affected side (dB) Median (IQR) | 50.00 (35.00–75.00) | 35.00 (20.00–40.00) | 60.00 (35.00–80.00) | 0.0010 * |
Threshold 2000 Hz affected side (dB) Median (IQR) | 50.00 (30.00–75.00) | 30.00 (20.00–35.00) | 60.00 (40.00–75.00) | 0.0001 * |
Threshold 4000 Hz affected side (dB) Median (IQR) | 60.00 (40–00–80.00) | 45.00 (35.00–50.00) | 70.00 (50.00–90.00) | 0.0003 * |
Threshold 8000 Hz affected side (dB) Median (IQR) | 7.00 (50.00–90.00) | 50.00 (40.00–65.00) | 80.00 (55.00–95.00) | 0.0006 * |
Stapedial reflex threshold 500 Hz affected side (dB) Median (IQR) | 95.00 (90.00–100.00) | 95.00 (85.00–97.50) | 97.50 (90.00–100.00) | 0.0808 * |
Stapedial reflex threshold 1000 Hz affected side (dB) Median (IQR) | 95.00 (90.00–100.00) | 95.00 (85.00–100.00) | 100.00 (90.00–100.00) | 0.1150 * |
Stapedial reflex threshold 2000 Hz affected side (dB) Median (IQR) | 95.00 (90.00–100.00) | 87.50 (85.00–100.00) | 100.00 (95.00–105.00) | 0.0301 * |
Stapedial reflex threshold 4000 Hz affected side (dB) Median (IQR) | 95.00 (90.00–100.00) | 90.00 (85.00–100.00) | 100.00 (90.00–105.00) | 0.1787 * |
Detection threshold affected side (dB) Median (IQR) | 30.00 (30.00–70.00) | 30.00 (20.00–30.00) | 45.00 (30.00–70.00) | 0.0017 * |
SDS50 affected side (dB) Median (IQR) | 40.00 (30.00–50.00) | 40.00 (30.00–40.00) | 45.00 (40.00–55.00) | 0.0323 * |
SDS100 affected side (dB) Median (IQR) | 50.00 (40.00–60.00) | 50.00 (40.00–60.00) | 50.00 (50.00–70.00) | 0.2816 * |
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Variable | Odds Ratio (95% C.I.) | Standard Error | p-Value |
---|---|---|---|
Age at diagnosis | 1.0174 (0.9687–1.0686) | 0.0255 | 0.490 |
Time to diagnosis | 1.0400 (0.9835–1.0996) | 0.0296 | 0.168 |
Oral steroid dose | 1.0214 (0.9646–1.0814) | 0.0298 | 0.469 |
PTA on the affected side at diagnosis | 1.0615 (1.0185–1.1063) | 0.0224 | 0.005 |
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Caragli, V.; Franz, L.; Incognito, A.; Bitonti, S.; Guarnaccia, M.; Cenedese, R.; Cocimano, D.; Romano, A.; Canova, G.; Zanatta, P.; et al. Prognostic Factors in Idiopathic Sudden Sensorineural Hearing Loss: The Experience of Two Audiology Tertiary Referral Centres. Medicina 2024, 60, 1130. https://doi.org/10.3390/medicina60071130
Caragli V, Franz L, Incognito A, Bitonti S, Guarnaccia M, Cenedese R, Cocimano D, Romano A, Canova G, Zanatta P, et al. Prognostic Factors in Idiopathic Sudden Sensorineural Hearing Loss: The Experience of Two Audiology Tertiary Referral Centres. Medicina. 2024; 60(7):1130. https://doi.org/10.3390/medicina60071130
Chicago/Turabian StyleCaragli, Valeria, Leonardo Franz, Alessandro Incognito, Salvatore Bitonti, Maria Guarnaccia, Roberta Cenedese, Debora Cocimano, Aaron Romano, Giuseppe Canova, Paolo Zanatta, and et al. 2024. "Prognostic Factors in Idiopathic Sudden Sensorineural Hearing Loss: The Experience of Two Audiology Tertiary Referral Centres" Medicina 60, no. 7: 1130. https://doi.org/10.3390/medicina60071130
APA StyleCaragli, V., Franz, L., Incognito, A., Bitonti, S., Guarnaccia, M., Cenedese, R., Cocimano, D., Romano, A., Canova, G., Zanatta, P., Genovese, E., de Filippis, C., & Marioni, G. (2024). Prognostic Factors in Idiopathic Sudden Sensorineural Hearing Loss: The Experience of Two Audiology Tertiary Referral Centres. Medicina, 60(7), 1130. https://doi.org/10.3390/medicina60071130