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Prognostic factors for profound sudden idiopathic sensorineural hearing loss: a multicenter retrospective study

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Abstract

The aim of this study was to assess the outcomes of various treatment modalities for profound idiopathic sudden sensorineural hearing loss (ISSNHL) and confirm the prognostic factors. In total, 191 patients were enrolled after a thorough medical chart review of patients diagnosed with unilateral, profound ISSNHL (≥90 dB). Epidemiological profiles, therapeutic regimens, and the results of pure tone audiometry tests were recorded for all patients. Final recovery was assessed according to Siegel’s criteria and by comparing the final hearing level of the affected ear with that of the unaffected ear. The mean follow-up duration and the final hearing level were 75 ± 54 days and 77 ± 24 dB, respectively. None of the evaluated prognostic factors were significantly associated with complete recovery (<25 dB). However, improved hearing in both ears, the absence of dizziness, the use of lipo-prostaglandin E1 (lipo-PGE1), and the use of plasma volume expanders were independently associated with a final hearing level of up to 45 dB (p < 0.05). Steroid dose reduction, worse initial hearing, and non-use of lipo-PGE1 increased the possibility of no recovery. Although the efficacy of oral steroid treatment for profound ISSNHL has been questioned, steroid dose reduction was significantly associated with no recovery. Therefore, adequate oral corticosteroid doses should be considered in the absence of contraindications. In addition, the use of lipo-PGE1 and/or a plasma volume expander seems preferable for better recovery, and their use for the management of profound ISSNHL should be considered.

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References

  1. Schreiber BE, Agrup C, Haskard DO, Luxon LM (2010) Sudden sensorineural hearing loss. Lancet 375:1203–1211. doi:10.1016/S0140-6736(09)62071-7

    Article  PubMed  Google Scholar 

  2. Stachler RJ, Chandrasekhar SS, Archer SM, Rosenfeld RM, Schwartz SR, Barrs DM, Brown SR, Fife TD, Ford P, Ganiats TG, Hollingsworth DB, Lewandowski CA, Montano JJ, Saunders JE, Tucci DL, Valente M, Warren BE, Yaremchuk KL, Robertson PJ, American Academy of Otolaryngology-Head and Neck Surgery (2012) Clinical practice guideline: sudden hearing loss. Otolaryngol Head Neck Surg 146:S1–S35. doi:10.1177/0194599812436449

    Article  PubMed  Google Scholar 

  3. Conlin AE, Parnes LS (2007) Treatment of sudden sensorineural hearing loss: I. A systematic review. Arch Otolaryngol Head Neck Surg 133:573–581. doi:10.1001/archotol.133.6.573

    Article  PubMed  Google Scholar 

  4. Fetterman BL, Saunders JE, Luxford WM (1996) Prognosis and treatment of sudden sensorineural hearing loss. Am J Otol 17:529–536

    CAS  PubMed  Google Scholar 

  5. Cvorovic L, Deric D, Probst R, Hegemann S (2008) Prognostic model for predicting hearing recovery in idiopathic sudden sensorineural hearing loss. Otol Neurol 29:464–469. doi:10.1097/MAO.0b013e31816fdcb4

    Article  Google Scholar 

  6. Lee HY, Jung SY, Park MS, Yeo SG, Lee SY, Lee SK (2012) Feasibility of three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging as a prognostic factor in patients with sudden hearing loss. Eur Arch Otorhinolaryngol 269:1885–1891. doi:10.1007/s00405-011-1834-1

    Article  PubMed  Google Scholar 

  7. Hong SM, Ko YG, Park CH, Lee JH, Kim JH (2012) Analysis of hearing improvement in patients with severe to profound sudden sensorineural hearing loss according to the level of pure tone hearing threshold. Eur Arch Otorhinolaryngol 269:2057–2060. doi:10.1007/s00405-011-1864-8

    Article  PubMed  Google Scholar 

  8. Zhao H, Fu YY, Zhang TY, Chi FL, Jing JH (2010) Different prognostic characteristics between profound sudden sensorineural hearing loss and total sudden hearing loss. Zhonghua er bi yan hou tou jing wai ke za zhi 45:570–573

    PubMed  Google Scholar 

  9. Naiboğllu B, Külekçi S, Sürmeli M, Verim A, Kalaycik Ertugay Ç, İhvan Ö, Şeneldir L, Zer Toros S (2015) Efficacy of multimodality approach to sudden hearing loss. Kulak Burun Bogaz Ihtis Derg 25:77–81. doi:10.5606/kbbihtisas.2015.65768

    Article  PubMed  Google Scholar 

  10. Oya R, Horii A, Akazawa H, Osaki Y, Inohara H (2016) Prognostic predictors of sudden sensorineural hearing loss in defibrinogenation therapy. Acta Otolaryngol 136:271–276. doi:10.3109/00016489.2015.1104723

    Article  PubMed  Google Scholar 

  11. Lee HY, Kim JC, Choi MS, Chang DS, Kim AY, Cho CS (2015) Therapeutic effect of combined steroid-lipoprostaglandin E1 for sudden hearing loss: a propensity score-matched analysis. Am J Otolaryngol 36:52–56. doi:10.1016/j.amjoto.2014.10.007

    Article  PubMed  Google Scholar 

  12. Siegel LG (1975) The treatment of idiopathic sudden sensorineural hearing loss. Otolaryngol Clin N Am 8:467–473

    CAS  Google Scholar 

  13. Wen YH, Chen PR, Wu HP (2014) Prognostic factors of profound idiopathic sudden sensorineural hearing loss. Eur Arch Otorhinolaryngol 271:1423–1429. doi:10.1007/s00405-013-2593-y

    Article  PubMed  Google Scholar 

  14. Chang NC, Ho KY, Kuo WR (2005) Audiometric patterns and prognosis in sudden sensorineural hearing loss in southern Taiwan. Otolaryngol Head Neck Surg 133:916–922. doi:10.1016/j.otohns.2005.09.018

    Article  PubMed  Google Scholar 

  15. Agarwal L, Pothier DD (2009) Vasodilators and vasoactive substances for idiopathic sudden sensorineural hearing loss. Cochrane Database Syst Rev 4:CD003422. doi:10.1002/14651858.CD003422.pub4

    Google Scholar 

  16. Wang CT, Chou HW, Fang KM, Lai MS, Cheng PW (2012) Treatment outcome of additional dextran to corticosteroid therapy on sudden deafness: propensity score-matched cohort analysis. Otolaryngol Head Neck Surg 147:1125–1130. doi:10.1177/0194599812458219

    Article  PubMed  Google Scholar 

  17. Hanchanale V, Eardley I (2014) Alprostadil for the treatment of impotence. Expert Opin Pharmacother 15:421–428. doi:10.1517/14656566.2014.873789

    Article  CAS  PubMed  Google Scholar 

  18. Hasegawa H, Ichioka S (2015) Effects of lipo-prostaglandin E1 on wound bed microcirculation. J Wound Care 24:293–294, 296, 298–299. doi:10.12968/jowc.2015.24.7.293

  19. Crane RA, Camilon M, Nguyen S, Meyer TA (2015) Steroids for treatment of sudden sensorineural hearing loss: a meta-analysis of randomized controlled trials. Laryngoscope 125:209–217. doi:10.1002/lary.24834

    Article  PubMed  Google Scholar 

  20. Wei BP, Stathopoulos D, O’Leary S (2013) Steroids for idiopathic sudden sensorineural hearing loss. Cochrane Database Syst Rev 7:CD003998. doi:10.1002/14651858.CD003998.pub3

    Google Scholar 

  21. Ng JH, Ho RC, Cheong CS, Ng A, Yuen HW, Ngo RY (2015) Intratympanic steroids as a salvage treatment for sudden sensorineural hearing loss? A meta-analysis. Eur Arch Otorhinolaryngol 272:2777–2782. doi:10.1007/s00405-014-3288-8

    Article  PubMed  Google Scholar 

  22. Nakache G, Migirov L, Trommer S, Drendel M, Wolf M, Henkin Y (2015) Steroid-based treatments for patients with total sudden sensorineural hearing loss. Acta Otolaryngol 135:907–913. doi:10.3109/00016489.2015.1034881

    Article  PubMed  Google Scholar 

  23. Battaglia A, Lualhati A, Lin H, Burchette R, Cueva R (2014) A prospective, multi-centered study of the treatment of idiopathic sudden sensorineural hearing loss with combination therapy versus high-dose prednisone alone: a 139 patient follow-up. Otol Neurotol 35:1091–1098. doi:10.1097/MAO.0000000000000450

    Article  PubMed  Google Scholar 

  24. Rauch SD, Halpin CF, Antonelli PJ, Babu S, Carey JP, Gantz BJ, Goebel JA, Hammerschlag PE, Harris JP, Isaacson B, Lee D, Linstrom CJ, Parnes LS, Shi H, Slattery WH, Telian SA, Vrabec JT, Reda DJ (2011) Oral vs intratympanic corticosteroid therapy for idiopathic sudden sensorineural hearing loss: a randomized trial. JAMA 305:2071–2079. doi:10.1001/jama.2011.679

    Article  CAS  PubMed  Google Scholar 

  25. Choi MS, Lee HY, Cho CS (2014) Optimal dosage of methylprednisolone for the treatment of sudden hearing loss in geriatric patients: a propensity score-matched analysis. PLoS One 9:e111479. doi:10.1371/journal.pone.0111479

    Article  PubMed  PubMed Central  Google Scholar 

  26. Noguchi Y, Takahashi M, Ito T, Fujikawa T, Kawashima Y, Kitamura K (2015) Delayed restoration of maximum speech discrimination scores in patients with idiopathic sudden sensorineural hearing loss. Auris Nasus Larynx. doi:10.1016/j.anl.2015.12.003 (Epub ahead of print)

    Google Scholar 

  27. Kim YH, Park KT, Choi BY, Park MH, Lee JH, Oh SH, Chang SO (2012) Early combination treatment with intratympanic steroid injection in severe to profound sudden sensorineural hearing loss improves speech discrimination performance. Eur Arch Otorhinolaryngol 269:2173–2178. doi:10.1007/s00405-011-1874-6

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education (NRF-2014R1A1A1002911 for D.K.K.) (NRF-2015R1D1A3A01018881 for Y.H.P.).

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Correspondence to Dong-Kee Kim or Yong-Ho Park.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Lee, H.Y., Kim, DK., Park, YH. et al. Prognostic factors for profound sudden idiopathic sensorineural hearing loss: a multicenter retrospective study. Eur Arch Otorhinolaryngol 274, 143–149 (2017). https://doi.org/10.1007/s00405-016-4276-y

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  • DOI: https://doi.org/10.1007/s00405-016-4276-y

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