Different prognoses in patients with profound sudden sensorineural hearing loss

Abstract

Background: Inner ear hemorrhage is increasingly recognized as a cochlear lesion that can cause profound sudden sensorineural hearing loss (SSNHL).

Objectives: To investigate changes of cochlear and vestibular function and to compare therapeutic recovery from profound SSNHL induced by different etiologies.

Material and methods: Eighty patients with profound SSNHL (≥90 dB) were divided into an inner ear hemorrhage group and a non-inner ear hemorrhage group by MRI. Statistical analysis was performed to compare the therapeutic effects from vertigo and hearing loss and the outcomes of follow-up in the two groups.

Results: There were significant differences between the two groups in terms of the overall 14-day therapeutic response rate (20 vs. 48%), the incidence of imbalance (26.7 vs. 6%), the incidence of semicircular canal dysfunction on the affected side (60 vs. 20%), the incidence of abnormal C-VEMP and O-VEMP on the affected side (63.3 vs. 38%; and 60 vs. 30%, respectively), the average hearing threshold (74.2 ± 10.7 vs. 53.6 ± 11.4 dB), and the word recognition score (65.5 ± 21.7 vs. 83.5 ± 24.5%) at a 12-month follow-up.

Conclusions and significance: A higher percentage of patients with profound SSNHL induced by inner ear hemorrhage were associated with vertigo and had a poor prognosis.

Chinese abstract

背景：内耳出血逐渐被认为是一种耳蜗病变, 可引起严重的突发性感音神经性听力损失（SSNHL）。

目的：研究耳蜗和前庭功能的变化, 并比较不同病因诱发的严重SSNHL的治疗恢复情况。

材料与方法：80例SSNHL（≥90dB）患者通过MRI被分为内耳出血组和非内耳出血组。进行统计分析以比较眩晕和听力损失的治疗效果以及两组随访的结果。

结果：两组患者之间差异显著:总体14天治疗反应率（20％对48％）, 失衡发生率（26.7％对6％）, 受影响侧的半规管功能障碍发生率（60%对20％）, 受影响侧C-VEMP和O-VEMP异常发生率（分别为63.3％和38％; 60％和30％）, 平均听力阈值（74.2±10.7dB 对53.6±11.4 dB）, 12个月的随访中的单词识别得分（65.5%±21.7%对83.5%±24.5％）。

结论和意义：内耳出血引起的SSNHL患者比例较高, 与眩晕有关, 预后较差。

Keywords:

• Inner ear hemorrhage
• sudden sensorineural hearing loss
• prognosis

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was funded by Guangzhou Science and Technology Programme (201605030003); Natural Science Foundation of Guangdong Province (2017A030313700, 2016A030313198).