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Available online 10 December 2021
Sudden sensorineural hearing loss: Recovery rates according to audiometric patterns
Hipoacusia neurosensorial súbita: tasas de recuperación en función de los patrones audiométricos
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Sofia Waissbluth
Corresponding author
sofia.waissbluth@gmail.com

Corresponding author.
, Valeria Sepúlveda, Pablo Urzúa
Department of Otorhinolaryngology, Pontificia Universidad Católica de Chile, Santiago, Chile
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Tables (5)
Table 1. Hearing thresholds for the affected ear at initial presentation.
Table 2. Degree of hearing loss at initial presentation.
Table 3. Differences in hearing thresholds between the affected ear and the contralateral ear at initial presentation.
Table 4. Recovery rates at 2 weeks and 3 months follow-up.
Table 5. Proportion of patients that presented with concomitant vertigo and/or dizziness.
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Abstract
Purpose

The aim of this study was to evaluate the different audiometric patterns in sudden sensorineural hearing loss (SSNHL), assess recovery rates based on the initial pattern and also, analyse the impact on speech discrimination scores (SDS).

Methods

A retrospective, descriptive, study was completed for patients with SSNHL from January 2010 until June 2020. Outcome measures included audiometric patterns, recovery rates, improvements over time for hearing loss as well as for SDS at 14 days and 3 months follow-up. The Kruskal–Wallis test and Mann–Whitney U test were used to compare differences between the different groups. Post-hoc testing involved the Wilcoxon signed-rank test. A P<0.05 was considered statistically significant.

Results

We included 211 patients, 64.3% showed downward-sloping or flat audiometric curves. Overall, 40% of the patients had recovered 50% or more of their hearing by day 14. We observed that hearing did improve over time, and this was more common for the upward-sloping cases, with 65% recovering to at least 50% of the maximum possible recovery by 3 months follow-up. Thirty percent had concomitant vertigo and/or dizziness; these patients had worse initial speech PTAs (pure tone average) (P0.0001) and inferior recovery rates (P=0.0007) as compared to patients without vertigo and/or dizziness.

Conclusion

SSNHL is still a controversial topic. Variability was observed with regards to audiometric curves, recovery rates and SDS recovery. We provide a table with recovery rates based on audiometric patterns that may help guide clinicians when explaining this condition to their patients.

Keywords:
Sudden sensorineural hearing loss
Hearing loss
Speech intelligibility
Vertigo
Resumen
Objetivo

El objetivo de este estudio fue evaluar los diferentes patrones audiométricos de la hipoacusia neurosensorial súbita (SSNHL), las tasas de recuperación sobre la base del patrón inicial, y analizar su impacto en las puntuaciones de discriminación del habla (SDS).

Métodos

Se realizó un estudio retrospectivo y descriptivo para pacientes con SSNHL desde enero de 2010 a junio de 2020. Los resultados incluyeron patrones audiométricos, tasas de recuperación, mejoras a lo largo del tiempo de la hipoacusia, así como de SDS a 14 días, y transcurridos 3 meses. Se utilizaron la prueba de Kruskal-Wallis y U de Mann-Whitney para comparar las diferencias entre los diferentes grupos. Las pruebas post-hoc incluyeron la prueba de Wilcoxon de rango con signo. Se consideró un valor p<0,05 estadísticamente significativo.

Resultados

Incluimos 211 pacientes, de los cuales el 64,3% presentó curvas descendentes o planas. En general, el 40% de los pacientes había recuperado el 50% o más de audición en el día 14. Observamos que la audición mejoró con el tiempo, siendo esto más común para los casos de curva ascendente, en los que el 65% había recuperado al menos el 50% del valor máximo posible en el seguimiento a los 3 meses. El 30% tuvo vértigo y/o mareo concomitante, y estos pacientes reflejaron peores PTA iniciales del habla (medias de tonos puros) (p0,0001) y tasas de recuperación inferiores (p=0,0007) en comparación con los pacientes sin vértigo y/o mareo.

Conclusión

La SSNHL continua siendo tema controvertido. Se observó variabilidad con respecto a las curvas audiométricas, tasas de recuperación y recuperación de SDS. Aportamos aquí una tabla que incluye las tasas de recuperación basadas en patrones audiométricos, que puede ayudar a los clínicos a la hora de explicar esta situación a sus pacientes.

Palabras clave:
Hipoacusia neurosensorial súbita
Hipoacusia
Inteligibilidad del habla
Vértigo

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