Idiopathic Sudden Sensorineural Hearing Loss: Predictive Factors for Hearing Recovery
| Main Author: | |
|---|---|
| Publication Date: | 2020 |
| Other Authors: | , , , |
| Format: | Article |
| Language: | por |
| Source: | Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) |
| Download full: | https://doi.org/10.34631/sporl.811 |
Summary: | Aims: This study aimed to evaluate treatment outcome of idiopathic sudden sensorineural hearing loss (ISSHL) and to investigate predictive factors of hearing recovery. Study Design: Retrospective study. Material and Methods: This study included 77 patients diagnosed with ISSHL, from January 2009 to December 2018. All patients were treated initially with systemic steroids (SS) and intratympanic steroids (ITS) were offered as salvage treatment to patients with incomplete recovery. Study population was divided into two groups according to achievement of hearing recovery, defined by an improvement in pure tone average (PTA) > 15 dB and a final PTA < 45 dB. Multivariate logistic regression analysis was performed to identify clinical predictors of recovery. Results: Overall, there was a mean PTA improvement of 22.1±16.3 dB and a recovery rate of 55.8%. We found poorer recovery rate in patients with profound hearing loss (p<0.01), later treatment (p<0.01), hyperlipidemia (p=0.02) and venous insufficiency (p=0.03).However, multivariate analysis identified degree of hearing loss (profound, OR 16.9, p=0.001) and duration from onset of symptoms until treatment (≥ 7 days, OR 12.5, p=0.002) as the only independent predictive factors of poor hearing outcome. Conclusion:Our results support the importance of early initiation of treatment. A profound hearing loss at admission was as a poor prognostic factor. |
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Idiopathic Sudden Sensorineural Hearing Loss: Predictive Factors for Hearing RecoverySurdez Neurossensorial Súbita Idiopática: Fatores Preditores de Recuperação AuditivaSudden Hearing LossPredictive FactorsHearing RecoveryIdiopathicSensorineuralSurdez SúbitaFatores PreditoresRecuperação AuditivaIdiopáticaNeurossensorialAims: This study aimed to evaluate treatment outcome of idiopathic sudden sensorineural hearing loss (ISSHL) and to investigate predictive factors of hearing recovery. Study Design: Retrospective study. Material and Methods: This study included 77 patients diagnosed with ISSHL, from January 2009 to December 2018. All patients were treated initially with systemic steroids (SS) and intratympanic steroids (ITS) were offered as salvage treatment to patients with incomplete recovery. Study population was divided into two groups according to achievement of hearing recovery, defined by an improvement in pure tone average (PTA) > 15 dB and a final PTA < 45 dB. Multivariate logistic regression analysis was performed to identify clinical predictors of recovery. Results: Overall, there was a mean PTA improvement of 22.1±16.3 dB and a recovery rate of 55.8%. We found poorer recovery rate in patients with profound hearing loss (p<0.01), later treatment (p<0.01), hyperlipidemia (p=0.02) and venous insufficiency (p=0.03).However, multivariate analysis identified degree of hearing loss (profound, OR 16.9, p=0.001) and duration from onset of symptoms until treatment (≥ 7 days, OR 12.5, p=0.002) as the only independent predictive factors of poor hearing outcome. Conclusion:Our results support the importance of early initiation of treatment. A profound hearing loss at admission was as a poor prognostic factor.Objetivos:Avaliar a eficácia terapêutica na surdez neurossensorial súbita idiopática (SNSI) e identificar fatores preditores de recuperação audiométrica. Desenho do estudo: Estudo retrospetivo. Material e Métodos:Foram incluídos 77 doentes com diagnóstico de SNSI, entre Janeiro de 2009 e Dezembro de 2018, aos quais foi administrado corticoide sistémico (CS) como tratamento inicial e proposta corticoterapia intratimpânica (CIT) na ausência de recuperação completa. Os doentes foram divididos em dois grupos de acordo com a presença de recuperação auditiva, definida por melhoria dos limiares tonais médios (LTM) superior 15 dB, com LTM final inferior a 45 dB. Foi realizada análise de regressão logística binária multivariada, para identificar variáveis independentes de sucesso terapêutico. Resultados:A avaliação terapêutica final evidenciou ganho auditivo médio de 22.1±16.3 dB e taxa de recuperação auditiva de 55.8%. Verificou-se menor taxa de recuperação em doentes com hipoacusia profunda (p<0.01), tratamento tardio (p<0.01), dislipidemia (p=0.02) e insuficiência vascular periférica (p=0.03). Contudo, a análise multivariada dos fatores preditores de recuperação audiométrica, obteve como únicas variáveis independentes de mau prognóstico a hipoacusia profunda à admissão (OR 16.9, p=0.001) e a duração dos sintomas ≥ 7 dias (OR 12.5, p = 0.002). Conclusão:Os nossos resultados confirmam a importância da instituição terapêutica precoce e evidenciam que a presença de hipoacusia profunda à admissão sinaliza doentes com prognóstico desfavorável.Sociedade Portuguesa de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço2020-07-08info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.34631/sporl.811https://doi.org/10.34631/sporl.811Portuguese Journal of Otorhinolaryngology and Head and Neck Surgery; Vol. 58 No. 1 (2020): Março; 23-29Revista Portuguesa de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço; Vol. 58 Núm. 1 (2020): Março; 23-29Revista Portuguesa de Otorrinolaringologia-Cirurgia de Cabeça e Pescoço; Vol. 58 N.º 1 (2020): Março; 23-292184-6499reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAPporhttps://journalsporl.com/index.php/sporl/article/view/2259https://journalsporl.com/index.php/sporl/article/view/2259/231Direitos de Autor (c) 2020 Revista Portuguesa de Otorrinolaringologia e Cirurgia de Cabeça e Pescoçoinfo:eu-repo/semantics/openAccessSalvador, PedroLombo, CatarinaMartins, MargaridaMoreira da Silva, FranciscoFonseca, Rui2024-06-06T12:57:40Zoai:journalsporl.com:article/2259Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T17:53:35.215658Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse |
| dc.title.none.fl_str_mv |
Idiopathic Sudden Sensorineural Hearing Loss: Predictive Factors for Hearing Recovery Surdez Neurossensorial Súbita Idiopática: Fatores Preditores de Recuperação Auditiva |
| title |
Idiopathic Sudden Sensorineural Hearing Loss: Predictive Factors for Hearing Recovery |
| spellingShingle |
Idiopathic Sudden Sensorineural Hearing Loss: Predictive Factors for Hearing Recovery Salvador, Pedro Sudden Hearing Loss Predictive Factors Hearing Recovery Idiopathic Sensorineural Surdez Súbita Fatores Preditores Recuperação Auditiva Idiopática Neurossensorial |
| title_short |
Idiopathic Sudden Sensorineural Hearing Loss: Predictive Factors for Hearing Recovery |
| title_full |
Idiopathic Sudden Sensorineural Hearing Loss: Predictive Factors for Hearing Recovery |
| title_fullStr |
Idiopathic Sudden Sensorineural Hearing Loss: Predictive Factors for Hearing Recovery |
| title_full_unstemmed |
Idiopathic Sudden Sensorineural Hearing Loss: Predictive Factors for Hearing Recovery |
| title_sort |
Idiopathic Sudden Sensorineural Hearing Loss: Predictive Factors for Hearing Recovery |
| author |
Salvador, Pedro |
| author_facet |
Salvador, Pedro Lombo, Catarina Martins, Margarida Moreira da Silva, Francisco Fonseca, Rui |
| author_role |
author |
| author2 |
Lombo, Catarina Martins, Margarida Moreira da Silva, Francisco Fonseca, Rui |
| author2_role |
author author author author |
| dc.contributor.author.fl_str_mv |
Salvador, Pedro Lombo, Catarina Martins, Margarida Moreira da Silva, Francisco Fonseca, Rui |
| dc.subject.por.fl_str_mv |
Sudden Hearing Loss Predictive Factors Hearing Recovery Idiopathic Sensorineural Surdez Súbita Fatores Preditores Recuperação Auditiva Idiopática Neurossensorial |
| topic |
Sudden Hearing Loss Predictive Factors Hearing Recovery Idiopathic Sensorineural Surdez Súbita Fatores Preditores Recuperação Auditiva Idiopática Neurossensorial |
| description |
Aims: This study aimed to evaluate treatment outcome of idiopathic sudden sensorineural hearing loss (ISSHL) and to investigate predictive factors of hearing recovery. Study Design: Retrospective study. Material and Methods: This study included 77 patients diagnosed with ISSHL, from January 2009 to December 2018. All patients were treated initially with systemic steroids (SS) and intratympanic steroids (ITS) were offered as salvage treatment to patients with incomplete recovery. Study population was divided into two groups according to achievement of hearing recovery, defined by an improvement in pure tone average (PTA) > 15 dB and a final PTA < 45 dB. Multivariate logistic regression analysis was performed to identify clinical predictors of recovery. Results: Overall, there was a mean PTA improvement of 22.1±16.3 dB and a recovery rate of 55.8%. We found poorer recovery rate in patients with profound hearing loss (p<0.01), later treatment (p<0.01), hyperlipidemia (p=0.02) and venous insufficiency (p=0.03).However, multivariate analysis identified degree of hearing loss (profound, OR 16.9, p=0.001) and duration from onset of symptoms until treatment (≥ 7 days, OR 12.5, p=0.002) as the only independent predictive factors of poor hearing outcome. Conclusion:Our results support the importance of early initiation of treatment. A profound hearing loss at admission was as a poor prognostic factor. |
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2020 |
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2020-07-08 |
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https://doi.org/10.34631/sporl.811 https://doi.org/10.34631/sporl.811 |
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por |
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por |
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https://journalsporl.com/index.php/sporl/article/view/2259 https://journalsporl.com/index.php/sporl/article/view/2259/231 |
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Sociedade Portuguesa de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço |
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Sociedade Portuguesa de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço |
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Portuguese Journal of Otorhinolaryngology and Head and Neck Surgery; Vol. 58 No. 1 (2020): Março; 23-29 Revista Portuguesa de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço; Vol. 58 Núm. 1 (2020): Março; 23-29 Revista Portuguesa de Otorrinolaringologia-Cirurgia de Cabeça e Pescoço; Vol. 58 N.º 1 (2020): Março; 23-29 2184-6499 reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia instacron:RCAAP |
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