Variables with prognostic value in the onset of idiopathic sudden sensorineural hearing loss

• Published in: Brazilian journal of otorhinolaryngology 2015-09, Vol.81 (5), p.520-526
• Main Authors: Bogaz, Eduardo Amaro, Maranhão, André Souza de Albuquerque, Inoue, Daniel Paganini, Suzuki, Flavia Alencar de Barros, Penido, Norma de Oliveira
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Audiometria; Audiometry; Audiometry, Pure-Tone; Child; Female; Hearing Loss, Sensorineural - etiology; Hearing Loss, Sensorineural - rehabilitation; Hearing Loss, Sudden - rehabilitation; Humans; Longitudinal Studies; Male; Middle Aged; Original; OTORHINOLARYNGOLOGY; Perda auditiva súbita; Prognosis; Prognóstico; Prospective Studies; Risk Factors; Sudden hearing loss; Young Adult
• ISSN: 1808-8694; 1808-8686; 1808-8686
• DOI: 10.1016/j.bjorl.2015.07.012

The establishment of an individualized prognostic evaluation in patients with a diagnosis of idiopathic sudden sensorineural hearing loss (ISSHL) remains a difficult and imprecise task, due mostly to the variety of etiologies. Determining which variables have prognostic value in the initial assessment of the patient would be extremely useful in clinical practice. To establish which variables identifiable at the onset of idiopathic sudden sensorineural hearing loss have prognostic value in the final hearing recovery. Prospective, longitudinal cohort study. Patients with ISSHL followed by the Department of Otology-Neurotology of a quaternary hospital were included. The following variables were evaluated and correlated with final hearing recovery: age, gender, vertigo, tinnitus, initial degree of hearing loss, contralateral ear hearing, and elapsed time to treatment. 127 patients with ISSHL were evaluated. Rates of absolute and relative recovery were 23.6dB and 37.2% respectively. Complete hearing improvement was observed in 15.7% patients; 27.6% demonstrated significant improvement and improvement was noted in 57.5%. During the onset of ISSHL, the following variables were correlated with a worse prognosis: dizziness, profound hearing loss, impaired hearing in the contralateral ear, and delay to start treatment. Tinnitus at the onset of ISSHL correlated with a better prognosis. Elaborar avaliação prognóstica individualizada em pacientes com diagnóstico de perda auditiva neurossensorial súbita idiopática (PANSI) permanece tarefa árdua e imprecisa devido, em grande parte, à variedade de etiologias. A determinação de quais variáveis teriam valor prognóstico na avaliação inicial do paciente seria de extrema utilidade na prática clínica. Estabelecer quais variáveis, identificáveis no momento de instalação da perda auditiva neurossensorial súbita idiopática, têm valor prognóstico na recuperação auditiva final. Estudo de coorte prospectivo, longitudinal. Incluídos pacientes com PANSI acompanhados pela Disciplina de Otologia–Neurotologia de um hospital quaternário. As seguintes variáveis foram avaliadas e correlacionadas com a recuperação auditiva final: idade, gênero, vertigem, zumbido, grau de perda auditiva inicial, audição na orelha contralateral, tempo para início de tratamento. Foram avaliados 127 pacientes com PANSI. As taxas de recuperação absoluta e relativa foram 23,6dB e 37,2% respectivamente. Apresentaram melhora completa da audição 15,7% dos pacientes; 2