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      Prognostic factors in sudden sensorineural hearing loss: a retrospective study using interaction effects

      research-article
      a , * , b ,
      Brazilian Journal of Otorhinolaryngology
      Elsevier
      hearing loss, sudden, regression analysis, vertigo

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          Abstract

          The prognostic significance of vertigo in patients with idiopathic sudden sensorineural hearing loss (SSNHL) remains a matter of debate.

          Objective

          This paper aims to verify the difference between a group with vertigo and a group without vertigo, and to analyze vertigo's validation as a prognostic factor in patients with SSNHL.

          Method

          This study involved 183 patients with SSNHL. A t-test was used to compare group A (SSNHL with vertigo, n = 31) and group B (SSNHL without vertigo, n = 152). Also we want to verify the interaction effects between vertigo and other prognostic factors using multiple regression analysis.

          Results

          There was a significant difference between group A and group B: the initial hearing level of group A was lower than group B, and their treatment onset was also shorter. In addition, vertigo itself didn't affect hearing improvement, but the interaction variable between vertigo and initial hearing level did affect hearing improvement significantly.

          Conclusion

          The clinical characteristics of patients with vertigo did not directly affect hearing improvement with SSNHL; however, vertigo had an influence on SSNHL though its interaction with the initial hearing levels.

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          Most cited references30

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          Sudden hearing loss: eight years' experience and suggested prognostic table.

          F M Byl (1984)
          The etiology, incidence, acute and late prognosis, and treatment of sudden hearing loss (SHL) are described variously in the literature. In an 8-year prospective study of 225 SHL patients, initiated in July 1973, overall, normal, or complete recovery occurred in 45% of patients and late otologic complications in 28%. Important prognostic indicators were severity of initial hearing loss and vertigo, time to initial audiogram, and elevated erythrocyte sedimentation rate; other indicators were age greater than 60 and less than 15 years, midfrequency audiogram configuration, and hearing status of the opposite ear. A common inflammatory cause is suggested for all degrees of severity in SHL, and a prognostic table is provided to aid the practitioner in predicting recovery. There is still no evidence that treatment achieves a result better than expected with spontaneous recovery.
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            The treatment of idiopathic sudden sensorineural hearing loss.

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              • Article: not found

              Natural history of sudden sensorineural hearing loss.

              This is a prospective in-depth study of patients with sudden idiopathic sensorineural hearing loss. We found that 65% recover completely to functional hearing levels spontaneously and independent of any type of medical treatment. The majority do so within 14 days and many within the first few days. Prognosis can be predicted according to the slope of the initial audiogram (low-frequency losses do better than high-frequency losses), hearing at 8 kHz, erythrocyte sedimentation rates, in some select instances spatial disorientation symptoms, and speech discrimination scores. There was a very poor correlation between hearing and vestibular test abnormalities, except hypoactive calories. There were no correlations with age (excepting the very elderly), with antecedent respiratory infections, hypertension, diabetes, or other chronic diseases. We conclude that there is a fundamental difference in the behavior of apical and basal cochlea losses, that hearing recovery is always better at low than at high frequencies, that because of the high spontaneous recovery rates, tympanotomies seeking peri-lymph fistulas should be delayed ten days unless there is a progressive hearing loss, and that none of the current recommended treatments, especially histamine, have any effect on the outcome.
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                Author and article information

                Contributors
                Journal
                Braz J Otorhinolaryngol
                Braz J Otorhinolaryngol
                Brazilian Journal of Otorhinolaryngology
                Elsevier
                1808-8694
                1808-8686
                08 October 2015
                May-Jun 2013
                08 October 2015
                : 79
                : 4
                : 466-470
                Affiliations
                [a ]Professor (Department of Otorhinolaryngology-Head & Neck Surgery, College of Medicine, Eulji University).
                [b ]Associate Professor (Department of Healthcare Management, Eulji University).
                []Department of Healthcare Management, College of Healthcare Industry, Eulji University.
                Author notes
                [* ]Send correspondence to: Young-Jin Choi. 212, Yangji-Dong, Sujeong-Gu, Seongnam-Si, Gyeonggi-do, South Korea. 461-713.
                Article
                S1808-8694(15)30198-1
                10.5935/1808-8694.20130083
                9442397
                23929147
                038800a0-3dd0-433f-9a94-2dc9a985281b
                © Neck Surgery, College of Medicine, Eulji University).

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 9 April 2013
                Categories
                Original Article

                hearing loss,sudden,regression analysis,vertigo
                hearing loss, sudden, regression analysis, vertigo

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