Document Detail


Prognostic model for predicting hearing recovery in idiopathic sudden sensorineural hearing loss.
MedLine Citation:
PMID:  18434930     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
HYPOTHESIS: To aid in realistic counseling of patients at the time of their first visit concerning their chances for recovery, we created a simple prognostic model for predicting hearing recovery in idiopathic sudden sensorineural hearing loss (ISSHL). BACKGROUND: An important element of research on ISSHL is to identify prognostic factors for this disease. Many studies have described predictive indicators to identify patients with a good prognosis needing no or minimal treatment. Only a few of these studies have included a model for calculating the probability for patient recovery, which may be important for clinical work, but these prognostic tables have not achieved widespread use clinically. METHODS: Evaluation of an electronic patient data base of 541 patients with ISSHL. The standard treatment was carbogen inhalation (95% O2 and 5% CO2 8 times per day in duration of 30 min) and prednisone orally (100 mg in 1 morning dose) for 7 days. Factors that were analyzed included the patient's age, the interval between the onset of symptoms and beginning of treatment, the presence or absence of vertigo and tinnitus, audiometric patterns, the severity of hearing loss, and hearing in the opposite ear. Hearing gain was expressed either as absolute hearing gain or as relative hearing gain. Significant recovery of hearing was defined as the final pure-tone audiometry of 30 dB or less (or the same as the pure-tone audiometry of the opposite ear). RESULTS: The absolute hearing gain was 15.1 dB. The mean relative hearing gain was 47%. Three hundred one (57%) patients had significant recovery of hearing, and 228 (43%) did not have significant recovery of hearing. Using step-wise multiple linear regression analysis, the most important factors for prognosis included severity of hearing loss, presence of vertigo, time between onset and treatment, the hearing of the other ear, and the audiogram shape (beta coefficient was -0.216, -0.231, 0.211, 0.113, and -0.064, respectively; constant, 0.968). A recovery expectancy table was developed using the data from this study. CONCLUSION: Based on a retrospective analysis, prognostic indicators for hearing recovery in ISSHL were found to be severity of hearing loss, presence of vertigo, time between onset and treatment, the hearing of the other ear, and the audiogram shape. We created a model for calculating the probability for hearing recovery based on the analysis of 529 patients with unilateral ISSHL.
Authors:
Ljiljana Cvorović; Dragoslava Deric; Rudolf Probst; Stefan Hegemann
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology     Volume:  29     ISSN:  1531-7129     ISO Abbreviation:  Otol. Neurotol.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-06     Completed Date:  2008-07-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100961504     Medline TA:  Otol Neurotol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  464-9     Citation Subset:  IM    
Affiliation:
Department of Otorhinolaryngology, University Hospital Zemun, Belgrade, Serbia. ljiljanamil@sezampro.yu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Algorithms
Anti-Inflammatory Agents / therapeutic use
Audiometry, Pure-Tone
Carbon Dioxide / therapeutic use
Female
Hearing Loss, Sudden / therapy*
Humans
Male
Middle Aged
Models, Statistical
Oxygen / therapeutic use
Predictive Value of Tests
Prednisone / therapeutic use
Prognosis
Retrospective Studies
Tinnitus / complications
Treatment Outcome
Vertigo / complications
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 124-38-9/Carbon Dioxide; 53-03-2/Prednisone; 7782-44-7/Oxygen; 8063-77-2/carbogen

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