Different prognoses in patients with profound sudden sensorineural hearing loss

Area of Science:

• Otolaryngology
• Neurology
• Radiology

Background:

• Inner ear hemorrhage is an emerging cause of profound sudden sensorineural hearing loss (SSNHL).
• Understanding the impact of hemorrhage on cochlear and vestibular function is crucial for treatment.
• Differentiating hemorrhage-induced SSNHL from other etiologies aids in predicting prognosis.

Purpose of the Study:

• To evaluate cochlear and vestibular function changes in SSNHL patients.
• To compare therapeutic recovery in SSNHL patients with and without inner ear hemorrhage.
• To analyze the long-term outcomes of SSNHL based on etiology.

Main Methods:

• Eighty patients with profound SSNHL (≥90 dB) were categorized into inner ear hemorrhage and non-hemorrhage groups using MRI.
• Statistical analysis compared therapeutic effects on vertigo and hearing loss between groups.
• Follow-up assessments included hearing thresholds, word recognition scores, and vestibular function tests.

Main Results:

• The inner ear hemorrhage group showed significantly lower 14-day therapeutic response rates (20% vs. 48%).
• Hemorrhage-induced SSNHL was linked to higher incidences of imbalance (26.7% vs. 6%), semicircular canal dysfunction (60% vs. 20%), and abnormal VEMP responses.
• At 12 months, the hemorrhage group had poorer hearing thresholds (74.2 dB vs. 53.6 dB) and word recognition scores (65.5% vs. 83.5%).

Conclusions:

• Inner ear hemorrhage is associated with a higher prevalence of vertigo in profound SSNHL.
• Patients with SSNHL caused by inner ear hemorrhage demonstrate a poorer prognosis and reduced recovery.
• MRI is essential for identifying inner ear hemorrhage as a critical factor in SSNHL outcomes.