[Clinical features of high-frequency sudden sensorineural hearing loss and factors influencing its therapeutic...

Objective: To analyze the clinical characteristics of patients with high-frequency sudden sensorineural hearing loss and the factors affecting therapeutic efficacy. Methods: The clinical data of patients with high-frequency sudden sensorineural hearing loss who were treated in the Department of Otology, Chinese PLA General Hospital, from January 2009 to April 2025 were retrospectively reviewed. Demographic characteristics, precipitating factors, accompanying symptoms, comorbidities, and audiological features were collected and analyzed. Multivariate logistic regression analysis was further performed to identify factors affecting treatment efficacy. Results: A total of 90 patients aged (41.1±14.1) years were included, with 57 males and 33 females. Definite precipitating factors were identified in 38.9% (35/90) of patients, and excessive fatigue was the most common factor (14.4%, 13/90). Hypertension was the most frequent comorbidity (20.0%, 18/90). Tinnitus was the most common accompanying symptom (94.4%, 85/90), followed by aural fullness (66.7%, 60/90) and vertigo (20.0%, 18/90). Compared with patients with involvement at 4 and 8 kHz, those with involvement at 2, 4, and 8 kHz were older, had lower phonetically balanced maximum scores, and showed lower otoacoustic emission response rates, with statistically significant differences (all P<0.05). The overall treatment effectiveness rate was only 20.0% (18/90). Multivariate logistic regression analysis demonstrated that delayed presentation after onset (OR=1.07, 95%CI: 1.02-1.12, P=0.005), aural fullness (OR=3.68, 95%CI: 1.05-12.86, P=0.042), and female sex (OR=7.73, 95%CI: 1.70-35.14, P=0.008) were associated with poor prognosis. Conclusions: Patients with high-frequency sudden sensorineural hearing loss frequently present with high-pitched tinnitus and aural fullness. Compared with patients without 2 kHz involvement, those with 2 kHz impairment are older and have poorer speech recognition ability. Overall treatment outcomes are unsatisfactory, and delayed presentation after onset, ear fullness, and female sex are associated with poor prognosis.