Prognosis and pathogenesis of sudden deafness with scaling out

Recovery of hearing in sudden deafness is said to be such that the severer the hearing loss and the longer the period from the disease onset to the start of treatment, the poorer the recovery of hearing. However, the prognosis of the so-called scaling out cases has not yet been fully studied. We have therefore studied 96 patients with severest sudden deafness who consulted us within 14 days after disease onset and who had scaling out in all the frequencies. We evaluated the extent to which recovery of hearing could be expected and whether any characteristics are seen in pathogenesis, etc. The results showed that there was no patient who experienced complete recovery, even when treatment was started as early as within 4 days. Recovery of hearing was better in low frequencies than in high frequencies. The site of the lesion was the inner ear in many cases, and some had retrocochlear lesions. Concerning pathogenesis, we think the difference in degree of lesion should be considered important, rather than there may be a substantial difference, compared to that of slight deafness.