Hearing evaluation with distortion-product otoacoustic emissions in young patients undergoing haemodialysis

Sensorineural hearing loss is frequently reported in young patients with chronic renal failure having haemodialysis. The effect of a single session of haemodialysis on hearing acuity was assessed prospectively in nine children with end-stage renal disease using pure-tone audiometry (PTA) and distortion-product otoacoustic emissions (DPOAEs). Results were compared with those obtained from nine audiologically normal healthy children also tested with PTA and DPOAEs twice during a 4-h interval. Sensorineural hearing loss of unknown aetiology was found in 55.5% of renal patients, mainly in the higher frequencies. Patients on HD had mean PTA thresholds significantly poorer than those of the control group in the frequency range 1000–12 000Hz (P < 0.05). Their mean DPOAE amplitudes were significantly lower in all frequencies > 1184 Hz (P < 0.05). Furthermore, patients' ears with normal PTA thresholds between 250 and 4000 Hz also had decreased DPOAE amplitudes. No significant changes in PTA thresholds or DPOAE amplitudes were encountered in renal patients before and after a HD session (P > 0.05). Changes in PTA thresholds or DPOAE amplitudes were not significantly different than those in the control group (P > 0.05). In conclusion, sensorineural hearing loss of unknown origin, especially in high frequencies, is frequent in young renal patients under HD and single HD sessions do not seem to alter the hearing acuity of these patients. DPOAEs seem to be more sensitive to incipient cochlear damage than behaviour thresholds in monitoring renal patients.     

Hearing evaluation with distortion-product otoacoustic emissions in young patients undergoing haemodialysis.

Sensorineural hearing loss is frequently reported in young patients with chronic renal failure having haemodialysis. The effect of a single session of haemodialysis on hearing acuity was assessed prospectively in nine children with end-stage renal disease using pure-tone audiometry (PTA) and distortion-product otoacoustic emissions (DPOAEs). Results were compared with those obtained from nine audiologically normal healthy children also tested with PTA and DPOAEs twice during a 4-h interval. Sensorineural hearing loss of unknown aetiology was found in 55.5% of renal patients, mainly in the higher frequencies. Patients on HD had mean PTA thresholds significantly poorer than those of the control group in the frequency range 1000-12 000Hz (P < 0.05). Their mean DPOAE amplitudes were significantly lower in all frequencies > 1184 Hz (P < 0.05). Furthermore, patients' ears with normal PTA thresholds between 250 and 4000 Hz also had decreased DPOAE amplitudes. No significant changes in PTA thresholds or DPOAE amplitudes were encountered in renal patients before and after a HD session (P > 0.05). Changes in PTA thresholds or DPOAE amplitudes were not significantly different than those in the control group (P > 0.05). In conclusion, sensorineural hearing loss of unknown origin, especially in high frequencies, is frequent in young renal patients under HD and single HD sessions do not seem to alter the hearing acuity of these patients. DPOAEs seem to be more sensitive to incipient cochlear damage than behaviour thresholds in monitoring renal patients.     

Transient otoacoustic emissions in children with chronic renal failure

This study was conducted on 34 children with chronic renal failure: 27 on regular haemodialysis and seven on conservative treatment. Twenty normal healthy children served as controls. They were subjected to clinical examination including otoscopic examination, basic audiological assessment and transient otoacoustic emission testing (TOAE). Four patients had a conductive hearing loss and five had a bilateral moderately severe high frequency sensory neural hearing loss. TOAE testing was carried out for the rest whose ears displayed normal hearing. No response (fail) was obtained in 8% of them but in none of the controls and a partial pass response in 38% versus 10% of controls (P < 0.001). Cochlear dysfunction was significant only at low frequency levels. The mean overall echo-level and reproducibility were significantly lower in patients than in controls. The same holds true for the subgroup of patients on haemodialysis but not for those on conservative treatment. The overall echo-levels did not correlate with serum urea, creatinine, sodium or potassium.     

Gastroesophageal reflux and sequelae of chronic tubotympanal disorders in children

OBJECTIVE: To compare sequelae of chronic tubotympanal disorders in children with and without gastroesophageal reflux (GER). MATERIAL AND METHODS: In 32 patients with chronic tubotympanal disorders GER was studied by means of 24-h continuous esophageal pH monitoring. After a period of 2-6 years (mean 4 years) sequelae of the tubotympanal disorders were examined, together with the clinical status of the ears and hearing status. The criteria for classification into mild, moderate and severe sequelae were based on the clinical status of the ear. Hearing was determined using tonal audiograms. Conductive hearing loss was classified as either slight (< or = 35 dB hearing loss in speech frequencies) or severe (>35 dB hearing loss in speech frequencies). RESULTS: In the group of 16 patients (mean age 6.1 years) with GER, sequelae were observed in 29 ears (mild, n=11; moderate, n=5; severe, n=13). Hearing impairment was determined in 20 ears (mild, n=8; severe, n=12). In the group of 16 patients (mean age 7.1 years) without GER, sequelae were observed in 17 ears (mild, n=11; moderate, n=1; severe, n=5). Hearing impairment was determined in 10 ears (mild, n=6; severe, n=4). CONCLUSION: The total number of ears with sequelae and the total number of ears with conductive hearing impairment were significantly higher in patients with GER.     

Severe to profound hearing loss in patients with progressed Alport's syndrome

Conclusion: The concept of hearing loss severity must be redefined, as there is a clear need for more active hearing management in Alport's syndrome patients with severe and profound hearing loss. Objectives: Sensorineural hearing loss (SNHL) caused by Alport's syndrome generally does not exceed 60–70 dB, because a cochlear lesion is responsible for this hearing loss. Careful management of renal function improves the prognosis and the longevity of Alport's syndrome patients; it is useful to reassess SNHL caused by Alport's syndrome. Patients and methods: Thirty-two patients with Alport's syndrome were analyzed retrospectively. Pure tone audiograms (PTAs), speech audiograms, and transiently evoked otoacoustic emissions (TEOAEs) were performed. Hearing loss severity was compared to duration of disease and severity of renal dysfunction. We also evaluated the correlation between OAEs and PTAs according to the hypothesis that evoked OAEs would be abnormal even in early stage SNHL in Alport's syndrome. Results: The level of hearing was positively correlated with disease duration. The hearing of the end-stage renal disease (ESRD) group, whose hearing threshold could exceed 70 dB, was worse than that of the non-ESRD group. OAEs were found in patients with normal hearing and mild hearing loss and had no significant early detection value.     

Defibrinogenation therapy for idiopathic sudden sensorineural hearing loss in comparison with high-dose steroid therapy

OBJECTIVE: The efficacy of defibrinogenation therapy for idiopathic sudden sensorineural hearing loss was studied in comparison with high-dose steroid therapy. MATERIAL AND METHODS: Eighty-eight consecutive patients with hearing levels > 40 dB and who had suffered hearing loss for < or = 30 days were enrolled: 40 patients for high-dose steroid therapy (PSL group) and 48 for defibrinogenation therapy (BX group). Hearing recovery was evaluated by grade assessment and by the improvement in hearing compared to the unaffected contralateral ear. RESULTS: The overall hearing outcomes of the two groups were roughly equivalent. However, with regard to patients with initial hearing levels < 80 dB, the hearing improvement rate of the BX group was significantly worse than that of the PSL group (61.2% +/- 7.3% vs 88.7% +/- 8.9%; p < 0.05), whereas in patients with initial hearing levels > or = 80 dB, the hearing outcomes did not differ between the 2 groups. Three patients in the PSL group manifested hyperglycemia while no serious side-effects were observed in the BX group. CONCLUSION: These results indicate that high-dose steroid therapy should be employed in preference to defibrinogenation therapy for patients with moderate hearing loss, whereas defibrinogenation therapy has an advantage for those with severe hearing loss, in view of its lower frequency of side-effects.     

Age-specific structural features of the nasal septum in children

Hearing was studied in 20 and 34 patients with subclinical and initial renal failure (RF), respectively. RF was secondary to chronic glomerulonephritis, chronic pyelonephritis, renal polycystosis (29, 24 and 1 patients, respectively). Hearing function was assessed at tonal threshold, suprathreshold and speech audiometry, ultrasound investigations. It was found that one third of the patients had bilateral symmetric hearing disorder of neurosensory hypoacusis type. The affection was not severe but involved both peripheral and central compartments of the acoustic analyzer. High-frequency sound sensitivity suffered most of all. There was a rise in hearing thresholds by air and bone conductivity at frequencies 12-18 kHz. This rise was the only marker of affected acoustic analyzer in 39% of the examinees. 12% of the patients demonstrated elevated hearing thresholds combined with elevated ultrasound thresholds, low differential threshold of sound intensity and abnormal threshold adaptation.     

Analysis of 200 university hospital hearing aid clinic patients]

We statistically studied patients who visited our hearing aid clinic to determine what segment of the population may benefit from hearing aids. Subjects were 200 patients from 5 to 89 years of age who had visited the Hearing Aid Clinic of Otorhinolaryngology, Nagoya University Hospital, between January 1998 and March 2000. This clinic lent out hearing aids. Subjects were divided into 2 groups those having their own hearing aids either new or earlier (HA group) and those giving up hearing aids after a trial (non-HA group). Mean better hearing levels in pure tone average were 50.6 dB in the HA group and 44.5 dB in the non-HA group. Mean better maximum speech recognition scores were 81.5% in the HA group and 85.3% in the non-HA group. The distribution of better hearing has shown that patients with mild hearing loss (better pure tone average < 40 dB) account for more than a quarter of all hearing aid clinic patients. Among patients with mild hearing loss, 60% had their own hearing aids. The need for rehabilitation in the mild hearing loss population thus appears large. Their intent to wear hearing aids influenced whether patients agreed or declined hearing aids after a trial. The period from use until patients made a decision was 2 weeks in 65% of those declining use and 35% of those agreeing to use. Over 15% of those agreeing called for a trial period longer than 8 weeks. Hearing aid trials provide useful information for both patients and surgeons before choosing surgery for a difficult ear condition. In this research, 18 patients needed counseling about both amplification and surgery. Bridging between ear surgery and hearing aid wearing is a vital role of hearing aid clinics at university hospitals.     

Terminale Niereninsuffizienz und Innenohrschwerhörigkeit

Summary Conflicting reports have been presented with respect to inner ear function of renal patients. Therefore, a detailed analysis of inner ear function was performed in patients of the Heidelberg Dialysis and Transplantation Program.From 1976 to 1980, 125 patients with terminal renal failure were examined; in 45 patients hearing defects were observed. In eight patients causes unrelated to renal disease were found. In 37 patients a recruitment positive hearing loss was observed with an average decrease of 20–30 dB at higher frequencies. Twenty-six patients had a history of administration of aminoglycosides or biopsy proven hereditary glomerulonephritis (Alport's syndrom). Eleven patients had not been given aminoglycosides in this university but had been treated outside with no records available. There was no relation between hearing loss and serum creatinine, urea or electrolyte concentrations. Hearing loss was also unrelated to duration of uremia and number of dialyses. None of the patients showed improvement of hearing function after succesful transplantation. — It is concluded that hearing loss possibly unrelated to aminoglycosides, diuretics or hereditary nephritis is found in less than 10% of all patients in terminal renal failure. In none of the patients was hearing loss improved by reversal of uremia. Therefore it is unlikely that the degree of uremie intoxication observed with current modalities of treatment adversely affects inner ear function.     

鼓室内注射治疗难治性突发性耳聋52例

目的 探讨鼓室内注射激素作为难治性突发性耳聋的补救治疗措施的临床疗效。方法 重度及极重度突发性耳聋患者96例,接受常规治疗加全身应用激素2周效果不佳,其中52例接受鼓室注射激素,另外44例拒绝鼓室内注射而继续口服药物治疗。纯音测听法(PTA)检测患者补救治疗前后听力,比较气导听阈(0.5、1.0、2.0、4.0 kHz四个频率气导之平均值),分析两组患者补救治疗前后听力结果。结果 鼓室注射组听力提高10 dB以上的患者16例,有效率为30.8%;而对照组仅有3例,有效率为6.8%。两组听力改善值之间的差异有统计学意义(P<0.01)。结论 鼓室内激素注射对突发性耳聋常规治疗无效的患者有良好的疗效,可以作为一种补救治疗措施。     

Serum antibody response and germinal centre reaction in the upper respiratory tract after antigen challenge in mice

The difference in the hearing threshold before and after treatment with cis-diaminnedichloroplatinum (DDP) is analysed in 69 patients. Hearing loss due to DDP treatment is mainly limited to 8,000 Hz and the incidence is about 40%. The effect of DDP is dose-related, although even at the lowest dose 20% of the patients are affected. The age of the patients is not an important factor. Loss of hearing due to DDP treatment occurs independent of any pre-existent hearing loss although those patients with great pre-existent hearing loss do not show a further loss. Of the patients with hearing loss, 39% show a difference of 20 dB or more between the left and the right ear. Hearing loss due to DDP is of minor importance compared with many of the other side-effects of DDP.     

Defibrinogenation Therapy for Idiopathic Sudden Sensorineural Hearing Loss in Comparison with High-dose Steroid Therapy

Objective--The efficacy of defibrinogenation therapy for idiopathic sudden sensorineural hearing loss was studied in comparison with high-dose steroid therapy.

Material and methods--Eighty-eight consecutive patients with hearing levels &gt;40 dB and who had suffered hearing loss for ≤30 days were enrolled: 40 patients for high-dose steroid therapy (PSL group) and 48 for defibrinogenation therapy (BX group). Hearing recovery was evaluated by grade assessment and by the improvement in hearing compared to the unaffected contralateral ear.

Results--The overall hearing outcomes of the two groups were roughly equivalent. However, with regard to patients with initial hearing levels &lt;80 dB, the hearing improvement rate of the BX group was significantly worse than that of the PSL group (61.2%±7.3% vs 88.7%±8.9%; p&lt;0.05), whereas in patients with initial hearing levels ≥80 dB, the hearing outcomes did not differ between the 2 groups. Three patients in the PSL group manifested hyperglycemia while no serious side-effects were observed in the BX group.

Conclusion--These results indicate that high-dose steroid therapy should be employed in preference to defibrinogenation therapy for patients with moderate hearing loss, whereas defibrinogenation therapy has an advantage for those with severe hearing loss, in view of its lower frequency of side-effects.     

An investigation of the audiologic handicap associated with unilateral sudden sensorineural hearing loss

OBJECTIVE: To determine the incidence of tinnitus and associated handicap after unilateral sudden sensorineural hearing loss (SSNHL); in addition, to determine the hearing handicap experienced as a consequence of such a loss. STUDY DESIGN: Identification of patients and determination of demographic and audiologic data by retrospective case review; determination of handicap and distress by postal questionnaire. SETTING: Teaching hospital department of otolaryngology. PATIENTS: Thirty-eight patients were identified as having been treated for a unilateral sudden sensorineural hearing loss in the period 1988 through 1997. Of those, 21 (55.3%) replied to the questionnaire. MAIN OUTCOME MEASURES: Audiometric data at admission and at 4-week follow-up, Tinnitus Handicap Inventory (THI), visual analogue scales of tinnitus loudness and distress, Hearing Handicap Inventory in Adults (HHIA). RESULTS: The questionnaire responder group did not significantly differ from the questionnaire nonresponder group on demographic nor audiometric variables, and hence were considered to be a representative sample. Tinnitus was present in 14 patients (67%). Hearing handicap was found in 86% of patients (of the 21 questionnaire responders) and tinnitus handicap in 57% (of the 14 with tinnitus). Correlations were found between tinnitus loudness, distress, and handicap. There was no correlation between time elapsed since SSNHL and tinnitus or hearing handicap, nor was there a correlation between the extent of audiometric loss and hearing or tinnitus handicap. A strong negative correlation was, however, found between recovery in audiometry in the first 4 weeks after onset and tinnitus and hearing handicap. The audiometric status of the contralateral ear correlated with hearing handicap. CONCLUSIONS: A majority of patients after unilateral SSNHL have a perceived handicap associated with tinnitus and hearing. Although this condition is an otologic emergency, careful thought should be given to the audiologic rehabilitation of this patient group.     

Assessment of hearing organ ability in high-frequency auditory in patients suffering from chronic renal failure treated by haemodialysis and human recombinant erythropoietin (rhPEO)

The problem of hearing loss occurrence in the course of chronic renal failure (CRF) was investigated in numerous research studies, attempting to explain both the etiological factors and treatment possibilities. According to various authors, the percentage of hearing loss occurrence in patients suffering from CRF differs between 20% and 80%. The idea of this paper is based on an observation that if peripheral blood parameters such; haemoglobin, amount of red blood cells improve when influenced by rhEPO, then tissue oxidation improvement connected with it causes also better metabolism of cilliar's cells, what helps to improve hearing. The purpose of this study has been to assess the influence of treatment with human recombinant erythropoietin obtained through genetic recombination and by haemodialysis upon the condition of the hearing organ in patients with CRF (as a result of both a single procedure and long-term treatment). 65 haemodialysed patients with chronic renal failure were enrolled in this study. 31 of them (with haematocrit value below 28%) were treated with rhEPO for 4 months (3 times a week, 4000 units). The remaining 34 patients (with haematocrit values of above 28%) were not treated with rhEPO. Impairment of hearing was found in 87.1% of the CRF patients examined, while the hearing loss in high frequency range (9-18 kHz) was significantly more pronounced than those observed in the conventional range. In 70% of the patients the hearing loss was the cochlear type. Thus, combining haemodialysis with recombinant human erythropoietin in treatment of CRF patients results in significant improvement of hearing, correlated with positive results in fighting anaemia. The improved hearing found is, most surely, related to better oxygen supply of ciliated cells of internal ear, resulting from improved oxygen supply in peripheral blood and tissues of the body, and may also be related to the centric activity of erythropoietin, as the presence of receptors for EPO was found in the central nervous system (CNS) neurocytes, and it was also proven that EPO is produced in CNS, probably in astrocytes.     

Hörstörungen bei Morbus Fabry

Background

Fabry disease is an X-linked lysosomal storage disease involving deficient activity of α-galactosidase A, which leads initially to pain, and later to renal insufficiency, cardiomyopathy and stroke. Until now few details are available on hearing impairment in patients with Fabry disease, and especially few relating to female patients.

Patients and methods

We examined 43 female and 29 male patients. In this study we looked into the question of whether and to what extent patients of both genders are affected by hearing impairment.

Results

Hearing loss is characteristic being more severe at high frequencies frequencies. Overall, 22 female and 15 male patients were found to have suffered a hearing loss. Patients with severe symptoms of Fabry disease usually demonstrate more prominent hearing losses.

Conclusions

Both men and women with Fabry disease are affected by hearing impairment. It seems that the hearing loss is less marked in female than in male patients. Children with Fabry disease complain of tinnitus more frequently than other children and quite early in the course of the disease.     

The surgical learning curve in aural atresia surgery

OBJECTIVE: The objective of this retrospective case review is to examine the effect of surgical learning on hearing outcomes and complications in congenital aural atresia surgery. PATIENTS: Sixty-four consecutive ears (in 60 patients) operated on during the period of 1994 to 2004 at a tertiary referral center were studied. INTERVENTION(S): Intervention consisted of aural atresiaplasty through an anterior approach by the same surgeon (C.S.). MAIN OUTCOME MEASURE(S): Hearing outcomes and complication rates were compared between four temporally sequential groups of 16 ears. Acceptable hearing and complication rate outcomes were defined as results comparable to larger series in the literature. RESULTS: Hearing results, in the short term, comparable to larger series were achieved during the first group of ears (nos. 1-16). A plateau in the learning curve for short-term hearing outcomes was achieved after the first two groups, that is, after 32 ears. Hearing outcomes, in the long term (>1 year) comparable to larger series, were achieved in the second group of ears (nos. 16-32). The learning curve for long-term hearing demonstrated a significant improvement in outcomes in the final group of 16 ears compared with the first 48 ears. Long-term hearing results for the final group show closure of the postoperative air-bone gap to less than 30 dB in 94% of cases. Postoperative complication rates were equivalent to larger series in the first group of 16 ears and showed no statistically significant difference between the four groups. There was one patient with sensorineural hearing loss after surgery; there were no anacoustic ears and no facial palsies in the study group. CONCLUSIONS: A learning curve of at least 32 ears was required to achieve stable short-term hearing results. To achieve stable long-term hearing results required a learning curve of at least 48 patients in our series. Complication rates remained stable throughout the study period.     

Gastroesophageal reflux and sequelae of chronic tubotympanal disorders in children

Objective—To compare sequelae of chronic tubotympanal disorders in children with and without gastroesophageal reflux (GER).

Material and Methods—In 32 patients with chronic tubotympanal disorders GER was studied by means of 24-h continuous esophageal pH monitoring. After a period of 2–6 years (mean 4 years) sequelae of the tubotympanal disorders were examined, together with the clinical status of the ears and hearing status. The criteria for classification into mild, moderate and severe sequelae were based on the clinical status of the ear. Hearing was determined using tonal audiograms. Conductive hearing loss was classified as either slight (≤ 35 dB hearing loss in speech frequencies) or severe (>35 dB hearing loss in speech frequencies).

Results—In the group of 16 patients (mean age 6.1 years) with GER, sequelae were observed in 29 ears (mild, n=11; moderate, n=5; severe, n=13). Hearing impairment was determined in 20 ears (mild, n=8; severe, n=12). In the group of 16 patients (mean age 7.1 years) without GER, sequelae were observed in 17 ears (mild, n=11; moderate, n=1; severe, n=5). Hearing impairment was determined in 10 ears (mild, n=6; severe, n=4).

Conclusion—The total number of ears with sequelae and the total number of ears with conductive hearing impairment were significantly higher in patients with GER.     

An investigation into hearing loss among patients of 50 years or older

Objects To investigate the extent of hearing loss in an elderly sample population to estimate hearing disorders among the age-equivalent population in China and to study primary clinical characteristic...     

Evaluation of hearing organ in patients with Turner syndrome

Hearing loss and middle ear diseases are often reported in some of Turner patients. In most of the reports hearing organ was evaluated with the use of subjective methods. The aim of the work was subjective and objective evaluation of hearing organ with an attempt to set the correlation between the results and the genotype of the patients with Turner syndrome (Ts). MATERIAL: 51 Ts patients aged 14.3 years on average. There were 29 girls with monosomy X and 22 having mosaicism. A detailed medical history was taken in each case with attention given to the hearing loss risk factors. METHOD: Physical ENT examination, hearing evaluation: pure tone audiometry, impedance audiometry, distortion products otoacoustic emissions (DPOAEs), brain auditory evoked potentials (BAEP). The control group consisted of 30 healthy patients. RESULTS: Recurrent acute otitis media was reported by 19.6% of Ts patients. Pure tone audiometry was improper in 36.3% ears; conductive hearing loss was present in 11.7% ears, mixed hearing loss in 5.9% ears and the moderate sensorineural hearing loss in 18.6% ears. Impedance audiometry was impaired in 14.7% of the cases. DPOAE disturbances were present in 41.4% of Ts patients, BAEP was improper in 52.0%. The percentage of the disturbances in DOPAEs and in BAEP in patients with mosaicism was 45.4 and 40.9% while in patients with monosomy 68.9 and 62%. CONCLUSIONS: Ts patients present predisposition to hearing disturbances. The disturbances seem to be connected with middle ear infections and with sensorineural hearing losses. Hearing loss in Ts women is not clinically apparent in most of the cases; this fact reflects the need of early evaluation and further monitoring of hearing organ in those patients. Sensorineural hearing loss seems to prevail in patients with 45,X genotype, so perhaps attention should be paid to this subgroup of Ts patients.     

Prognostic factors in sudden deafness

Sudden sensorineural hearing loss is still a diagnostic and therapeutic dilemma and is very difficult to predict recovery in it. Different factors may influence a prognosis like severity of hearing loss, duration of symptoms before treatment, presence of vertigo, type of audiogram and age of patients. The aim of the study was an evaluation of the hearing improvement in sudden deafness in relation to some of these elements. A retrospective analysis of 119 patients treated for sudden sensorineural hearing loss during 10 years was done. Clinical otolaryngological, neurological and ophthalmological examination, audiologic and ENG tests were carried out. Hearing improvement was obtained in 51 patients (43%). Hearing recovery was recorded in 38 patients (66%) in whom duration of disease before treatment was no longer than 7 days, in 9 patients (25%) with a period 8-14 days and in 4 patients (16%)--with period 15-30 days (66% vs 25% vs 16%, p < 0.001, 25% vs 16% p = 0.39). Hearing improvement was more frequent in patients with initially mild (51.6%) than severe (38.7%) and profound hearing loss (25%) (51.5% vs 25%, p < 0.05). Hearing recovery was observed in 18 patients (33.3%) with vertigo and in 33 patients (50.8%) without vertigo (p = 0.056). In analysis of age (five groups: until 30 years, 31-40 years, 41-50 years, 51-60 years, over 60 years) in comparison with hearing recovery it was not found any significance (45.5% vs 45.8% vs 46.4% vs 37% vs 38.9%, p = 0.94). It was stated that in patients with sudden deafness duration of the disease before treatment and level of hearing loss may significantly influence an outcome, also vertigo may worsen a recovery, contrary age of the patients does not seem as important prognostic factor.