儿童突发性聋的临床特征及预后相关因素分析

目的 分析儿童突发性聋的临床特征、疗效及影响预后的相关因素,为临床治疗及预后评估提供依据。 方法 收集2010年1月至2017年10月就诊的67例突发性聋患儿临床资料,对其临床特征及治疗效果进行回顾性分析,同时根据疗效将患者分为总体有效组(36例)及无效组(31例),采用单因素及多因素分析的方法分析患者的性别、年龄、病程、初诊听阈、是否伴发耳鸣、眩晕、病毒感染史、发病季节和听力曲线类型对预后的影响。 结果 儿童突聋患者中64.18%在春冬季发病,其就诊时听阈为(76.62±25.97)dB HL,耳鸣及眩晕伴发率分别为70.15%和61.19%,病毒感染率为19.40%,听力曲线中10.44%为低频下降型、2.99%为高频下降型、34.33%为平坦型及52.24%为全聋型。经治疗后,患者听阈为(60.41±31.52)dB HL,总体有效率为53.73%,其中痊愈率、显效率及有效率分别为20.90%、16.42%和16.42%。多因素分析结果显示,初诊听阈越高及听力曲线为全聋型,预后越差(P均<0.05);伴有病毒感染的非全聋型患者预后较好(P<0.05)。 结论 儿童突发性聋患者病毒感染率较高且大部分在春冬季发病,就诊时听力损失较重并常伴有耳鸣及眩晕,其听力曲线以平坦型及全聋型为主。就诊时听力损伤程度轻、伴有病毒感染的非全聋型患者预后较好。     

鼓室内注射地塞米松治疗突聋的临床研究

目的:观察鼓室内注射地塞米松治疗突聋的临床效果。方法:对21例突聋患者采用鼓膜穿刺注入5 g/L地塞米松1 ml治疗,每日1次,7 d为1个疗程。比较地塞米松鼓室内注射前后4个频率(500、1 000、2 000、4 000 Hz)气导纯音听阈均值(PTA),下降10 dB以上为有效。结果:21例患者鼓室内注射地塞米松前后PTA分别为(65.65±24.73)dB HL和(50.25±25.59)dB HL,有明显下降,P<0.01。10例有效,11例无效,总有效率为47.6%。对发病至治疗的时间短、不伴眩晕的突聋患者应用鼓室内注射地塞米松治疗效果好。本组病例未出现鼓室内感染、鼓膜穿孔和听力下降。结论:鼓室内注射地塞米松治疗突聋安全、有效,发病至治疗的时间以及是否伴有眩晕是影响预后的因素。     

鼻咽癌放疗后突发性聋18例

目的 探讨鼻咽癌放疗后突发性聋(突聋)的临床特征及预后,为该类疾病的临床诊治提供依据.方法 收集并分析18例鼻咽癌放疗后突聋患者的临床资料,包括年龄、性别、耳侧、病程、伴随症状、听力曲线类型、听力损失程度、放疗后突聋发病间隔以及听力预后.结果 18例均为单侧发病,左侧10耳(55.56％),右侧8耳(44.44％);其...     

Stapedius reflex test, brainstem audiometry and opto-vestibular tests in diagnosis of acoustic neurinomas. A comparison of test sensitivity in patients with moderate hearing loss

The stapedius reflex test, brainstem audiometry and the opto-vestibular tests for identifying acoustic neurinomas (AN) were evaluated and compared in a study of 21 patients with radiologically or surgically verified AN and a pure tone average not exceeding 60 dB HL. The stapedius reflex test results were interpreted according to the criteria developed at this clinic. The stimuli for the auditory brainstem response (ABR) were 2 kHz haversine waves and 4 kHz square waves. The vestibular examination consisted of a caloric test and the recording of eye-tracking and gaze nystagmus. In the cases studied the stapedius reflex test gave 1 false-negative result and ABR none. The ENG gave 3 false-negatives whereas the results of speech discrimination tests were misleading in no fewer than 1/3 of the cases. The results of the different tests were directly correlated but correlation coefficients did not exceed 0.65. Tumours larger than 15-20 mm showed a different test pattern than those below that size: stapedius reflex response, ABR and caloric response were eliminated and all of these patients had abnormal optomotor function. It is suggested that an optimal routine test procedure should consist of a pure tone audiogram, supplemented by ABR or the stapedius reflex test. Opto-vestibular tests may be of value in a preliminary estimation of tumour size.     

Intratympanic dexamethasone for sudden sensorineural hearing loss after failure of systemic therapy

OBJECTIVE: Intratympanic steroids are increasingly used in the treatment of inner ear disorders, especially in patients with sudden sensorineural hearing loss (SNHL) who have failed systemic therapy. We reviewed our experience with intratympanic steroids in the treatment of patients with sudden SNHL to determine overall success, morbidity, and prognostic factors. HYPOTHESIS: Intratympanic steroids have minimal morbidity and the potential to have a positive effect on hearing recovery in patients with sudden SNHL who have failed systemic therapy. STUDY DESIGN: The authors conducted a retrospective review. METHODS: Patients presenting with sudden SNHL defined as a rapid decline in hearing over 3 days or less affecting 3 or more frequencies by 30 dB or greater who underwent intratympanic steroids therapy (24 mg/mL dexamethasone) were reviewed. Excluded were patients with Meniere disease, retrocochlear disease, autoimmune HL, trauma, fluctuating HL, radiation-induced HL, noise-induced HL, or any other identifiable etiology for sudden HL. Patients who showed signs of fluctuation of hearing after injection were excluded. Pretreatment and posttreatment audiometric evaluations including pure-tone average (PTA) and speech reception threshold (SRT) were analyzed. Patient variables as they related to recovery were studied and included patient age, time to onset of therapy, status of the contralateral ear, presence of diabetes, severity of HL, and presence of associated symptoms (tinnitus, vertigo). A 20-dB gain in PTA or a 20% improvement in SDS was considered significant. RESULTS:: Forty patients fit the criteria for inclusion in the study. The mean age of the patients was 54.8 years with a range from 17 to 84 years of age. Overall, 40% (n = 16) showed any improvement in PTA or SDS. Fourteen (35%) men and 26 (65%) women were included. Using the criteria of 20-dB improvement in PTA or 20% improvement in SDS for success, 27.5% (n = 11) showed improvement. The mean number of days from onset of symptoms to intratympanic therapy was 40 days with a range of 7 days to 310 days. A statistically significant difference was noted in those patients who received earlier injection (P = .0008, rank sum test). No patient receiving intratympanic dexamethasone after 36 days recovered hearing using 20-dB PTA decrease or a 20% increase in discrimination as criteria for recovery. Twelve percent (n = 5) of patients in the study had diabetes with 20% recovering after intratympanic dexamethasone (not significantly different from nondiabetics at 28.6%, Fisher exact test, P = 1.0). Comparison to other studies that used differing steroid type, concentration, dosing schedule, inclusion criteria, and criteria for success revealed, in many instances, a similar overall recovery rate. CONCLUSIONS: Difficulty in proving efficacy of a single modality is present in all studies on SNHL secondary to multiple treatment protocols, variable rates of recovery, and a high rate of spontaneous recovery. Forty percent of patients showed some improvement in SDS or PTA after treatment failure. When criteria of 20-dB PTA or 20% is considered to define improvement, the recovery rate was 27.5%. Modest improvement is seen with the current protocol of a single intratympanic steroid injection of 24 mg/mL dexamethasone in patients who failed systemic therapy. Dramatic hearing recovery in treatment failures was rarely encountered. No patient showed significant benefit from intratympanic steroids after 36 days when using this protocol for idiopathic sudden SNHL. If patients injected after 6 weeks are excluded from the study, the improvement rate increases from 26.9% to 39.3%. Earlier intratympanic injection had a significant impact on hearing recovery, although with any therapeutic intervention for sudden SNHL, early success may be attributed to natural history. If we further exclude seven patients treated with intratympanic steroids within 2 weeks of the onset of symptoms (i.e., study only those patients treated with intratympanic dexamethasone between 2 and 6 weeks after onset of symptoms), still, 26% improved by 20 dB or 20% SDS. The recovery rates after initial systemic failure are higher than would be expected in this treatment failure group given our control group (9.1%) and literature review. These findings indicate a positive effect from steroid perfusion in this patient population.     

镫骨肌反射阈存在的突聋患者预后及影响因素

目的 分析镫骨肌反射阈存在的突聋患者的预后情况,探讨其影响因素。方法 回顾性分析2018年1月至2021年12月收治的282例镫骨肌反射阈存在的突聋患者的临床资料,采用Excel进行数据整理,SPSS 26.0对收集的资料进行描述性分析及统计分析,对性别、年龄、就诊时间、是否伴有耳鸣、眩晕、基础疾病(糖尿病、高血压、冠心病)、听力曲线类型、听力损失程度、镫骨肌反射阈、镫骨肌反射阈与纯音听阈差值(A-T)等因素进行统计学分析。结果 282例镫骨肌反射阈存在的突发性聋患者中,治愈101例,显效8例,有效54例,无效119例,总有效率57.8%。耳聋侧别(P=0.907)、伴随症状(P_眩晕=0.686,P_耳鸣=0.534)、基础疾病(P_高血压=0.338,P_糖尿病=0.262,P_心脏病=0.780)、镫骨肌反射阈(P_{0.5 kHz}=0.152,P_{1.0 kHz}=0.701,P_{2.0 kHz}=0.810)、镫骨肌反射阈与...     

Hunt综合征39例分析

为提高Ｈｕｎｔ综合征的诊治水平，报告Ｈｕｎｔ综合征３９例，２３例获早期诊断，１６例分别误诊为Ｂｅｌｌ面瘫，突发性聋，疱疹性咽炎和急性化脓性中耳炎，均用强的松或地塞米松加抗病毒药物治疗。２７例痊愈，１２例后遗面瘫，其中１１例伴感音神经性聋，且８例为重度聋。认为：①不明原因的特发性面瘫合并感音神经性聋，即使无耳部疱疹，也应考虑Ｈｕｎｔ综合征；②治疗以皮质类固醇和抗病毒剂等保守措施为主，且口服和静脉给药     

Prognostic model for predicting hearing recovery in idiopathic sudden sensorineural hearing loss.

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.     

Comparisons among vestibular examinations and symptoms of vertigo in sudden sensorineural hearing loss patients

ObjectivesVertigo in sudden sensorineural hearing loss (SSNHL) is hypothesized as an extension of the disease caused by the anatomical proximity of the cochlea and vestibule. The present study aimed to demonstrate the association of vestibular function test (VFT) results with SSNHL disease severity and prognosis.Materials and methodsThis study assessed clinical records of 263 SSNHL patients admitted to our hospital, between January 2010 and October 2017. Steroid treatment comprised high-dose intravenous dexamethasone (16 mg/d) or oral methylprednisolone (64 mg/d) for 4 days and tapered oral methylprednisolone for 8 days after discharge. Caloric tests were performed in all patients, and cervical vestibular-evoked myogenic potential (c-VEMP) and ocular VEMP (o-VEMP) tests were performed in 209 and 144 patients, respectively.ResultsNinety six patients had vertigo, and caloric abnormalities were observed in 119 patients. Initial PTA in patients with vertigo were worse than in those without vertigo (63.0 dB vs 72.7 dB, P = .002). Initial PTA in patients with abnormal o-VEMP was worse than in those with normal o-VEMP (61.4 dB vs 73.0 dB, P = .004). PTA improvement after steroid treatment in patients with vertigo was lower than in those without vertigo (25.0 dB vs 20.9 dB, P = .028). PTA improvement after treatment in patients with abnormal caloric results was lower than in those with normal caloric results (26.0 dB vs 18.4 dB, P = .013).ConclusionThe functions of vestibular organs, particularly the utricle and lateral semicircular canal, are associated with disease severity and hearing outcome in SSNHL patients.     

Effect of crossed stapedius reflex on vibration of mallear handle in man

The ear drum was made to vibrate using frequency-modulated sound pulses of 40 ms duration, and the vibration velocity of the tip of the mallear handle (umbo) was measured with laser vibrometry before and during stapedius muscle contractions (elicited by sound of 100 dB HL in the contralateral ear). The stapedius reflex caused: an attenuation of the mallear vibrations below 1 kHz, a slight enhancement of the vibrations between 300 Hz and 1,500 Hz. These effects of the stapedius reflex appear to be caused by an increased stiffness in the structures affecting the mallear vibrations.     

The Acoustic Reflex at Low Sensation Levels

The acoustic stapedial reflex, with normally occurs at a hearing level of about 80dB, can be detected at lower levels by means by means of preactivation. Two rechniques are presented, which allow the detection of reflex activity at intensities from 30 to 50 dB HL. It was the authors' intention to find a way to determine the hearing threshold from the stapedius reflex threshold even in patients, in whom the hearing threshold was not horizontal.     

Variables with prognostic value in the onset of idiopathic sudden sensorineural hearing loss

IntroductionThe establishment of an individualized prognostic evaluation in patients with a diagnosis of idiopathic sudden sensorineural hearing loss (ISSHL) remains a difficult and imprecise task, due mostly to the variety of etiologies. Determining which variables have prognostic value in the initial assessment of the patient would be extremely useful in clinical practice.ObjectiveTo establish which variables identifiable at the onset of idiopathic sudden sensorineural hearing loss have prognostic value in the final hearing recovery.MethodsProspective, longitudinal cohort study. Patients with ISSHL followed by the Department of Otology-Neurotology of a quaternary hospital were included. The following variables were evaluated and correlated with final hearing recovery: age, gender, vertigo, tinnitus, initial degree of hearing loss, contralateral ear hearing, and elapsed time to treatment.Results127 patients with ISSHL were evaluated. Rates of absolute and relative recovery were 23.6 dB and 37.2% respectively. Complete hearing improvement was observed in 15.7% patients; 27.6% demonstrated significant improvement and improvement was noted in 57.5%.ConclusionDuring the onset of ISSHL, the following variables were correlated with a worse prognosis: dizziness, profound hearing loss, impaired hearing in the contralateral ear, and delay to start treatment. Tinnitus at the onset of ISSHL correlated with a better prognosis.     

Normal values of the ipsilateral acoustic stapedius reflex threshold

It is frequently taken for granted that the acoustically evoked stapedius reflex is bilaterally symmetrical. Contrary to this, M?ller described an asymmetry of the acoustic stapedius reflex with an ipsilaterally 2--14 dB lower threshold. The determination of normal values of the ipsilateral acoustic stapedius reflex threshold with a large number of patients is difficult as the intensity of the stimulus depends considerably on the position of the probe in the acoustic meatus and is therefore not defined with sufficient accuracy. For this reason we determined the values of the ipsilateral threshold by applying a stimulus sound of high intensity to the deaf ear of unilaterally completely deaf patients with a normal headphone, which can be calibrated much more accurately. After subtraction of the individual cross hearing loss, the exact ipsilateral intensity was obtained. By this method a stapedius reflex could be evoked with 49 of the 62 patients. By mathematical consideration of the data of the positive cases, as well as the maximum available intensities with the negative cases, determination of the median value of the ipsilateral threshold was possible: at 0.5 kHz 59 dB; at 1kHz 62.5 dB; at 2 kHz 67 dB; at 4 kHz approx. 67 dB. The difference between ipsilateral and contralateral stapedius reflex threshold was in the range of 15 dB. A new definition of the normal value for the ipsilateral measured Metz recruitment appears necessary.     

Kombinierte Funktionsdiagnostik zur prognostischen Beurteilung der sog. idiopathischen Fazialisparese

Summary In 82 patients with Bell's palsy nerve excitability test (NET) and electrogustometry (EGM) were done and the stapedius muscle reflex (SMR) was measured on the day of admission. The comparison of test results with the final outcome of the disease allowed the following observations: in cases with normal SMR a soon and complete regeneration may most probably be expected. The EGM seems to be of prognostic value during the first couple of days after onset only; together with a loss of stapedial function a threshold difference of 15 EGU or more indicates an unfortunate course of the disease. The NET does not say anything about prognosis before the third day after onset. When the threshold of electrical excitability on both sides differs 3.5 mA or more an incomplete recovery has strongly to be expected; however, during the first two weeks a normal excitability does not exclude an incomplete recovery; only after that time such finding means a good prognosis. Those cases with pathological results in all three function tests made a — sometimes severe — defective recovery. These observations suggest, that the above function tests supplement each other very well and that a combined application of these tests can improve prognostic evaluation of Bell's palsy. It seems of special value that by means of these tests cases with a bad prognosis may be already recognized on the third or fourth day after onset with a relatively high reliability.     

Normal values of the ipsilateral acoustic stapedius reflex threshold

Summary It is frequently taken for granted that the acoustically evoked stapedius reflex is bilaterally symmetrical. Contrary to this, Møller described an asymmetry of the acoustic stapedius reflex with an ipsilaterally 2–14 dB lower threshold. The determination of normal values of the ipsilateral acoustic stapedius reflex threshold with a large number of patients is difficult as the intensity of the stimulus depends considerably on the position of the probe in the acoustic meatus and is therefore not defined with sufficient accuracy.For this reason we determined the values of the ipsilateral threshold by applying a stimulus sound of high intensity to the deaf ear of unilaterally completely deaf patients with a normal headphone, which can be calibrated much more accurately. After subtraction of the individual cross hearing loss, the exact ipsilateral intensity was obtained. By this method a stapedius reflex could be evoked with 49 of the 62 patients. By mathematical consideration of the data of the positive cases, as well as the maximum available intensities with the negative cases, determination of the median value of the ipsilateral threshold was possible: at 0.5 kHz 59 dB; at 1 kHz 62.5 dB; at 2 kHz 67 dB; at 4 kHz approx. 67 dB. The difference between ipsilateral and contralateral stapedius reflex threshold was in the range of 15 dB. A new definition of the normal value for the ipsilateral measured Metz recruitment appears necessary.     

Menière-Krankheit und Hörsturz

Summary The question is, is there any relation between sudden deafness and Menière's disease? Total hearing loss without recovery is typical of viral infection. In cases of sudden deafness some hearing rest generally remains. It can be the first symptom of Menière's disease, like the first attacks of vertigo which may occur without deafness.Measurements of stapedius reflex threshold and Békésy audiogram, especially the difference between the impulse tone and continuous tone indicate an inner hair cell damage and are helpful in the diagnosis of sudden deafness. But pathological adaptations are seen in cases of sudden deafness and also in Menière's disease. A decrease in the distance between the hearing threshold and the reflex threshold is a further indication of inner ear damage. The independence of the stapedius reflex threshold up to a hearing loss of 60 dB seems to be an indication for the different function of both types of hair cells. The reflex is supposed to be dependent only on the presence of the inner hair cells because the reflex threshold increases as soon as an inner hair cell damage of about 60 dB occurs. Clinical and audiological findings reveal no differences in sudden deafness and Menière's disease.

     

Acute sensorineural hearing loss in 277 outpatient cases]

Subjects were 227 patients with acute sensorineural hearing loss of 17,146 patients seen at our ear, nose, and throat (E.N.T.) outpatient clinic from October 1994 through September 2000. Of these, 45 suffered from profound and moderate idiopathic sudden hearing loss diagnosed when the arithmetical mean of hearing thresholds at 0.25, 0.5, 1, 2, and 4 KHz was 40 dB or worse. Of the 30 patients whose medical treatment was started within 7 days of onset, 18 (60%) showed excellent or complete recovery of hearing, whereas none of the 15 whose treatment was started 8 days or late after onset showed satisfactory improvement. In general, the sooner treatment was started, the better hearing recovered. Idiopathic acute low-tone sensorineural hearing loss was found in 111 (49%) patients with a female preponderance at a M:F ratio of 1:2.3, but no gender difference was seen in other diseases. The most common symptom was a feeling of pressure or fullness in the affected ear. Only 16% of patients were aware of their hearing disturbance. Some 73 (66%) showed complete recovery. Meniere's disease was diagnosed in 13, in whom hearing improved in only 2 (15%). Probable Meniere's disease was diagnosed in 9 patients who had 1 definitive episode of vertigo with low-tone sensorineural hearing loss, and their prognosis was good. The prognosis in 7 patients with hearing loss due to acoustic trauma and 1 with psychogenic hearing loss was good, but normal hearing was not restored in 1 with mumps or 1 with acoustic neurinoma. A patient with diabetic nephropathy had low-tone hearing loss and nystagmus toward the affected ear. Attacks of vertigo were controlled by diuretic therapy, but hearing recovery occurred by a little less than 10 dB. Some 35 patients had mild idiopathic hearing loss and prognosis was relatively good. Hearing was disturbed after head injury in 2 and after nose blowing in 1, probably attributable to concussion of the labyrinth or the formation of a perilymphatic fistula. The diagnosis of this condition could not be made with certainty by surgical exploration of the ear.     

Will contralateral white noise interfere with the monaurally click-evoked brainstem response?

Monaurally evoked (and ipsilaterally recorded) ABRs to clicks at 70 dB nHL in the presence of contralateral masking by white noise at 60, 70, 80 and 90 dB HL were compared with the corresponding ABRs without contralateral masking. The investigation was performed in 11 normal, young female subjects. There were no differences concerning wave shape and relative amplitudes, except slight changes in one subject. The following latency findings concern group statistics. The latency of wave I did not change significantly with contralateral noise at any one of the four levels. The latency of wave III was significantly prolonged only at the noise level of 90 dB HL. The latency of wave V was significantly increased at the noise levels of 80 and 90 dB HL. The average latency prolongations were on the order of 0.05 ms. The findings suggest the latency increments to be attributable to central masking rather than to acoustic crossover or stapedius reflex elicitation. Contralateral white noise levels below 80 dB HL would not seem to affect the ABR to clicks above 65 dB nHL.     

Clinical features and prognosis of severe-to-profound sudden sensorineural hearing loss

PurposeSudden sensorineural hearing loss (SSNHL) is an otologic emergency. Despite multiple efforts to clarify the factors affecting the prognosis of severe-to-profound SSNHL, various studies showed inconsistent results and lack of clinical significance. Therefore, we examined the clinical features and outcomes of severe-to-profound SSNHL.Materials and methodsWe included patients who experienced SSNHL between 2018 and 2021 and were diagnosed according to the American Academy of Otolaryngology-Head and Neck Surgery criteria; hearing loss over 70 dB on initial pure tone audiometry (PTA) was used to define severe-to-profound SSNHL. We retrospectively examine the demographic, laboratory, radiologic, and audiometric data of SSNHL patients. We also evaluated the final hearing gain of these patients by assessing their PTA findings and word-recognition scores.ResultsOf the 178 patients, 94 (52.81%) and 84 (47.19%) showed profound (>90 dB) and severe (>70 to 90 dB) hearing loss, respectively. The presence of vertigo and hypertension differed significantly between the severe and profound groups (p < 0.001 and p = 0.012, respectively), as did the initial serum creatinine level (p = 0.043). Recovery in PTA showed a reliable correlation with the interval between onset and treatment in the severe group and periventricular white-matter findings in the profound group (p < 0.001 and p = 0.011, respectively). The presence of hypertension was related to recovery of low tone (p = 0.023 for 250 Hz; p = 0.034 for 500 Hz), while glycated hemoglobin level was related to recovery of high tone in the severe group (p = 0.049 for 4000 Hz; p = 0.047 for 8000 Hz).ConclusionsSevere-to-profound SSNHL showed poor prognosis for hearing gain. The interval from onset to treatment was a significant prognostic factor for severe SSNHL, while the presence of vertigo, estimated glomerular filtration rate, and periventricular white-matter findings were significant prognostic factors for profound SSNHL.