Tinnitus as a prognostic factor in sudden deafness

doi:10.1016/S0196-0709(84)80054-X

American Journal of Otolaryngology

Volume 5, Issue 6, November–December 1984, Pages 394-396

https://doi.org/10.1016/S0196-0709(84)80054-X Get rights and content

Recovery from idiopathic sudden hearing loss depends on many factors, some as yet unknown. This study found tinnitus to be a favorable prognostic sign, based on an analysis of symptoms and recovery rates in a series of 60 patients. Hearing improved in 80 per cent of the patients studied. Tinnitus was one of the complaints in 71 per cent of the patients who recovered, whereas it was present in only 39 per cent of those who did not recover. A possible explanation of the association between tinnitus and recovery from sudden hearing loss is suggested and discussed.

References (12)

LG Siegel
The treatment of idiopathic sudden sensorineural hearing loss
Otolaryngol Clin North Am
(1975)
B Jaffe
Hypercoagulation and other causes of sudden hearing loss
Otolaryngol Clin North Am
(1975)
A De Kleyn
Sudden complete or partial loss of function of the octavus system in apparently normal persons
Acta Otolamyngol
(1944)
B Jaffe
Clinical studies in sudden deafness
Adv Otorhinolaryngol
(1973)
DE Mattox et al.
Natural history of sudden sensorineural hearing loss
Ann Otol Rhinol Laryngol
(1977)
JWP Harell et al.
Tinnitus masking a significant contribution to tinnitus management
Br J Audiol
(1981)

There are more references available in the full text version of this article.

Cited by (27)

Classification of Tinnitus: Multiple Causes with the Same Name
2020, Otolaryngologic Clinics of North America
Citation Excerpt :
Some causes require urgent diagnosis, such as vestibular schwannoma (acoustic neuroma), stroke, malignancy, noise, and ototoxic medication, which may present as SSHL.38 Although the presence of tinnitus causes greater emotional reactions in these patients,40 its presence is a positive outcome factor for hearing recovery.41 Rapidly progressive bilateral sensorineural hearing loss is defined as a shift of 15 dB or more at any frequency or 10 dB or more at 2 or more consecutive frequencies, or a significant change in discrimination score that occurs within 3 months or more apart.42
Sudden sensorineural hearing loss – A contemporary review of management issues
2020, Journal of Otology
Citation Excerpt :
However, it has not been a universal observation(Fetterman et al., 1996; Nosrati-Zarenoe and Hultcrantz, 2012; Zadeh et al., 2003). Tinnitus has been reported as a good(Danino et al., 1984), bad(Ben-David et al., 2002), and neutral(Chang et al., 2005) prognostic factor in various studies. Duration of hearing loss – The patients presenting to the physician within a week are more likely to have a better recovery rate compared to the late presenters(Byl, 1984; Fetterman et al., 1996; Nosrati-Zarenoe and Hultcrantz, 2012; Zadeh et al., 2003).
Sudden sensorineural hearing loss (SSNHL) is an enigmatic entity, with obscure pathophysiology and debatable efficacy of the treatment agents used. An underlying cause is identified in only 10–15% of cases. The management of the remaining patients, classified as ‘idiopathic’, is empirical, and is conventionally with systemic steroids, vasodilator therapy, rheological agents, and antioxidants, to list a few amongst the host of the agents employed for the treatment. The availability of conflicting outcomes and lack of conclusive evidence has resulted in the propagation of consensus-based treatment protocols. In the present review, we discuss the various controversial issues and newer developments in the management of idiopathic SSNHL. The current review aims to present a narrative outlook of the updated evidence base available from PUBMED, augmented with relevant designated publications.
Sudden sensorineural hearing loss in children and adolescents: Clinical characteristics and age-related prognosis
2018, Auris Nasus Larynx
Citation Excerpt :
However, since only 6 patients in the present study have a descending type on initial audiogram, the significance of this finding may be slight and further investigations with a large population are required to evaluate the hearing type on initial audiogram as a prognostic factor. Presence of tinnitus has been correlated with favorable outcomes in various studies of pediatric and adult populations [16,26,27]. In our study, tinnitus was a positive prognostic factor for hearing recovery, which was consistent with previous studies.
Although many studies have investigated sudden sensorineural hearing loss (SSNHL) in adults, there were few studies on SSNHL in the pediatric population; especially research on treatment and prognosis of pediatric SSNHL was limited. The aim of this study was to evaluate clinical characteristics, treatment outcomes and prognostic factors in children and adolescents with SSNHL.
A retrospective review of medical records of 67 pediatric patients (67 ears) who had diagnosed with SSNHL at our hospitals was performed to analyze patients’ clinical manifestations and audiograms. All patients were treated with high-dose systemic prednisolone (1 mg/kg), and 17 of them underwent intratympanic steroid injection therapy. Audiological evaluation was carried out before and after treatment, and hearing recovery was defined as complete recovery and partial recovery according to Siegel’s criteria. Patients were divided into two groups: childhood group (ages between 4 and 12 years old) and adolescence group (age > 12 years), and clinical characteristics and treatment outcomes were investigated. In addition, patients were divided into two groups according to degree of hearing recovery, and evaluation was made regarding possible prognostic factors.
The recovery rate in total 67 patients was 55.2%. The recovery rate of the childhood group was significantly lower than that of the adolescence group (p = 0.038). While the presence of vertigo did not significantly correlate with prognosis (p = 0.219), the presence of tinnitus was significantly associated with hearing recovery (p = 0.005). Audiological assessment revealed that a low initial hearing threshold, high speech discrimination score, and descending type of audiogram were positively associated with hearing recovery (p = 0.002, p = 0.003, and p = 0.029, respectively).
The childhood group had worse treatment outcomes than the adolescence group. High initial hearing threshold and absence of tinnitus were poor prognostic factors of hearing recovery. Active treatment is required for patients with these poor prognostic factors and childhood patients with SSNHL.
Variables with prognostic value in the onset of idiopathic sudden sensorineural hearing loss
2015, Brazilian Journal of Otorhinolaryngology
Citation Excerpt :
This group of patients had statistically significant higher rates of absolute and relative recovery compared to the group without tinnitus, corroborating previous studies.10,22,23 It is assumed that presence of tinnitus after cochlear injury would indicate that hair cells remain viable.24 Vertigo was present in 52.8% of subjects, who showed lower relative recovery rates compared to the group without this symptom (p = 0.002).
The 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.
To establish which variables identifiable at the onset of idiopathic sudden sensorineural hearing loss have prognostic value in the final hearing recovery.
Prospective, 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.
127 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%.
During 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.
Elaborar avaliação prognóstica individualizada em pacientes com diagnóstico de perda auditiva neurossensorial súbita idiopática (PANSI) permanece tarefa árdua e imprecisa devido, em grande parte, à variedade de etiologias. A determinação de quais variáveis teriam valor prognóstico na avaliação inicial do paciente seria de extrema utilidade na prática clínica.
Estabelecer quais variáveis, identificáveis no momento de instalação da perda auditiva neurossensorial súbita idiopática, têm valor prognóstico na recuperação auditiva final.
Estudo de coorte prospectivo, longitudinal. Incluídos pacientes com PANSI acompanhados pela Disciplina de Otologia–Neurotologia de um hospital quaternário. As seguintes variáveis foram avaliadas e correlacionadas com a recuperação auditiva final: idade, gênero, vertigem, zumbido, grau de perda auditiva inicial, audição na orelha contralateral, tempo para início de tratamento.
Foram avaliados 127 pacientes com PANSI. As taxas de recuperação absoluta e relativa foram 23,6 dB e 37,2% respectivamente. Apresentaram melhora completa da audição 15,7% dos pacientes; 27,6% apresentaram melhora significativa e 57,5% melhora.
No momento da instalação da PANSI, as seguintes variáveis correlacionaram-se com pior prognóstico: vertigem, perda auditiva profunda, audição alterada na orelha contralateral e demora para início do tratamento. Presença de zumbido na instalação da PANSI correlacionou-se com melhor prognóstico.
Impact of prognostic factors on recovery from sudden hearing loss
2007, Journal of Laryngology and Otology
Prognosis of Bilateral Sudden Sensorineural Hearing Loss: A Systematic Review and Meta-Analysis
2024, Laryngoscope

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Tinnitus as a prognostic factor in sudden deafness

Otolaryngol Clin North Am

Otolaryngol Clin North Am

Sudden complete or partial loss of function of the octavus system in apparently normal persons

Acta Otolamyngol

Clinical studies in sudden deafness

Adv Otorhinolaryngol

Natural history of sudden sensorineural hearing loss

Ann Otol Rhinol Laryngol

Tinnitus masking a significant contribution to tinnitus management

Br J Audiol