Correlation Analysis Between Clinical Characteristics And Treatment Prognosis Of Explosive Deafness

Objective: To investigate factors affected and provide the basis for clinical estimate in the prognosis of explosive deafness.Methods: A retrospective analysis of the clinical data of 52 patients(70ears)who were diagnosed with explosive deafness in the Department of Otorhinolaryngology Head and Neck Surgery of the Second Affiliated Hospital of Hunan Normal University from January 2017 to December2020.According to the prognosis,the patients were divided into three groups: cured,effective,and invalid.Differences in results and other indicators:the age,gender,course of disease,affected side,presence or absence of tinnitus and tinnitus tone frequency,and distortion product otoacoustic emission examination(DPOAE)on the day of admission are compared.Then the patients were divided into ≤7 days group and >7 days group according to the course of disease,and the correlation between the effection of patients with different courses and pure tone audiometry(PTA)hearing threshold was compared;and whether the patient had a good prognosis(effective/ineffective)as the reason variables,for indicators with statistical significance in the difference,the single-factor Logistic regression analysis is performed first,and the variables with P<0.1 in the single-factor analysis are further included in the multi-factor Logistic regression analysis;finally,the ROC curve is drawn for the statistically significant variables,and the best calculation the cut-off value and the sensitivity and specificity of various factors in prognostic judgment are used to judge the value of each influencing factor in predicting the prognosis of blast deafness.Results: 1.Among 52 patients(70 ears)with explosive deafness in this study,there were statistically significant differences in the efficacy,age and course of the three groups of patients(Fisher,P<0.05);they were at4.0,6.0,and 8.0 kHz.The DPOAE results amplitude(H values were7.358,9.142,and 9.433)and SNR(H values were 7.084,11.379,and11.813)between the groups were statistically significant(P<0.05);the prognosis of patients in the ≤7 days group was similar to There is a correlation in the hearing threshold at 8.0 kHz(F=4.010,P=0.032).2.The results of single-factor Logistic regression analysis showed that the prognosis of patients with explosive deafness was related to the patient’s age,whether the course of the disease was greater than 7 days,the threshold of hearing at 8.0 kHz,and the amplitude and signal-to-noise ratio of DPOAE at 4.0,6.0 and 8.0 kHz(P <0.1).3.Multivariate Logistic regression analysis was performed on the prognosis of the patient and the ROC curve chart was further drawn.It was found that the age and course of the patient were independent risk factors for the prognosis of patients with explosive deafness.The amplitude of the distortion product otoacoustic emission at 8.0 kHz is an independent protective factor affecting the prognosis.4.The area under the ROC curve for age and poor prognosis is 0.778,the best cut-off point is 23.5 years,the sensitivity is 69.4%,and the specificity is 79.4%;the area under the curve for the course of disease is0.861,and the best cut-off point is 14.50 days,The sensitivity is 83.3%,and the specificity is 82.4%.The area under the curve between amplitude and good prognosis at 8.0 kHz by DPOAE was 0.630,the best cut-off point was-7.90 dB SPL,the sensitivity was 64.7%,and the specificity was 69.4%.Conclusion: The prognosis of patients with explosive deafness is related to age,course of disease,and functional status of outer hair cells at 8.0kHz.The younger the patient(cutoff value is 23.5 years),the shorter the time from onset to diagnosis(cutoff value of 14.5 days),and the higher the amplitude of DPOAE 8.0 kHz(cutoff value of-7.9dB SPL),the better the prognosis of the patient.