Clinical Characteristics And Therapeutic Effects Of Patients With Bilateral Sudden Sensorineural Hearing Loss

Objective: This study adopts a retrospective study,including all eligible sudden deafness patients who were hospitalized in our hospital from October 2018 to December 2022(during which there was no significant change in relevant treatment medication),and are divided into two groups: unilateral sudden sensorineural hearing loss(USSNHL)and bilateral sudden sensorineural hearing loss(BSSNHL),BBSNHL was divided into two subgroups,namely,simultaneous bilateral sudden sensorineural hearing loss(si-BSSNHL)and sequential bilateral sudden sensorineural hearing loss(se-BSSNHL).The purpose of collecting and analyzing the clinical data of patients is to discuss in detail the clinical characteristics of BBSNHL and the difference between the clinical characteristics of BBSNHL and USSNHL,and the inter-group and intra-group effects of si-BSSNHL,seBSSNHL and USSNHL were compared in order to deepen the understanding of sudden hearing loss and improve the level of clinical diagnosis and treatment.Methods: The clinical data of 925 patients with sudden hearing loss admitted to the otolaryngology head and neck surgery of our hospital from October 2018 to December2022 were retrospectively analyzed,including gender,age,time from onset to visit,pure tone average,concomitant symptoms,combined basic diseases,type of hearing curve,classification of hearing loss,hematology index,etc.According to the inclusion and exclusion criteria,a total of 74 cases of BSSNHL with complete data were included in the study(including 31 cases of si-BSSNHL and 43 cases of se-BSSNHL).The clinical characteristics were analyzed,and the efficacy was compared with 547 cases of USSNHL with complete data in the same period.At the same time,the efficacy of each group was compared,and we followed up patients with si-BSSNHL who had poor therapeutic effect on both ears.All patients were treated according to the recommended scheme of the 2015 version of the guidelines for sudden hearing loss,and the efficacy was evaluated based on the results of pure tone average,and spss 25.0 was used for statistical analysis.Results: Among the 925 patients,there were 846 cases of USSNHL and 79 cases of BSSNHL.BSSNHL accounted for 8.54%(79/925)of all sudden hearing loss patients admitted in the same period.There were no significant differences in the basic data of the three groups of patients,such as gender,age,pure tone average at admission,time from onset to visit,tinnitus,ear tightness,vertigo/dizziness(P>0.05).The proportion of BSSNHL patients with basic diseases was higher than that of USSNHL patients,but there was no significant difference in diabetes among the three groups(p>0.05).As far as the type of hearing curve is concerned,si-BSSNHL group is mainly of flat decline type and high frequency decline type,se-BSSNHL group is mainly of flat decline type and total deafness type,and USSNHL group is mainly of low frequency decline type and flat type.In terms of the degree of hearing loss,the se-BSSNHL group has the most severe loss,followed by the si-BSSNHL group,the USSNHL group has the least loss,the si-BSSNHL group and the se-BSSNHL group are mainly moderate,and the USSNHL group is mainly mild hearing loss.In terms of inter-group efficacy,the total effective rate of the USSNHL group was significantly higher than that of the BSSNHL group.The efficacy of the seBSSNHL group was the worst,and the USSNHL group was the best.The pure tone average after treatment was significantly different between the se-BSSNHL group and the USSNHL group(P<0.05).In terms of intra-group efficacy,the treatment methods used in this study are effective for all three groups of patients(P<0.05).The hearing level of the two ears in the si-BSSNHL group is basically the same.In se-BSSNHL group,the hearing loss of the present sick ear was lighter than that of the previous sick ear.After treatment,the hearing loss of the previous sick ear was also increased,but the difference was not statistically significant(P>0.05).Conclusions: 1.BSSNHL and USSNHL may have different pathophysiological mechanisms and prognosis.The proportion of patients with BSSNHL complicated with cardiovascular disease is higher than that of USSNHL group,the degree of hearing loss is more serious than that of USSNHL group,and the total effective rate of treatment is lower than that of USSNHL group.2.Se-BSSNHL group had the worst hearing loss and the worst curative effect among the three groups at admission,followed by si-BSSNHL group,and USSNHL group had the best curative effect.3.As for the two subtypes of BSSNHL,there is no statistically significant difference in clinical characteristics and curative effect between the two(p>0.05),but si-BSSNHL patients who have failed to treat both sides may have different etiology from se-BSSNHL,so such patients still need to be closely followed up within two years after discharge.