Relationship Between Prognosis And Vestibular Function In Patients With Unilateral Idiopathic Sudden Sensorineural Hearing Loss

Objective:1.To explore the location of vestibular injury in patients with unilateral idiopathic sudden sensorineural hearing loss(UISSNHL)by assessing the vestibular function;2.1 To explore the relationship between hearing outcome and vestibular function in patients with UISSNHL with or without vertigo.2.2 To explore the relationship between hearing outcome and vestibular function in patients with profound UISSNHL.2.3.To explore the relationship between hearing outcome and vestibular function in patients with flat-type UISSNHL.3.To explore the relationship between prognosis and classification of vestibular function in patients with UISSNHL.Methods:A retrospective analysis of 101 patients(101 ears)with UISSNHL(including 47 patients(47 ears)with profound UISSNHL and 32 patients(32ears)with flat-type UISSNHL)was carried out.Ocular vestibular evoked myogenic potential(o VEMP),cervical vestibular evoked myogenic potential(c VEMP),video head impulse test(vHIT),and caloric test were used to observe in terms of the curative efficacy and explore the effect on the hearing outcome based on the vestibular function.According to the results of various vestibular examinations,the function of each part of the vestibular(elliptic sac,balloon,and semicircular canal)was separately reflected.The vestibular injuries of patients with UISSNHL were summarized and described,and the vestibular injury classification was set according to the number of vestibular injuries standard(level 1-4).According to the results of vestibular function tests and clinical efficacy in patients with UISSNHL with or without vertigo,the statistics were included in the UISSNHL,profound UISSNHL patients and flat-down UISSNHL patients.The number of cases of treatment failure and total effectiveness in each group was compared with a statistical difference;according to the number of vestibular dysfunction items,patients with UISSNHL were divided into all normal groups,1 abnormal group,2 abnormal groups,3 abnormal group and all abnormal groups,the number of cases in which the treatment was ineffective and the total effective number of each group were counted,and there was a statistical difference.Results:1.Of 101 patients with UISSNHL,the alveus communis had the highest abnormal frequency,followed by the sacculus,and the semicircular canal was the lowest.The vestibular function level of patients with UISSNHL was negatively correlated with the curative effect.2.Of 101 patients with UISSNHL,there was a significant difference in the hearing outcome between patients with normal and abnormal vestibular function.Patients with abnormal o VEMP,c VEMP,vHIT,and caloric tests showed lower curative efficacy;Patients with normal o VEMP and c VEMP in the affected ear or in both affected ear and unaffected ear showed better efficacy.The rate of treatment inefficiency significantly increased in patients with abnormal o VEMP and c VEMP in the affected ear,whether the unaffected ear was normal or not.Patients with normal vHIT and caloric tests showed better hearing outcome.There was a significant difference in the curative efficacy in patients with profound UISSNHL between with normal and abnormal vestibular function.Patients with abnormal o VEMP,c VEMP,vHIT,and caloric tests showed lower curative efficiency;Patients with normal o VEMP and c VEMP in the affected ear or in both affected ear and unaffected ear showed better efficacy.The rate of treatment inefficiency significantly increased in patients with abnormal o VEMP and c VEMP in the affected ear,whether the unaffected ear was normal or not.Patients with normal vHIT and caloric tests showed better hearing outcome.In patients with flat-type UISSNHL,there was a significant difference in curative efficacy between those with and without vertigo.Patients with normal o VEMP and c VEMP showed higher total treatment effectiveness;the results of caloric test and vHIT did not affect the total effectiveness and hearing outcome.Conclusion:The alveus communis had the highest abnormal frequency in patients with UISSNHL,followed by the sacculus,and the semicircular canal was the lowest.The vestibular function level of patients with UISSNHL was negatively correlated with the curative effect.Patients with UISSNHL who have abnormal vestibular dysfunction had poorer curative efficiency.Patients with SSNHL with normal o VEMP and c VEMP had better hearing outcome.The impact of normal caloric test and vHIT on patients with UISSNHL needs further confirmation.The results of these vestibular function tests may be effective indicators for predicting the prognosis of patients with UISSNHL.Therefore,vestibular function tests aforementioned are recommended as routine examinations for patients with ISSNHL in order to detect possible vestibular function impairment,and provide vestibular rehabilitation training in time.