Prognostic Factors In Unilateral Sudden Deafness

Objective Sudden deafness is usually unilateral and can cause a slight impairment of hearing to virtual deafness. The prognosis for recovery of hearing is unknown. To investigate the prognosis factors in unilateral sudden deafness with a retrospective study. To investigate inner ear of patients with unilateral sudden deafness with three-dimensional fluid-attenuated inversion recovery MR imaging, and the relationship between the results of 3D FLAIR and prognosis.Method 1 The clinical data of 339 in-patients of unilateral sudden hearing loss in Department Of Otolaryngology Head and Neck Surgery of The 1st Hospital affiliated Anhui Medical University during Jan. 2004 to Dec. 2009 were retrospectively studied. Combined with the aim of the present study, determine the inclusion criteria and exclusion standards. Patients were divided into different groups, according to age, gender, audiogram patterns, and vestibular symptoms and so on. The relationship between each impact factor and the prognosis was analyzed with Rank sum test.2 The in-patients of unilateral sudden hearing loss in Department Of Otolaryngology Head and Neck Surgery of The 1st Hospital affiliated Anhui Medical University during Apr. 2010 to Oct. 2010 were studied. A total of 30 patients with sudden deafness were available for studying and all the patients were of their own accord. Thirty patients were performed with 3D-FLAIR at 3T MRI, the signals of inner ear were recorded. All the patients received the typical pharmaceutical treatment at least seven days, or the patients had acquired recovery within seven days. Hearing levels were evaluated at initial visit and after treatment. The relationship between 3D-FLAIR findings and hearing prognosis was evaluated.Results 1.A total of 339 patients with sudden deafness were available for analysis. Of the 339 patients, 55(16.2%) were cured, 85 (25.1%) had marked recovery, 56 (16.5%) had slight recovery, and 143 (42.2%) remained unchanged. There was no correlation between the hearing outcomes, time elapsed from onset of sudden deafness to hospitalization and other factors (gender, et al).The final hearing threshold was correlated with age, audiogram patterns, presence of tinnitus, presence of vertigo, hypertension and diabetes mellitus. The prognosis was worse in patients with vertigo tinnitus and in patients without tinnitus . Elder had worse prognosis than middle age people and young people. Patients with hypertension or diabetes mellitus will receive bad prognosis and the prognosis will be worse if patients have two diseases at a time. The best prognosis was found in patients with the upward-sloping and concave audiograms group. A total of 83.8% hearing recovery was achieved in the concave audiograms group and 78.2% in the upward-sloping. The worse prognosis was found in downward-sloping audiograms, flat audiograms and profound hearing loss group. The worst was found for total deafness group, and only 30.6% hearing recovery was achieved.2. Twelve patients with sudden deafness showed high signals in the affected cochlea on 3D-FLAIR, the others of affected cochlea and all of contra-lateral cochlea showed no signal on 3D-FLAIR. Of the 12 patients with high signals in the affected inner ear, only one patient had slight recovery. But in patient without high signals in the affected inner ear, two patients were cured and a total of 61.1% hearing recovery was achieved.Conclusion 1.Sudden deafness patients with the upward-sloping and concave audiograms group have better prognosis. Total deafness group have the worst prognosis. Elder had worse prognosis. The prognosis will be worse in patients with vertigo and in patients without tinnitus. Patients with hypertension or diabetes mellitus will receive bad prognosis.2. 3D-FLAIR can show high signal in affected inner ear in sudden deafness patients, and which is related to a poor hearing prognosis. The high signal in affected ear is a new prognostic factor for sudden deafness.