Clinical Study On 136 Children With Sudden Sensorineural Earing Loss

Objectives:The prevalence of sudden sensorineural hearing loss in children (CSSNHL) is consistently increasing. However, the pathology and prognosis of CSSNHL are still poorly understood. This retrospective study evaluated clinical characteristics and possible associated factors of CSSNHL to provide a basis for clinical diagnosis and treatment.Methods:One hundred and thirty-six CSSNHL patients treated in Department of Otolaryngology-Head and Neck Surgery and Institute of Otolaryngology at Chinese PL A General Hospital between July 2008 and August 2015 were included in this study. These patients were analyzed for clinical characteristics, audiological characteristics, laboratory examinations, and prognostic factors.Results:In this study,136 patients (151 ears) with CSSNHL were identified, accounting for 8.6%of all patients (1584 cases) with SSNHL who were treated in our departmentAmong the 136 patients (151 ears),53.0%(80 ears) were from males and 47.0%(71 ears) were from females.121 patients (121 ears,80.1%) were diagnosed with unilaterally CSSNHL, and 15 patients (30 ears,19.9%) with bilateral CSSNHL. The mean age of all of patients was 11.7 years old (range:2-18 years).13.9%of patients (21 ears) complained ear fullness,80.8%of patients (122 ears) reported tinnitus, and 52.3%(79 ears) of patients reported vertigo. Among the 151 ears,56ears (37.1%) accompanied with obvious causative factors,13 ears (9.0%) with epidemic mumps,29 ears (19.0%) with upper respiratory infections.37(24.5%) were identified as severe degree hearing loss,90(59.6%) as profound degree hearing loss. And 86 ears (57.0%) were ascertained as profound audiogram curve types,35 ears (23.2%) was ascertained as flat audiogram curve types. The complete recovery rate of CSSNHL was 9.3%, and the overall recovery rate was 37.7%.We found that initial degree of hearing loss, onset of treatment, tinnitus, gender, side of hearing loss, the recorded auditory brainstem response (ABR), and distortion product otoacoustic emissions (DPOAEs) had prognostic significance. Age, the type of audiogram, ear fullness, and vertigo had no significant correlation with recovery. Furthermore, the relevant blood tests showed 30.8%of the children had abnormal white blood cell (WBC) counts,22.1%had elevated homocysteine levels,65.8%had high alkaline phosphatase (ALP),33.8%had high IgE antibody levels,86.1%had positive cytomegalovirus (CMV) IgG antibodies and 33.8%with high IgE antibody levels.Conclusions:CSSNHL commonly occurs unilaterally and results in severe hearing loss. Initial severe hearing loss and bilateral hearing loss are negative prognostic factors for hearing recovery, while positive prognostic factors include tinnitus, gender, early treatment, identifiable ABR waves, and DPOAEs. Age, the type of audiogram, vertigo, and ear fullness are not correlated with the recovery. Some serologic indicators, including the level of WBC, platelet, homocysteine, ALP, positive CMV IgG antibody, fibrinogen, and some immunologic indicators, are closely related to CSSNHL.