The Short-term Efficacy Of Sudden Sensorineural Hearing Loss With Comorbid Benign Paroxysmal Positional Vertigo

Objective: To evaluate the short-term therapeutic effect of sudden sensorineural hearing loss patients with comorbid benign paroxysmal positional vertigo(BPPV).Method: we retrospectively analyzed 240 patients suffering from sudden sensorineural hearing loss(SSHL). According to whether accompanied by BPPV,the patients were divided into two groups. One is without BPPV group(n=185) and another is with BPPV group(n=55).BPPV was identified and categorized by using the roll or Dix-Hallpike test and nystagmography. Furthermore,the SSHL patients were classcified as 4 types according to the pure-tone audiogram. It were low intermediate frequency descent curve, Medium and high frequency down slope curve, Flat descent curve and Full deafness.All sudden sensorineural hearing loss patients were treated with combination therapy of systemic steroids and intravenous drug using.Besides oral prednisone for 3~5 d,4 types patients were given intravenous infusion of sodium aescinate, Xingding injection plus lidocaine, Xingding injection plus batroxobin lnjection and Xingding injection plus batroxobin lnjection for 2 weeks,respectively. 55 cases with BPPV underwent manipulative reduction in treatment. Comparative analyses between groups with BPPV and groups without BPPV were conducted.Outcome data were analyzed using the t test and X2 test.Result: Among the 240 Sudden sensorineural hearing loss patients, hearing improvement efficiency rate of the group with BPPV were 66.67%(2/3), 25%(1/4), 44.44%(4/9)and 48.72%(19/39)in 4 audiogram types, respectively. In group without BPPV,it were 90.32%(28/31), 23.08%(6/26), 58.18%(32/55) and 69.86%(51/73), respectively; Hearing improvement total effective rate was 47.27%(26/55) in group with BPPV and 63.24%(117/185)in group without BPPV; Patients without BPPV showed higher hearing recovery than those with BPPV on initial and follow-up audiograms. The final result show statistically significant difference(x2=4.490, P<0.05).A comparison of the same audiogram types between two groups was made. The hearing improvement rate was not statistically significant difference(x2=0.166, P>0.05) in Flat type patients, but in Full deafness patients, it was statistically significant difference(x2=4.849, P<0.05). BPPV were cured by manual reduction about 1 ~4 times.Conclusion: A comparison of the two groups indicated that the short term therapeutic effects of sudden sensorineural hearing loss with comorbid BPPV is poor, especially Full deafness.