| Objective:To investigate the effects of treatment and the influencing factors for its prognosis of idiopathic sudden sensorineural hearing loss(ISSNHL)in different types.Methods:We retrospectively analyzed the clinical data of 146 patients with ISSNHL of single ear from March 2017 to March 2018 who treated by the Department of Otolaryngology Head and Neck Surgery,China-Japan Union Hospital of Jilin University.According to the audiometric curve,it was divided into 4 types:the type in low-frequencies、high-frequency、all frequency and total deafness.The age,sex,inducement,side,time to onset of treatment,severity,presence or absence of tinnitus,ear nausea,dizziness,systemic disease and lateral ear condition were counted in all types.All patients were given corresponding treatment according to the type of ISSNHL.And then analyze the data。Statistical analysis was performed using SPSS21.0.The chisquare test was used for the analysis of the count data.P<0.05 was statistically significant.Combined with the total effective rate,univariate and multivariate unconditional logistic regression analyses were used.RESULTS:A total of 146 cases of ISSNHL with single ear were collected.The ratio of male to female was 0.87:1.The age was 19-64 years old and the average age was43.93±12.83 years.According to the audiometric curve classification,the type in low frequency has 38 ears(26.03%),in high frequency has 30 ears(20.53%),in all frequency has 50 ears(34.25%),in total deafness has 28 ears(19.18%).The cure rate of the type in low-frequency,all-frequency,total-deafness and high-frequency are 89.5%,24%,14.3%and 13.3%respectively.The type in low-frequency has the highest cure rate and the differences were statistically significant(c~2=39.422,37.099,37.311,respectively,P<0.001);The cure rate of the type in all frequency was slightly higher than in high-frequency and the total-deafness,and the difference was not statistically significant(c~2=1.333,1.039,respectively,P>0.0083);The cure rate of the type in high-frequency and the total-deafness were close,the difference not statistically significant(c~2=0.011,P>0.0083).The total effective rate difference of the four types of ISSNHL was statistically significant(c~2=41.307,P<0.001);It from high to low is the type in low-frequency,all-frequency,high-frequency,total-deafness in this study.Pairwise comparison:The type in low-frequency is obviously higher than the other three types,and the difference is statistically significant(c~2=24.194,24.736,37.440,respectively,P<0.008);The type in all frequency was slightly higher than in high-frequency and the total-deafness,and the difference was not statistically significant(c~2=0.123,3.974,respectively,P>0.0083);The type in high-frequency and the total-deafness were close,the difference not statistically significant(c~2=2.334,P>0.0083).Among them,the type in low-frequency treatment effect was statistically significant different from the age,course of disease,ear nausea,dizziness,simultaneous tinnitus and dizziness and the severity of each group(P<0.05).The type in high-frequency was different from time to onset of treatment(P<0.05).The type in all-frequency was different from the inducement,time to onset of treatment,dizziness,simultaneous tinnitus and dizziness,and severity(P<0.05).The type of total-deafness was different from dizziness,simultaneous tinnitus and dizziness,and lateral ear condition(P<0.05).Univariate logistic regression analysis showed that factors such as types of ISSNHL,inducement,side,time to onset of treatment,dizziness,simultaneous tinnitus and dizziness,and severity were related to clinical efficacy(P<0.05).multi-factor logistic regression analysis results show that the type of total deafness(OR=3.555,95%CI=1.194-10.582,P=0.023),history of upper respiratory tract infection(OR=4.25,95%CI=1.694-10.677,P=0.002),simultaneous tinnitus and dizziness(OR=2.624,95%CI=1.103-6.245,P=0.029)is a risk factor for the prognosis of patients with ISSNHL.Conclusion:1.Different types of ISSNHL have different therapeutic effects,and the type in low-frequency has the best curative effect,followed by the type in all-frequency and high-frequency,and the type of total deafness has poor curative effect.2.The prognosis of patients with ISSNHL is related to the types of ISSNHL,inducement,side,severity and whether there is simultaneous tinnitus and dizziness.3.The type of total deafness,history of upper respiratory tract infection,simultaneous tinnitus and dizziness are important risk factors of the prognosis in ISSNHL. |
