Prognostic factors regarding the hearing outcome in severe to profound sudden sensorineural hearing loss treated by tympanotomy and sealing of labyrinthine windows after ineffective systemic corticosteroid application
| Autor: | Silke Drewermann, Jan Peter Thomas, Stefan Dazert, Christiane Voelter |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Multivariate analysis medicine.drug_class Hearing Loss Sensorineural Audiology 03 medical and health sciences 0302 clinical medicine Audiometry Adrenal Cortex Hormones Vertigo otorhinolaryngologic diseases medicine Humans 030223 otorhinolaryngology Aged Retrospective Studies Absolute threshold of hearing biology business.industry Retrospective cohort study General Medicine Odds ratio Hearing Loss Sudden Middle Aged biology.organism_classification Prognosis Middle Ear Ventilation Treatment Outcome Otorhinolaryngology 030220 oncology & carcinogenesis Ear Inner Multivariate Analysis Corticosteroid Female Neurosurgery business |
| Zdroj: | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 275(7) |
| ISSN: | 1434-4726 |
| Popis: | Tympanotomy and sealing of labyrinthine membranes has become in some centers used to treat severe to profound sudden sensorineural hearing loss refractory to conservative treatment. The aim of this retrospective study was to determine which preoperative factors influence the likelihood of postoperative recovery according to different audiological assessment criteria. The mean final hearing threshold, the hearing improvement, the probability of a complete recovery according to two different classifications, and probability of a significant recovery of 136 adult subjects were studied by univariate and multivariate analyses. The subject’s mean postoperative 4-pure-tone-average was 63.9 ± 35.9 dB, the mean improvement was 42.8 ± 32.6 dB. Depending on the classification system used, 18.4–28.0% of subjects experienced a complete recovery. 77.2% of subjects had a significant hearing improvement. History of a pressure change (odds ratio (OR):4.6) was the only positive prognostic factor for hearing improvement. It also enhanced probability of experiencing a complete hearing recovery (OR: 2.8–6.3). Preoperative total deafness (OR: 1.5–1.9) and vertigo (OR: 3.3–4.6) were negative prognostic factors for the mean final hearing threshold and the probability of a complete hearing recovery. Patients with a preceding pressure change event achieved a complete recovery in 45.5–50.0%, those without such an event recovered completely only in 13.2–23.7%. Evaluating prognostic factors and the rate of complete hearing recovery are influenced by the underlying assessment parameters. In addition to the mean postoperative hearing threshold and hearing gain, the probability of regaining a serviceable hearing is clinically important for the individual and should be added to the assessment criteria in future studies. |
| Databáze: | OpenAIRE |
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