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Patients with idiopathic hearing loss compared to patients with sudden non-idiopathic sensorineural hearing loss: epidemiological multicentre study in Thuringia
18 April 2018 (online)
To compare inpatient treated patients with idiopathic (ISSNHL) and non-idiopathic sudden sensorineural hearing loss (NISSNHL) regarding frequency, hearing loss, treatment and outcome.
All 574 inpatient patients (51% male, median age: 60 years) with ISSNHL and NISSNHL, who were treated in federal state Thuringia in 2011 and 2012, were included. Univariate and multivariate statistical analysis were performed.
ISSNHL was diagnosed in 490 patients (85%), NISSNHL in 84 patients (15%). 49% of these cases had hearing loss due to acute otitis media, 37% through varicella zoster infection or Lyme disease, 10% through Menière's disease and 7% other. Patients with ISSNHL and NISSNHL showed no difference between age, gender, side or type of hearing loss, presence of tinnitus or vertigo and their comorbidity. 45% of patients with ISSNHL and 62% with NISSNHL had an outpatient treatment prior to inpatient treatment (p < 0,001). The measured interval between the onset of the hearing loss to inpatient treatment was 7,7days in ISSNHL and 8,9days in NISSNHL (p = 0,02). The initial hearing loss of the three most affected frequencies in pure-tone audiometry (3PTAmax) scaled 66,7dB in ISSNHL and 63,3dB in NISSNHL. In case of acute otitis media 3PTAmax (60dB) was lower than in case of varicella zoster infection or Lyme disease (76,76dB; p = 0,015). Median absolute hearing gain (Δ3PTAabs) was 10dB in general and 10dB in patients with ISSNHL, whereas Δ3PTAabs was 11,7dB in patients with NISSNHL. 48% of the patients with ISSNHL and 62% with NISSNHL reached a Δ3PTAabs ≥10dB (p = 0,02).
ISSNHL and NISSNHL show no difference between hearing loss or epidemiological data. NISSHNL is more common associated with good outcome.