심도 돌발성 난청 환자의 예후 인자
The Prognostic Factors in Profound Sudden Sensorineural Hearing Loss
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초록
Background and Objectives：Profound sudden sensorineural hearing loss (SSNHL) is particularly known to have poor prognosis. However, there were few studies on the prognosis of profound idiopathic SSNH. The aim of the study is to investigate the possible prognostic factor in profound SSNHL using various clinical parameters. Materials and Methods：A retrospective study was performed with 65 patients who treated with profound SSNHL from January 2011 to December 2017. High dose steroid and intratympanic steroid therapy was uniformly applied and then, hearing recovery was determined by the AAO and HNS classification. Prognostic factors, including clinical characteristic, audiological outcomes and vestibula function tests were assessed by uni and multi-variable analysis. Results：In 65 patients with profound SSNHL, class A hearing recovery was achieved in just 9 (13.8%) patients, while 44 (67.7%) patients showed no hearing improvement. In a subgroup analysis, patients with vertigo showed lower hearing gain than those without vertigo (p=0.032). In addition, canal paresis on caloric test was negatively correlated with hearing gain (r=-0.279). Univariate analysis showed that no hearing improvement group were frequently accompanied with vertigo and higher initial hearing threshold. According to the multivariate analysis, initial hearing threshold was only factor that related to the poor hearing recovery. Conclusions：In profound SSNHL, caloric loss was correlated with poor hearing gain and initial hearing level was associated with the hearing recovery.
Abstract
Background and Objectives：Profound sudden sensorineural hearing loss (SSNHL) is particularly known to have poor prognosis. However, there were few studies on the prognosis of profound idiopathic SSNH. The aim of the study is to investigate the possible prognostic factor in profound SSNHL using various clinical parameters. Materials and Methods：A retrospective study was performed with 65 patients who treated with profound SSNHL from January 2011 to December 2017. High dose steroid and intratympanic steroid therapy was uniformly applied and then, hearing recovery was determined by the AAO and HNS classification. Prognostic factors, including clinical characteristic, audiological outcomes and vestibula function tests were assessed by uni and multi-variable analysis. Results：In 65 patients with profound SSNHL, class A hearing recovery was achieved in just 9 (13.8%) patients, while 44 (67.7%) patients showed no hearing improvement. In a subgroup analysis, patients with vertigo showed lower hearing gain than those without vertigo (p=0.032). In addition, canal paresis on caloric test was negatively correlated with hearing gain (r=-0.279). Univariate analysis showed that no hearing improvement group were frequently accompanied with vertigo and higher initial hearing threshold. According to the multivariate analysis, initial hearing threshold was only factor that related to the poor hearing recovery. Conclusions：In profound SSNHL, caloric loss was correlated with poor hearing gain and initial hearing level was associated with the hearing recovery.
참고문헌 (27)
- 정수희, "Intra-Tympanic Steroid Treatment Alone as an Initial Treatment for the Patients with Severe or Profound Sudden Sensorineural Hearing Loss and Medical Problems in Steroid Use", 대한이비인후-두경부외과학회지, 59(3), pp.202~206 (2016), 대한이비인후과학회[DOI]
- 홍병수, "돌발성 난청 환자에서 회전성 어지러움증이 예후에 미치는 영향", 대한이비인후-두경부외과학회지, 45(7), pp.651~655 (2002), 대한이비인후과학회
- 박창호, "노인 돌발성 난청 환자의 임상적 특징 및 예후인자에 대한 분석", 대한이비인후-두경부외과학회지, 57(8), pp.511~517 (2014), 대한이비인후과학회[DOI]
- Mattox DE, "Natural history of sudden sensorineural hearing loss", Ann Otol Rhinol Laryngol, 86(4), pp.463~480 (1977)
- Gao Y, "Combined intratympanic and systemic use of steroids for idiopathic sudden sensorineural hearing loss: a meta-analysis", Eur Arch Otorhinolaryngol, 273(11), pp.3699~3711 (2016)
- 김영준, "돌발성 난청 환자에서 고실 내 스테로이드 투여 약제에 따른 치료 효과 비교", 대한이비인후-두경부외과학회지, 60(9), pp.441~448 (2017), 대한이비인후과학회[DOI]
- Min HJ, "The combination effects of early intratympanic dexamethasone injection for patients with sudden sensorineural hearing loss", Otolaryngology-Head and Neck Surgery, 145(2_suppl), pp.228~229 (2011)
- Dai Y, "Intratympanic methylprednisolone perfusion as a salvage treatment for profound idiopathic sudden sensorineural hearing loss", J Laryngol Otol, 131(5), pp.404~410 (2017)
- Weiss D, "Predictors of hearing recovery in patients with severe sudden sensorineural hearing loss", J Otolaryngol Head Neck Surg, 46(1), pp.27~ (2017)
- Wen YH1, "Prognostic factors of profound idiopathic sudden sensorineural hearing loss", Eur Arch Otorhinolaryngol, 271(6), pp.1423~1429 (2014)
- 조시영, "Outcomes of Severe to Profound Idiopathic Sudden Sensorineural Hearing Loss", Clinical and Experimental Otorhinolaryngology, 8(3), pp.206~210 (2015), 대한이비인후과학회[DOI]
- Jongkees LBW, "Value of the caloric test of the labyrinth", Arch Otolaryngol, 48(4), pp.402~417 (1948)
- Murofushi T, "Absent vestibular evoked myogenic potentials in vestibular neurolabyrinthitis: an indicator of inferior vestibular nerve involvement?", Arch Otolaryngol Head Neck Surg, 122(8), pp.845~848 (1996)
- 박건, "돌발성 난청환자에서 전정기능의 평가", 대한이비인후-두경부외과학회지, 53(12), pp.761~767 (2010), 대한이비인후과학회
- Halmagyi GM, "The video head impulse test", Front Neurol, 8, pp.258~ (2017)
- Stachler RJ, "Clinical practice guideline:sudden hearing loss", Otolaryngol Head Neck Surg, 146(3_suppl), pp.S1~S35 (2012)
- 남기윤, "돌발성 난청 환자에서 전신 스테로이드 투여 용법에 따른 단기 치료 효과 비교", 대한이비인후-두경부외과학회지, 60(2), pp.63~68 (2017), 대한이비인후과학회[DOI]
- You TZ, "Registering grades of sudden deafness to predict the hearing outcome via an inner-ear test battery", Int J Audiol, 53(3), pp.153~158 (2014)
- Chau JK, "Systematic review of the evidence for the etiology of adult sudden sensorineural hearing loss", Laryngoscope, 120(5), pp.1011~1021 (2010)
- 정승곤, "잠재적 전정기능 장애를 동반한 돌발성 난청 환자에서 전정기능검사의 역할", 대한이비인후-두경부외과학회지, 56(11), pp.700~705 (2013), 대한이비인후과학회[DOI]
- Liu J, "Assessment of balance and vestibular functions in patients with idiopathic sudden sensorineural hearing loss", J Huazhong Univ Sci Technolog Med Sci, 37(2), pp.264~270 (2017)
- Inagaki T, "Vestibular system changes in sudden deafness with and without vertigo: a human temporal bone study", Otol Neurotol, 33(7), pp.1151~1155 (2012)
- Korres S, "Prognosis of patients with idiopathic sudden hearing loss: role of vestibular assessment", J Laryngol Otol, 125(3), pp.251~257 (2011)
- Ahn JH, "Analysis of prognosis in patients with sudden sensorineural hearing loss and dizziness", Korean J Otolaryngol-Head Neck Surg, 44(10), pp.1032~1037 (2001)
- Curthoys IS, "A critical review of the neurophysiological evidence underlying clinical vestibular testing using sound, vibration and galvanic stimuli", Clin Neurophysiol, 121(2), pp.132~144 (2010)
- Pogson JM, "Vertigo with sudden hearing loss:audio-vestibular characteristics", J Neurol, 263(10), pp.2086~2096 (2016)
- Rambold H, "Differential vestibular dysfunction in sudden unilateral hearing loss", Neurology, 64(1), pp.148~151 (2005)