객관적 전정기능의 장애가 동반된 감각신경성 난청 환자의 특성
Characteristic of Sudden Sensorineural Hearing Loss with Objective Vestibular Involvement
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Background and Objectives To analyze the difference in audiologic-vestibular and clinicalcharacteristics between acute cochlea-vestibulopathy (ACV) and idiopathic sudden sensorineuralhearing loss (ISSNHL). Subjects and Method We retrospectively analyzed the clinical characteristics of 91 patientsdiagnosed as sudden hearing loss (ACV; n=20, ISSNHL; n=71). Patients with vestibular hypofunctionwere categorized as ACV and all others as ISSNHL. Demographics and clinical findingswere compared. Audiologic features such as degree of hearing loss, type of audiometricconfiguration and hearing improvements were analyzed. In addition, vestibular function testresults and hearing recovery were further analyzed among ACV group. Results Demographics and other clinical findings were not much different between groups. There was a significant difference with respect to audiologic features between the ACV groupand ISSNHL group: the initial hearing threshold of the ACV group was higher than that of theISSNHL group, and their treatment onset was also shorter. There was also a significant differencein the hearing outcome showing very low rate of complete recovery in ACV group. The finalhearing threshold of the ACV group was higher than that of the ISSNHL group. Dizziness wasthe only significant variable in the multiple regression analysis. In the ACV group, the cervicalvestibular evoked myogenic potential inter-aural amplitude difference (cVEMP IAD) ratioshowed a correlation to the hearing recovery in some frequencies; patients with no cVEMP responseshowed poor outcome compared to those with cVEMP waveform. Conclusion The ACV group shows a poor prognosis just as in the case of sudden hearing lossdefined in the traditional sense of vertigo. The IAD value of the vestibular evoked myogenic potentialstest will be helpful in assessing hearing improvement, especially when a high IAD valueat the middle frequency is associated with a poor prognosis.
Abstract
Background and Objectives To analyze the difference in audiologic-vestibular and clinicalcharacteristics between acute cochlea-vestibulopathy (ACV) and idiopathic sudden sensorineuralhearing loss (ISSNHL). Subjects and Method We retrospectively analyzed the clinical characteristics of 91 patientsdiagnosed as sudden hearing loss (ACV; n=20, ISSNHL; n=71). Patients with vestibular hypofunctionwere categorized as ACV and all others as ISSNHL. Demographics and clinical findingswere compared. Audiologic features such as degree of hearing loss, type of audiometricconfiguration and hearing improvements were analyzed. In addition, vestibular function testresults and hearing recovery were further analyzed among ACV group. Results Demographics and other clinical findings were not much different between groups. There was a significant difference with respect to audiologic features between the ACV groupand ISSNHL group: the initial hearing threshold of the ACV group was higher than that of theISSNHL group, and their treatment onset was also shorter. There was also a significant differencein the hearing outcome showing very low rate of complete recovery in ACV group. The finalhearing threshold of the ACV group was higher than that of the ISSNHL group. Dizziness wasthe only significant variable in the multiple regression analysis. In the ACV group, the cervicalvestibular evoked myogenic potential inter-aural amplitude difference (cVEMP IAD) ratioshowed a correlation to the hearing recovery in some frequencies; patients with no cVEMP responseshowed poor outcome compared to those with cVEMP waveform. Conclusion The ACV group shows a poor prognosis just as in the case of sudden hearing lossdefined in the traditional sense of vertigo. The IAD value of the vestibular evoked myogenic potentialstest will be helpful in assessing hearing improvement, especially when a high IAD valueat the middle frequency is associated with a poor prognosis.
참고문헌 (24)
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