돌발성 난청에서 온도안진검사의 의의
Caloric Test as a Possible Prognostic Indicator in Sudden Deafness
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Background and Objectives Dizziness has been known as a prognostic factor in suddensensorineural hearing loss (SSHL), but it is difficult to describe and quantify its subjectivesymptoms. Also, dizziness itself cannot imply vestibular dysfunction in SSHL. Comprehensiveevaluation of vestibular function may help us understand the extent of lesions in sudden deafness. The purpose of this study is to determine whether an impaired caloric response is associatedwith disease severity and hearing outcome. Subjects and Method A retrospective chart review was conducted of 488 patients diagnosedas unilateral SSHL. The patients were divided into two, an abnormal caloric group (canal paresis＞20%) and normal caloric group (canal paresis ≤20%). Initial demographic and audiologicfindings and final hearing outcomes were compared between the two groups. Results The initial pure tone averages of SSHL patients of abnormal caloric group and normalcaloric group were 75.4±28.4 dB HL and 68.2±25.4 dB HL (p=0.004), respectively. Patientsof abnormal caloric test group showed worse hearing outcome across all frequenciescompared to those of the normal caloric group. Also, a significant correlation was noted betweenthe magnitude of hearing recovery and canal paresis (r=-0.223, p<0.001). Conclusion SSHL patients of abnormal caloric test showed worse initial hearing level andpoorer hearing outcome. Evaluation of vestibular function in SSHL patients is important becausesubjective symptoms alone cannot account for vestibular hypofunction patients, and thecaloric test can help in the counseling of patients and prediction of hearing outcome in SSHLpatients.
Abstract
Background and Objectives Dizziness has been known as a prognostic factor in suddensensorineural hearing loss (SSHL), but it is difficult to describe and quantify its subjectivesymptoms. Also, dizziness itself cannot imply vestibular dysfunction in SSHL. Comprehensiveevaluation of vestibular function may help us understand the extent of lesions in sudden deafness. The purpose of this study is to determine whether an impaired caloric response is associatedwith disease severity and hearing outcome. Subjects and Method A retrospective chart review was conducted of 488 patients diagnosedas unilateral SSHL. The patients were divided into two, an abnormal caloric group (canal paresis＞20%) and normal caloric group (canal paresis ≤20%). Initial demographic and audiologicfindings and final hearing outcomes were compared between the two groups. Results The initial pure tone averages of SSHL patients of abnormal caloric group and normalcaloric group were 75.4±28.4 dB HL and 68.2±25.4 dB HL (p=0.004), respectively. Patientsof abnormal caloric test group showed worse hearing outcome across all frequenciescompared to those of the normal caloric group. Also, a significant correlation was noted betweenthe magnitude of hearing recovery and canal paresis (r=-0.223, p<0.001). Conclusion SSHL patients of abnormal caloric test showed worse initial hearing level andpoorer hearing outcome. Evaluation of vestibular function in SSHL patients is important becausesubjective symptoms alone cannot account for vestibular hypofunction patients, and thecaloric test can help in the counseling of patients and prediction of hearing outcome in SSHLpatients.
참고문헌 (22)
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