Anne Heuschkel1, Katharina Geißler2, Daniel Boeger3, Jens Buentzel4, Dirk Esser1, Kerstin Hoffmann5, Peter Jecker6, Andreas Mueller7, Gerald Radtke8, Orlando Guntinas-Lichius9. 1. Department of Otorhinolaryngology, HELIOS-Klinikum, Erfurt, Germany. 2. Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany. 3. Department of Otorhinolaryngology, Zentralklinikum, Suhl, Germany. 4. Department of Otorhinolaryngology, Südharz-Krankenhaus gGmbH, Nordhausen, Germany. 5. Department of Otorhinolaryngology, Sophien/Hufeland-Klinikum, Weimar, Germany. 6. Department of Otorhinolaryngology, Klinikum Bad Salzungen, Bad Salzungen, Germany. 7. Department of Otorhinolaryngology, SRH Wald-Klinikum, Gera, Germany. 8. Department of Otorhinolaryngology, Ilm-Kreis-Kliniken, Arnstadt, Germany. 9. Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany. orlando.guntinas@med.uni-jena.de.
Abstract
PURPOSE: The aim was to determine inpatient treatment rates of idiopathic sudden sensorineural hearing loss (ISSNHL) with focus on diagnostics, treatment, and outcome. METHODS: A retrospective population-based study in the federal state Thuringia in 2011 and 2012 was performed on all 490 inpatients (51% females, median age: 60 years) treated for ISSNHL (Median duration: 7 days). The association between analyzed parameters and the probability of recovery was tested using univariable and multivariable statistics. RESULTS: The inpatient treatment rate for ISSNHL was 11.23 per 100,000. 172 patients (35%) had an outpatient treatment prior to inpatient treatment. For pure-tone audiometry of the three most affected frequencies (3PTAmax), the initial median hearing loss was 66.67 dB, the median absolute hearing gain ΔPTAabs was 10.0 dB, and the median relative hearing gain in relation with the contralateral side ΔPTArel contral was 30.86%. 51% of the patients reached a ΔPTAabs of ≥ 10 dB. About 2 of 5 patients recovered to a ΔPTArel contral ≥ 50% or reached ≤ 10 dB of contralateral ear. The multivariate analysis revealed that an ISSNHL on the left side [Hazard ratio (HR) = 1.6.88; confidence interval (CI) = 1.161-2.454], no down-sloping audiogram type (HR = 2.016; CI = 1.391-2.921), and no prior outpatient prednisolone treatment (HR = 2.374; CI = 1.505-3.745) were independent factors associated with better recovery (ΔPTAabs ≥ 10 dB). CONCLUSION: Inpatient treatment of ISSNHL is variable in daily practice. The population-based recovery rate was worse than reported in clinical trials. More standardization and clearer criteria for outpatient, inpatient, and salvage therapy are needed.
PURPOSE: The aim was to determine inpatient treatment rates of idiopathic sudden sensorineural hearing loss (ISSNHL) with focus on diagnostics, treatment, and outcome. METHODS: A retrospective population-based study in the federal state Thuringia in 2011 and 2012 was performed on all 490 inpatients (51% females, median age: 60 years) treated for ISSNHL (Median duration: 7 days). The association between analyzed parameters and the probability of recovery was tested using univariable and multivariable statistics. RESULTS: The inpatient treatment rate for ISSNHL was 11.23 per 100,000. 172 patients (35%) had an outpatient treatment prior to inpatient treatment. For pure-tone audiometry of the three most affected frequencies (3PTAmax), the initial median hearing loss was 66.67 dB, the median absolute hearing gain ΔPTAabs was 10.0 dB, and the median relative hearing gain in relation with the contralateral side ΔPTArel contral was 30.86%. 51% of the patients reached a ΔPTAabs of ≥ 10 dB. About 2 of 5 patients recovered to a ΔPTArel contral ≥ 50% or reached ≤ 10 dB of contralateral ear. The multivariate analysis revealed that an ISSNHL on the left side [Hazard ratio (HR) = 1.6.88; confidence interval (CI) = 1.161-2.454], no down-sloping audiogram type (HR = 2.016; CI = 1.391-2.921), and no prior outpatientprednisolone treatment (HR = 2.374; CI = 1.505-3.745) were independent factors associated with better recovery (ΔPTAabs ≥ 10 dB). CONCLUSION: Inpatient treatment of ISSNHL is variable in daily practice. The population-based recovery rate was worse than reported in clinical trials. More standardization and clearer criteria for outpatient, inpatient, and salvage therapy are needed.
Authors: Robert J Stachler; Sujana S Chandrasekhar; Sanford M Archer; Richard M Rosenfeld; Seth R Schwartz; David M Barrs; Steven R Brown; Terry D Fife; Peg Ford; Theodore G Ganiats; Deena B Hollingsworth; Christopher A Lewandowski; Joseph J Montano; James E Saunders; Debara L Tucci; Michael Valente; Barbara E Warren; Kathleen L Yaremchuk; Peter J Robertson Journal: Otolaryngol Head Neck Surg Date: 2012-03 Impact factor: 3.497
Authors: Daniel Kampfner; Andreas Anagiotos; Jan Christoffer Luers; Karl-Bernd Hüttenbrink; Simon F Preuss Journal: Eur Arch Otorhinolaryngol Date: 2013-09-22 Impact factor: 2.503