Evaluación de pacientes diagnosticados de hipoacusia súbita profunda unilateral: estudio retrospectivo de 12 años

Abstract

Introduction and objective: Multiple prognostic factors have been proposed regarding hearing recovery after sudden hearing loss (SHL). The degree of hearing loss and the delay in starting treatment seem to be the most clearly demonstrated factors. Our objective is to analyze the percentage of patients with profound hearing loss at diagnosis and to evaluate their subsequent evolution.
Method: Patients diagnosed with sudden unilateral hearing loss in our hospital between 1992 and 2004 were recorded, including variables such as sex, age, cardiovascular risk factors, degree of hearing loss, recovery according to one-year follow-up, tests performed, treatment received and final etiological diagnosis. Of these, those with profound unilateral idiopathic sensorineural hearing loss were selected and the associated factors and their evolution were described.
Results: A total of 138 patients with HS were registered, of which 33 who presented idiopathic unilateral profound hearing loss (10 men and 23 women) with a mean age of 54.5 [21-75] were selected. The diagnostic delay was a mean of 6 days (1-30). Tinnitus was the most frequent accompanying symptom (30 patients) followed by vertigo (11 patients). All patients received treatment with corticosteroids (oral and/or intravenous and/or intratympanic) and hyperbaric oxygen. After audiometric follow-up at one year, 25 patients did not show improvement in hearing and 8 partially recovered. No clear differences were found between patients who improved hearing and those who did not.
Discussion: Severity of hearing loss and diagnostic delay are independent prognostic factors described in the literature. Other factors such as age, cardiovascular risk factors or the presence of other symptoms such as tinnitus or vertigo have been proposed without being clearly demonstrated. Our data suggest a poor prognosis for profound hearing loss regardless of the other factors.
Conclusions: Despite the fact that it is a retrospective study with a small sample, our data coincide with those of the literature that sudden profound hearing loss constitutes an independent poor prognostic factor for recovery.