PROGNOSIS AND TREATMENT OF SUDDEN SENSORINEURAL HEARING-LOSS

Most cases of sudden sensorineural hearing loss (SHL) are idiopathic. Consequently, the otologist may be asked to predict hearing recovery a nd select a treatment strategy without fully understanding the disease process. We retrospectively reviewed the charts of 837 patients with SHL to evaluate the prognostic value of specific clinical parameters a nd the effectiveness of steroid and vasodilator treatments. Treatment response was defined by the patient's subjective response and audiolog ical criteria. Patients who were treated with steroids and/or vasodila tors were more likely to improve. Patients who improved had a worse in itial pure-tone average (PTA) than those who did not improve. In addit ion, those with poorer initial speech discrimination scores, worse ini tial thresholds at 4,000 Hz, younger age, and greater number of treatm ents were more likely to improve. Neither the electronystagmogram resu lts nor the initial audiogram shape were valuable indicators. Recognit ion of prognostic indicators can help in counselling patients and in t he evaluation of treatment response.