Vestibular diagnosis as prognostic indicator in sudden hearing loss with vertigo

The majority of episodes of sudden hearing loss are caused by inner ear dis orders, often accompanied by vertigo. The patterns of hearing loss usually influence the prognosis. The purpose of this study was to analyze vestibula r diagnoses in sudden hearing loss with vertigo, and to correlate them with the recovery of hearing loss. The clinical records of 125 patients with su dden hearing loss were reviewed. Various vestibular evaluations were perfor med in 36 patients with vertigo. The vertigo in these patients was classifi ed as normal, unilateral hypofunction, directional preponderance, benign pa roxysmal positional vertigo (BPPV), non-specific or irritative. The initial and final pure-tone audiograms of these patients were compared. The distri bution of vestibular diagnoses was unilateral hypofunction in 30.6%. of pat ients, BPPV in 25.7%, normal in 19.4%, non-specific in 11.1%, directional p reponderance in 8.3% and irritative in 83%. The recovery of hearing in pati ents with vertigo was significantly worse than in those without vertigo. Th e recovery of hearing in patients with spinning vertigo did not differ from that of patients with non-spinning vertigo. The recovery of hearing was wo rst in the BPPV group, especially in the high frequency range, followed by the unilateral hypofunction group, who showed hearing thresholds between th ose in the BPPV group and those in the normal vestibular function test grou p. This study suggests that the diagnostic classification of vestibulopathy is a useful prognostic indicator of hearing recovery in sudden hearing los s with vertigo. We conclude that otolithic and semicircular canal involveme nt may cause poor hearing results, especially in the high frequency range.