突发性感音神经性听力损失的预后因素分析

IF 0.3 Q3 MEDICINE, GENERAL & INTERNAL Journal of The Korean Medical Association Pub Date : 2023-10-10 DOI:10.5124/jkma.2023.66.10.573
Tae Hoon Kong
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引用次数: 0

摘要

背景:突发性感音神经性听力损失(SSNHL)是指听觉敏锐度迅速且通常无法解释的下降。不同研究报告的SSNHL的恢复率不同;然而,这些通常在40%到60%的范围内。尽管许多研究已经调查了影响听力恢复的因素,但预测患者的听力恢复仍然具有挑战性。当前概念:SSNHL的自然恢复率在32.0% - 65.0%之间,治疗通常包括全身类固醇治疗和鼓室内地塞米松注射。辅助治疗,如抗病毒药物、血管扩张剂、抗凝血剂、高压氧治疗和星状神经节阻滞治疗也被使用。通常在2周内恢复,约66.0%的患者听力完全或部分恢复。恢复主要发生在早期;约78.2%至90.0%的患者在1个月内康复,98.0%的患者在3个月内康复。年龄是与康复相关的一个重要因素;≥40岁患者恢复率低。同时存在的头晕通常与不良结果有关。听力损失的严重程度和类型(基于听力损伤的频率特异性模式)与预后不良相关。此外,高血压和糖尿病等全身性疾病也可能是致病因素。除了各种听力学评估来评估耳蜗功能外,环境因素,包括颗粒物和空气污染也会影响结果。讨论与结论:在SSNHL治疗过程中,评估已知影响恢复的因素对于确定患者听力恢复潜力非常重要。积极主动的患者咨询对于指导治疗决策是必要的,特别是在听力恢复不完全或缺乏恢复后开始听觉康复。影响听力恢复的重要变量是有用的预后指标。这些研究有望更好地了解SSNHL的病理生理,并为治疗干预提供循证基础。
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Prognostic factors of sudden sensorineural hearing loss
Background: Sudden sensorineural hearing loss (SSNHL) refers to rapid and often unexplained decline in auditory acuity. Reported recovery rates for SSNHL vary across studies; however, these are usually within the range of 40% to 60%. Although numerous studies have investigated factors that affect auditory restoration, prediction of patients’ hearing recovery remains challenging.Current Concepts: Natural recovery rates for SSNHL range between 32.0% and 65.0%, and treatments commonly include systemic steroid therapy and intratympanic dexamethasone injections. Adjunctive treatments, such as antiviral agents, vasodilators, anticoagulants, hyperbaric oxygen therapy, and stellate ganglion block therapy are also utilized. Recovery typically occurs within 2 weeks, and approximately 66.0% of patients have complete or partial hearing restoration. Recovery predominantly occurs early; approximately 78.2% to 90.0% patients recover within 1 month and >98.0% within 3 months. Age is an important factor associated with recovery; patients aged ≥40 years show low recovery rates. Coexisting dizziness is generally associated with unfavorable outcomes. Hearing loss severity and types (based on the frequency-specific pattern of hearing impairment) are associated with poor prognosis. Additionally, systemic conditions like hypertension and diabetes are implicated as etiopathogenetic contributors. In addition to a variety of audiological assessments to evaluate cochlear function, environmental factors, including particulate matter and air pollution affect outcomes.Discussion and Conclusion: During SSNHL treatment, evaluation of factors known to affect recovery is important to determine patients’ hearing restoration potential. Proactive patient counseling is necessary to guide treatment decision-making, particularly for initiation of auditory rehabilitation following incomplete or lack of recovery. Significant variables that affect hearing recovery are useful prognostic indicators. These studies are expected to provide better understanding of the pathophysiology of SSNHL and offer an evidence-based foundation for therapeutic interventions.
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来源期刊
Journal of The Korean Medical Association
Journal of The Korean Medical Association Medicine-General Medicine
CiteScore
0.50
自引率
0.00%
发文量
84
审稿时长
4-8 weeks
期刊介绍: The Journal of the Korean Medical Association (JKMA) is the official peer-reviewed, open-access, monthly journal of the Korean Medical Association (KMA). It contains articles in Korean or English. Its abbreviated title is ''J Korean Med Assoc''. The aims of the Journal include contributing to the treatment of and preventing diseases of public health importance and to improvement of health and quality of life through sharing the state-of the-art scientific information on medicine by the members of KMA and other national and international societies.
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