Analysis Of Clinical Factors Related To The Prognosis Of Unilateral Total Sudden Deafness With Vertigo

purposeThe objective is to investigate the effect of clinical factors on the prognosis of patients with unilateral total sudden deafness with vertigo.MethodsThe clinical data of 245 patients with unilateral total sudden deafness with vertigo in the department of otology(2)of the first affiliated Hospital of Zhengzhou University from January 2018 to January 2021 were analyzed retrospectively,all patients meet the criteria of the guidelines for the diagnosis and treatment of sudden deafness(version 2015).Chi-square test and rank sum test were used to compare the differences of hearing recovery efficiency and hearing improvement threshold among patients with different sex,age,lateral ear,onset of treatment time(time to start treatment),whether with accompanying disease(high blood pressure,diabetes),caloric test and video head impulse test results.Binary Logistic regression analysis was used to analyze the influence of the above-mentioned clinical factors on the effective rate of hearing recovery.P<0.05 was judged as statistical difference.ResultsThere a total of 245 patients with unilateral total sudden deafness with vertigo were collected,including 101 males(41.22%)and 144 females(58.78%);the age was≤50 years old in 135 cases(55.10%),>50 years old in 110 cases(44.90%);131 cases(53.47%)were left side,114 cases(46.53%)were right side;onset of treatment time≤14 days in 171 cases(69.80%),onset of treatment time>14 days in 74 cases(30.20%);without accompanying diseases in 196 cases(80.00%)and accompanying diseases in 49 cases(20.00%);caloric test results was normal in 93 cases(37.96%)and abnormal in 152 cases(62.04%);video head impulse test results was normal in 110 cases(44.90%)and abnormal in 135cases(55.10%).Hearing effect:cured in 6 cases(2.45%);markedly effective ear in 48 cases(19.59%);effective ear in 81 cases(33.06%);the total effective rate was 55.10%;ineffective ear 110(44.90%).The effects of related clinical factors on the effective rate of hearing recovery showed that there were significant differences in age group(P=0.001),onset of treatment time group(P<0.001),accompanying diseases group(P<0.001),caloric test group(P=0.002)and video head impulse test group(P=0.001),but there was no significant difference in gender group(P=0.865)and side group(P=0.326).Analysis of the effect of clinical factors on hearing threshold showed that there were significant differences in age group(P=0.010),onset of treatment time group(P<0.001),accompanying diseases group(P=0.001),caloric test group(P=0.001)and video head impulse test group(P=0.003),but there was no significant difference in gender group(P=0.893)and side group(P=0.738).Logistic regression analysis showed that the effective rate of hearing recovery in patients with onset of treatment time>14 days was 0.428 times that of patients ≤14 days(OR=0.428,95%CI=0.236～0.774,P=0.005),and the effective rate of hearing recovery in patients with accompanying diseases was 0.287 times higher than that in patients without accompanying diseases(OR=0.287,95%CI=0.142～0.580,P=0.001);the effective rate of hearing recovery in patients with abnormal caloric test results was 0.529 times that of normal patients(OR=0.529,95%CI=0.296～0.946,P=0.032),and that in patients with abnormal video head impulse test results were 0.464 times higher than that in normal patients(OR=0.464,95%CI=0.264～0.816,P=0.008)ConclusionsAdvanced age,long onset of treatment time,accompanying disease(high blood pressure,diabetes),abnormal caloric test test and abnormal video head impulse test results indicate that the prognosis of unilateral total sudden deafness with vertigo is poor.Abnormal vestibular function indicates that the extent of inner ear lesion in patients with sudden deafness is large and the degree of injury is severe.