Analysis Of Recurrent Causes And Prognostic Factors Of Idiopathic Sudden Sensorineural Hearing Loss

Background and purposeIdiopathic sudden sensorineural hearing loss(short for sudden deafness)is one of the common acute diseases in the department of otology,often accompanied by hearing loss,tinnnitus,ear tightness,dizziness and other symptoms.Some patients with sudden deafness have relapsing.According to existing literature reports,the recurrence rate of sudden deafness is 0.8%?40%.The cause of relapse of sudden deafness is not clear at present,and there are few literatures about the recurrence of sudden deafness,the occurrence of sudden deafness has different degrees of influence on patients' body and psychology,and the repeated onset of sudden deafness causes patients'psychological panic.Therefore,it is necessary to analyze the causes of recurrence of sudden deafness and provide the basis for clinical diagnosis and treatment.Due to the unknown etiology of sudden deafness and the large difference in prognosis,a large number of literatures have reported some factors that may affect the prognosis of sudden deafness,but the previous studies are still controversial and need to be confirmed by further studies.Moreover,there is still a lack of objective index to describe the change of sudden deafness.Therefore,this paper intends to retrospectively analyze 665 patients with sudden deafness and summarize the possible factors affecting their recurrence and prognosis.so as to pro,vide more basis for clinical diagnosis and treatment and prevention of recurrence.Methods1.Case data of 665 patients with sudden deafness were retrospectively analyzed,including 12 patients with recurrent sudden deafness.Logistic regression analysis was performed to analyze possible factors affecting recurrence,and P<0.05 was considered statistically significant.2.Were retrospectively analyzed the data of 665 cases of patients with sudden deafness,will affect the prognostic factors(such as hearing curve type,whether with dizziness,such as age,to see a doctor after onset time may affect factors)and the treatment effect to establish R*C table chi-square test or Spearman rank correlation analysis(alpha = 0.05),and p<0.05 factors orderly Logistic regression analysis.Collected at the same time "all frequency drop type of sudden deafness patients in the hospital,the analysis of the detection of DPOAE in all frequency drop changes observed in the type of sudden deafness:measurement data using mean +/-standard deviation('x + s),said the differences between groups with Fisher's exact test-multiple sets of mean comparison using single factor analysis of variance.Each patient received at least three DPOAE test,single factor repetitive measure analysis of variance,respectively,evaluation of three groups(group is invalid,improve group and cure group)each frequency DPOAE SNR value with the change of time,many factors repeated measurement variance analysis evaluation,the difference between the three groups and group interaction factor and time factor,a scatter diagram and Pearson correlation analysis to investigate the pure tone hearing threshold before and after the treatment of the relationship between the changes and SNR.P<0.05 was considered statistically significant.Results1.Factors that may lead to recurrence of sudden deafness include hyperlipidemia(odds ratio 54.943.,P=0.000)and combined radiotherapy(odds ratio 64.100,P=0.000).2.Factors influencing:the curative effect of sudden deafness included whether patients were complicated with vertigo,types of sudden deafness and the number of days and age from onset to the first visit(P<0.05)3.The change of partial DPOAE frequency among the three groups presented statistical difference.Starting from the 6th day of treatment,the cured group(40%)was significantly higher than the other two groups(0%,0%)4.The time points of f2-1105hz and f2-2211hz in the cure group showed statistically significant changes,showing a linear increase trend,while there was no significant linear change trend in other frequencies and the other two groups.At the frequencies of f2-1105hz,f2-1560hz and f2-2211hz,there were statistically significant differences in SNR values between the three groups.Moreover,there was an interaction between the grouping factor and the time factor in the two frequencies of f2-1105hz and f2-2211hz,and the SNR value in the cured group was more and more different from the other two groups with the treatment.There was a linear correlation between the mean changes of the three frequency SNR before and after the treatment of f2-1105hz,f2-1560hz and f2-2211 hz and the pure tone threshold changes,with the correlation coefficient of 0.528Conclusions1.Hyperlipidemia and a history of radiotherapy to the head and neck are risk factors for recurrence of sudden deafness.2.Whether patients are complicated with vertigo or sudden deafness,the time from onset to initial diagnosis,and age are important factors affecting the curative effect of sudden deafness3.The SNR values of f2-1105hz and f2-2211hz in early DPOAE(within 6 days after treatment)showed a linear increase trend with time,which may indicate that patients with partial sudden deafness have a higher chance of hearing improvement.