[Is sudden sensorineural hearing loss a therapeutic emergency? Early results in a prospective cohort of 136 patients].
Idiopathic sudden sensorineural hearing loss is one of the most controversial issues in otology. A prospective cohort study including 136 sudden hearing losses seen at the ENT emergency referral center of Lariboisiere Hospital during an 18-month period was conducted. Patients were hospitalized and a corticotherapy course was administered, eventually associated with an antiviral treatment, low molecular weight dextran or sedative. At the end of the 5-day hospitalization, 74% of the patients had recovered, at least partially, with a mean gain of 22 dB. The outcome was considered satisfactory, i.e. superior to 50% of the initial loss, in 30% of the patients. After 1 month, 86% of the patients recovered at least partially with a mean gain of 30 dB. The outcome was considered satisfactory in 44% of the patients. A prognosis analysis showed that vertigo, age of the patient and anacusis are pejorative factors. Ascending audiogram shapes seem to involve a better prognosis. The therapeutic delay is not correlated with the quality of the outcome, which questions the classical notion of therapeutic emergency.
Baujat
B
B
Service ORL, Hôpital Lariboisière, 2, rue Ambroise Paré, 75475 Paris cedex 10, France.
De Minteguiaga
C
C
Lecanu
J B
JB
Herman
P
P
Tran Ba Huy
P
P
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000925:Anticoagulants / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003911:Dextrans / Q000627:therapeutic use; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D003639:Hearing Loss, Sudden / Q000188:drug therapy / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014717:Vertigo / Q000150:complications
D000305:Adrenal Cortex Hormones; D000925:Anticoagulants; D000998:Antiviral Agents; D003911:Dextrans; D006993:Hypnotics and Sedatives