title: Clinical, etiological and progression factors of hearing in sudden deafness.
abstract: Out of the many forms of therapy for sudden deafness, some require hospitalization and present significant risks.
  
  
  OBJECTIVE
  This prospective study analyzes etiology and evolution in cases of sudden deafness (SD) where outpatient oral treatment was used.
  
  
  METHODS
  Clinical with transversal cohort.
  
  
  METHODS
  Forty cases of sudden hearing loss were followed for at least one year. All were submitted to initial clinical evaluation, auditory tests, routine blood analysis, and magnetic resonance imaging. All received initial treatment with pentoxifylline and prednisone.
  
  
  RESULTS
  45% (n=18) presented normal auditory thresholds, 40% (n=16) showed some improvement in hearing, 15% (n=6) maintained initial hearing level. Nine cases (22.5%) presented clinical conditions possibly implicated in hearing loss (viral infection, immunomediated hearing loss, vascular disorders, and so on); three (7.5%) had cerebellopontine tumors. Evolution of hearing in these 12 cases with presumed etiology presented no differences from hearing in the 28 cases without any known etiological factor. Clinical treatment within the first seven days was the only statistically significantly different condition in patients who improved hearing.
  
  
  CONCLUSIONS
  An objective search for etiological bases should be conducted in any case of acute sensorineural hearing loss. The presence of cerebellopontine tumors in 7.5% of cases of SD, among other treated causes, justifies a thorough clinical investigation in these patients. Overall good evolution of hearing was observed in 67.5% of cases of SD, regardless of its etiology. Therapy within the first seven days of SD was significantly related to better outcomes in hearing.
authors.affiliation: Federal University of Sao Paulo, Escola Paulista de Medicina.
authors.forename: Norma de Oliveira
authors.initials: Nde O
authors.lastname: Penido
authors.forename: Hugo Valter Lisboa
authors.initials: HV
authors.lastname: Ramos
authors.forename: Flávia Alencar
authors.initials: FA
authors.lastname: Barros
authors.forename: Oswaldo Laércio Mendonça
authors.initials: OL
authors.lastname: Cruz
authors.forename: Ronaldo Nunes
authors.initials: RN
authors.lastname: Toledo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001309:Auditory Threshold / Q000502:physiology; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D003639:Hearing Loss, Sudden / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010431:Pentoxifylline / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D011446:Prospective Studies; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use / Q000652:urine
chemical_list: D005938:Glucocorticoids; D014665:Vasodilator Agents; D010431:Pentoxifylline; D011241:Prednisone