Clinical, etiological and progression factors of hearing in sudden deafness.
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.
Penido
Norma de Oliveira
Nde O
Federal University of Sao Paulo, Escola Paulista de Medicina.
Ramos
Hugo Valter Lisboa
HV
Barros
Flávia Alencar
FA
Cruz
Oswaldo Laércio Mendonça
OL
Toledo
Ronaldo Nunes
RN
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
D005938:Glucocorticoids; D014665:Vasodilator Agents; D010431:Pentoxifylline; D011241:Prednisone