title: Simultaneous and sequential bilateral sudden sensorineural hearing loss: are they different from unilateral sudden sensorineural hearing loss?
abstract: OBJECTIVE
  To compare bilateral (BSSHL) with unilateral (USSHL) sudden sensorineural hearing loss.
  
  
  METHODS
  Two hundred and thirty-two patients with USSHL, 11 with simultaneous BSSHL and 7 with sequential BSSHL, who were older than 15 years had onset of hearing loss <30 days, no head injuries or history of acoustic trauma. All patients received the same treatment (prednisolone).
  
  
  RESULTS
  Hearing loss was more severe in simultaneous BSSHL in comparison to sequential BSSHL (p = 0.01) or USSHL (p = 0.03). Autoimmune diseases were far more common in simultaneous BSSHL (36% of patients) than USSHL. Positive antinuclear antibody was found in half of BSSHL patients and in only 8% of unilateral cases (p = 0.01). The frequency of hearing improvement was much lower in simultaneous BSSHL than in USSHL (p = 0.001). Complete or partial improvement was noted in 74% of unilateral cases versus 27% in simultaneous bilateral cases. Patients with sequential BSSHL improved in a similar way to unilateral cases.
  
  
  CONCLUSIONS
  Simultaneous BSSHL, sequential BSSHL and USSHL may have a completely different profile and should not be managed as one disease. Hearing loss, underlying autoimmune diseases, antinuclear antibodies, and improvement/recovery of hearing loss vary in a degree that implies different pathophysiology and prognosis.
authors: ENT Department, Athens University, and Ippokratio and Attiko Hospital, Athens, Greece.
authors: John
authors: J
authors: Xenellis
authors: Thomas P
authors: TP
authors: Nikolopoulos
authors: Pelagia
authors: P
authors: Stavroulaki
authors: Pavlos
authors: P
authors: Marangoudakis
authors: Michael
authors: M
authors: Androulakis
authors: Michael
authors: M
authors: Tsangaroulakis
authors: Eleftherios
authors: E
authors: Ferekidis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D006312:Hearing Loss, Bilateral / Q000175:diagnosis* / Q000453:epidemiology; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis*; D003639:Hearing Loss, Sudden / Q000175:diagnosis* / Q000453:epidemiology; D046088:Hearing Loss, Unilateral / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D014012:Tinnitus / Q000175:diagnosis / Q000453:epidemiology; D014717:Vertigo / Q000175:diagnosis / Q000453:epidemiology