title: Uni- and multivariate models for investigating potential prognostic factors in idiopathic sudden sensorineural hearing loss.
abstract: With a worldwide incidence estimated at 8-15 per 100,000 population a year, idiopathic sudden sensorineural hearing loss (ISSHL) is a common clinical finding for otologists. There is a shortage of information on the clinical factors capable of predicting hearing recovery and response to therapy. The aim of the present study was to retrospectively investigate the prognostic value of clinical variables in relation to hearing recovery, in a cohort of 117 consecutive patients with ISSHL. Clinical parameters (signs, symptoms, comorbidities and treatments) and audiometric data were analyzed with univariate and multivariate statistical approaches for prognostic purposes to identify any correlation with hearing recovery, also expressed according to the Wilson criteria. Univariate analysis showed that age and hypertension were significantly related to hearing outcome (p = 0.004 and p = 0.015, respectively). Elderly patients and those with hypertension were at higher risk of experiencing no hearing recovery (OR = 3.25 and OR = 2.89, respectively). Age was an independent prognostic factor on multivariate analysis (p = 0.007). Tinnitus as a presenting symptom showed a trend towards an association with hearing recovery (p = 0.07). The treatment regimen, the time elapsing between the onset of symptoms and the start of therapy (p = 0.34), and the duration of the treatment (p = 0.83) were unrelated to recovery on univariate analysis. Among the parameters considered, only age was significantly and independently related to hearing outcome. There is a need for well-designed, randomized clinical trials to enable an evidence-based protocol to be developed for the treatment of ISSHL.
authors.affiliation: Otolaryngology Section, Department of Neurosciences, University of Padua, Padua, Italy, marcolionello@email.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Lionello
authors.forename: Claudia
authors.initials: C
authors.lastname: Staffieri
authors.forename: Stefano
authors.initials: S
authors.lastname: Breda
authors.forename: Chiara
authors.initials: C
authors.lastname: Turato
authors.forename: Luciano
authors.initials: L
authors.lastname: Giacomelli
authors.forename: Paola
authors.initials: P
authors.lastname: Magnavita
authors.forename: Cosimo
authors.initials: C
authors.lastname: de Filippis
authors.forename: Alberto
authors.initials: A
authors.lastname: Staffieri
authors.forename: Gino
authors.initials: G
authors.lastname: Marioni
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001299:Audiometry / Q000379:methods; D004234:Diuretics, Osmotic / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis* / Q000503:physiopathology; D003639:Hearing Loss, Sudden / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010431:Pentoxifylline / Q000627:therapeutic use*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011379:Prognosis; D020127:Recovery of Function; D012189:Retrospective Studies; D014012:Tinnitus / Q000503:physiopathology
chemical_list: D004234:Diuretics, Osmotic; D005938:Glucocorticoids; D010975:Platelet Aggregation Inhibitors; D010431:Pentoxifylline