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. 2023 Sep 27:14:1230340.
doi: 10.3389/fneur.2023.1230340. eCollection 2023.

Clinical characteristics and prognosis of sudden sensorineural hearing loss in single-sided deafness patients

Yupeng Liu  1   2   3 , Wenjin Wu  1   2   3 , Shuna Li  1   2   3 , Qing Zhang  1   2   3 , Jingchun He  1   2   3 , Maoli Duan  4   5 , Jun Yang  1   2   3
Affiliations

Clinical characteristics and prognosis of sudden sensorineural hearing loss in single-sided deafness patients

Yupeng Liu et al. Front Neurol. .

Abstract

Background: Sudden sensorineural hearing loss (SSNHL) in patients with single-sided deafness (SSD) is rare. The prognosis of the sole serviceable hearing ear is very important for these patients. However, the clinical characteristics and prognosis of SSNHL in SSD patients are not well-documented.

Objective: This study aimed to investigate the clinical features and treatment outcomes of SSNHL in SSD patients.

Methods: Clinical data of 36 SSD patients and 116 non-SSD patients with unilateral SSNHL from January 2013 to December 2022 were retrospectively investigated. The clinical characteristics of the SSD patients were analyzed. All SSD patients were treated with intratympanic steroids plus intravenous steroids. Pure-tone average (PTA) and word recognition score (WRS) before and after treatment were recorded. The hearing recovery of SSNHL in SSD patients in comparison with non-SSD patients was explored. Auditory outcomes in SSD patients with different etiologies were also compared.

Results: Initial hearing threshold showed no significant differences between the SSD group and the non-SSD group (66.41 ± 24.64 dB HL vs. 69.21 ± 31.48 dB HL, p = 0.625). The SSD group had a higher post-treatment hearing threshold (median (interquartile range, IQR) 53.13(36.56) dB HL) than the non-SSD group (median 32.50(47.5) dB HL, p < 0.01). Hearing gains (median 8.75(13.00) dB) and the rate of significant recovery (13.89%) were lower in the SSD group than in the non-SSD group (median 23.75(34.69) dB, 45.69%). The etiology of SSD was classified as SSNHL, special types of infection, chronic otitis media, and unknown causes. SSNHL accounted for the maximum proportion (38.9%) of causes of SSD in the SSD group. Hearing gains were lower in the SSNHL-SSD group than in other causes of the SSD group. A binary logistic regression analysis demonstrated that SSD serves as an indicator of unfavorable hearing recovery outcomes (OR = 5.264, p < 0.01).

Conclusion: The prognosis of SSNHL in SSD patients is unsatisfactory. SSNHL accounts for the maximum proportion of causes of SSD in this group of patients. For SSD patients caused by SSNHL, less hearing improvement after treatment was expected when SSNHL occurred in the contralateral ear in comparison with SSD patients with other causes.

Keywords: clinical feature; glucocorticoid; prognosis; single sided deafness; sudden sensorineural hearing loss.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Etiology of hearing loss in the SSD group. Fourteen cases were attributed to SSNHL, eight cases were attributed to special types of infection (three cases of parotitis, two cases of herpes zoster, two cases of meningitis, and one case of upper respiratory tract infection), four cases were attributed to chronic otitis media, and ten cases were attributed to unknown causes. SSD, single-sided deafness; SSNHL, sudden sensorineural hearing loss.
Figure 2
Figure 2
According to the “World Report On Hearing” of the World Health Organization in 2021, hearing loss was classified from “mild” to “total.” In the SSD group, five (13.9%) patients were mild hearing loss, six (16.7%) patients were moderate hearing loss, eight (22.2%) patients were moderate–severe hearing loss, seven (19.4%) patients were severe hearing loss, six (16.7%) patients were profound hearing loss, and four (11.1%) patients were total hearing loss. In the non-SSD group, 24 (20.7%) patients were mild hearing loss, 8 (6.9%) patients were moderate hearing loss, 14 (12.1%) patients were moderate–severe hearing loss, 22 (19.0%) patients were severe hearing loss, 23 (19.8%) patients were profound hearing loss, and 25 (21.6%) patients were total hearing loss. SSD, single-sided deafness.
Figure 3
Figure 3
Initial hearing threshold showed no significant differences between the SSD group and the non-SSD group (66.41 ± 24.64 dB HL vs. 69.21 ± 31.48 dB HL, p = 0.625). SSD group had a higher post-treatment hearing threshold (median 53.12(36.56) dB HL) than the non-SSD group (32.50(47.50) dB HL, p < 0.01). SSD, single-sided deafness.
Figure 4
Figure 4
In the whole SSD group and four subgroups, hearing gains were not significantly correlated with pre-treatment PTA (p = 0.563, 0.368, 0.866, 0.200, and 0.828, respectively). In the non-SSD group, hearing gains were significantly correlated with pre-treatment PTA (r = 0.514, p < 0.01). SSD, single-sided deafness; SSNHL, sudden sensorineural hearing loss; COM, chronic otitis media.
Figure 5
Figure 5
Subgroup analysis of the SSD group based on the cause of SSD. The Kruskal–Wallis test revealed a significant difference between the four groups (p = 0.03). The “SSNHL” group had lower hearing gains than the other three groups (p = 0.013, 0.034, and 0.048, respectively). SSD, single-sided deafness; SSNHL, sudden sensorineural hearing loss; COM, chronic otitis media.
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