심도 돌발성 난청 환자의 예후 인자

Abstract

심도 돌발성 난청 환자에서 청력회복은 온도안진검사의 반고리관 마비와 음의 상관관계를 였으나, 다변량 분석 결과 초기 청력이 청력의 회복과 연관이 있는 것으로 확인되었다. 또한 본 연구를 통해 온도안진검사가 심도 돌발성 난청환자의 예후판단에 이용될 수 있는 가능성을 확인하였으며, 추후 더 많은 환자를 대상으로 한 전향적인 연구가 필요할 것으로 생각된다. Background and Objectives：Profound sudden sensorineural hearing loss (SSNHL) is particularly known to have poor prognosis. However, there were few studies on the prognosis of profound idiopathic SSNH. The aim of the study is to investigate the possible prognostic factor in profound SSNHL using various clinical parameters. Materials and Methods：A retrospective study was performed with 65 patients who treated with profound SSNHL from January 2011 to December 2017. High dose steroid and intratympanic steroid therapy was uniformly applied and then, hearing recovery was determined by the AAO and HNS classification. Prognostic factors, including clinical characteristic, audiological outcomes and vestibula function tests were assessed by uni and multi-variable analysis. Results：In 65 patients with profound SSNHL, class A hearing recovery was achieved in just 9 (13.8%) patients, while 44 (67.7%) patients showed no hearing improvement. In a subgroup analysis, patients with vertigo showed lower hearing gain than those without vertigo (p=0.032). In addition, canal paresis on caloric test was negatively correlated with hearing gain (r=-0.279). Univariate analysis showed that no hearing improvement group were frequently accompanied with vertigo and higher initial hearing threshold. According to the multivariate analysis, initial hearing threshold was only factor that related to the poor hearing recovery. Conclusions：In profound SSNHL, caloric loss was correlated with poor hearing gain and initial hearing level was associated with the hearing recovery.