Inpatient treatment of patients with idiopathic sudden sensorineural hearing loss: a population-based healthcare research study

Abstract

Purpose

The aim was to determine inpatient treatment rates of idiopathic sudden sensorineural hearing loss (ISSNHL) with focus on diagnostics, treatment, and outcome.

Methods

A retrospective population-based study in the federal state Thuringia in 2011 and 2012 was performed on all 490 inpatients (51% females, median age: 60 years) treated for ISSNHL (Median duration: 7 days). The association between analyzed parameters and the probability of recovery was tested using univariable and multivariable statistics.

Results

The inpatient treatment rate for ISSNHL was 11.23 per 100,000. 172 patients (35%) had an outpatient treatment prior to inpatient treatment. For pure-tone audiometry of the three most affected frequencies (3PTAmax), the initial median hearing loss was 66.67 dB, the median absolute hearing gain ΔPTA_abs was 10.0 dB, and the median relative hearing gain in relation with the contralateral side ΔPTA_{rel contral} was 30.86%. 51% of the patients reached a ΔPTA_abs of ≥ 10 dB. About 2 of 5 patients recovered to a ΔPTA_{rel contral} ≥ 50% or reached ≤ 10 dB of contralateral ear. The multivariate analysis revealed that an ISSNHL on the left side [Hazard ratio (HR) = 1.6.88; confidence interval (CI) = 1.161–2.454], no down-sloping audiogram type (HR = 2.016; CI = 1.391–2.921), and no prior outpatient prednisolone treatment (HR = 2.374; CI = 1.505–3.745) were independent factors associated with better recovery (ΔPTA_abs ≥ 10 dB).

Conclusion

Inpatient treatment of ISSNHL is variable in daily practice. The population-based recovery rate was worse than reported in clinical trials. More standardization and clearer criteria for outpatient, inpatient, and salvage therapy are needed.

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