Article
The importance of pure tone audiometry and otoacoustic emissions in the therapy of patients with idiopathic sudden sensorineural hearing loss
Zur Bedeutung des Reintonaudiogramms und otoakustischer Emissionen bei der Therapie von Patienten mit idiopathischem Hörsturz
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Authors
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Ioannis Charalampakis
- Department of Otorhinolaryngology, Head and Neck Surgery, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany
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Dorothea Rostalski
- Department of Otorhinolaryngology, Head and Neck Surgery, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany
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Jan Rudolf
- Department of Otorhinolaryngology, Head and Neck Surgery, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany
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Hellmut von Specht
- Department of Otorhinolaryngology, Head and Neck Surgery, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany
| Published: | September 7, 2006 |
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Outline
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Objective: The aim of this study was to evaluate the prognostic value of otoacoustic emissions (OAE) in patients with sudden sensorineural hearing loss (SSNHL).
Patients and methods: We examined 51 hospitalised patients with SSNHL who underwent a ten-day intravenous therapy course with Pentoxifyllin and Prednisolon (Stennert-schema). Besides pure tone audiometry, transiently evoked otoacoustic emissions (TEOAE) and distortion-product otoacoustic emissions (DPOAE) were recorded on the 1st or 2nd, 5th and 9th day of therapy: 1st, 2nd, and 3rd control. Patients were excluded from the further evaluation according to the following criteria: vertigo, spontaneous nystagmus (Frenzel glasses), Ménière’s disease, normacusis in the 1st control, acoustic trauma, middle ear pathology (tympanic membrane microscopy, tympanometry), retrocochlear pathology (auditory brainstem responses), infection with Borrelia burgdoferi (IgM serologic test). In one patient we proved aggravation by means of TEOAE and DPOAE.
Results: Due to the excluding criteria only 31 patients could be included in the data analysis. The average hearing thresholds (pure tone average, PTA for 0,5; 1; 2; 3; 4 kHz) in 1st, 2nd, and 3rd control were 37.8, 30.5, and 26.6 dB respectively. The patients with initially better hearing thresholds tended to have better final values in the audiograms. On the other hand, those with initially greater hearing losses showed better improvement of PTA values. The improvement in the hearing thresholds was also detected in the recordings of TEOAE and DPOAE. As is known, in patients with greater hearing losses, OAE were not detectable. The hearing improvement between 1st and 3rd control correlated better with the hearing improvement at the 2nd control (χ²= 24,7), as did the change of TEOAE-recordings (amplitudes: χ²= 3,96; reproducibility: χ²= 2,36). We found similar results in the DPOAE-recordings (at 2 and 3 kHz).
Conclusions: The recording of TEOAE and DPOAE is most valuable at the 1st control with respect to differential diagnosis of SSNHL, but their prognostic value was confirmed in some patients only. The best prognostic value for hearing improvement over the course of the therapy was its improvement up to the 5th day. Nevertheless, the pure tone audiogram has priority in the follow-up during the therapy of SSNHL-patients.
