돌발성 난청 환자의 예후 인자에 대한 분석

Background and Objective: Idiopathic sudden sensorineural heaing loss (ISSNHL) can be defined as hearing levels poorer than 30 dB at least three continuous audiometric frequencies occurring within 3 days or less. The pathophysiologic mechanism and specific treatment regimen of this disease are unclear. The purpose of this study is to identify the contributing effect of each prognostic factor by analysis of hearing improvement after treatment. Materials and Method: Retrospective chart review was performed in 224 patients with ISSNHL admitted in from November 1997 to April 2003. Result: Overall recovery rate was 52.2%. Initial hearing level, vertigo and age was closely related with prognosis of hearing. The prognosis according to audiogram was better in the usual order following up-slope, U-shape, flat and down-slope against profound shape. The beginning of treatment was related with only whether improvement is present. The erythrocyte sedimentation rates (ESR) were related with only degree of hearing recovery. Other factors such as presence of whirling vertigo or non-whirling vertigo, accompanying symptoms, preexisting systemic disease, abnormal thyroid function test and speech discrimination score were not related with prognosis. Conclusion: To predict prognosis of ISS- NHL, investigators should considerate both ,whether improvement is present and how is degree of recovery. Initial hearing level, vertigo, audiogram and age were direct predictors of prognosis in patients with ISSNH. Beginning of treatment and ESR were relatively considerable prognostic factors. (J Clinical Otolaryngol 2005;16:89–95)