Prognosis of Audiologic Recovery From Sudden Sensorineural Hearing Loss Following Corticosteroid Intervention: A Retrospective Chart Review Across Multiple Outcome Measures.

Abstract

Objective: This study aimed to evaluate associations among pretreatment hearing deficit, corticosteroid intervention, and audiologic recovery among patients presenting with sudden sensorineural hearing loss within an integrated health system.

Methods: Electronic health records within a multicenter integrated health system were queried for clinical encounters with a diagnosis of sudden sensorineural hearing loss in 2021. Patient demographics, audiometric data, and therapeutic steroid intervention were recorded. Audiologic response was defined as a decrease of 15 dB in 4-frequency (500, 1000, 2000, 4000 Hz) pure tone average (PTA). Audiologic recovery, or complete response, was defined as a follow-up PTA (PTA2) of ≤ 25 dB or within 10 dB of 1) baseline or 2) contralateral ear. Logistic regressions were performed to evaluate for predictive factors.

Results: A total of 403 patients (mean age 59.27 ± 15.80 years, 57.32% male) met inclusion criteria, of which 355 underwent corticosteroid intervention. The nonsteroid group had a less severe hearing deficit (median PTA1 49.38 dB vs 58.75 dB with steroid group; P < .05). Median PTA improvement was 6.25 dB with steroid therapy and 3.63 dB without (P < .05), but median PTA2 between steroid and nonsteroid users was not significantly different (42.5 dB and 38.13 dB, respectively; P = .821). Steroid intervention within 14 days was predictive of an audiologic response (odds ratio [OR] = 2.33) and recovery (OR = 2.46; both P < .05) compared with patients who did not undergo steroid therapy, whereas delayed steroid intervention was not, regardless of steroid regimen. Severe hearing loss had worse odds of audiologic response (OR = 0.40) or recovery (OR = 0.10; both P < .05) compared with mild hearing loss.

Conclusion: Pretreatment hearing deficit and initiation of empiric steroid therapy within 14 days were associated with audiologic prognosis, independent of the corticosteroid regimen. These findings reinforce the benefit of prompt steroid intervention, while further highlighting a need for standardized measures of audiometric outcomes.