■该研究旨在评估与发病前环境噪声暴露相关的单侧突发性感觉神经性听力损失(SSNHL)相关的临床特征和预后因素。
■2018年1月至2022年10月,共纳入50例发病前暴露于环境噪声的单侧SSNHL患者(病例组)和924例未暴露于发病前明显诱发因素的单侧SSNHL患者(对照组)。我们使用卡方检验回顾性分析两组之间的差异,费希尔的精确检验,独立t检验,在基于性别的倾向得分匹配(PSM)之前和之后,年龄,和初始纯音平均(PTA)。在有效组和无效组之间使用单变量和多变量逻辑分析来分析病例组的预后因素。
■PSM之前,在年龄上有显著差异,性别,治疗的时间,合并糖尿病的比例,初始PTA,听力增益,眩晕或听觉的发生率,前庭功能障碍或内耳MRI异常的发生率,有效率,葡萄糖和同型半胱氨酸水平,两组之间听力图曲线类型的比例(P<0.05)。PSM之后,与对照组相比,治疗时间较长(Z=-3.02,P<0.05),较高的最终PTA(Z=-2.39,P<0.05),较低的听力增益(Z=-3.46,P<0.05),前庭功能障碍发生率较低(χ2=55.1,P<0.001),病例组有效率较低(χ2=4.87,P<0.05)。两组听力图曲线类型比较,差异有统计学意义(χ2=14.9,P<0.05)。治疗时间(95%置信区间:0.692-0.965,P<0.05)和最终PTA(95%置信区间:0.921-0.998,P<0.05)与病例组的临床结局相关。
■在发病前暴露于环境噪声触发因素的单侧SSNHL患者的有效率和前庭功能障碍发生率均低于未发病的患者。治疗时间和最终PTA与这些患者的预后相关。
UNASSIGNED: The study aimed to evaluate the clinical characteristics and prognostic factors associated with unilateral sudden sensorineural hearing loss (SSNHL) related to environmental noise exposure before its onset.
UNASSIGNED: A total of 50 unilateral SSNHL patients exposed to environmental noise before onset (case group) and 924 unilateral SSNHL patients without any exposure to obvious inducing factors before onset (control group) were enrolled between January 2018 and October 2022. We retrospectively analyzed differences between both groups using the chi-square test, Fisher\'s exact tests, independent t-tests, and Mann-Whitney U-tests as appropriate before and after propensity score matching (PSM) based on sex, age, and initial pure-tone average (PTA). Prognostic factors for the case group were analyzed using univariate and multivariate logistic analyses between the effective and ineffective groups.
UNASSIGNED: Before PSM, significant differences were noted in age, sex, time to treatment, the proportion of combined diabetes mellitus, initial PTA, hearing gain, the incidence of vertigo or aural fulness, the rate of vestibular dysfunction or inner ear MRI abnormalities, the effective rate, the glucose and homocysteine levels, and the proportion of audiogram curve types (P < 0.05) between both groups. After PSM, compared to the control group, a longer time to treatment (Z= -3.02, P < 0.05), higher final PTA (Z= -2.39, P < 0.05), lower hearing gain (Z= -3.46, P < 0.05), lower rate of vestibular dysfunction (χ2 = 55.1, P < 0.001), and lower effective rate (χ2 = 4.87, P < 0.05) were observed in the case group. There was a significant difference between the audiogram curve types in both groups (χ2 = 14.9, P < 0.05). Time to treatment (95% confidence interval: 0.692-0.965, P < 0.05) and final PTA (95% confidence interval: 0.921-0.998, P < 0.05) were associated with the clinical outcomes for the case group.
UNASSIGNED: Unilateral SSNHL patients exposed to environmental noise triggers before onset showed a poorer effective rate and a lower rate of vestibular dysfunction than those who were not. The time to treatment and final PTA were associated with the prognosis of these patients.