This study aimed to establish a deep learning-based predictive model for the prognosis of idiopathic sudden sensorineural hearing loss (SSNHL). Data from 1108 patients with SSNHL between January 2015 and May 2023 were retrospectively analyzed. Patients underwent standardized treatment protocols including high-dose steroid therapy and hearing outcomes were assessed after three months using Siegel\'s criteria and the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) classification. For predicting patient recovery, a two-layered classification process was implemented. Initially, a set of 22 Multilayer Perceptrons (MLP) networks was employed to categorize the patients. The outcomes from this initial categorization were subsequently relayed to a second-layer meta-classifier for final prognosis determination. The validity of this methodology was ascertained through a K-fold cross-validation procedure executed with 10 distinct splits. The prediction model for complete recovery, based on Siegel\'s criteria, demonstrated an accuracy of 0.892 and area under the curve (AUC) of 0.922. For the class A prediction, according to AAO-HNS classification, the model showed an accuracy of 0.847 and AUC of 0.918. These results suggest that the model may have the potential to contribute to the establishment of tailored patient management strategies by predicting hearing recovery in patients with SSNHL.

Objective: To analyze the clinical characteristics, curative effect related factors and follow-up situation of bilateral sudden sensorineural hearing loss (BSSHL). Methods: The clinical data of 169 patients(338 ears) with BSSHL were retrospectively summarized, and the demographic characteristics, predisposing factors, concomitant symptoms and diseases, and audiological characteristics were statistically described. Additionally, influencing factors of curative effect and prognosis were statistically analyzed. Results: Among the 169 patients, 50.9% (86/169) of patients had at least one incentive, with cold and fatigue being the most common incentives(both 23/169). There were high rates of accompanying symptoms including tinnitus (150/169, 88.8%) and dizziness (100/169, 59.2%). Hypertension(49/169, 29.0%)and diabetes(23/169, 13.6%)were the most common concomitant diseases observed. Most cases exhibited all frequencies involvement, with flat type and total deafness type accounting for 83.1%(281/338 ears). The most common degree of hearing loss was total deafness(86/338 ears), with approximately 60.1%(203/338 ears) of the cases being severe or worse. The total effective rate of treatment was only 29.0%, but it increased to 39.5% for patients with course of disease≤14 days, however, when course of disease>30 days, the effective rate decreased sharply to 3.6%, showing a significant difference between these two groups(χ2=13.776,<0.01). Different types of hearing curves showed statistically significant difference in efficiency(χ2=14.782, P<0.01). Comparing the hearing improvements of 28 BSSHL patients from admission to discharge and from discharge to follow-up, it was found that the hearing improvement of the two groups showed statistically significant difference at the frequencies of L-250 Hz, L-500 Hz, R-125 Hz, R-250 Hz and R-500 Hz(Z value was -2.495, -3.083, -3.970, -3.388 and -3.264 respectively, all P<0.05). The proportion of patients with elevated serum IgE was much higher than that of the normal population. Conclusion: BSSHL patients suffer from serious hearing loss, and many also experience tinnitus and vertigo symptoms. Due to the poor efficiency of treatment, it is better for patients to be treated within 30 days of onset. For patients of hearing loss in the low frequency range, hearing improvement is more significant during hospitalization. And the occurrence of BSSHL may involve an immune mechanism.
目的： 分析双侧突发性聋（bilateral sudden sensorineural hearing loss，BSSHL）患者的临床特征及疗效。 方法： 回顾性总结解放军总医院第一医学中心169例（338耳）BSSHL患者临床资料，对其人口学特征、发病诱因、伴随症状及伴发疾病、听力学特征、实验室检查结果进行统计描述，并对其疗效及影响因素、预后情况进行统计分析。 结果： 50.9%（86/169）患者至少存在一种诱因，其中上呼吸道感染（23/169）、劳累（23/169）最为多见；伴随症状中耳鸣（150/169，88.8%）、眩晕（100/169，59.2%）较高，伴发疾病中高血压（49/169，29.0%）、糖尿病（23/169，13.6%）较为常见。听力损失类型多为全频受累，平坦型和全聋型占83.1%（281/338耳）；听力损失程度以全聋型最多见（86/338耳），重度及以上占60.1%（203/338耳）。治疗总有效率仅29.0%，病程≤14 d、14 d<病程≤30 d患者有效率分别为39.5%和25.5%，病程>30 d者有效率为3.6%，差异有统计学意义（χ2=13.776，P<0.01）；不同类型的听力曲线治疗有效率差异有统计学意义（χ2=14.782，P<0.01）；比较28例BSSHL患者入院至出院和出院至随访的听力提高值，发现左-250 Hz、左-500 Hz、右-125 Hz、右-250 Hz、右-500 Hz处，两组听力提高值差异有统计学上意义（Z值分别为-2.495、-3.083、-3.970、-3.388、-3.264，P值均<0.05）。患者血清IgE升高比例远高于健康人群。 结论： BSSHL患者听力损失严重，更多患者伴耳鸣、眩晕，疗效欠佳，发病30 d内就诊疗效优于30 d后就诊；对低频范围内听力损失，住院治疗听力提高更显著；且BSSHL的发生可能存在免疫机制。.

BACKGROUND: Hearing loss among military personnel is a well-known challenge, reported as the second most common VA service-connected disability. Although most hearing loss occurs gradually, a subset occurs suddenly and significantly impacts quality of life and military readiness and is considered as a medical emergency. This study aims to evaluate the incidence of sudden hearing loss among different subpopulations within the military system to better identify at-risk groups.
METHODS: This study was a retrospective population-based study reviewing all cases of diagnosed sudden hearing loss between January 1, 2016 and December 31, 2021 within active duty service members in the U.S. DoD. Statistical analysis of multiple subpopulations was performed.
RESULTS: There were 2,650 cases of sudden hearing loss diagnosed in active duty service members during the study period, with an average incidence of 32.9 cases per 100,000 people per year, compared with 5 to 27 cases per 100,000 people per year reported in civilian populations. Senior officers demonstrated significantly increased rates of sudden hearing loss with 103.9 cases per 100,000 people per year, likely as a result of increased age, as did Air Force personnel with 45.1 cases per 100,000 people per year. There was no difference in incidence based on military occupational specialty, though service members located overseas were noted to have decreased incidence compared with those stationed within the USA. There was no significant difference during the years before coronavirus-19 pandemic (2016-2019) compared to the years following the start of the pandemic (2020-2021).
CONCLUSIONS: Sudden hearing loss appears to occur more frequently in military personnel than in the civilian population. The increased incidence in senior officers is likely driven by increased age, though further evaluation into the discrepancies between reported incidence of hearing loss among enlisted service members and officers is warranted. Although military occupational specialty did not demonstrate any significant difference in incidence, for thus far unknown reasons those in the Air Force demonstrated increased rates of sudden hearing loss. Although other potentially at-risk groups were identified, focused efforts to better understand contributing factors to elevated incidence in senior officers and Air Force personnel will help to better mitigate the incidence and effects of sudden hearing loss.

It is reported that sudden sensorineural hearing loss (SSNHL) is closely related to diabetes, hypertension, and hyperlipidemia. While the metabolic syndrome (MetS) is a multifactorial disease that includes diabetes, hypertension, dyslipidemia, and obesity, which are known to be associated with SSNHL. Weather conditions have long been known to affect the SSNHL. This study aimed to make a clear connection between MetS, or weather conditions, and the severity and prognosis of SSNHL. 127 SSNHL patients have been divided into the MetS group and the non-MetS group, and the demographic and clinical characteristics of the 2 groups have been analyzed retrospectively. There were 52 (40.9%) patients in the MetS group, while there were 75 (59.1%) patients in the non-MetS group. The rate of vertigo, hypertension, diabetes, lower high-density lipoprotein cholesterol (HDL-C) levels, high triglyceride (TG), and body mass index (BMI) ≥25 (kg/m2 ) were significantly higher in the MetS group than those in non-MetS group. Vertigo, hypertension, and Mets were linked to the severity of hearing loss. The rate of complete recovery and partial recovery in the MetS group was clearly lower than that in non-MetS group. According to the multivariate analysis, MetS was significantly associated with a poorer prognosis of SSNHL; a high ambient temperature difference at onset and hypertension were correlated with a poor prognosis. These results demonstrate that the severity and prognosis of SSNHL can be influenced by the MetS. High ambient temperature differences at onset and hypertension were indicators of a poor prognosis for SSNHL.

Objective: To explore the incidence of sudden deafness accompanied with tinnitus, the selection of examination protocols and treatment, and to provide reference for the establishment of new guidelines for sudden deafness. Methods: CiteSpace software was used for analysis and data mining to analyze and summarize the computer-retrieved articles on diagnostic examination and treatment of sudden deafness accompanied with tinnitus collected from CNIC, Wanfang and Web of Science databases from 2011 to 2021. Results: A total of 207 randomized controlled studies were retrieved in this study, including 121 in Chinese and 86 in English. Finally, 74 Chinese literatures and 16 English literatures were included. Among the 74 valid Chinese literatures, 64 (86.5%) were accompanied with tinnitus, 58 (78.4%) with dizziness/vertigo, 25 (33.8%) with aural fullness, 10 (13.5%) with headache, 4 (5.4%) with insomnia, 4 (5.4%) with a mixture of dizziness and tinnitus, and 2 (2.7%) with vomiting. Among the 16 English literatures, 15 (93.8%) were accompanied with tinnitus, 12 (75.0%) with vertigo, 1 (6.3%) with aural fullness, and 1 (6.3%) with a mixture of various symptoms. Among the 64 Chinese articles mentioning tinnitus, only 9 mentioned tinnitus matching tests, and 1 mentioned that the treatment for tinnitus accompanying symptoms was sound therapy and psychological counseling. The incidence rates of tinnitus accompanying four different types of sudden deafness, from low to high, are as follows: low-to-mid frequency, 82.4%; mid-to-high frequency, 90.7%; complete deafness, 92.4%; and flat type, 92.8%. Conclusion: Tinnitus is the most common accompanying symptom of sudden deafness, and tinnitus matching test is an effective evaluation method. When establishing a scientific, comprehensive, and systematic diagnosis and treatment system or guidelines for sudden deafness, attention should be paid to the diagnosis and treatment of tinnitus symptoms and their adverse psychological reactions, in order to reduce the incidence of tinnitus patients in the later stage of recovery from sudden deafness.
目的： 探讨突发性聋（突聋）伴耳鸣的发生率、检查方案选择及治疗，为临床建立完善的突聋新指南提供参考。 方法： 运用CiteSpace软件分析及数据挖掘，对计算机检索出的2011—2021年中国知网、万方以及Web of Science数据库收录的有关突聋伴耳鸣相关辅助检查和治疗的文章进行分析总结。 结果： 本研究共检索随机对照研究207篇，其中中文121篇，英文86篇；最终纳入中文文献74篇，英文文献16篇。74篇中文文献中，伴随症状为耳鸣的64篇（86.5%），头晕/眩晕58篇（78.4%），耳闷25篇（33.8%），头痛10篇（13.5%），失眠4篇（5.4%），头晕耳鸣混杂4篇（5.4%），呕吐2篇（2.7%）；16篇英文文献中伴随症状为耳鸣的15篇（93.8%），眩晕12篇（75.0%），耳闷1篇（6.3%），各种症状混杂1篇（6.3%）。64篇提及耳鸣的中文文献中，仅9篇提到了耳鸣匹配检查；1篇提到耳鸣伴随症状的治疗为声治疗及心理辅导。4种不同类型突聋伴耳鸣发生率由低到高依次为：低中频82.4%，中高频90.7%，全聋型92.4%，平坦型92.8%。 结论： 耳鸣是突聋最常见的伴随症状，耳鸣匹配检查是有效评估手段。在建立科学、完善、全面、系统的突聋诊疗体系或指南的同时应重视耳鸣症状及其不良心理反应的诊疗，减少突聋康复后期耳鸣的发生率。.

Idiopathic sudden sensorineural hearing loss is an unexplained sudden loss of sensorineural hearing, with no specific pathogenesis, and is difficult to treat. The most common therapeutic strategy for idiopathic sudden sensorineural hearing loss is the use of steroids combined with neurotrophic drugs, as other treatments have shown limited efficacy. However, in recent years, hyperbaric oxygen therapy has emerged as a promising treatment option. Studies have shown that hyperbaric oxygen therapy, in combination with conventional treatments, can effectively alleviate inner ear edema, improve blood circulation, and suppress inflammation. Therefore, hyperbaric oxygen therapy plays an important role in the treatment of idiopathic sudden sensorineural hearing loss. In this review, we aim to assess existing studies and summarize the clinical effects and mechanisms of hyperbaric oxygen therapy in idiopathic sudden sensorineural hearing loss, providing a basis for further research on the clinical treatment of this disorder.

Background and Objectives: Although different hypotheses have been proposed over time, there is a dearth of information on factors able to predict the response to treatment for idiopathic sudden sensorineural hearing loss (ISSNHL) and hearing recovery. The aim of this study was to apply univariate and multivariate statistical models in a retrospective clinical setting of patients given therapy for ISSNHL at our tertiary academic audiological centers to investigate the prognostic value of clinical signs, symptoms, and comorbidities in relation to hearing recovery. Materials and Methods: The inclusion criteria were: history of ISSNHL diagnosed and treated at the Padova or Modena tertiary academic audiological centers; age ≥ 18 years; availability of clinical and audiological outcome data. The exclusion criteria were: hearing loss in acoustic schwannoma, endolymphatic hydrops, meningitis, trauma (head trauma, temporal bone fracture, acoustic trauma), barotrauma, perilymphatic fistula; exposure to noise levels ≥ 80 dB in the work environment; any unilateral or bilateral hearing loss (except for presbycusis) prior to ISSNHL diagnosis; any disorders affecting the external or middle ear; any previous ear surgery; refusal to make medical data available for research purposes. Eighty-six consecutive patients (38 females, 48 males; median age: 58 years; interquartile range: 47.00-69.00 years) were included. A systemic steroid therapy was administered to all patients, either orally with prednisone or intravenously with methylprednisolone. Second-line therapy included intratympanic steroid injections and/or hyperbaric oxygen therapy. Results: A multivariate logistic regression model was used, including the non-multicollinear clinical and audiological variables, which showed a p-value < 0.10 at the univariate analyses (namely age at diagnosis, time to diagnosis, oral steroid dose, and PTA on the affected side). Only PTA on the affected side retained its statistical significance (OR: 1.0615, 95% CI: 1.0185-1.1063, p = 0.005). Conclusions: The analysis of our data showed an association between the hearing threshold before treatment and the recovery from ISSNHL. Further studies on larger cohorts (especially in a prospective setting) are needed to shed more light on the prognostic role of clinical parameters in patients with ISSNHL. In a correct counseling setting, with regard to the patient\'s concern about not being able to recover hearing, it is important to offer perspectives of appropriate hearing rehabilitation approaches.

OBJECTIVE: Identify if pre-incident aspirin influences severity and outcome of idiopathic sudden sensorineural hearing loss (SSNHL).
METHODS: Retrospective review.
METHODS: Tertiary care center.
METHODS: Patients with idiopathic SSNHL were identified and separated into aspirin and non-aspirin groups. Variables, including demographics, comorbid conditions, audiologic outcomes were identified and compared between groups.
RESULTS: One hundred forty-eight patients were included that met inclusion criteria. There were 38 patients who were on pre-incident aspirin therapy and 110 patients not on aspirin prior to the onset of SSNHL. Pre- and post-treatment audiologic status was worsened in the aspirin group. Other comorbid conditions, including hyperlipidemia, coronary artery disease (CAD), cerebrovascular accident (CVA), and vertigo symptoms had an effect as well. With multivariate analysis, CAD, CVA, and vertigo symptoms appeared to have an effect more than aspirin.
CONCLUSIONS: Patients on aspirin have a worsened pre- and post-treatment audiologic status. This appears to be more due to the underlying CAD or history of CVA rather than aspirin use itself.

OBJECTIVE: This study evaluates intratympanic lidocaine\'s efficacy and safety for tinnitus relief in sudden sensorineural hearing loss (SSNHL) patients.
METHODS: In a double-blind randomized controlled trial, 100 SSNHL patients with unilateral tinnitus received either intratympanic lidocaine or saline plus usual care. Treatment impact was assessed at 1 and 3 months using the Tinnitus Handicap Inventory, subjective visual analog scale, pure-tone audiometry.
RESULTS: The lidocaine group demonstrated significant tinnitus relief according to the Tinnitus Handicap Inventory and visual analog scale, without pure-tone audiometry improvement or serious adverse events throughout the study period.
CONCLUSIONS: Intratympanic lidocaine provides a safe, efficacious treatment option for SSNHL tinnitus. Further studies should refine the dosage and delivery parameters because of SSNHL\'s heterogenous nature.

Hearing loss is the cause of significant morbidity throughout the United States and the world. Because of numerous factors, such as ongoing noise exposure, poorly controlled chronic disease, and an aging population, the burden of hearing loss is expected to continue to increase. Hearing loss commonly is categorized as conductive, sensorineural, or mixed. The type of hearing loss can be determined through a combination of patient history and physical examination, and then confirmed with audiometry and tympanometry. Advanced imaging is not typically necessary, but it may be helpful in specific instances. The presentation of sudden sensorineural hearing loss should prompt urgent referral to an otolaryngologist and audiologist. Management of this condition is selective but may initially include oral corticosteroids. Management for chronic hearing loss involves the use of hearing aids, which can offer a large benefit to users but historically have been expensive and not covered by many insurance plans. Recent US legislation has made hearing aids more accessible and affordable by allowing direct-to-consumer marketing and offering over-the-counter hearing aids without a clinical evaluation.