Am J Otolaryngol. 2025 Apr 26;46(4):104660. doi: 10.1016/j.amjoto.2025.104660. Online ahead of print.
ABSTRACT
BACKGROUND: Sudden sensorineural hearing loss (SSNHL) is an acute auditory disorder commonly treated with steroids. However, the prognostic factors for patients with hepatitis B virus (HBV) undergoing intra-tympanic steroid injections (ITSIs) remain unclear. This research seeks to explore the prognostic factors affecting the outcome of ITSI treatment in HBV patients with unilateral SSNHL.
METHODS: This retrospective study included 77 patients with HBV who presented with unilateral SSNHL from October 2018 to October 2024. All patients underwent ITSIs, and their clinical and audiological data were thoroughly analyzed.
RESULTS: The mean age of the patients was 48.61 ± 15.98 years. Following ITSIs, the mean gain in hearing level was 15.51 ± 19.22 dB, the mean gain in speech reception threshold (SRT) was 16.23 ± 31.02 dB, and the mean gain in speech discrimination score (SDS) was 17.55 ± 30.69 %. According to Siegel's criteria, 6 patients (7.79 %) achieved complete recovery, 13 (16.88 %) experienced partial recovery, 33 (42.86 %) had slight recovery, and 25 (32.47 %) showed no improvement. In univariate analyses, factors such as age ≥ 50 years (odds ratio [OR] = 0.3257, 95 % confidence interval [CI]: 0.1085-0.9781, p = 0.0391), the presence of vertigo (OR = 0.2656, 95 % CI: 0.0696-1.0137, p = 0.0335), and profound hearing loss as measured by pure-tone audiometry (PTA; OR = 0.0638, 95 % CI: 0.0080-0.5099, p = 0.0003) were identified as adverse prognostic factors. In the multivariate analysis, age ≥ 50 years (OR = 0.2799, 95 % CI: 0.0830-0.9437, p = 0.0400) and profound hearing loss (OR = 0.0609, 95 % CI: 0.0072-0.5133, p = 0.0101) emerged as independent negative prognostic factors.
CONCLUSIONS: ITSIs are effective in managing SSNHL in patients with HBV while minimizing the side effects associated with high-dose systemic steroids. Among the 77 HBV patients with SSNHL who received ITSI, age ≥ 50 years and profound hearing loss were identified as negative prognostic factors. For HBV patients with these risk factors, timely and proactive treatment is essential.
PMID:40311490 | DOI:10.1016/j.amjoto.2025.104660