AUTHOR=Chen Itay , Eligal Shalom , Menahem Ori , Salem Riki , Sichel Jean-Yves , Perez Ronen , Shaul Chanan 

TITLE=Time from sudden sensory neural hearing loss to treatment as a prognostic factor

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1158955

DOI=10.3389/fneur.2023.1158955

ISSN=1664-2295

ABSTRACT=Introduction: The widely accepted treatment for sudden sensorineural hearing loss (SSNHL) is corticosteroid treatment (oral or intratympanic). The main goal of this work is to define the significance of the time between symptom onset and treatment initiation, as well as other prognostic factors, for hearing improvement.
Methods: This retrospective study included 666 patients treated for SSNHL. Demographic data, audiometry, treatment method, time since symptom onset, and associated symptoms were recorded for each patient. The patients were divided into five groups according to the treatment initiation time—half a week, one week, two weeks, three weeks, or four weeks and over—after symptom onset. The degree of improvement was assessed by comparing the audiometry at the beginning and the end of the treatment. 
Results: The average period of hearing loss from symptom onset to treatment initiation was 10.8 days. Significant differences were found between the groups of half a week, one week, and two weeks and the groups of three weeks and four weeks and over (each separately, P<0.001). No difference was found between the half-week, one-week, and two-week groups, nor was there a difference between the three-week and four-week-and-over groups. A correlation was found between the treatment initiation time in days and the degree of improvement in hearing for both speech recognition threshold (SRT) and discrimination, R=0.26 P<0.001 and R=0.17 P<0.001, respectively. No correlation was found for gender, age of the patients, comorbidities, or associated symptoms.
Conclusions: The threshold for treatment initiation time is up to two weeks, after which the amplitude of hearing improvement decreases significantly. The other prognostic factors measured were not found to be statistically significant predictors.