Psychological stress as a measure for treatment response prediction in idiopathic sudden hearing loss

Nomogram for predicting the prognostic role in idiopathic sudden sensorineural hearing loss

PURPOSE

A nomogram model was constructed to assist in early prediction of idiopathic sudden sensorineural hearing loss (ISSHL) prognosis. Additionally, this study contributed to evaluating and analyzing the usefulness of the nomogram model in ISSHL clinical intervention.

METHODS

A retrospective analysis was performed concerning 355 ISSHL patients who were hospitalized between June 2021 and August 2022. Single-factor analysis was used to filter variables, which were subsequently used for multivariate analysis to construct a nomogram. The discriminative capability and clinical usefulness of the predictive model were estimated by calculating the area under the curve (AUC), calibration curve, and decision curve analysis (DCA).

RESULTS

Hearing loss type, duration from onset to treatment, vertigo, periauricular paresthesia, and batroxobin use were included in the nomogram for ISSHL. The predictive model showed fair discrimination values (AUC =0.764; 95%CI: 0.715-0.813) and was well-calibrated, the C-index was 0.746 (95%CI: 0.715-0.793) in the internal validation. DCA indicated that the model was also clinically beneficial when the threshold range was between 0.246 and 0.840.

CONCLUSIONS

The nomogram prediction model may have potential clinical practicability in effectively assisting clinicians in predicting ISSHL prognosis and optimizing treatment protocols.

Evaluation of the Quality of Online Information on Sudden Sensorineural Hearing Loss

OBJECTIVE

To evaluate the quality of leading Internet resources of information on sudden sensorineural hearing loss (SSNHL).

STUDY DESIGN

Cross-sectional descriptive design.

SETTINGS

An online search by means of the Google search engine.

METHODS

An online search was conducted using terms related to SSNHL. We defined "quality" according to scaled readability measures (Flesch Reading Ease [FRE] and Flesch-Kincaid Grade-Level [FKGL]), as well as "understandability" and "actionability" (Patient Education Materials Assessment Tool), and Clinical Practice Guideline (CPG) adherence. Scoring was performed by two independent physicians.

RESULTS

The 10 most frequently encountered patient education websites were analyzed. The average FRE score was "fairly difficult" (mean 57.28, median 55.55, range 46.4-71.8) and the average FKGL score was "standard" (mean 9th grade, median 9th grade, range 5th-10th grade). Nine websites were understandable (mean 83%, median 84%, range 69-100%), and seven had good actionability scores (mean 73%, median 75%, range 50-100%). Most websites conformed with the CPG for patient education at a reasonable level (mean 5.6, median 5.5, range 3-7). Notably, all websites encouraged seeking medical help.

CONCLUSION

Internet resources for patient education on SSNHL vary in quality and are generally understandable to the average layman. There is still much room for better, more comprehensive and easier-to-read information to improve patients' medical knowledge about their condition.Level of Evidence: 1.

Psychological state of patients with sudden deafness and the effect of psychological intervention on recovery

OBJECTIVE

To determine the effect of personalized psychological interventions on the recovery of patients with sudden deafness.

METHODS

Participants were 438 patients with sudden deafness who were randomly allocated to observation and control groups. Patients in the control group received routine nursing care and drug treatment. Patients in the observation group received personalized psychological interventions, routine nursing care and drug treatment. The Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS) were used to measure anxiety and depression. The Simple Coping Style Questionnaire (SCSQ) and the Satisfaction With Life Scale (SWLS) were used to evaluate coping styles, attitude toward life and quality of life.

RESULTS

Patients in both groups had similar SAS and SDS scores at the time of admission. After treatment, there was a significant difference in SAS and SDS scores between the observation and control groups, indicating that the observation group had less anxiety and depression. Both groups had increased SCSQ and SWLS scores following treatment, indicating improvements in positive coping and satisfaction with life.

CONCLUSION

Effective psychological interventions may change negative thoughts, increase response rate and improve quality of life.

Recovery From Sudden Sensorineural Hearing Loss May Be Linked to Chronic Stress Levels and Steroid Treatment Resistance

Purpose This article investigates the possible connections between the level of chronic stress and success of steroid therapy in patients with sudden sensorineural hearing loss (SSNHL). Method A single-center, retrospective, longitudinal cohort study on 55 patients in a tertiary referral otology center was examined. Patients diagnosed with SSNHL between 2014 and 2017 were asked to complete a Measure of Perceived Stress (Brajac, Tkalcic, Dragojević, & Gruber, 2003 ) questionnaire. Inclusion criteria were patients > 18 years of age, SSNHL diagnosed within 4 previous weeks, completed steroid treatment, and complete documentation. Results There were 30 patients (55%) that showed significant improvement in their pure-tone audiogram (PTA) hearing threshold average (≥ 15 dB) after steroid treatment. Two-step cluster analysis identified 3 clusters based on average PTA hearing threshold recovery and average Measure of Perceived Stress scores. The difference between pretreatment and posttreatment hearing levels was significantly higher in the cluster with moderate stress compared to clusters with mild and high stress levels (Kruskal-Wallis test, Friedman test, p < .001). There were no significant differences in average PTA hearing threshold recovery after steroid therapy between groups of patients with mild and severe stress. Conclusion Patients with moderate stress levels show significantly better results after steroid treatment for SSNHL than patients with low or high stress levels.

Necessity of admission to improve the hearing-recovery rate in idiopathic sudden sensorineural hearing loss

OBJECTIVES

The purpose of this study was to determine the prognostic potential of admission of a patient for idiopathic sudden sensorineural hearing loss (ISSNHL).

STUDY DESIGN

Retrospective clinical study.

METHODS

We conducted a retrospective study of 301 patients with ISSNHL. The patients were divided into a study (57 patients at out-patients department (OPD) based treatment, using systemic steroids and intra-tympanic (IT) steroid injection) and a control groups (301 patients at admission, using systemic steroids and IT steroid injection). We compared the success rate (15 dB cut off), Siegel's criteria and hearing gain decibels between two groups.

RESULTS

The overall recovery rate of the OPD based treatment group (29.8%) was poor than that of the admission group (52.9%) (p = .002). The odd ratio of OPD based treatment factor was 2.035 when the OPD based treatment and poor prognostic factors were analyzed at logistic regression test (Duration of delayed treatment, 1.073; average hearing loss level, 0.972) (p = .041).

CONCLUSION

Admission must be strongly recommended when the patients with ISSNHL asked about the necessity of admission. We hypothesized that resting, getting out of their social stress, and relief of anxiety might be helpful to their hearing recoveries.