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Otology/Neurotology

Sudden Sensorineural Hearing Loss Recovery Prognosis With Modified Siegel's Criteria

Tuesday, October 3, 2023
1:30 PM - 1:36 PM East Coast USA Time
Location: 104BC

    Presenting Author(s)

  • Pauline P. Huynh, MD

    Resident Physician
    Kaiser Permanente Med Group - Northern California
    Oakland, CA, United States

    • Co-Author(s)

  • Elias S. Saba, MD

    Resident Physician
    Kaiser Permanente - Oakland
    Oakland, CA, United States

  • JH

    Jacob E. Hoerter, MD

    Resident Physician
    Kaiser Permanente Med Group - Northern California
    Oakland, CA, United States

    • Senior Author(s)

  • Nancy Jiang, MD

    Chair, Department of Head & Neck Surgery
    Kaiser Permanente Med Group - Northern California
    Orinda, CA, United States

Disclosure(s):
Pauline P. Huynh, MD: No relevant relationships to disclose.
Elias S. Saba, MD: No relevant relationships to disclose.
Jacob E. Hoerter, MD: No relevant relationships to disclose.
Introduction: Patients with sudden sensorineural hearing loss (SSNHL) are advised to start empiric steroid therapy (oral, intratympanic injection, or combination regimens) to optimize chances of audiologic recovery. Siegel’s Criteria defines recovery as a pure tone average (PTA) decrease of at least 15 decibels (dB). This study aims to use modified Siegel’s criteria to compare rates of audiologic recovery based on the differing steroid regimens used.

Methods: A retrospective chart review was performed of patients presenting with SSNHL in 2021 at an equal-access, integrated healthcare system. Patient demographics, audiometric data, therapeutic steroid intervention, and data regarding treatment response were recorded. Modified Siegel’s Criteria was used to stage pretreatment PTA ( < 25dB; 26-45dB; 46-75dB; 75-90dB; >90dB) as well as audiologic recovery (complete recovery; partial recovery; slight improvement; no improvement; non-serviceable).

Results: 318 patients (mean age 57.1 + 15.3 years, 55.4% male) met inclusion criteria during this preliminary analysis. 43.1% of patients had any audiologic recovery (27.0% complete + 10.7% partial + 5.4% slight improvement) following completion of steroid therapy. Timely start of steroid intervention, defined as within 14 days, was associated with a greater proportion of patients noting improvement (48.3% vs 28.6% who started after 14 days, p < 0.01). There was a significant difference in audiologic recovery based on treatment regimen (Kruskal-Wallis test; chi-squared(3)=14.187, p < 0.05), with patients undergoing salvage therapy having poorer outcomes (20.9% improvement vs 43-56% with other regimens).

Conclusions: This study evaluated the prognostic ability of incident audiometric data and steroid regimen on audiologic recovery using modified Siegel’s Criteria in patients with SSNHL at an multicenter, integrated healthcare system. These findings may assist in patient counseling regarding SSNHL outcomes, including prognosis and steroid regimen modalities.