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Otology/Neurotology

Gender Differences in Treatment Response of Sudden Hearing Loss Patients

Tuesday, October 3, 2023
1:12 PM - 1:18 PM East Coast USA Time
Location: 104BC

    Presenting Author(s)

  • Madelyn I. Frank, BA

    Medical Student
    University of California, Irvine
    Irvine, CA, United States

    • Co-Author(s)

  • KU

    Kayla K. Umemoto, BA

    Medical Student
    California Northstate University
    Sacramento, California, United States

  • KT

    Karen Tawk, MD

    Postdoctoral Fellow
    University of California, Irvine
    Orange, California, United States

  • KG

    Khodayar Goshtasbi, MD, MS

    University of California, Irvine, USA

    • Senior Author(s)

  • Mehdi Abouzari, MD, PhD

    Assistant Professor
    University of California, Irvine
    Orange, California, United States

  • Hamid R. Djalilian, MD

    Professor of Otolaryngology, Neurosurgery, and Biomedical Engineering, Director of Division of Neurotology and Skull Base Surgery
    University of California, Irvine
    Irvine, CA, United States

Disclosure(s):
Karen Tawk, MD: No relevant relationships to disclose.
Introduction: To investigate gender differences in treatment response for patients with sudden sensorineural hearing loss (SSNHL).

Methods: A retrospective chart review of 124 patients with SSNHL at a tertiary care neurotology clinic was done. Information on timing of presentation, presenting symptoms, audiograms before and after treatment, treatment type, and resolution of hearing loss was collected.

Results: Fifty-six percent of the cohort were female patients (n=70). The mean age of SSNHL onset was 57.1  17.4 in men and 47.5  18.3 in women. There was a subjective history of migraine in 18.2% of men and 28.5% of women (p=0.123). More women than men presented with a history of tinnitus (women 78.5%, men 63.6%, p=0.0019) and vertigo or dizziness (women 64.3%, men 36.4%, p< 0.001). Men and women completed a course of prednisone at similar rates of 72.7% and 71.4% (p=0.82). There was no significant difference in prescription of topiramate (men 72.7%, women 64.3%, p=0.085) and more women were treated with nortriptyline (men 45.5%, women 64.3%, p< 0.001). Women received at least one intratympanic injection 78.5% of the time compared to 63.6% in men. (p < 0.001). Change in PTA and SRT after treatment was not significantly different between the two genders (p=0.1 and p=0.8, respectively). Men reported improvement in hearing at a rate of 54.5% compared to 64.3% of women (p=0.052). Of the 16% of patients that utilized hearing aids, 75% were women. There were no reoccurrences of hearing loss in men while 21.4% of women returned with recurrent hearing loss (p < 0.001).

Conclusions: Among patients with SSNHL, women were more likely to report tinnitus and dizziness/vertigo, receive treatment with nortriptyline and intratympanic injection, and return with recurrence. There was no difference in rates of reported hearing improvement. While women and men can have different presenting symptoms and treatment courses, audiologic enhancement and subjective improvement in hearing are similar.