Hearing at 4～8 kHz in the Healthy Ear can Suggest the Prognosis of Unilateral Sudden Hearing Loss

SUN Xuan; LI Yi

doi:10.3969/j.issn.1672-2922.2025.03.010

Abstract：Objective Sudden hearing loss is a common emergency in otology.Its etiology has not been fully elucidated and its prognosis is difficult to assess,hindering targeted treatment.Hearing in the healthy ear at the onset of unilateral sudden hearing loss may indirectly reflect the baseline condition of the patient's auditory system,including aging and sound damage.In this study,hearing data of the healthy ears in the early stage of the disease were extracted,and their relationship to the prognosis of unilateral sudden hearing loss was examined by cluster analysis.Methods Data from 229 patients with unilateral sudden hearing loss treated in Beijing Tongren Hospital,Capital Medical University,from August 2022 to April 2023 were collected as a retrospective cohort.Hearing of the healthy ear at the onset of unilateral sudden hearing loss was extracted in segments,and the cluster analysis algorithm was used to divide them into two clusters.After successful clustering,clinical presentation and treatment outcomes were compared between the two clusters.Results clustering of the 229 patients yielded a silhouette coefficient of 0.45.There was a significant difference in treatment efficacy between the two clusters(P=0.02).The disparity in treatment efficacy primarily arose from patients aged 51 years and older.Conclusion Hearing in the healthy ear at 4 to 8 kHz serves as an independent prognostic indicator in sudden hearing loss,independent of the absolute binaural hearing thresholds.For patients aged 51 years and older and/or those presenting with a flat audiometric configuration,a concomitant sharp decline in hearing at 8 kHz in the healthy ear is associated with significantly poorer prognosis,for whom aggressive treatment strategies should be considered.This population may warrant further exploration of independent etiological and pathological factors.