Subjects were 310 patients with sudden sensorinural hearing loss treated at our hospital between 1986 and 2002. A statistical analysis of clinical data showed significant prognostic factors to be age, time from onset to the initial visit and start of treatment, severity of initial hearing loss, and the presence or absence of vestibular symptoms. When we looked at the number of days until the average threshold of five frequencies improved more than 10dB, cases improving within 7 days showed significantly better prognosis than those after 8 days. We concluded that the pattern of improvement one week after the beginning of treatment could be used to predict prognosis in patients with sudden sensxorineural hearing loss.
We studied the status of the opposite ear in a group of 309 patients experiencing sudden deafness (Grade 3: 194 cases, Grade 4: 115 cases). The ratio of cases with hearing levels worse than ordinary aging aggravation was significantly higher in Grade 4 cases than in Grade 3. Patients were divided into four groups by Grades 3 or 4 with/without vertigo. We studied the relationship between hearing recovery and opposite ear hearing status by multiple regression analysis to regulate the following four prognostic factors: age, pattern of initial audiogram, initial hearing level, and opposite ear hearing levels. We found that only in the Grade 4 group with vertigo, opposite ear hearing levels significantly impacted on hearing recovery. Our study confirmed that when opposite ear hearing levels became worse, hearing recovery improved-quite the opposite of what we had anticipated.
We have step data on 1, 839 patients with idiopathic sudden sensorineural hearing loss (sudden deafness) at Nagoya University since 1972. Of the 845 men and 944 women, no significant gender difference was seen in age distribution. In hearing recovery the elderly tend to recover less well than younger ones. Hearing recovery was relatively poor in patients aged were 9 years old or less. The percentage of patients with vertigo was significantly higher in women (33.9%) than in men (26.3%). Nevertheless, recovery did not show gender differences. Patients with vertigo had poorer recovery rate than those without vertigo. We calculated the correlation coefficient at each frequency between hearing levels different times from onset and final hearing level. The correlation coefficient was generally low at low frequencies than at high frequencies. Recovery did not differ between patients who examined 1-4days from onset and 5-7 days from onset if the hearing level was the same.
In a nationwide survey of the number of patients and clinical manifestations of idiopathic sudden sensorineural hearing loss (sudden deafness) in 2001 in Japan, data were collected for 2, 815 patients. Of these, we selected 1, 285 whose initial and final audiograms were completely recorded with the day of onset to investigate factors influencing prognosis. In the 600 men and 685 women, the initial hearing level of the average of five frequencies from 250Hz to 4kHz was 57.4±24.9dB and the final hearing level of that was 33.3±23.6dB. Multivariate analysis showed that the degree of hearing loss on the initial audiogram, the lapse in days from onset to the first hospital visit, age, the presence of vertigo and a “downward” audiometric curve were negative factors in hearing recovery. The presence of tinnitus or aural fullness was not associated with prognosis. Some 91.8% of patients received vitamins, 87.2% ATP, 85.3% steroids, 32.6% prostaglandin, 11.1% hyperbaric oxygen therapy, and 7.9% stellate ganglion block.
We evaluated the usefulness of digital versus analog hearing aids through questionnaires given to 37 subjects. Both hearing aids were fitted to obtain similar speech recognition. Questionnaires were completed after one week of hearing aid use. We found no significant difference between hearing aids. To look at results in greater detail, subjects were classified into two groups based on hearing level. For those with mild hearing loss (18 subjects), the digital hearing aid was rated superior to the analog under noisy conditions, while those with severe hearing loss (19 subjects) indicated no significant difference in benefits under noisy conditions. To determine the effect on speech recognition, subjects with severe hearing loss were classified into two groups based on speech recognition scores. Those with better speech recognition (9 subjects) rated the digital superior to the analog hearing aid under noisy conditions. Subjects with poorer speech recognition (10) indicated overall preference for the analog hearing aid. Our results indicate that digital hearing aids are not always superior to analog. When considering the use of digital hearing aids, it is therefore necessary to evaluate the hearing level and speech recognition score.
Two patients with bilateral congenital atresia who wore digital bone-conduction hearing aids (DBCA) behind the ear are reported here. No developmental delay in speech, language, or auditory perception was observed after more than 4 years of education at our institution, compared to their hearing peers. Because they suffered from environmental noise and poor speech perception in noisy circumstances while wearing conventional bone-conduction hearing aids, we fitted them with digital bone-conduction hearing aids remade from digital hearing aids. Marked improvement in speech intelligibility in noise and less suffering from unpleasant noise was observed after subjects began wearing digital bone conduction hearing aids (DBCHA). These results suggest that DBCHA fitting is highly effective and may play an important role during rehabilitation for children with congenital aural atresia and microtia.
We stastically analyzed and clinically investigated 84 satisfied patients who used digital hearing aids. Since 2001, we have fitted hearing aids for 305 hearing-impaired-154 with digital hearing aids and 84 with digital hearing aids for first-time users. Most digital hearing aid users are in their 70s, reflect the aging of society. The most commonly used digital hearing aid is a Japanese handicapped person welfare digital hearing aid. We examined the Japanese speech discrimination score (SDS) by the presentation sound pressure level of 50dBSPL, 60dBSPL, and 70dBSPL at about 1m from a sound source in a shielded room for the 3 groups separatel-group I: moderate (<50dBnHL), group II: moderate to severe (50-69dBnHL), and group III: severe (>70dBnHL). The best recovery result in mean SDS between aided and unaided was 22.1% (50dBSPL) in group I, 32% (60dBSPL) in group II, and 34% (60dBSPL) in group III. We can thus selectively aid patients with digital hesring aids depending on input sound pressure.