ENT - September 2020 - 529

Sun et al

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Table 1. Clinical Characteristics of Patients With Sudden Sensorineural Hearing Loss and Normal Controls.

Table 2. Siegel Criteria and Grouping of ISSHL Patients According to
Treatment Results.

Patients with idiopathic sudden sensorineural hearing loss (n ¼ 14)
Age, years

Mean (SD)

57.9 (15.4)

Sex
Affected ears

Range
Male:female
Left:right

31-72
7:8
6:8

Normal controls (n ¼ 24)
Age, years
Mean (SD)
Range
Sex
Male:female

Treatment
responsive

Complete recovery

Partial recovery

Interval between onset and treatment, days
Mean (SD)

Recovery From
Hearing Loss
(Siegel Classification) Explanation

3.6 (1.4)
Slight improvement
54.0 (9.9)
33-76
11:13

Abbreviations: SD, standard deviation.

patients without history of hearing loss was measured in this
study. The age and sex ratio of the 2 groups were similar
(Table 1). Plasma prestin concentrations of ISSHL were measured before and after treatment, respectively.
The diagnostic criteria for ISSHL consisted of rapid onset of
hearing loss greater than 30 dB in 3 consecutive frequencies
occurring within 3 days. Audiometry, history taking, physical
examination, and inner ear magnetic resonance imaging or
computed tomography were performed to confirm the diagnosis of ISSHL. Patients with recognized causes of sensorineural
hearing loss such as Meniere disease or autoimmune hearing
loss were excluded. Additionally, pregnant patients and those
who had received previous treatment were also excluded.
Patients with ISSHL were hospitalized and treated with the
same strategy within 7 days after the onset of the disease. All
patients received oral prednisolone 1 mg/kg for 5 days, intravenous ginkgo biloba extract, and intramuscular cobamamide
every day during the whole course of treatment. Besides,
batroxobin was administered intravenously once every other
day according to patient's coagulation function, which was
monitored by blood test. The patients with ISSHL were separated into 2 groups according to pure tone audiometry performed at the end of treatment. According to Siegel criteria5,
patients with complete recovery, partial recovery, and slight
improvement were considered as the treatment responsive
group. Patients with no recovery were considered as the treatment unresponsive group (Table 2).
Blood samples were collected using EDTA as an anticoagulant and centrifuged for 15 minutes at 1000Âg within 30 minutes
of collection. The samples were stored in a -80 C refrigerator
until time of assay. Prestin concentration was measured using
Human Prestin (SLC26A5) ELISA Kit (MyBioSource.com, San
Diego, California) as described in the manufacturer's instruction
manual. A 1:50 dilution was prepared, and the optical density in
the wells of the enzyme-linked immunosorbent assay (ELISA)
microplate was measured at 450 nm using a KHB ST-360 plate
reader (Kehua Bio-engineering Co., Ltd, Shanghai, China).

Treatment
No improvement
unresponsive

Final hearing levela better
than 25 dB, regardless of
the amount of gain.
Gained more than 15 dB in
hearing and had a final
hearing level between
25 and 45 dB.
15 dB gain and a final hearing
level poorer than 45 dB.
Gain less than 15 dB

Abbreviations: ISSHL, idiopathic sudden sensorineural hearing loss.
a
Final hearing level: arithmetic mean value of 500, 1000, 2000, and 4000 Hz
according to Committee on Hearing and Equilibrium of the American Academy
of Otolaryngology-Head and Neck Surgery.

Figure 1. Plasma prestin concentration of patients with idiopathic
sudden sensorineural hearing loss (ISSHL) and control patients.

Figure 2. Comparison of mean plasma prestin levels. Error bars
represent SD. ISSHL indicates idiopathic sudden sensorineural hearing
loss, SD, standard deviation. ***P < .001 compared to control.

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ENT - September 2020

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