Otoacoustic emissions in the prediction of sudden sensorineural hearing loss outcome

Objective: To evaluate the role of otoacoustic emissions (OAEs) in the prediction of idiopathic sudden sensorineural hearing loss (ISSNHL) outcome.

Study Design: Open-label prospective study.

Setting: Tertiary referral medical center.

Patients: Fifteen ISSNHL patients (age: 57.6 ± 16.2 years) were prospectively followed 7 days, 14 days, and 3 months postpresentation and the commencement of treatment.

Intervention: Pure-tone audiometry, TEOAEs (Transient Evoked OAEs), and DPOAEs (Distortion Product OAEs) testing.

Main Outcome Measures: The pure-tone threshold averages of the three most affected frequencies, detectability, and the signalto-noise ratios (SNRs) values of the TEOAEs and DPOAEs were calculated. The main outcome measures were pure-tone hearing improvement, sensitivity, and specificity of the OAEs measures towards ISSNHL outcome.

Results: Patients having detectable TEOAEs on the first follow-up evaluation had average hearing improvement of 62 ± 41% whereas those with no response improved only by 11 ± 15% (P < 0.001). For the DPOAEs hearing improvement, results were 71 ± 37% and 10 ± 14%, respectively (P < 0.001). The sensitivity of recordable TEOAEs on the seventh day of follow-up towards the prediction of significant hearing improvement reached 71% and the specificity 100%. For the DPOAEs, the corresponding values were 83% and 100%. Univariate analysis showed significant contribution for the variance in hearing improvement by both TEOAEs and DPOAEs and their interaction (P values of 0.043, 0.005, and 0.009, respectively).

Conclusion: The results suggest potential role of TEOAEs and DPOAEs evaluation in the early stage of treatment in the prediction of ISSNHL outcome.