Modified Siegel's criteria for sudden sensorineural hearing loss: Reporting recovery outcomes with matched pretreatment hearing grades

Abstract

Background: Sudden sensorineural hearing loss (SSNHL) is an emergency clinical otology condition defined as hearing loss greater than 30 dB over three consecutive frequencies within 72 h. We aimed to integrate pretreatment hearing grades with reports of treatment recovery outcomes of SSNHL using the modified Siegel's criteria. Methods: This was a retrospective cohort study comprising 110 patients with SSNHL seen between January 2014 and January 2015. The patients were treated with combined systemic and intra-tympanic steroid therapy. The audiometric results were recorded using the modified Siegel's criteria, including pretreatment hearing grades 1e5 (grade 1: hearing threshold under 25 dB, grade 2: hearing threshold 26e45 dB, grade 3: hearing threshold 46e70 dB, grade 4: hearing threshold 71e90 dB, grade 5: hearing threshold over 90 dB) and hearing recovery outcomes, consisting of complete recovery (CR), partial recovery (PR), slight improvement (SI), no improvement (NI) or non-serviceable ears (NS). Patients were further assessed based on the treatment modality (initial or salvage treatment) and duration of the treatment delay. Results: Hearing improvements (CR þ PR þ SI) were seen in 56 patients. Patients with pretreatment hearing grade 3 had the highest improvement rate (88.2% or 30/34). Patients who received the combined steroid therapy as the initial modality had a better overall hearing improvement rate than did the salvage group. Treatment within the first 14 days yielded a better hearing improvement rate than did late treatments of more than 14 days, especially in patients with a pretreatment hearing grade of 5. Conclusion: Using the modified Siegel's criteria, we report the hearing recovery outcomes with matched pretreatment hearing grades of patients with SSNHL treated with combined intra-tympanic steroid therapy. Our results show the prognostic significance of pretreatment hearing grades in patients with SSNHL.