Sordera súbita idiopática. Revisión de 58 casos

Jonathan Edgard DELGADO-GIL, Claudio KRSTULOVIC, Vanesa PÉREZ-GUILLÉN, Enrique GARCÍA-ZAMORA, Herminio PÉREZ-GARRIGUES

Resumen


Introduccion y Objetivo: La sordera súbita (SS) se define como la hipoacusia neurosensorial de inicio brusco, en menos de 72 horas, con pérdida de 30 o más decibelios (dB) en tres frecuencias consecutivas en la audiometría tonal. En el 90% de los casos no es posible determinar su etiología dando lugar a lo que se conoce como sordera súbita idiopática (SSI). El objetivo de este estudio es describir las características de los pacientes con SSI diagnosticados en los últimos 20 años, identificar factores pronósticos y mostrar los resultados en función del tratamiento. Método: Estudio descriptivo retrospectivo de 58 pacientes diagnosticados de SSI entre 1995-2016. Se determinaron el nivel de pérdida auditiva y el grado de recuperación posterior. Se estudiaron los factores de riesgo cardiovascular, asociación con otros síntomas, inicio del tratamiento, severidad de la hipoacusia y morfología de la curva auditiva. Resultados: No se encontró relación entre la recuperación auditiva y los diferentes factores de riesgo cardiovascular. Presentaron una mejoría completa un 24,1%, parcial un 17,2% y leve el 17,2%. El 41,5% no obtuvo ninguna mejoría con un peor pronóstico auditivo en los sujetos con hipoacusia profunda. Se obtuvo un 100% de recuperaciones completas en los sujetos con morfología inclinación ascendente. El síntoma asociado más frecuente fue el acúfeno. Los síntomas vestibulares al inicio del cuadro, determinaron un peor pronóstico auditivo. El tiempo de inicio desde la aparición de la hipoacusia hasta la instauración del tratamiento intravenoso no se ha relacionado con una mejor evolución. El porcentaje “sin mejoría” es del 54% (DIT y tratamiento sistémico) frente al 75% en los tratados exclusivamente con tratamiento intravenoso, pero esta mejoría no tiene significación estadística. Conclusiones: La afectación vestibular, severidad de la hipoacusia y la morfología de la curva auditiva son determinantes como factor pronóstico. Aunque hay mejores resultados utilizando la DIT como tratamiento de rescate, nuestra experiencia no determino un beneficio evidente de su uso en sujetos con SSI.

Palabras clave


sordera súbita; vértigo; pronóstico.

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Referencias


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DOI: http://dx.doi.org/10.14201/orl.20151

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