# Efficacy evaluation and clinical value exploration of secondary inpatient treatment for total deafness-type SSNHL: a single-center prospective study

## TL;DR

This study shows that secondary inpatient treatment helps patients with total deafness-type sudden hearing loss recover faster and better, especially if they are young and receive early care.

## Contribution

The study introduces a predictive model and identifies key factors for successful recovery in total deafness-type SSNHL patients.

## Key findings

- Secondary treatment led to faster and greater hearing recovery compared to the control group.
- Young age, early disease duration, and normal vestibular function predicted better outcomes.
- The predictive model showed strong accuracy and clinical usefulness for prognosis.

## Abstract

Total deafness-type sudden sensorineural hearing loss (SSNHL) represents one of the most challenging subtypes of SSNHL due to its poor response to initial therapy and uncertain prognosis. Secondary inpatient treatment has been proposed as a potential salvage strategy; however, its efficacy and predictors of favorable outcomes remain poorly defined.

This study included 120 patients with unilateral total deafness-type SSNHL, divided into secondary treatment and control groups. Hearing thresholds at low, middle, high, and full frequencies, pure-tone average (PTA) at speech frequencies, and speech recognition rate were evaluated across six time points (T1–T6). Tinnitus Handicap Inventory (THI) scores and improvement rates were also analyzed. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of marked hearing recovery. A nomogram was constructed to predict the hearing prognosis of patients with SSNHL.

Compared with the control group, the secondary treatment group exhibited significantly earlier onset and greater magnitude of improvements in hearing thresholds and speech recognition rate (all p < 0.05), with distinct frequency-specific patterns. Recovery initiated at 4–8 weeks and stabilized after 12 weeks, while the control group showed delayed improvement. Tinnitus relief occurred earlier in the secondary treatment group. Multivariate analysis identified age ≤50 years, disease duration ≤3 days, absence of vertigo, and normal vestibular function (vHIT and caloric test) as independent predictors of marked recovery (all p < 0.05). The area under the receiver operating characteristic (ROC) curve was 0.876 (95% confidence interval [CI]: 0.762–0.989). The calibration curve showed good agreement with the standard curve. The decision curve analysis demonstrated that the prediction model yielded positive net benefits across nearly all threshold probability ranges.

Secondary inpatient treatment offers a significant auditory benefit for patients with total deafness-type SSNHL by accelerating and amplifying recovery. Young age, early intervention, and well-preserved vestibular function are key determinants of a favorable prognosis. The predictive model constructed hereby can effectively predict the prognosis of patients.