Comparable Outcomes in Pediatric and Adult Patients With Sudden Sensorineural Hearing Loss.

Abstract

To identify prognostic factors for unilateral idiopathic sudden sensorineural hearing loss (SSNHL) in pediatric and adult patients, and to compare therapeutic efficacy between these age groups: METHODS: This retrospective cohort study included 1947 hospitalized patients (219 pediatric, 1728 adult) with unilateral idiopathic SSNHL from January 2008 to December 2022. All patients received inpatient therapy following the Chinese Guidelines for SSNHL, with pediatric dosing adjusted for age and weight. To compare therapeutic outcomes, multivariable logistic regression, full propensity score matching (PSM), restricted cubic spline (RCS), and machine learning algorithms were employed. Baseline median ages were 13 (IQR, 10-15) years for pediatric and 43 (IQR, 33-50) years for adult patients. Shared independent prognostic factors in both groups included audiogram configuration, degree of hearing loss, and treatment-onset time. Furthermore, after matching, pediatric and adult patients had comparable complete recovery (18.7% vs. 16.4%) and overall efficacy rates (52.5% vs. 54.1%). The therapeutic window was identified as 14 days for children and 15 days for adults. Consistent with this, treatment-onset time emerged as the most influential feature in predictive models, with pediatric outcomes achieving an area under the curve (AUC) of 0.849 and adult outcomes an AUC of 0.901. Pediatric and adult patients with unilateral idiopathic SSNHL share major prognostic factors. Therapeutic efficacy is comparable between groups when appropriate treatment is provided. Early intervention, ideally within 2 weeks of symptom onset, is critical to maximize auditory recovery.