Objective This systematic review and meta-analysis aimed to identify prognostic factors influencing hearing recovery in children with sudden sensorineural hearing loss (SSNHL), thereby providing a reference for developing prevention strategies and optimizing therapeutic interventions. Methods We conducted a comprehensive search of PubMed, Web of Science, Cochrane Library, Embase, CNKI, and SinoMed databases to identify relevant studies published prior to 2024. Inclusion criteria encompassed pediatric patients with SSNHL (18 years old) who had clearly documented audiological outcomes. We extracted data on demographic characteristics, clinical features, and treatment regimens to investigate the association between prognostic factors and hearing recovery. Results This meta-analysis included 1,006 patients from 13 studies. The combined rates for partial and complete hearing recovery were 19.6% 95% confidence interval (CI): 13.6–25.7%, I² = 80.63% and 18.6% (95% CI: 12.2–25.1%, I² = 85.99%), respectively. Better prognosis was associated with unilateral hearing loss odds ratio (OR): 2.741, P = 0.004, age 12 years (OR: 1.911, P = 0.034), treatment delay ≤ 14 days (OR: 6.402, P 0.001), and an ascending audiogram curve (OR: 6.910, P 0.001). Conversely, poorer outcomes were associated with profound hearing loss curves (OR: 0.376, P 0.001) and initial pure-tone average (PTA) thresholds 80 dB HL (OR: 0.451, P = 0.005). Conclusion Early intervention (≤14 days) and targeted treatment for profound hearing loss (PTA 80 dB HL) hold promise for improving pediatric outcomes. Systemic inflammatory markers (neutrophil-to-lymphocyte ratio) and age-specific pathophysiological mechanisms warrant further investigation. Conducting multicenter prospective studies is essential to validate these findings and establish standardized diagnostic and treatment protocols for pediatric SSNHL. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD42024612409 , CRD42024612409.
Wu et al. (Wed,) studied this question.