Characteristics and prognostic assessment of acute low-frequency sensorineural hearing loss: a retrospective analysis of 546 cases

Background/Objectives The incidence of acute low-frequency hearing loss has gradually increased in recent years. However, its specific etiology and pathophysiology remain largely unclear. Therefore, the aim of this study was to investigate the prognostic factors of acute low-frequency sensorineural hearing loss.Patients and methods Patients were grouped based on post-treatment pure-tone hearing thresholds: complete, marked, and slight recovery, or no change. We analyzed correlations between prognosis and age, sex, affected side, pathogenesis, underlying diseases, onset days, dizziness, degree of hearing loss, vestibular function, electrocochleography results, and gadolinium-enhanced inner ear MRI. Correlational analyses were completed using univariate and multivariate logistic regression. A p-value < 0.05 was considered statistically significant.Results Overall 546 patients with acute low-frequency sensorineural hearing loss were included. Univariate analysis revealed significant differences among groups regarding age, onset days, degree of hearing loss, cochlear hydrops on gadolinium-enhanced inner ear magnetic resonance imaging, and abnormal electrocochleography (all p < 0.001), and in caloric and head impulse test results (all p < 0.05). Multivariate logistic regression analysis showed that age, severe hearing loss, and abnormal electrocochleography results were significantly associated with prognosis. Age (p < 0.001) and electrocochleography results (p < 0.05) were significantly associated with complete recovery; degree of hearing loss was significantly associated with obvious effects (p < 0.01).Conclusions Advancing age, abnormal electrocochleography, and degree of hearing loss were independently associated with poor prognosis of ALHL . With further study, these results could drive the development of improved clinical diagnostic guidelines to ultimately impact patient outcomes.