A clinical analysis of psychogenic sudden deafness.

摘要

OBJECTIVE: Sudden deafness, in most cases, has no apparent cause. In some cases viral infection, vascular occlusion, or a cochlear membrane rupture may be responsible for the sudden loss of hearing. In this study, we analyzed etiology, audiologic, psychiatric, and clinical aspects of psychogenic sudden deafness through a retrospective chart review. Patients included were thought to have sudden deafness as a result of psychogenic causes and/or stresses. STUDY DESIGN AND SETTING: We reviewed the records of 277 patients who had been admitted to the Department of Otolaryngology, Kangbuk Samsung Hospital, from January 1997 to July 2003, with the initial diagnosis of idiopathic sudden hearing loss. RESULTS: In the medical history of 9 patients, there was an association between sudden onset of hearing loss and psychogenic events. There were 4 patients who had a preexisting mental health condition. A psychiatrist provided the classification of psychogenic sudden deafness for 7 patients (2.5%) who had organic causes ruled out. These patients showed discrepancy between pure tone audiometry and ABR. There were 2 males and 5 females; 4 patients were in their 10's, 1 in his 20's, and 2 in their 40's. Three patients had bilateral hearing loss and 4 had unilateral loss. The hearing test scores revealed: 4 patients with severe to profound hearing loss at 71 dB or higher, 2 patients with moderately severe hearing loss ranging from 56 to 70 dB, and 1 patient with moderate hearing loss from 41 to 56 dB. Hearing was restored in all patients, partially or completely, by treatment with steroid injections and psychotherapy. CONCLUSIONS: A total of 2.5% of sudden onset hearing loss cases in our study were a result of psychogenic causes. We observed distinctive features for audiologic measures, psychiatric findings, and clinical characteristics. The recovery rate and prognosis were better in patients who had accurate audiometry and were under the care of a psychiatrist. EBM RATING: C-4.