■ OBJECTIVES: There continues to be debate about the prognostic significance of vertigo in idiopathic sudden sensorineural hearing loss(ISSHL). We reviewed the clinical manifestations of ISSHL with benign paroxysmal positional vertigo (BPPV) and analyzed the prognostic significance of BPPV and its relationship to other prognostic factors.

■ METHODS: We conducted a retrospective study on 182 patients with ISSHL. These patients were divided into four group according to the presence of dizziness and the vestibular function test(VFT) finding; non dizziness group in 66.4%, normal VFT in 10.4%, abnormal VFT(canal paresis, directional preponderance, other non specific nystagmus) in 7.6%, BPPV group in 15.3%. We evaluated the initial hearing and the improvement of hearing as well as the recovery rate. We retrospectively analyzed the prognostic significance of BPPV in patients with ISSHL by controlling the confound factors such as treatment initiation, systemic disease, initial hearing loss, the age.

■ RESULTS: There were no significant differences in the affected ear, gender, age, and mean time of treatment initiation between four groups. Initial profound hearing loss was found more frequently in the ISSHL with BPPV group. The overall recovery rate and the percent with complete recovery were higher in the non dizziness and the normal VFT group than the abnormal VFT and the BPPV group. For the patients with profound hearing loss(>90 dB), there was no significant difference in hearing improvement for each of the frequencies tested in each group. For the patients with an initial hearing loss of less than 90dB, the non dizziness and the normal group had a better prognosis than other two groups. For the over and the under 60 age groups, the non dizziness and the normal VFT group is higher in hearing recovery than other two groups. However, overall there was no significant difference in hearing recovery between the over and the under 60 age group.

■ CONCLUSION: ISSHL accompanied with BPPV or abnormal VFT had a poor prognosis compared to the non dizziness group and the ISSHL with normal VFT group. However BPPV and abnormal VFT had no additional negative effects on prognosis in patients with initial profound hearing loss.