Paired-ear tympanometric pressure patterns and hearing recovery in unilateral sudden sensorineural hearing loss: a retrospective cohort study
4 affiliations
- 1Department of Otolaryngology, Xiongan Xuanwu Hospital
- 2Department of Otolaryngology, Xiong'an Health Management Center, Peking University People's Hospital
- 3Department of Otolaryngology, Xuanwu Hospital Capital Medical University
- 4Department of Otolaryngology, Rongcheng Traditional Chinese Medicine Hospital
Abstract
Background: Sudden sensorineural hearing loss (SSNHL) remains difficult to phenotype and predict. Tympanometry is routinely performed, yet its quantitative pressure information is largely discarded once conductive hearing loss is excluded. We used a paired-ear strategy to compare middle-ear pressure between the affected and contralateral ears in unilateral SSNHL.
Methods: We retrospectively studied 203 adults with unilateral SSNHL and bilateral tympanometric peak pressure (TPP) measurements. Rather than relying on a single abnormality threshold, we integrated signed interaural differences, absolute pressure asymmetry, laterality-aware pressure phenotypes, and threshold-sensitivity analyses. Among patients with follow-up audiometry, hearing recovery was quantified as both continuous hearing gain and clinically meaningful ≥15-dB improvement, and was further examined in relation to categorical and continuous TPP phenotypes.
Results: Paired-ear analysis showed no significant pressure shift in the affected ear compared with the contralateral ear ( p = 0.410), indicating no consistent affected-ear pressure abnormality at the population level. Laterality-aware classification identified affected-ear-only negative pressure in 14 patients (6.9%) and contralateral-ear-only negative pressure in 11 patients (5.4%). This subgroup would be largely invisible using conventional single-ear classification. Across complementary binary, continuous, and multivariable analyses, tympanometric pressure showed no robust relationship with short-term hearing recovery, and this conclusion remained stable across alternative pressure thresholds.
Conclusion: Unilateral SSNHL is not characterized by a universal middle-ear pressure abnormality. Paired-ear assessment can identify individual differences in middle-ear pressure that may be overlooked by single-ear classification. However, baseline TPP was not clearly associated with short-term hearing recovery in this cohort.
Related
- Modified supraclavicular approach for hemithyroidectomy with central neck dissection in unilateral papillary thyroid microcarcinoma: a feasibility-focused retrospective cohort study
- Clinical Outcomes and Feasibility of Unilateral Biportal Endoscopic Decompression for Thoracic Ossification of the Ligamentum Flavum: A Retrospective Single-Center Study
- Association of intraoperative mitoxantrone hydrochloride injection with incidental parathyroidectomy and parathyroid autotransplantation during gasless unilateral axillary endoscopic thyroidectomy: a propensity score-matched retrospective cohort study
- Pressure-modulated dural repair during unilateral biportal endoscopic spine surgery: technique description and preliminary feasibility report.
- What triggers intraoperative blood pressure/heart rate surges and postoperative hypertonia during unilateral biportal endoscopy?
BibTeX
@article{zhang2026pairedear,
title = {{Paired-ear tympanometric pressure patterns and hearing recovery in unilateral sudden sensorineural hearing loss: a retrospective cohort study}},
author = {Tianyu Zhang and Yaxue Xie and Yingxuan Li and Haibo Zhang and Hanzhai Tian and Ziye Zhu and Zhiyu Yang and Zhenlin Wang and Jiali Duan and Tianyang Zhang},
journal = {Frontiers in Neurology},
year = {2026},
month = oct,
doi = {10.3389/fneur.2026.1982019},
url = {https://www.frontiersin.org/articles/10.3389/fneur.2026.1982019/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Paired-ear tympanometric pressure patterns and hearing recovery in unilateral sudden sensorineural hearing loss: a retrospective cohort study
AU - Tianyu Zhang
AU - Yaxue Xie
AU - Yingxuan Li
AU - Haibo Zhang
AU - Hanzhai Tian
AU - Ziye Zhu
AU - Zhiyu Yang
AU - Zhenlin Wang
AU - Jiali Duan
AU - Tianyang Zhang
PY - 2026
DA - 2026/10/16
JO - Frontiers in Neurology
DO - 10.3389/fneur.2026.1982019
UR - https://www.frontiersin.org/articles/10.3389/fneur.2026.1982019/full
AB - Background: Sudden sensorineural hearing loss (SSNHL) remains difficult to phenotype and predict. Tympanometry is routinely performed, yet its quantitative pressure information is largely discarded once conductive hearing loss is excluded. We used a paired-ear strategy to compare middle-ear pressure between the affected and contralateral ears in unilateral SSNHL. Methods: We retrospectively studied 203 adults with unilateral SSNHL and bilateral tympanometric peak pressure (TPP) measurements. Rather than relying on a single abnormality threshold, we integrated signed interaural differences, absolute pressure asymmetry, laterality-aware pressure phenotypes, and threshold-sensitivity analyses. Among patients with follow-up audiometry, hearing recovery was quantified as both continuous hearing gain and clinically meaningful ≥15-dB improvement, and was further examined in relation to categorical and continuous TPP phenotypes. Results: Paired-ear analysis showed no significant pressure shift in the affected ear compared with the contralateral ear ( p = 0.410), indicating no consistent affected-ear pressure abnormality at the population level. Laterality-aware classification identified affected-ear-only negative pressure in 14 patients (6.9%) and contralateral-ear-only negative pressure in 11 patients (5.4%). This subgroup would be largely invisible using conventional single-ear classification. Across complementary binary, continuous, and multivariable analyses, tympanometric pressure showed no robust relationship with short-term hearing recovery, and this conclusion remained stable across alternative pressure thresholds. Conclusion: Unilateral SSNHL is not characterized by a universal middle-ear pressure abnormality. Paired-ear assessment can identify individual differences in middle-ear pressure that may be overlooked by single-ear classification. However, baseline TPP was not clearly associated with short-term hearing recovery in this cohort.
SN - 1664-2295
ER -