Objective: We aimed to evaluate the prognostic factors for acute-onset tinnitus associated with unilateral idiopathic sudden sensorineural hearing loss (ISSNHL) and to assess the relationship between these factors and the final recovery. Methods: A total of 770 patients with unilateral ISSNHL were enrolled retrospectively and their medical records reviewed. Patients were classified into two groups according to the presence of acute-onset tinnitus at the initial examination. Patient characteristics and the results of pure-tone audiometry were compared between the two groups initially and 3 months later. Results: A total of 70.9% (n = 546) of patients had tinnitus initially. There was no significant difference in the mean hearing thresholds of the affected ear irrespective of accompanying tinnitus. In contrast, patients with tinnitus in the affected ear tended to have significantly better mean hearing thresholds in the nonaffected ear (p < 0.05). The logistic regression analysis revealed that better mean hearing thresholds in the nonaffected ear were associated with tinnitus occurrence (p < 0.05). Better hearing thresholds in the nonaffected ear, younger age, absence of dizziness, low-tone hearing loss, and combined intratympanic dexamethasone injection were associated with full recovery (p < 0.05). However, tinnitus was not an independent risk factor for full recovery. Conclusion: Better contralateral hearing was associated with both an increased incidence of concurrent tinnitus and a better final recovery. However, tinnitus was not related to full recovery.

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