[Metrology analysis and thoughts of literatures on tinnitus associated with sudden deafness based on CiteSpace].

Objective: To explore the incidence of sudden deafness accompanied with tinnitus, the selection of examination protocols and treatment, and to provide reference for the establishment of new guidelines for sudden deafness. Methods: CiteSpace software was used for analysis and data mining to analyze and summarize the computer-retrieved articles on diagnostic examination and treatment of sudden deafness accompanied with tinnitus collected from CNIC, Wanfang and Web of Science databases from 2011 to 2021. Results: A total of 207 randomized controlled studies were retrieved in this study, including 121 in Chinese and 86 in English. Finally, 74 Chinese literatures and 16 English literatures were included. Among the 74 valid Chinese literatures, 64 (86.5%) were accompanied with tinnitus, 58 (78.4%) with dizziness/vertigo, 25 (33.8%) with aural fullness, 10 (13.5%) with headache, 4 (5.4%) with insomnia, 4 (5.4%) with a mixture of dizziness and tinnitus, and 2 (2.7%) with vomiting. Among the 16 English literatures, 15 (93.8%) were accompanied with tinnitus, 12 (75.0%) with vertigo, 1 (6.3%) with aural fullness, and 1 (6.3%) with a mixture of various symptoms. Among the 64 Chinese articles mentioning tinnitus, only 9 mentioned tinnitus matching tests, and 1 mentioned that the treatment for tinnitus accompanying symptoms was sound therapy and psychological counseling. The incidence rates of tinnitus accompanying four different types of sudden deafness, from low to high, are as follows: low-to-mid frequency, 82.4%; mid-to-high frequency, 90.7%; complete deafness, 92.4%; and flat type, 92.8%. Conclusion: Tinnitus is the most common accompanying symptom of sudden deafness, and tinnitus matching test is an effective evaluation method. When establishing a scientific, comprehensive, and systematic diagnosis and treatment system or guidelines for sudden deafness, attention should be paid to the diagnosis and treatment of tinnitus symptoms and their adverse psychological reactions, in order to reduce the incidence of tinnitus patients in the later stage of recovery from sudden deafness.

Sudden Sensorineural Hearing Loss and Facial Palsy in Patients with Vestibular Schwannoma Based on the Population Data of Korea.

BACKGROUND: The prevalence of sudden sensorineural hearing loss and facial palsy in patients with vestibular schwannoma and the association of sudden sensorineural hearing loss or facial palsy with vestibular schwannoma were investigated based on the population data of Korea. METHODS: This retrospective study used the Korean National Health Insurance Service data. Patients with vestibular schwannoma and those with a previous history of sudden sensorineural hearing loss or facial palsy were identified based on diagnostic, medication, magnetic resonance imaging, or audiometric codes from 2005 to 2020. The control group was established with propensity score matching. The risk for vestibular schwannoma in patients with a previous history of sudden sensorineural hearing loss or facial palsy was analyzed. RESULTS: There were 5751 patients in the vestibular schwannoma group and 23004 in the control group. The rate of patients with a previous history of sudden sensorineural hearing loss in the vestibular schwannoma group (25.8%) was significantly higher than in the control group (P -lt; .0001), as was the rate of patients with a previous history of facial palsy in the vestibular schwannoma group (4.7%) (P -lt; .0001). Previous history of sudden sensorineural hearing loss was a significant risk factor for vestibular schwannoma (hazard ratio=7.109, 95% confidence interval=6.696-7.547). Previous history of facial palsy was also a significant risk factor for vestibular schwannoma (hazard ratio=3.048, 95% confidence interval=2.695-3.447). CONCLUSION: The prevalence of sudden sensorineural hearing loss or facial palsy was significantly higher in patients with vestibular schwannoma than in those without vestibular schwannoma. Based on the population data of Korea, sudden sensorineural hearing loss and facial palsy were significant risk factors for vestibular schwannoma.

Cerebellopontine angle tumor presenting as acute audiovestibular syndrome.

BACKGROUND: Acute audiovestibular deficits may be a harbinger of vestibular schwannoma (VS). OBJECTIVE: To investigate clinical and laboratory features of 25 consecutive patients with VS presenting with acute audiovestibular deficits. METHODS: A symptomatic combination of acute audiovestibular deficits was investigated. Audiometric and vestibular function tests, and internal auditory canal magnetic resonance imaging (IAC MRI) results were evaluated. RESULTS: Varying combinations of symptoms may develop in VS patients with acute audiovestibular deficits, of whom sudden hearing loss (HL) without acute vertigo or acute facial nerve palsy (FNP) was most common. The most common audiometric configuration was high-tone hearing loss, and no patient showed low-tone hearing loss. IAC MRI demonstrated that the tumor had an intracanalicular portion and attachment to the bony IAC wall in all patients and widened the IAC wall in some patients. CONCLUSION: Different symptomatic combinations of acute audiovestibular deficits may develop in patients with VS. Awareness about the possibility of VS as a cause of sudden HL, acute vertigo, and acute FNP, as well as subsequent IAC MRI scanning is vital to earlier diagnosis of VS in these patients.

Sudden bilateral deafness in a patient with vertebrobasilar artery occlusion: A case report.

RATIONALE: Sudden bilateral deafness is often associated with serious systematic conditions such as neoplasms, vascular events, autoimmune diseases, infections, and iatrogenic injury, but very rarely to cerebrovascular disease. This is a rare case of sudden bilateral deafness in a patient with the vertebrobasilar artery occlusion. PATIENT CONCERNS: A 46-year-old man was admitted to a local hospital for sudden bilateral deafness, the patient suffered inarticulate speech and walking unsteadily 6 days later. DIAGNOSES: Difusion-weighted magnetic resonance imagin demonstrated acute cerebral infarction in the pons and bilateral cerebellum; Magnetic resonance angiography showed vertebrobasilar artery occlusion. INTERVENTIONS: Aspirin and clopidogrel were given for antiplatelet therapy, revascularization was obtained by endovascular treatment. OUTCOMES: The symptoms of dysarthria, ataxia and weakness gradually improved and were discharged 14 days after admission revascularization. After 3 months telephone followed-up the patient was self-cared. LESSONS: Deafness sometimes can be an early warning sign of impending vertebrobasilar ischemic stroke. Early recognition of deafness with acute ischemic stroke should allow special management, and misdiagnosis may result in significant morbidity, or even mortality.

Correlation between right-to-left shunt and sudden sensorineural hearing loss: protocol for a case-control study.

BACKGROUND AND PURPOSE: Sudden sensorineural hearing loss (SSNHL) is a neurological and otolaryngological emergency during which rapid diagnosis and early treatment are of great importance. Clinical experience indicates that a considerable number of patients with SSNHL have concurrent right-to-left shunt (RLS). With limited reports, the association between SSNHL and RLS is yet unclear and there is a need for large observational studies to explore their latent relationship. METHODS AND ANALYSIS: This proposed study is a prospective, observational case-control study. A total of 194 eligible participants matched in age and sex will be divided equally into two groups: 97 patients with SSNHL included in the case group and 97 individuals without SSNHL in the control group. Medical evaluations, including clinical characteristics, laboratory examination, audiological examination and ultrasonography examination, will be performed in all subjects. The primary outcome of the study is the difference in RLS rates between the groups. Differences in patent foramen ovale rates and other measured variables will be further assessed. A conditional logistic regression as a correlation analysis will be used to evaluate the relationship between RLS and SSNHL. DISCUSSION: This study may provide evidence on the correlation between RLS and SSNHL in order to enrich the aetiology of SSNHL. ETHICS AND DISSEMINATION: The study protocol has been approved by the Ethics Committee of Peking University Shenzhen Hospital. A written informed consent form will be signed and dated by the participants and the researchers before the study begins. The results will be disseminated in peer-reviewed publications. TRIAL REGISTRATION NUMBER: ChiCTR2200064067.

A case of sudden hearing loss in a patient with chronic myelomonocytic leukemia.

Chronic myelomonocytic leukemia is a myeloid stem cell disease characterized by an abnormal production and accumulation of monocytic cells in association with other signs of myeloproliferation. Extramedullary manifestations of CMML are common and can affect the spleen, liver skin, and lymph nodes. However, otologic manifestations are extremely rare and could have occurred from either direct leukemic infiltration, hemorrhage of the cochlea, labyrinth, leukostasis, or infection. There is no standard treatment protocol for sensorineural hearing loss in CMML patients. More research is needed to improve the understanding of the pathogenesis of this condition, in order to provide better treatment options.

[Clinical characteristics of sudden sensorineural hearing loss with acute cerebral infarction].

Objective: To analyze the clinical and imaging features of patients with sudden sensorineural deafness and acute cerebral infarction in order to provide evidence for early recognition of such diseases. Methods: This was a case series reporting study. A retrospective analysis was performed on the clinical and imaging data of 29 patients with sudden hearing loss (SHL) who admitted to the Otolaryngology Head and Neck Surgery Department of Beijing Tiantan Hospital from January 2017 to December 2021 and diagnosed with acute cerebral infarction using MRI-DWI. Results: The patients were aged 31-71 years, with an average age of 56±12 years, and 82.8% (24/29) were men. In total, 82.8% (24/29) of the patients had three or more atherosclerotic risk factors, and 24.1% (7/29) had a history of SHL. The hearing types were flat and total deafness: 86.2% (25/29) of the patients had severe hearing loss, 27.6% (8/29) had bilateral SHL, 17.2% (5/29) had further hearing loss during hospitalization, and 82.8% (24/29) had dizziness or vertigo at the onset. The signs of central nervous system involvement mainly included speech impairment, diplopia, dysphagia, central facial paralysis, facial and limb hypoesthesia, ataxia, and decreased muscle strength. Imaging evaluation showed that 21 cases were located in the posterior circulation supply area and 8 cases in the anterior circulation supply area. Additionally, 82.8% (24/29) patients had vertebrobasilar artery stenosis, and 58.6% (17/29) patients had severe vertebrobasilar artery stenosis or occlusion. Conclusions: Patients with SHL who progress to cerebral infarction often have multiple atherosclerotic risk factors and SHL. Most of the patients are middle-aged and older men who often complain of dizziness or dizziness accompanied by severe flat and total deafness with unilateral or bilateral SHL. Imaging findings suggest that most patients have posterior circulation infarction, often accompanied by severe stenosis or occlusion of the vertebrobasilar artery.

Cardiovascular Risk Factors in Patients With Sudden Sensorineural Hearing Loss: A Systematic Review and Meta-analysis.

OBJECTIVE: The interruption of vascular supply to the inner ear is one of several proposed etiologies of sudden sensorineural hearing loss (SSNHL). The increased presence of cardiovascular risk factors may predispose patients to SSNHL through this pathway. This systematic review and meta-analysis studies the presence of cardiovascular risk factors in patients diagnosed with SSNHL. DATA SOURCES: Databases included PubMed/Medline, OVID, EMBASE, Cochrane, and Web of Science. REVIEW METHODS: Inclusion criteria included studies featuring SSNHL patients presenting with 1+ cardiovascular risk factors. Exclusion criteria included case reports and studies without outcome measures. Two investigators independently reviewed all manuscripts and performed quality assessments using validated tools. RESULTS: Of 532 identified abstracts, 27 studies met inclusion criteria (19 case-control, 4 cohorts, 4 case series). Of these, 24 underwent meta-analysis encompassing a total of 77,566 patients (22,620 SSNHL patients, 54,946 matched controls). The mean age was 50.43 years. SSNHL patients were more likely to have concomitant diabetes (odds ratio [OR] 1.61 [95% confidence interval [CI]: 1.31, 1.99; p < .00001]) and hypertension (OR 1.5 [95% CI: 1.16, 1.94; p = .002]). An increased standard mean difference of total cholesterol of 11.09 mg/dL (95% CI; 3.51, 18.67; p = .004) was noted in the SSNHL group compared with the controls. No significant differences in smoking, high-density lipoprotein, triglycerides, or body mass index were detected. CONCLUSION: Patients presenting with SSNHL have a significantly higher risk of concomitant diabetes, hypertension, and higher total cholesterol in comparison to matched controls. This may indicate a higher cardiovascular risk profile in this population. More prospective and matched cohort studies are needed to understand the role of cardiovascular risk factors in SSNHL.

[Long-term evaluation and physical and mental effects of residual tinnitus following treatment of sudden hearing loss].

Objective: To clarify the long-term characteristics of tinnitus following treatment of sudden deafness and its long-term physical and mental effects on patients. Methods: A retrospective analysis was performed on 88 patients (46 males and 42 females; Age from 11 to 89 years) with sudden deafness treated in Department of Otoscope Surgery of Peoples's Libration Army General Hospital in Beijing from April 2020 to January 2021, and the occurrence of tinnitus and treatment effect of all patients were analyzed. Follow-up was conducted for patients with residual tinnitus after treatment for more than 1 year by the investigation and filling in the survey information collection form, Tinnitus Evaluation Questionnaire (TEQ) and Tinnitus Handicap Inventory (THI). Descriptive statistics and SPSS 22.0 software were used for statistical data analysis. Results: In this study, 93.2% (82/88) of patients with sudden deafness were accompanied by tinnitus at the onset, and the proportion of long-term tinnitus after treatment was 90.2% (74/82). After 1 year of treatment for sudden deafness, the improvement of tinnitus was significant in low-frequency sudden deafness compared with those of high-frequency, flat and total deafness sudden deafness (χ2 value was 6.801, 4.568 and 4.038, all P<0.05). In patients with residual tinnitus, 9 (12.2%) patients felt minimal loudness or even no loudness, 34 (46.0%) patients felt slight loudness, 28 (37.8%) patients felt tinnitus was relatively loud, and 3 (4.1%) patients felt tinnitus was loud or noisy. Nine (12.2%) patients's sleep was often affected, 41 (55.4%) patients's sleep was sometimes affected, 9 (12.2%) patients's sleep was rarely affected, 15 (20.3%) patients's sleep was almost not affected. Twenty-eight (37.8%) patients basically completely adapted to tinnitus and 46 (62.2%) patients did not completely adapted to residual tinnitus. Eight (10.8%) patients had no impact on life, 39 (52.7%) patients had slight impact, 22 (29.7%) patients had moderate impact, and the other 5 (6.8%) patients had greater impact. According to tinnitus evaluation questionnaire(TEQ), there were 12 cases (16.2%) of grade Ⅰ, 26 cases (35.1%) of grade Ⅱ, 28 cases (37.8%) of grade Ⅲ, 7 cases (9.5%) of grade Ⅳ and 1 case (1.4%) of grade Ⅴ. According to tinnitus handicap inventory(THI), tinnitus disability was classified into grade Ⅰ, 22 cases (29.7%), grade Ⅱ, 14 cases (18.9%), Grade Ⅲ, 27 cases (36.5%) and grade Ⅳ, 11 cases (14.9%). Conclusion: The rate of residual tinnitus following treatment of sudden deafness is high. Some of the patients can completely adapt residual tinnitus after one year, but some of them will be affected when sleep, work and study. Residual tinnitus can lead to tinnitus disability in different degrees.

Sudden Hearing Loss Following Vaccination Against COVID-19.

Importance: Spontaneous adverse reaction reports of sudden hearing loss have been observed, and a population-based cohort study conducted in Israel showed an increase in the incidence of sudden sensorineural hearing loss (SSNHL) following vaccination with messenger RNA COVID-19 vaccine BNT162b2 (Pfizer-BioNTech). However, in this setting, the possibility of confounding remained. Objective: To assess a potential association between COVID-19 vaccinations and SSNHL. Design, Setting, and Participants: This register-based country-wide retrospective cohort study of 5.5 million Finnish residents was conducted from January 1, 2019, to April 20, 2022, and included all individuals who were identified from the population information system who were alive or born during the study period except individuals who had SSNHL during 2015 to 2018 according to specialized care derived diagnosis codes for SSNHL (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ICD-10] code H91.2) as a primary or secondary diagnosis. Exposures: The a priori primary risk period was 0 to 54 days following each COVID-19 vaccination. The risk periods for different vaccine doses did not overlap so that a later vaccine exposure ended the previous risk period. The secondary risk period was from 55 days following each COVID-19 vaccination until a subsequent COVID-19 vaccination. A secondary analysis included a risk time from 0 to 54 days following a positive polymerase chain reaction test result for SARS-CoV-2. Main Outcomes and Measures: The incidences of SSNHL following COVID-19 vaccination were compared with the incidences before the COVID-19 epidemic in Finland. The Poisson regression model included calendar time, age, sex, diabetes, cardiovascular disease, other chronic diseases, and the number of visits in primary health care. Results: For the 5.5 million Finnish residents included in the study, the comparison time comprised 6.5 million person-years, the primary risk time of 1.7 million person-years, and the secondary risk time of 2.1 million person-years. Before the COVID-19 epidemic in Finland, 18.7/100 000 people received a diagnosis of SSNHL annually. The study data suggested no increased risk for SSNHL following any COVID-19 vaccination. In particular, adjusted incidence rate ratios with 95% confidence intervals for the BNT162b2 vaccine's 3 doses were 0.8 (95% CI, 0.6-1.0), 0.9 (95% CI, 0.6-1.2), and 1.0 (95% CI, 0.7-1.4), respectively. There was no association between SARS-CoV-2 infection and an increased incidence of SSNHL. Conclusions and Relevance: The results of this cohort study show no evidence of an increased risk of SSNHL following COVID-19 vaccination. The study accounted for previous disease and other potential confounding factors. These results are based on diagnosis codes in specialized care but still need to be verified in settings that are capable of evaluating the degree of hearing loss.

Could the Audiometric Criteria for Sudden Sensorineural Hearing Loss Miss Vestibular Schwannomas?

OBJECTIVE: To investigate the likelihood of missing a vestibular schwannoma (VS) diagnosis in patients who present with a sudden hearing loss (SHL) that does not meet the most accepted audiometric criteria for sudden sensorineural hearing loss (SSNHL) (a decrease of ≥30 dB at three consecutive frequencies). METHODS: All adult patients (>18 years) diagnosed with SHL of any severity in a tertiary care referral medical center between 2015 and 2020 and who underwent an MRI scan to rule out VS were included. Statistical analyses were conducted to evaluate the difference between the rate of VS among patients with an initial audiogram, which met the abovementioned criteria, and those who did not. Other audiometric criteria for SNHL were also evaluated (≥10 dB at ≥2 frequencies and ≥ 15 dB at one frequency). RESULTS: Of the 332 patients included in the study, 152 met the audiometric criteria for SSNHL, and 180 did not. Both groups had a similar VS rate (8.6% vs. 8.9%, p = 0.914). Similar results were found when other audiometric criteria for asymmetric SNHL were analyzed. In a subgroup analysis of patients with VS-associated SSNHL, neither the tumor size nor the Koos classification was associated with any of the audiometric criteria systems. CONCLUSION: There should be a high index of suspicion for the presence of VS in patients with an SHL of any severity. LEVEL OF EVIDENCE: 3 Laryngoscope, 133:670-675, 2023.

Hipoacusia súbita asociada a depresión: síntoma inusual en adultos mayores infectados por Sars-CoV-2 / Sudden hearing loss associated with depression: an unusual symptom in older adults infected with Sars-CoV-2

Se comienza acumular información sobre las alteraciones en pacientes positivos a Covid-19, donde relacionan el virus con el daño del oído medio y oído interno, tanto en la porción vestibular como la auditiva en adultos mayores, generando episodios depresivos. Por tal razón, se propuso como objetivo evaluar la relación hipoacusia súbita asociada a depresión en adultos mayores infectados por Sars-CoV-2 atendidos en el Hospital Básico Pillaros, perteneciente al sector Ciudadela Ciudad Nueva, Ecuador 2020-2021. El estudio fue cuantitavo, descriptivo correlacional de corte transversal con una muestra de 87 pacientes >65 años positivos para Sars-CoV-2. Para la recolección de datos se aplicó el Test audiométrico y la escala de depresión geriátrica de Yesavage. El análisis de los datos fue con estadística descriptiva en base a frecuencias, porcentajes, IC 95% y X2 a través de SPSS. Como resultado 73,6% eran fememnino y 26,4% masculino, 54,0% tenían de 65-75 años, el tipo de presbiacusia más existente fue neural (31,2%) y coclear (31,0%). Así mismo, 81,6% presentaron signos de depresión, mientras que 18,4% no. En el test Vasayage 88,5% expresó no sentirse lleno de energía y 59,8% sienten temor a que algo malo suceda. Como conclusión, la presencia de trastornos auditivos constituye un problema para la comunicación de los adultos mayores que pudiese conllevar a estados depresivos, por ello, incentivar el desarrollo de investigaciones pudieran orientar hacia el desarrollo de alternativas de intervención temprana que favorezcan el mejoramiento de la calidad de vida de este grupo poblacional(AU)

Information is beginning to accumulate on the alterations in patients positive for Covid -19, where they relate the virus to damage to the middle ear and inner ear, both in the vestibular and auditory portions in older adults, generating depressive episodes. For this reason, the objective was to evaluate the relationship between sudden hearing loss associated with depression in older adults infected with Sars-CoV- treated at the Pillaros Basic Hospital, belonging to the Ciudadela Ciudad Nueva sector, Ecuador 2020-2021. The study was quantitative, descriptive correlational cross-sectional with a sample of 87 patients >65 years positive for Sars-CoV-2. For data collection, the audiometric test and the Yesavage geriatric depression scale were applied. The analysis of the data was with descriptive statistics based on frequencies, percentages, CI 95% and X2 through SPSS. As a result, 73.6% were female and 26.4% male, 54.0% were 65-75 years old, the most common type of presbycusis was neural (31.2%) and cochlear (31.0%). Likewise, 81.6% presented signs of depression, while 18.4% did not. In the Vasayage test, 88.5% expressed not feeling full of energy and 59.8% were afraid that something bad would happen. In conclusion, the presence of hearing disorders constitutes a problem for the communication of older adults that could lead to depressive states, therefore, encouraging the development of research could guide the development of early intervention alternatives that favor quality improvement. life of this population group(AU)

Rare case of sudden onset sensorineural hearing loss in a patient diagnosed with sarcoidosis.

We report the case of a woman in her 30s who was referred to the ear, nose and throat department with sudden onset left-sided sensorineural hearing loss (SNHL), left anterior uveitis and erythematous lower limb lesions with bilateral pitting oedema. Based on her symptoms, an underlying inflammatory systemic disease was suspected. Autoantibodies were negative but an X-ray and high-resolution CT scan of the chest were suggestive of sarcoidosis, which was confirmed on endoscopic bronchial biopsy. Following treatment with a course of oral steroids, the patient's hearing has improved but she still suffers from episodes of uveitis. While immune-mediated inner ear disorders are a recognised cause of SNHL, sarcoidosis is a very rare cause. This case demonstrates the importance of screening for systemic autoimmune aetiology in SNHL and highlights the importance of an effective multidisciplinary team in the diagnosis and management of these patients.

Acoustic neuromas associated with sudden sensorineural hearing loss.

BACKGROUND: Several studies have reported sudden sensorineural hearing loss (SHL) as an initial symptom of acoustic neuromas (ANs). AIMS/OBJECTIVES: We aimed to retrospectively evaluate the incidence of SHL and the associated rates of post-treatment improvement in patients diagnosed with ANs. MATERIALS AND METHODS: We analysed the clinical data of 686 patients with ANs and examined tumour size, correlation with hearing loss, number of episodes of SHL, extent of auditory recovery, and associated audiogram patterns. RESULTS: Among 686 enrolled patients with ANs, 232 (86 with intracanalicular and 146 with extrameatal tumours) experienced SHL at some point in their clinical history. The incidence of SHL was not significantly associated with tumour size. Of the 172 patients analysed, 119, 44, and 9 patients experienced one, two, or three or more episodes of SHL, respectively. Confirmed auditory recovery occurred in 61%, 45.3%, and 33.3% of the patients after the first, second, or third or later episodes of SHL, respectively. The audiograms of 78/172 (45.3%) patients showed a typical trough-shaped pattern of hearing loss at medium-level frequencies. CONCLUSIONS AND SIGNIFICANCE: Among patients with ANs, 7.7% experienced two or more episodes of SHL. The recovery rate of SHL decreased with each successive occurrence.

[Analysis of coagulation state in sudden deafness patients with total deafness and vertigo].

Objective:To analyze the coagulation status and prognosis of sudden deafness patients with total deafness accompanied by vertigo, and to provide basis for improving the treatment of this disease. Methods:From January 2017 to December 2020, 33 patients with total deafness and vertigo sudden deafness who were hospitalized in the Department of Otolaryngology Head and Neck Surgery, Hebei Provincial People's Hospital were selected as the research group. During the same period, 33 cases of low frequency type, full frequency type, total deafness and 26 cases of high frequency type were treated as control group.Thirty-three cases of inpatients without history of middle ear and inner ear diseases were treated as normal control group. The levels of fibrinogen（FIB）, D-Dimer（D-D）, Prothrombin Time（PT）, Activated Partial Thrombin Time（APTT） between the research group and the control group were analyzed, and the therapeutic effects of different types of sudden deafness patients were analyzed. Results:FIB and D-D of total deafness with vertigo were 2.50（2.11, 2.95）and 0.27（0.16, 0.51） respectively, which were higher than 2.31（1.92, 2.50） and 0.17（0.12, 0.21） of normal group. APTT was 25.2（23.1, 28.1）, lower than 27.3（26.4, 29.7） in the normal group, the differences were statistically significant（P<0.01）. ② FIB of total deafness with vertigo was 2.50（2.11, 2.95）, which was higher than that of low frequency group 2.37（1.81, 2.68）. D-D was 0.27（0.16, 0.51）, higher than low frequency group 0.16（0.12, 0.25）, high frequency group of 0.13（0.11, 0.23）, the whole frequency group 0.16（0.11, 0.28）, total of 0.18（1.45, 0.30）. APTT was 25.75±3.18/25.2（23.1, 28.1）, lower than 27.72±2.22 in low frequency group and 26.7（25.8, 28.7） in full frequency group, with statistical significance（P<0.05）. ③ The total deafness with vertigo group had the worst curative effect（ineffective rate was 63.6%）, and the low frequency group had the best curative effect（recovery rate was 75.8%）. The difference of curative effect among different types of sudden deafness groups was statistically significant（P<0.05）. Conclusion:Hypercoagulability and thrombosis may be one of the influencing factors of total sudden deafness. The hypercoagulable state of sudden deafness patients with total deafness and vertigo is more serious than that of total deafness and other types of sudden deafness, and the prognosis is the worst.

Association of sudden sensorineural hearing loss with asthma: a longitudinal follow-up study using a national sample cohort.

OBJECTIVE: To investigate the risk of sudden sensorineural hearing loss (SSNHL) in asthma patients. DESIGN: A longitudinal follow-up study using a retrospective cohort SETTING: The 2002-2013 Korean National Health Insurance Service-Health Screening Cohort PARTICIPANTS AND INTERVENTIONS: The ≥40 years old Korean population were enrolled. The asthma patients were 1:1 matched with the control group for age, sex, income and region of residence. MAIN OUTCOME MEASURE: The occurrence of SSNHL was followed in both asthma and control groups. The stratified Cox proportional hazard model was used. Age, sex, income and region of residence were stratified, and Charlson Comorbidity Index scores, obesity, smoking, alcohol consumption and atopic dermatitis histories were adjusted. Subgroup analysis was performed according to age, sex, obesity, smoking and alcohol consumption. RESULTS: The results showed that 1.0% (877/90 564) of the asthma group and 0.8% (706/90,564) of the control group exhibited SSNHL (p<0.001). The asthma group demonstrated a higher HR for SSNHL than the control group (adjusted HR 1.23, 95% CI 1.11 to 1.36, p<0.001). According to age and sex, the female subgroup showed elevated HRs for SSNHL in asthma patients. Both the non-smoker and current smoker groups demonstrated higher HRs for SSNHL in asthma patients than in controls. According to alcohol consumption or obesity, the <1 time a week alcohol consumption group and normal weight and severe obesity groups showed higher HRs for SSNHL in asthma patients than in the controls. CONCLUSIONS: Adult asthma patients had a higher risk of SSNHL than the control participants matched for demographic and socioeconomic factors.

Rapidly progressive hearing loss occurring over weeks: review of differential diagnoses.

BACKGROUND: Sudden hearing loss, or progressive hearing loss occurring over months to years, are well-established presentations. However, little is described in the medical literature on how to approach patients presenting with a rapidly progressive hearing loss occurring over weeks. This study aimed to evaluate the clinical significance of patients presenting with rapidly progressive hearing loss. METHODS: A case of rapidly progressive hearing loss occurring over 12 weeks is presented. A PubMed literature review was performed to determine the evidence-based differential diagnoses for rapidly progressive hearing loss. RESULTS: Fifteen causes were identified for rapidly progressive hearing loss: intracranial aetiologies (meningioma, lymphoma, metastatic deposit, cavernous angioma, meningitis, superficial siderosis); paraneoplastic syndrome (small cell lung carcinoma, thymoma); inflammatory or autoimmune disorders (autoimmune inner-ear disease, sarcoidosis, vasculitis, Sjögren's syndrome); infective disorders (syphilis, human immunodeficiency virus); and medication-induced causes. CONCLUSION: Rapidly progressive hearing loss should be considered a 'red flag' symptom that warrants urgent action. Most causes are systemic or sinister in nature, and the patient's hearing loss can potentially be reversed.

[Construction and evaluation of a model for predicting ischemic stroke risk in patients with sudden sensorineural hearing loss].

Objective:To explore the related factors of sudden sensorineural hearing loss complicated with ischemic stroke, construct the risk prediction model, and verify the prediction effect of the model. Methods:A retrospective analysis was performed on 901 sudden sensorineural hearing loss patients hospitalized from January 2017 to December 2020, The patients were divided into the ischemic stroke group（100 cases） and the sudden deafness group（801 cases） according to whether they were complicated with ischemic stroke, The independent correlation factors of sudden deafness complicated with ischemic stroke were screened by univariate analysis and multivariate Logistic regression model, and the risk prediction model and internal verification were established. The original data were randomly divided into the modeling group（631 cases） and the validation group（270 cases） at a 7∶3 ratio. Hosmer-Lemeshow and receiver operating characteristic curve were used to test the goodness of fit and predictive effect of the model, and 270 patients were included again in the application research of the model and to test the prediction effect of the model. Results:The results of single factor analysis showed that age, NEUR, NC, NLR, PLR, TC, HDL-C, BUN, TC-HDL-C, TG/HDL-C, LDL-C/HDL-C, Hcy, FIB and cervical vascular plaque were related factors of sudden sensorineural hearing loss complicated with ischemic stroke（P<0.05）. Age（OR=2.816）, NEUR（OR=2.707）, Hcy（OR=88.833）, FIB（OR=1.389）, TC-HDL-C（OR=1.613）, cervical vascular plaque（OR=2.862） are the independent risk factors of SNHL complicated with ischemic stroke. These 6 factors are used to construct a prediction model. Hosmer-lemeshow test results, the area under the ROC curve of the modeling group was 0.846, P=0.555, Youden index was 0.564, sensitivity was 0.820, and specificity was 0.744. In the validation group, the area under ROC curve was 0.847, P=0.288, Youden index was 0.432, sensitivity was 0.783, and specificity was 0.649. Conclusion:The risk prediction model constructed in this study shows good prediction efficiency. which can provide references for the clinical screening of ischemic stroke risks in patients with sudden sensorineural hearing loss and early interventions in early stage.

[Effect analysis of benign paroxysmal positional vertigo secondary to sudden sensorineural hearing loss].

Objective:To compare the effectiveness of canalith repositioning procedure between BPPV secondary to sudden sensorineural hearing loss（SSNHL） group and idiopathic BPPV（i-BPPV） group. Methods:A retrospective study of patients with evidence of idiopathic BPPV or SSNHL with BPPV. All participants were identified and categorized by using the Dix-Hallpike test and roll test, and then followed by canalith repositioning procedures （CRPs）. The assessment of outcome was conducted at one-week post-CRPs. Results:Sixty-four BPPV patients secondary to sudden sensorineural hearing loss and 328 patients with idiopathic BPPV were included. The posterior canal is the most affected in both group. At one-week post-treatment, the effectiveness of CRPs in the BPPV with SSNHL group was significantly lower than that of the i-BPPV group （P<0.001）. Conclusion:The clinical characteristics of BPPV secondary to SSNHL were like those of i-BPPV, while BPPV secondary to SSNHL was associated with poorer outcomes than i-BPPV when treated by CRPs.

Iron deficiency is associated with poor prognosis in idiopathic sudden sensorineural hearing loss.

OBJECTIVE: The effects of iron deficiency on the prognosis of idiopathic sudden sensorineural hearing loss are unclear. This study aimed to investigate the association between serum iron levels and idiopathic sudden sensorineural hearing loss prognosis and its usefulness as an independent prognostic marker for idiopathic sudden sensorineural hearing loss. METHODS: The audiological and haematological data, including hearing recovery and serum iron levels, of 103 patients with idiopathic sudden sensorineural hearing loss evaluated between 2015 and 2018 were retrospectively analysed. RESULTS: The overall complete recovery rate was 16.5 per cent. Initial higher hearing threshold was associated with poor idiopathic sudden sensorineural hearing loss prognosis. Serum iron levels were significantly higher in the complete recovery group than in the non-complete recovery group (p < 0.05). CONCLUSION: The possibility of complete recovery from idiopathic sudden sensorineural hearing loss was significantly lower with lower serum iron levels, suggesting that the serum iron level might be a novel prognostic marker for idiopathic sudden sensorineural hearing loss.