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1.
PLoS One ; 19(5): e0302447, 2024.
Article in English | MEDLINE | ID: mdl-38713651

ABSTRACT

OBJECTIVE: Vascular disease like small-vessel disease (SVD) is the most likely cause among the potential causes of Sudden sensorineural hearing loss (SSNHL). Understanding the relationship between SVD and SSNHL is crucial for developing effective prevention and treatment strategies. To confirm the relationship between SVD and SSNHL, the effect of SVD is confirmed by focusing on the duration and recurrence of SSNHL. METHODS: This article reports a retrospective observational study that investigated the relationship between SVD and SSNHL using the South Korea Health Insurance Review and Assessment Service (HIRA) database from 2010 to 2020. This retrospective observational study included 319,569 SSNHL patients between 2010 and 2020. RESULTS: Participant demographics were controlled using Propensity Score Matching. The hazard ratios (HR) for the effect of SVD on the duration of SSNHL were 1.045 for the group with SVD before the onset of SSNHL and 1.234 for the group with SVD after the onset of SSNHL. SVD was statistically significant for the recurrence of SSNHL, with an odds ratio of 1.312 in the group with SVD compared to the group without SVD. The HR for the period until a recurrence in the group with SVD was 1.062. CONCLUSIONS: The study identified SVD as a possible cause of SSNHL and found that the duration of SSNHL increased only in the presence of SVD. SVD also affected the recurrence of SSNHL, with the recurrence rate being 1.312 times higher in the group with SVD.


Subject(s)
Hearing Loss, Sensorineural , Hearing Loss, Sudden , Humans , Male , Hearing Loss, Sensorineural/etiology , Hearing Loss, Sensorineural/epidemiology , Hearing Loss, Sensorineural/complications , Female , Middle Aged , Retrospective Studies , Republic of Korea/epidemiology , Hearing Loss, Sudden/etiology , Hearing Loss, Sudden/epidemiology , Adult , Aged , Risk Factors , Recurrence , Young Adult , Propensity Score
2.
Am J Otolaryngol ; 45(3): 104234, 2024.
Article in English | MEDLINE | ID: mdl-38430842

ABSTRACT

BACKGROUND: Syphilis is a sexually transmitted disease caused by the spirochete Treponema pallidum, whose incidence has increased significantly in recent years. Some patients may develop sudden hearing loss (SHL) against the background of otosyphilis. OBJECTIVES: The objective of our study was to determine whether routine lues serology is useful in patients presenting with sudden hearing loss. METHODS: For this purpose, all cases of SHL treated in our hospital during a period of 6 years were propectively collected. The frequency of positivity for syphilis in these patients, the treatment received, and their evolution were determined. RESULTS: Of the total number of patients evaluated during that period, 71 underwent serological screening for syphilis, of whom 2 (2.8 %) presented positive screening antibodies. In one of them, the RPR was normal and had been treated with lues a few years before. After treatment there was no improvement. The other patient, diagnosed with otosyphilis with unconfirmed suspected neurological disease, showed normalization of hearing after specific treatment. CONCLUSIONS: Since it is a potentially curable disease, despite the low overall frequency of syphilis in patients with SHL it is advisable to perform serological screening for syphilis in high risk patients (e.g., incarceration, multiple recent sexual partners, men who have sex with men) or atypical clinical presentation (e.g., concurrent neuropathies).


Subject(s)
Hearing Loss, Sudden , Syphilis , Humans , Hearing Loss, Sudden/etiology , Hearing Loss, Sudden/microbiology , Hearing Loss, Sudden/diagnosis , Syphilis/complications , Syphilis/diagnosis , Male , Adult , Middle Aged , Female , Syphilis Serodiagnosis , Retrospective Studies , Treponema pallidum/immunology , Treponema pallidum/isolation & purification
3.
World Neurosurg ; 185: e549-e554, 2024 May.
Article in English | MEDLINE | ID: mdl-38382763

ABSTRACT

OBJECTIVE: This study aims to determine the prevalence of vestibular schwannoma (VS) among patients presenting with sudden hearing loss (SHL) and to characterize the clinical features of individuals diagnosed with both VS and SHL. METHODS: We conducted an observational retrospective review at a tertiary referral center, spanning a 30-year period, focusing on patients diagnosed with SHL where VS was confirmed as the underlying cause. We included patients meeting these criteria while excluding those lacking imaging or with a pre-existing diagnosis of VS. We evaluated the audiological characteristics at the time of diagnosis and assessed clinical outcomes following treatment. RESULTS: Among the 403 patients presenting with SHL during the study period, 9 (2.2%) were diagnosed with VS, aged between 25 and 72 years. Although audiometric profiles varied, high-frequency hearing loss predominated, mostly categorized as mild to moderate. Six patients (66%) had Koos grade I-II schwannomas. Only 2 patients achieved complete hearing recovery post-treatment, while 4 showed no improvement. CONCLUSIONS: VS is a rare etiology of SHL, accounting for slightly over 2% of cases. Its symptomatology, severity, and audiometric patterns do not significantly differ from SHL caused by other factors. Tumor size does not correlate with hearing characteristics. Treatment modalities resemble those for other SHL cases, and hearing improvement does not obviate the necessity for follow-up magnetic resonance imaging (MRI) scans.


Subject(s)
Hearing Loss, Sudden , Neuroma, Acoustic , Humans , Neuroma, Acoustic/complications , Neuroma, Acoustic/diagnostic imaging , Middle Aged , Female , Male , Adult , Hearing Loss, Sudden/etiology , Aged , Retrospective Studies , Audiometry
4.
Sci Rep ; 14(1): 2910, 2024 02 05.
Article in English | MEDLINE | ID: mdl-38316838

ABSTRACT

Whether cervical spondylosis (CS) is a risk factor for sudden sensorineural hearing loss (SSNHL) remains unclear. This study used national population-based data to investigate the risk of SSNHL in patients with CS in Taiwan of different ages and sexes. This study used data covering 2 million people in Taiwan, which were obtained from the National Health Insurance Research Database. The data that support the findings of this study are available from National Health Insurance Research Database but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the corresponding authors upon reasonable request and with permission of National Health Insurance Research Database. This retrospective cohort study enrolled 91,587 patients with a newly diagnosed CS between January 2000 and December 2018. Case and control cohorts were matched 1:1 according to age, sex, and comorbidities. SSNHL incidence rate and risk were compared between the groups. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). The mean follow-up period was 8.80 (SD = 4.12) and 8.24 (SD = 4.09) years in the CS and control cohorts, respectively. The incidence rate of SSNHL in the CS cohort (85.28 per 100 000 person-years) was 1.49-fold significantly higher than that in the non-CS cohort (57.13 per 100,000 person-years) (95% CI 1.32-1.68, P < .001). After age, sex, and selected comorbidities were adjusted for, CS exhibited an independent risk factor for SSNHL (adjusted HR = 1.52; 95% CI 1.34-1.71, P < .001). An age-stratified analysis in this study demonstrated a strong and highly significant association between CS and SSNHL in patients aged < 35 years (IRR = 2.28, 95% CI 1.18-4.39, P = .013). This large-scale Taiwanese-population-based retrospective study found that CS was associated with an increased risk of SSNHL. Acute hearing loss in patients with CS, particularly at a young age, should be carefully evaluated, and prompt treatment for SSNHL should be initiated.


Subject(s)
Hearing Loss, Sensorineural , Hearing Loss, Sudden , Humans , Retrospective Studies , Comorbidity , Risk Factors , Hearing Loss, Sensorineural/etiology , Hearing Loss, Sensorineural/complications , Hearing Loss, Sudden/etiology , Hearing Loss, Sudden/complications
6.
Ann Otol Rhinol Laryngol ; 133(4): 411-417, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38186353

ABSTRACT

OBJECTIVES: To investigate the role of normal weight central obesity (NWCO) in the prognosis of sudden sensorineural hearing loss (SSNHL). METHODS: We retrospectively investigated 807 cases of SSNHL from January of 2008 to August of 2019 from the Department of Otorhinolaryngology at Kaohsiung Medical University Hospital in southern Taiwan. We analyzed the association between overweight and obesity, NWCO, and the prognosis of SSNHL. The demographic and clinical characteristics, audiometry results, and outcomes were also reviewed. RESULTS: The nonobese (body mass index [BMI] < 24 kg/m2) and overweight and obese groups (BMI ≥ 24 kg/m2) comprised 343 (42.50%) and 464 (57.50%) patients, respectively. The favorable prognosis rates in the nonobese and the overweight and obese groups were 45.48% and 45.91%, respectively, without a significant difference (P = .9048). Multivariate logistic regression revealed that BMI (adjusted odds ratio [aOR] = 1.00, 95% CI = 0.948-1.062, P = .9165) was not significantly associated with SSNHL recovery. The normal weight noncentral obesity (NWNCO) and NWCO groups comprised 266 (77.55%) and 77 (22.45%) patients, respectively, and had favorable prognosis rates of 48.50% and 35.06%, respectively. The difference between the groups was significant (P = .0371). Multivariate logistic regression analysis revealed that NWCO (aOR = 2.51, 95% CI = 1.292-5.019, P = .0075) was significantly associated with SSNHL recovery. CONCLUSIONS: NWCO may significantly affect the prognosis of SSNHL.


Subject(s)
Hearing Loss, Sensorineural , Hearing Loss, Sudden , Humans , Obesity, Abdominal/complications , Obesity, Abdominal/epidemiology , Prognosis , Retrospective Studies , Risk Factors , Overweight , Obesity/complications , Obesity/epidemiology , Hearing Loss, Sudden/diagnosis , Hearing Loss, Sudden/etiology , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/epidemiology , Hearing Loss, Sensorineural/etiology
7.
Laryngoscope ; 134(3): 1417-1425, 2024 Mar.
Article in English | MEDLINE | ID: mdl-37737442

ABSTRACT

OBJECTIVES: The aims of this study were to investigate the cumulative recurrence rate of SSNHL and to determine association between comorbidities and recurrence of SSNHL by comparing patients with and without recurrence. METHODS: Using the National Health Insurance Claims Database (NHICD) from 2009 to 2020, we conducted a population-based study. We only enrolled patients whose records showed a prescription for steroid and audiometry findings as well as an appropriate diagnostic code. Recurrence of SSNHL was defined as an episode of SSNHL greater than or equal to 3 months after the first episode of SSNHL. We compared the recurrence rate of SSNHL according to age and number of SSNHL recurrences. We also explored comorbidities including autoimmune, metabolic, chronic renal diseases, cancer, and migraine associated with recurrent SSNHL. RESULTS: A total of 257,123 patients were identified. We found that 6.7% (17,270/257,123) of the patients had at least one recurrence of SSNHL. The recurrence rate increases with the number of recurrences and over time. The incidence per 100,000 people tended to increase with age, and the recurrence rate appeared to decrease with age. We found an increase in the incidence of ankylosing spondylitis (AS) and a decrease in the incidence of type 2 diabetes mellitus (T2DM), myocardial infarction (MI), and hemorrhagic stroke in patients with recurrence. CONCLUSION: For patients with recurrence or AS, considerable efforts should be made to prevent recurrence. As SSNHL is an emergent otologic condition, when symptoms occur, they should receive immediate treatment. Additional well-designed population-based studies are required to generalize our results. LEVEL OF EVIDENCE: 3 Laryngoscope, 134:1417-1425, 2024.


Subject(s)
Diabetes Mellitus, Type 2 , Hearing Loss, Sensorineural , Hearing Loss, Sudden , Humans , Diabetes Mellitus, Type 2/complications , Hearing Loss, Sensorineural/etiology , Hearing Loss, Sensorineural/complications , Hearing Loss, Sudden/epidemiology , Hearing Loss, Sudden/etiology , Comorbidity , Incidence , Retrospective Studies
8.
Laryngoscope ; 134(5): 2372-2376, 2024 May.
Article in English | MEDLINE | ID: mdl-37987243

ABSTRACT

OBJECTIVES: This study investigated the association between sudden sensorineural hearing loss (SSNHL) and the risk of cardio-cerebrovascular disease (CCVD) among older adults in South Korea. METHODS: Data from 38,426 patients in the Korean National Health Insurance Service-Senior Cohort from 2002 to 2019 were collected. The risk of CCVD includes both stroke and acute myocardial infarction. Propensity score matching (1:1) was used to identify pairs of individuals with and without SSNHL (n = 19,213 for cases and controls). Cox proportional hazards regression models were used to analyze the associations between variables. RESULTS: Patients with SSNHL had a higher risk of CCVD (hazard ratio [HR] = 1.17, 95% confidence interval [CI] = 1.11-1.24) compared to those without. The risk of CCVD was higher among those who experienced a stroke than those who did not (HR = 1.17 95% CI = 1.10-1.25). Compared to their matched controls, patients with SSNHL were 1.69 times (HR = 1.69 CI = 1.46-1.94) more likely to have CCVD during the first 12 months of the follow-up period. CONCLUSION: Older patients with SSNHL are at an increased risk of CCVD. Hence, a more attentive approach featuring aggressive monitoring of patients with SSNHL is required to lessen their risk of CCVD. LEVEL OF EVIDENCE: 3 Laryngoscope, 134:2372-2376, 2024.


Subject(s)
Cerebrovascular Disorders , Hearing Loss, Sensorineural , Hearing Loss, Sudden , Stroke , Humans , Aged , Follow-Up Studies , Incidence , Cerebrovascular Disorders/complications , Cerebrovascular Disorders/epidemiology , Stroke/complications , Stroke/epidemiology , Hearing Loss, Sensorineural/complications , Hearing Loss, Sensorineural/epidemiology , Hearing Loss, Sudden/etiology , Hearing Loss, Sudden/complications , Risk Factors
9.
Clin Otolaryngol ; 49(1): 117-123, 2024 Jan.
Article in English | MEDLINE | ID: mdl-37864503

ABSTRACT

OBJECTIVE: To compare the clinical features of sudden hearing loss (SHL) in patients with and without endolymphatic hydrops (EH), and to investigate the association between SHL with EH and Ménière's disease (MD). METHODS: The clinical data of 63 SHL patients with first symptoms were evaluated retrospectively. Patients were separated into two groups based on the results of gadolinium-enhanced magnetic resonance imaging: EH and non-EH groups. Independent sample t-test and U-test were used to compare groups for continuous variables, and the chi-squared test, corrected chi-squared test and Bonferroni correction test were used to compare groups for binary and ordinal variables. The binary logistic regression model was utilised for univariate and multivariate analysis of follow-up patient prognosis. RESULTS: The EH and non-EH groups contained 32 and 31 patients, respectively. The EH group had a higher prevalence of low-tone descending hearing loss. Fifty-one patients were followed for more than 2 years. In the EH group, 11 and 15 patients were diagnosed with sudden sensorineural hearing loss (SSNHL) and MD, respectively, while in the non-EH group, 24 patients were diagnosed with SSNHL and only one with MD. EH, low-tone descending hearing loss and vertigo were risk factors for the diagnosis of MD in a subgroup univariate regression analysis of patients experiencing SHL. EH was found to be a risk factor for the progression of SHL into MD in a multifactor regression analysis. CONCLUSIONS: Patients with SHL who have EH are more likely to present with low-tone descending hearing loss. EH is a risk factor for the subsequent development of MD.


Subject(s)
Endolymphatic Hydrops , Hearing Loss, Sensorineural , Hearing Loss, Sudden , Meniere Disease , Humans , Meniere Disease/complications , Meniere Disease/diagnostic imaging , Gadolinium , Hearing Loss, Sudden/diagnostic imaging , Hearing Loss, Sudden/etiology , Retrospective Studies , Endolymphatic Hydrops/complications , Endolymphatic Hydrops/diagnostic imaging , Hearing Loss, Sensorineural/diagnostic imaging , Hearing Loss, Sensorineural/etiology , Magnetic Resonance Imaging/methods
10.
Eur Arch Otorhinolaryngol ; 281(5): 2373-2381, 2024 May.
Article in English | MEDLINE | ID: mdl-38123733

ABSTRACT

PURPOSE: To determine the prevalence of perilymphatic fistula (PLF) in sudden-onset sensorineural hearing loss (SSNHL) patients by employing the Cochlin-tomoprotein (CTP) detection test, a specific diagnostic marker for perilymph. We also analyzed the clinical characteristics associated with hearing outcomes in this cohort. METHODS: A total of 74 eligible patients were prospectively enrolled. Following myringotomy, middle ear lavage (MEL) samples underwent the CTP test to identify perilymph leakage. Intratympanic dexamethasone (IT-DEX) therapy was administered, and hearing outcomes were assessed. Control groups comprised patients with chronic otitis media (n = 40) and non-inflammatory middle ears (n = 51) with concurrent MEL sample collection. RESULTS: CTP was positive in 16 (22%) patients. No control samples showed positive results. Multiple regression analysis indicated that age and pre-treatment hearing levels significantly contributed to the CTP value. We found a positive correlation between CTP values, age, and pre-treatment pure-tone averages. Notably, CTP values in SSNHL cases aged 60 and above were significantly higher than in those below 60 years. Patients with positive CTP had significantly worse recovery rates after IT-DEX treatment. CONCLUSION: This study is the first prospective investigation demonstrating a positive relationship between CTP values, age, and hearing severity in SSNHL, indicating that PLF might be the essential cause of SSNHL, particularly in the elderly. Our findings suggest that IT-DEX may be less effective for PLF-associated SSNHL. Future research could reveal that PLF repair surgery is a viable treatment strategy for SSNHL. This study was registered under the UMIN Clinical Trials Registry (UMIN000010837) on 30/May/2013.


Subject(s)
Fistula , Hearing Loss, Sensorineural , Hearing Loss, Sudden , Vestibular Diseases , Aged , Humans , Prevalence , Prospective Studies , Vestibular Diseases/diagnosis , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/epidemiology , Hearing Loss, Sensorineural/etiology , Hearing Loss, Sudden/diagnosis , Hearing Loss, Sudden/epidemiology , Hearing Loss, Sudden/etiology , Treatment Outcome , Hearing , Fistula/surgery , Biomarkers
12.
Am J Otolaryngol ; 45(1): 104087, 2024.
Article in English | MEDLINE | ID: mdl-37839178

ABSTRACT

BACKGROUND: Functional hearing loss can be due to an auditory manifestation of functional neurological disorder, previously known as conversion disorder. METHODS: This is a case series of 3 pediatric patients with a diagnosis of idiopathic SSNHL who ultimately were found to have functional neurological disorder. RESULTS: Average age was 12.7 years at presentation (range 10-14 years). All three patients underwent invasive interventions prior to their initial clinic visit. All patients demonstrated profound SNHL on behavioural audiogram, but normal otoacoustic emissions (OAE) and auditory brainstem response testing. With counselling, both patients demonstrated significant hearing improvement. CONCLUSIONS: Early use of OAE's in the workup of SSNHL can avoid unnecessary and potentially harmful therapies and expedite access to counselling services which may help lead to symptom resolution.


Subject(s)
Hearing Loss, Sensorineural , Hearing Loss, Sudden , Humans , Child , Adolescent , Hearing Loss, Sudden/diagnosis , Hearing Loss, Sudden/etiology , Hearing Loss, Sudden/therapy , Evoked Potentials, Auditory, Brain Stem , Hearing Tests , Otoacoustic Emissions, Spontaneous
13.
J Int Adv Otol ; 19(6): 468-471, 2023 Nov.
Article in English | MEDLINE | ID: mdl-38088318

ABSTRACT

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.


Subject(s)
Bell Palsy , Facial Paralysis , Hearing Loss, Sensorineural , Hearing Loss, Sudden , Neuroma, Acoustic , Humans , Neuroma, Acoustic/complications , Neuroma, Acoustic/epidemiology , Neuroma, Acoustic/diagnosis , Facial Paralysis/epidemiology , Retrospective Studies , Hearing Loss, Sensorineural/etiology , Hearing Loss, Sensorineural/complications , Hearing Loss, Sudden/etiology , Hearing Loss, Sudden/complications , Bell Palsy/complications , Bell Palsy/epidemiology , Republic of Korea/epidemiology
14.
J Int Adv Otol ; 19(6): 478-484, 2023 Nov.
Article in English | MEDLINE | ID: mdl-38088320

ABSTRACT

BACKGROUND: Labyrinthitis is an inner ear disorder of unknown incidence, characterized by sudden hearing loss and concurrent vertigo. Cohort studies of patients diagnosed with labyrinthitis are nonexistent. This study aims to describe the clinical characteristics and prognosis of patients diagnosed with idiopathic labyrinthitis. METHODS: Patients with labyrinthitis in the absence of a clear viral, bacterial, or autoimmune pathogenesis were retrospectively identified from electronic patient files. Symptoms at presentation and results from vestibular testing were retrieved. The 9-item Vestibular Activity Avoidance Instrument, administered during follow-up interviews by telephone, was used to assess the presence of persistent balance problems and activity avoidance behavior. RESULTS: Sixty-one patients with idiopathic labyrinthitis were included. All patients had vestibular weakness at presentation. After a median of 61 months of follow-up (interquartile range 81), 72.5% of patients still experienced balance problems. Subjective hearing recovery only occurred in 20% of cases. CONCLUSION: Patients presenting in a tertiary dizziness clinic with idiopathic labyrinthitis have a poor prognosis for both hearing and balance function impairment. Prospective observational cohorts are required to establish objectifiable vestibular and audiological follow-up data.


Subject(s)
Hearing Loss, Sudden , Labyrinthitis , Vestibule, Labyrinth , Humans , Hearing Loss, Sudden/diagnosis , Hearing Loss, Sudden/etiology , Labyrinthitis/diagnosis , Prognosis , Retrospective Studies , Vertigo/etiology , Vertigo/complications
15.
Acta Otolaryngol ; 143(11-12): 951-957, 2023.
Article in English | MEDLINE | ID: mdl-38108643

ABSTRACT

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.


Subject(s)
Ear, Inner , Facial Paralysis , Hearing Loss, Sudden , Neuroma, Acoustic , Humans , Neuroma, Acoustic/diagnosis , Neuroma, Acoustic/diagnostic imaging , Ear, Inner/pathology , Vertigo/diagnosis , Magnetic Resonance Imaging/methods , Hearing Loss, Sudden/etiology , Hearing Loss, Sudden/complications , Syndrome , Facial Paralysis/complications , Cerebellopontine Angle/diagnostic imaging , Cerebellopontine Angle/pathology
16.
Medicine (Baltimore) ; 102(51): e36691, 2023 Dec 22.
Article in English | MEDLINE | ID: mdl-38134117

ABSTRACT

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.


Subject(s)
Arterial Occlusive Diseases , Deafness , Hearing Loss, Sudden , Ischemic Stroke , Vertebrobasilar Insufficiency , Male , Humans , Middle Aged , Hearing Loss, Bilateral/etiology , Ischemic Stroke/complications , Vertebrobasilar Insufficiency/complications , Vertebrobasilar Insufficiency/diagnosis , Hearing Loss, Sudden/etiology , Hearing Loss, Sudden/complications , Arterial Occlusive Diseases/complications , Arteries
17.
Medicina (Kaunas) ; 59(11)2023 Nov 09.
Article in English | MEDLINE | ID: mdl-38004026

ABSTRACT

Fibrinogen and homocysteine (HCY) are molecules known to play a role in vascular homeostasis, and their blood levels are often elevated in patients with metabolic syndrome. Recent evidence suggests that sudden sensorineural hearing loss (SSHL) may have a vascular origin. This has led many authors to advocate that fibrinogen, homocysteine, and metabolic syndrome (MetS) may play a direct role in SSHL. The aim of this brief review is to examine the role and influence of these molecules and MetS on the mechanisms of SSHL. Elevated fibrinogen levels have been associated with a worse prognosis in SSHL, possibly due to increased blood viscosity and decreased blood flow. Similarly, HCY has been associated with vascular damage, particularly in hyperhomocysteinemia, although the exact association with SSHL remains controversial. MetS has been demonstrated to function both as a causative factor and as a contributor to poorer recovery in cases of SSHL. However, although some studies suggest a possible role for these biomarkers and MetS in the prognosis and treatment of SSHL, specific therapeutic and preventive strategies based solely on these factors have yet to be developed. Given their potential role in prognosis and treatment and the global epidemic of metabolic syndrome, this issue needs to be analyzed comprehensively. Thus, further quality studies need to be conducted, even though it is difficult to determine the actual impact of MetS on the development of SSHL, as it is a multifactorial disease affecting multiple organs.


Subject(s)
Hearing Loss, Sensorineural , Hearing Loss, Sudden , Metabolic Syndrome , Humans , Fibrinogen/metabolism , Metabolic Syndrome/complications , Homocysteine , Hearing Loss, Sensorineural/etiology , Hearing Loss, Sudden/etiology , Hearing Loss, Sudden/therapy
18.
J Int Adv Otol ; 19(5): 435-439, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37789633

ABSTRACT

Carbon monoxide (CO) can cause "irreversible" severe-to-profound sensorineural hearing loss. However, there are few reports of detailed hearing test results. Here, we report a case of acute sensorineural hearing loss caused by acute CO poisoning with partial hearing recovery, evaluated by a detailed hearing examination. A 25-year-old woman was brought to the emergency department for attempted suicide. On admission, her consciousness was impaired, and she was treated for severe CO poisoning, including using hyperbaric-oxygen therapy. After regaining consciousness, symptoms of hearing loss and tinnitus were discovered, and a detailed audiological examination revealed bilateral hearing loss, suggesting cochlear damage. Steroids were systemically administered, and her hearing impairment was partially resolved. Sensorineural hearing loss caused by acute CO poisoning includes cochlear pathology and may be partially treatable. The early evaluation of hearing in patients with severe CO poisoning is advisable for early treatment.


Subject(s)
Carbon Monoxide Poisoning , Deafness , Hearing Loss, Sensorineural , Hearing Loss, Sudden , Hyperbaric Oxygenation , Humans , Female , Adult , Carbon Monoxide Poisoning/complications , Carbon Monoxide Poisoning/diagnosis , Carbon Monoxide Poisoning/therapy , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/etiology , Hearing Loss, Sensorineural/therapy , Hearing Loss, Sudden/diagnosis , Hearing Loss, Sudden/etiology , Hearing Loss, Sudden/therapy
19.
Immun Inflamm Dis ; 11(10): e1055, 2023 10.
Article in English | MEDLINE | ID: mdl-37904686

ABSTRACT

BACKGROUND: The etiology and pathophysiological mechanisms of sudden sensorineural hearing loss (SSNHL) remain unclear, but it is generally believed to be associated with viral infections, vascular diseases, and autoimmune disorders. Considering that coronavirus disease 2019 (COVID-19) is promising candidates for SSNHL, we studied the immune cells changes by COVID-19 in patients with SSNHL. METHODS: We collected data from 47 patients with SSNHL and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive. Patients were divided into ineffective or effective groups based on the degree of hearing recovery at discharge. Clinical information was collected and processed for both groups. Logistic regression models were used to determine the risk factors for an unfavorable prognosis in COVID-19-related SSNHL. Receiver operating characteristic (ROC) curves were used to estimate the predictive value. RESULTS: There was statistically significant difference in C-reactive protein (CRP), auditory curve, degree decline, pretreatment hearing, posttreatment hearing, systolic blood pressure, diastolic blood pressure, total bilirubin, neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), indirect-bilirubin and platelet count between groups (p < 0.05). In the logistic regression model, high levels of SII and NLR were associated with treatment ineffectiveness, pre- and postcorrectively (both, p < 0.05). And ROC curve analysis showed higher AUC of 0.765 for SII, 0.697 for NLR,0.681 for CRP, and 0.553 for platelet-to-lymphocyte ratio (PLR) in predicting treatment outcomes. CONCLUSION: The prognosis of COVID-19-related SSNHL was associated with inflammation. SII, NLR and CRP could serve as predictive markers of unfavorable outcomes in COVID-19-related SSNHL. SII may be considered an independent risk factor for poor prognosis in COVID-19-related SSNHL.


Subject(s)
COVID-19 , Hearing Loss, Sensorineural , Hearing Loss, Sudden , Humans , COVID-19/complications , SARS-CoV-2 , Biomarkers , Inflammation , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/etiology , Hearing Loss, Sudden/diagnosis , Hearing Loss, Sudden/etiology , Bilirubin
20.
Eur Arch Otorhinolaryngol ; 280(12): 5167-5176, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37594544

ABSTRACT

INTRODUCTION: COVID-19 vaccines are essential to prevent complications and reduce the burden of SARS-CoV-2. However, these vaccines showed side effects such as fatigue, pain, fever, and rarely hearing loss. In this review, we aim to summarize studies investigating hearing loss following COVID-19 vaccination and try to find the possible association and risk factors for this hazardous complication. METHODS: We performed a comprehensive search of five electronic databases (PubMed, Scopus, Web of Science, google scholar, Cochrane) from inception until 9 October 2022. We finally included 16 studies after the first and second scans. We used SPSS to analyze the extracted data. RESULTS: A total of 630 patients were identified, with a mean age of 57.3. Of the patients, 328 out of 609 vaccinated patients took the Pfizer-BioNTech BNT162b2 vaccine, while 242 (40%) took the Moderna COVID-19 vaccine. The mean time from vaccination to hearing impairment was 6.2, ranging from a few hours to one month after the last dose. The results found a significant difference between vaccine types in terms of incidence and prognosis of the condition, while they showed that the number of doses prior to the onset had no significance. CONCLUSION: SNHL has been reported in a small number of people who have received the COVID-19 vaccine, but it is unclear at this time whether the vaccine is directly causing this condition. However, the COVID-19 vaccine has been demonstrated to be safe and effective in preventing illness, and the benefits of vaccination are significant compared to any potential risks. PROTOCOL REGISTRATION: The protocol of this study was registered on Prospero CRD42022367180.


Subject(s)
COVID-19 , Deafness , Hearing Loss, Sudden , Humans , Middle Aged , Hearing Loss, Sudden/etiology , COVID-19 Vaccines/adverse effects , 2019-nCoV Vaccine mRNA-1273 , BNT162 Vaccine , COVID-19/epidemiology , COVID-19/prevention & control , SARS-CoV-2 , Vaccination/adverse effects
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