Comorbid diabetes or hypercholesterolemia may indicate a smaller probability of major or moderate PTA improvement for patients with ISSNHL.

The complication rate for COM remained steady in the past 10 years, regardless of the overall reduction in the prevalence of COM with use of antibiotics. A high index of suspicion and imaging studies for early identification are recommended. Pneumococcal vaccination is recommended, particularly for the elderly patients who are treated conservatively because of relatively poor general health conditions.

ObjectivesThis study aims to test the hypothesis that gallstone disease (GSD) is a risk factor for the development of idiopathic sudden sensorineural hearing loss (ISSNHL). Research has shown risks of cardiovascular and cerebrovascular events in patients with GSD; however, well-conducted English studies on the association between GSD and the development of ISSNHL are lacking.Design and settingRetrospective cohort study using the Taiwan Longitudinal Health Insurance Database.ParticipantsWe compared 26 449 patients diagnosed with GSD between 1 January 2001 and 31 December 2007, with 52 898 age-matched, gender-matched and comorbidities propensity scores-matched controls.Outcome measuredWe followed each patient until the end of 2011 and evaluated the incidence of ISSNHL for at least 4 years after the initial GSD diagnosis.ResultsThe incidence of ISSNHL was 1.42 times higher in the GS cohort than in the non-GS cohort (9.27 vs 6.52/10 000 person-years). Using Cox proportional hazard regressions, the adjusted HR was 1.44 (95% CI 1.19 to 1.74). In the cohort of patients with GSD who needed a cholecystectomy, 37 patients suffered from ISSNHL. Among those patients, 31 (83.7%) patients sustained ISSNHL before cholecystectomy and 6 (16.2%) patients sustained ISSNHL after cholecystectomy.ConclusionsA diagnosis of GSD may be an independent risk for ISSNHL. This finding suggests that an underlying vascular and inflammatory mechanism may contribute to the development of ISSNHL. Physicians may want to counsel patients with GSD to seek medical attention if they have hearing impairments, because patients may be at an increased risk of developing ISSNHL.