MR evaluation of encephalic leukoaraiosis in sudden sensorineural hearing loss (SSNHL) patients

Kim

Ann Otol Rhinol Laryngol

et al. 2021

Objectives: To assess the clinical value of periventricular white matter hyperintensity (PWMH) found on brain magnetic resonance imaging (MRI) in patients with sudden sensorineural hearing loss (SSNHL). Methods: In this prospective study, 115 patients who were diagnosed with SSNHL aged between 55 and 75 years were analyzed. All subjects underwent brain MRI and were divided into a PWMH and control groups, depending on the presence of PWMH on MRI. PWMH was subdivided into 3 groups according to severity. Pure-tone average results and hearing gain were compared between the 2 groups before treatment and 2 months after treatment. Hearing improvement was assessed using Sigel’s criteria. Results: A total of 106 patients (43 in the PWMH group and 63 in the control group) finally completed the 2-month follow-up. Average hearing gain in the PWMH group was significantly higher than in the control group (34.8 ± 20.3 and 25.9 ± 20.3, respectively, P = .029). PWMH score 1 showed significantly better hearing levels and hearing gain compared to PWMH score 3 and the control group. Multivariate analysis revealed that younger age, better initial hearing level, and the presence of PVWM score 1 were associated with good recovery. Conclusions: The presence of PWMH score 1 on brain MRI in patients with SSNHL was associated with better treatment response and was a good prognostic factor in a multivariate analysis while the hearing recovery in more severe PWMH (scores 2, 3) was not different from the control group.

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Clinical Value of Periventricular White Matter Hyperintensity on MRI in Sudden Sensorineural Hearing Loss

Kim

Ann Otol Rhinol Laryngol

et al. 2021

“…However, patients with a higher Fazekas score did have a lower probability of complete hearing recovery. By contrast, Dicuonzo et al ( 27 ) found significantly more WMHs in both the deep white matter and the periventricular white matter in patients with iSSNHL compared with controls. However, with only 36 subjects in the study sample, a reliable regression analysis could not be performed.…”

Section: Discussionmentioning

confidence: 83%

Cerebral Small Vessel Disease in Elderly Patients with Sudden Sensorineural Hearing Loss

Oussoren¹,

Leeuwen

Schermer³

et al. 2023

Otol Neurotol

Background The cause of sudden sensorineural hearing loss (SSNHL) is uncertain in a significant number of patients. A vascular etiology has been proposed because SSNHL increases the risk of developing a stroke. Cardiovascular risk factors can cause cerebral small vessel disease (CSVD). The presence of CSVD in turn raises the risk of stroke. Aim The aim of this study was to compare the presence of CSVD and cardiovascular risk factors in elderly patients with idiopathic SSNHL (iSSNHL) to a control cohort. Method Patients with iSSNHL of 50 years and older were compared with a control cohort with patients suspected of trigeminal neuralgia or vestibular paroxysmia. The primary outcome was the difference in the number of white matter hyperintensities using the ordinal Fazekas scale. Secondary outcomes were the presence of brain infarctions on MRI and the difference in cardiovascular risk factors. Results In the SSNHL cohort, Fazekas score 2 was most frequently seen compared with Fazekas 1 in the control cohort. The distribution of Fazekas scores did not differ significantly. The sum of the Fazekas scores were 13,925 and 14,042 for iSSNHL and controls, respectively ( p = 0.908). Brain infarctions were seen in 8 patients with iSSNHL (n = 118) and in 13 patients in the control cohort (n = 118) ( p = 0.361). None of the cardiovascular risk factors were more frequently seen in the iSSNHL cohort. Conclusion Patients with iSSNHL did not exhibit more CSVD on MRI than controls. This result is in contrast with previous literature demonstrating a higher risk of stroke in patients with iSSNHL than in controls. A prospective analysis with a larger study population is therefore warranted.

“…Sudden sensorineural hearing loss (SSNHL) is defined as an acute sensorineural hearing loss occurring within 72 hours and characterized by a hearing loss of 30 dB or greater over in at least three contiguous audiometric frequencies [1]. The incidence of SSNHL varies from 5 to 30 per 100000 people [2,3], and the pathogenesis of SSNHL remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Evidence of Immune disorder served as the main pathogenesis in SSNHL: elevated serum concentration of MMP-9 following treatment was associated with favorable outcomes in patients

Lü

Chen

Dai

et al. 2020

Preprint

Objectives: Sudden sensorineural hearing loss (SSNHL) is an emergency disease with undefined pathogenesis in the otolaryngology department. In our previous study, we found patients with SSNHL had lower serum concentration of Matrix metalloprotease 9 (MMP-9) than healthy controls, and the result was accordant with auto-immune diseases. This study aimed to reveal the correlation between changes in serum MMP-9 concentration following treatment with the outcomes of patients and to provide further evidence that immune disorder was the main pathogenesis of SSNHL. Design, setting, and participants: Fifty-two patients with SSNHL, hospitalized in The First Affiliated Hospital of Chongqing Medical University from March 2019 to August 2019, were enrolled. The serum concentration of MMP-9 was detected by enzyme-linked immunosorbent assay (ELISA). Main outcome measure: The mean concentration of MMP-9 before treatment was compared with the post-treatment concentration by the Mann-Whitney U test. The correlations between favorable outcomes of patients and clinical characteristics were measured with the Chi-squared test and binary multiple logistic regression analysis. Results: In treatment responders, mean serum concentration was elevated from 106.85±41.40ng/ml to 144.03±37.65 ng/ml following treatment (P¡0.001), while in non-responders it decreased from 132.09+-59.21 ng/ml to 106.82+-49.93 ng/ml (P=0.142). Changes in MMP-9 concentration was the only factor associated with favorable outcomes (P=0.008, OR=5.13, 95% CI: 1.53-17.28). Conclusions: Elevated MMP-9 concentration is a potential prognosis biomarker in patients with SSNHL. These findings are in line with auto-immune diseases and indicate immune disorder is mainly pathogenesis in SSNHL. Keywords Sudden sensorineural hearing loss; Matrix metalloprotease 9; Immune disorder; prognosis; Enzyme-linked immunosorbent assay