Perda auditiva neurossensorial súbita idiopática: evolução na presença de hipertensão arterial sistêmica, diabetes melito e dislipidemias

Abstract

Ret rospective study aiming at evaluating the interference of associate diseases in the evolution and prognosis of idiopathic sudden sensorineural hearing loss. Materials and methods:Case-Control Study. Thirty-five patients with idiopathic sudden sensorineural hearing loss were divided in two groups, one of them with associate diseases (hypertension, diabetes mellitus and dyslipidemias), and another one without co-occurrence of such diseases. The groups were evaluated regarding: age, gender, associate diseases, presence of tinnitus, dizziness and ear fullness sensation, presence of cerebral microangiopathy observed in magnetic resonance imaging, ophthalmoscopic findings, treatment onset, improvements in audiometric findings and at speech discrimination tests. Statistical analysis of data was performed. Results:The associate disease group showed higher ages, cerebral microangiopathy observed in magnetic resonance imaging and later improvement in speech discrimination tests, being this difference statistically significant. Conclusion:Idiopathic sudden sensorineural hearing loss co-occurring with hypertension, diabetes mellitus or dyslipidemias, in older patients, is associated with a higher prevalence of cerebral microangiopathy, revealed by magnetic resonance imaging, and associated with a slower hearing recovering, showed by later improvements in speech discrimination tests. Braz J Otorhinolaryngol. 2010;76(3):363-9. ORIGINAL ARTICLE BJORL

Association of Metabolic Syndrome With Sudden Sensorineural Hearing Loss

“…This disruption ultimately impairs oxygen supply in target organs such as the cochlea. 16,17 Correction of dyslipidemia in patients with chronic-phase SSNHL was found to improve hearing, providing further evidence that dyslipidemia is associated with the onset of impaired hearing and its prognosis. 12 Hypertension is a risk factor for SSNHL, with the rate of SSNHL being higher and the recovery rate lower in patients with hypertension than in those without hypertension.…”

“…Dyslipidemia disrupts blood flow through the processes of plaque formation, vascular remodeling, and vascular luminal obstruction, inducing endothelial dysfunction and vascular inflammation and increasing the accumulation of lipid and cholesterol on the intima of vessel walls. This disruption ultimately impairs oxygen supply in target organs such as the cochlea . Correction of dyslipidemia in patients with chronic-phase SSNHL was found to improve hearing, providing further evidence that dyslipidemia is associated with the onset of impaired hearing and its prognosis …”

“…This damage may lead to hemorrhage in the inner ear, resulting in SSNHL. 13,16 Few studies to date have analyzed the association between obesity and SSNHL. Obesity is an independent risk factor for presbycusis, with increasing BMI enhancing the severity of sensorineural hearing loss.…”

“…Because metabolic syndrome has been associated with microangiopathy, it could affect the incidence of and recovery from SSNHL. Most previous studies, however, have analyzed the effects of 1 or 2 factors of metabolic syndrome, such as type 2 diabetes, hypertension, abnormal lipid levels, and obesity, on SSNHL. Studies assessing the association of metabolic syndrome with SSNHL have compared findings in patients with and without SSNHL, limiting the ability to evaluate the association of metabolic syndrome with prognosis in patients with SSNHL .…”

Selected Blood Inflammatory and Metabolic Parameters Predicted Successive Bilateral Sudden Sensorineural Hearing Loss

“…However, in our study, there were significant differences only in the proportion of diabetes but not in hypertension. Many studies suggested that diabetes were more likely to affect the internal environment, which would interfere the development of sudden deafness; however, hypertension was reported to partially restrict the reaction to therapy or recovery [17].…”