Sudden Sensorineural Hearing Loss: A Review

Tripathi, Priyanshi; Deshmukh, Prasad

doi:10.7759/cureus.29458

Cited by 19 publications

(17 citation statements)

References 32 publications

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“…The inner ear is especially sensitive to the blood supply, which is regulated by adrenergic receptors, plasma viscosity, and platelet function ( 2 ). Supplied by two tiny arteries at the end, the cochlea is vulnerable to damage due to several important factors, such as the small diameter of the arteries and the absence of arterial branches ( 10 ). The obstruction of blood flow of the labyrinthine artery or its origins for more than 1 min would lead to irreversible damage to audio-vestibular function ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

Cardiocerebrovascular risk in sensorineural hearing loss: results from the National Health and Nutrition Examination Survey 2015 to 2018

Zheng

Cheng

et al. 2023

Front. Neurol.

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ObjectiveThis study aims to determine whether the risks of cardiocerebrovascular disease are relevant to sensorineural hearing loss (SNHL) based on a national database.MethodsA total of 1,321 participants aged from 18 to 69 with complete data including medical history and audiometry from the NHANES database (2015–2018) were analyzed. All included participants had available hearing data and the average thresholds of the hearing data were measured and calculated as low-frequency pure-tone average (LFPTA; 500, 1,000, and 2,000 Hz) and high-frequency pure-tone average (HFPTA; 3,000, 4,000, 6,000, and 8,000 kHz). SNHL was defined as an average pure tone of more than or equal to 20 dB in at least one better ear. Multivariable models to assess the association between cardiocerebrovascular risks and SNHL were used in this study.ResultsThe prevalence of stroke was 1.6% in individuals with SNHL and 0.4% in individuals without SNHL (p = 0.023). A higher cardiovascular risk score was observed in SNHL patients compared to participants without SNHL (1.58 vs. 0.90, p < 0.001). Stroke was associated with a 3.67-fold increase in the risk of SNHL (95% CI: 1.12–12.00, p = 0.032) in univariable logistic regression, and the association (OR = 4.22, 95%CI = 1.28–13.93, p = 0.020) remained significant after adjusting for several covariates. Multivariable logistic regression models indicated a positive correlation between cardiovascular risk and SNHL (OR = 1.66, 95% CI = 1.40–1.96, p < 0.001), but no significant relationship was shown with all covariates adjusted. However, significant associations were found between SNHL and both age and sex in both univariable and multivariable logistic regression models.ConclusionOur findings suggested that a higher cardiocerebrovascular risk burden was associated with an increased risk of SNHL, and the relationship may be influenced by age and sex. Future longitudinal studies are needed to investigate the mechanistic and pathologic vascular hypothesis of SNHL.

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Section: Introductionmentioning

confidence: 99%

Cardiocerebrovascular risk in sensorineural hearing loss: results from the National Health and Nutrition Examination Survey 2015 to 2018

Zheng

Cheng

et al. 2023

Front. Neurol.

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“…The cofactors including the average age, gender distribution, and the distribution of auditory types and hearing degrees in the three groups were inequivalent, so we analyzed the efficacy of SSNHL patients with different audiogram-type SSNHL. It is reported that comparing patients with other types of audiometric curves, patients with low-frequency hearing loss may have a better prognosis ( 1 , 17 ). In 2015, a Chinese multicenter study showed that the curative rate of patients with low-frequency hearing loss could be as high as 90.73%, whereas, in patients with high-frequency hearing loss, the number was only 65.96% ( 18 ).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of intratympanic or postauricular subperiosteal corticosteroid injection combined with systemic corticosteroid in the treatment of sudden sensorineural hearing loss: A prospective randomized study

et al. 2023

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ObjectivesThis study aimed to investigate the efficacy and safety of intratympanic or postauricular subperiosteal glucocorticoid injection combined with systemic glucocorticoid in the treatment of sudden sensorineural hearing loss (SSNHL).MethodsThis study is a prospective randomized controlled study. This study included unilateral SSNHL patients who were hospitalized in our department between January 2020 and June 2021. Patients were randomly divided into three groups (groups A, B, and C). Patients in group A were treated with an intratympanic corticosteroid injection combined with systemic corticosteroid treatment, and patients in group B received a postauricular corticosteroid injection combined with systemic corticosteroid treatment. Patients in group C (control group) were treated with systemic corticosteroid alone. The case number of groups A, B, and C was 311, 375, and 369, respectively.ResultsThere was no significant difference in gender distribution, the proportion of left and right affected ears, and the average interval from onset to treatment among the three groups (P > 0.05). However, there were significant differences in their average age, distribution of audiogram type, and hearing loss levels among them (P < 0.01). Our study shows that there was no significant difference in average hearing threshold improvement before and after treatment in the three groups (P > 0.05). Regarding the complications, in group A, 33 patients (10.6%) had a transient vertigo attack during tympanic injection, which lasted for ~1–3 min. In group B, 20 patients (6.43%) complained of pain at the injection site, which disappeared after 1–3 days. No other complications occurred in all the other patients.ConclusionThe addition of intratympanic or postauricular corticosteroid to systemic steroids did not result in a significant effect on hearing recovery in SSNHL. No obvious complications occur in SSNHL patients treated with intratympanic injection or postauricular injection of corticosteroid.Clinical trial registration[chictr.org.cn], registration number: ChiCTR2100048762.

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“…Created with BioRender.com Specifically, western blot analysis in these patients has revealed the presence of antibodies against cochlin and β-tectorin, which are distributed across various regions in the inner ear, such as the spiral limbus, spiral ligament, basal hair cells, supporting cells, cochlear, and vestibular labyrinths [16,17]. Additionally, other proteins like Kresge Hearing Research Institute-3 (KHRI-3), expressed in the wall of the saccule, utricle, endolymphatic sac, supporting cells, as well as type II collagen, expressed in the subepithelial layer of the endolymphatic duct and the spiral ligament, could also be potential targets in immune-mediated hearing loss [18]. The inner ear contains hair cells that are responsible for converting sound vibrations into electrical signals, which are then transmitted to the brain for interpretation.…”

Section: Pathophysiology Of Inner Ear Diseases In Autoimmune and Auto...mentioning

confidence: 99%

Decoding the impact of autoinflammatory/autoimmune diseases on inner ear harmony and hearing loss

Athanasopoulos,

Samara,

Athanasopoulos

2024

Explor Immunol

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Autoimmune and autoinflammatory diseases affecting the inner ear can cause symptoms such as hearing loss, imbalance, vertigo, and tinnitus, presenting demanding and often underdiagnosed conditions. Diagnostic challenges arise due to their diverse manifestations, potential long-term consequences, and the absence of specific serological markers, necessitating a multidisciplinary approach combining clinical evaluation, audiological assessments, and imaging techniques. Various autoimmune disorders, including systemic lupus erythematosus, rheumatoid arthritis, and Sjogren’s syndrome, have been implicated in immune-mediated damage to auditory structures, resulting in inner ear dysfunction. Inflammatory processes in autoinflammatory diseases like Cogan’s syndrome and relapsing polychondritis can also affect the inner ear. While the exact mechanisms of inner ear involvement in these conditions are still being studied, immune-mediated inflammation, damage to auditory structures, and vascular involvement play significant roles in auditory impairments. Treatment strategies primarily focus on immunomodulation and inflammation control using corticosteroids, immunosuppressants, and targeted biologic agents to ameliorate symptoms and preserve hearing function. Hearing aids and cochlear implants may be also considered for severe hearing loss. Individualized approaches are necessary due to patient response heterogeneity. This review provides a concise overview of key autoimmune and autoinflammatory diseases impacting the inner ear, highlighting clinical manifestations, diagnostics, pathophysiology, and treatment options. Early recognition and appropriate management are crucial for optimizing patient outcomes. Further research is needed to understand underlying mechanisms and identify novel therapeutic targets. Collaboration between otolaryngologists, rheumatologists, and immunologists is crucial for improving the quality of life in these complex conditions.

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Sudden Sensorineural Hearing Loss: A Review

Cited by 19 publications

References 32 publications

Cardiocerebrovascular risk in sensorineural hearing loss: results from the National Health and Nutrition Examination Survey 2015 to 2018

Cardiocerebrovascular risk in sensorineural hearing loss: results from the National Health and Nutrition Examination Survey 2015 to 2018

Efficacy of intratympanic or postauricular subperiosteal corticosteroid injection combined with systemic corticosteroid in the treatment of sudden sensorineural hearing loss: A prospective randomized study

Decoding the impact of autoinflammatory/autoimmune diseases on inner ear harmony and hearing loss

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