The Relationship of the Herpesvirus Family to Sudden Hearing Loss: A Prospective Clinical Study and Literature Review

Abstract

The herpesvirus family is associated with sudden hearing loss syndrome and the evidence includes clinical findings (HV-Z), temporal bone studies (CMV and HV-Z), and serologic studies. The data presented demonstrate that herpes infections, in association with sudden viral hearing loss, occur as part of a multiple viral infection in 70% of instances. This feature is unique to the herpesvirus infections when compared to other neurotropic viral agents. The study also demonstrates that the variables of viral hearing loss, such as degree of hearing loss, percentage of recovery, or the incidence of vertigo are unaffected by the presence of herpesvirus infection. Mechanisms for inner ear injury may be influenced by temporary alterations in cellular immunity secondary to simultaneous viral infections as well as the native virulence of the infecting herpesvirus.

Surdez súbita idiopática: aspectos etiológicos e fisiopatogênicos

“…Later, the ganglionic cells degenerations is greater and that of hair cells is minor. Differently from that, in the case of a complete arterial obstruction, the degeneration of ganglionic cells, stria vascularis, spiral ligament and other inner ear structures is more diffuse; after some months, the ear is subject to an invasion of fibrous tissue and, sooner or later, cochlear ossification 15 .…”

“…There are cases in which the hearing loss may be sudden or happen in a short period o time until it becomes complete 4,20 . Others report that this hearing loss may develop along a few days 1,2 , although many authors accept the time period of up to 72 hours 9,15,21,22 . In a shorter and more contemporary way, it may be defined as a 30dB hearing loss minimum, in at least three continuous frequencies of up to 72 hours of onset.…”

“…In a shorter and more contemporary way, it may be defined as a 30dB hearing loss minimum, in at least three continuous frequencies of up to 72 hours of onset. It varies according to intensity and frequency affected; and in order to be classified as ISHL all known causes have to be ruled out previoulsly 9,15,21,22 .…”

“…However, damage happens initially on the cochlear endolymphatic compartment structures and the degree of hair cell atrophy is progressive, starting with mild changes in the upper turn up to complete loss in the basal turn 15 . Later, the ganglionic cells degenerations is greater and that of hair cells is minor.…”

“…In 1957, Van Dishoeck & Bierman 15 influenced by previous studies and seeing that flue-like symptoms almost always precede ISHL, are among the first to report a viral infection as a possible cause for such disorder, specially when they compared cochlear lesions found in temporal bones of individuals with ISHL with those with viral labyrinthitis.…”