Update on Clinical Manifestation in Acute Low-Tone Hearing Loss

Abstract

Background and Objectives Acute low-tone hearing loss (ALHL) is gaining attention as an independent disease identity with close association with endolymphatic hydrops and early stage Meniere’s disease (MD). This study aims to compare patients of ALHL with patients exhibiting low-tone hearing loss and ear fullness without vertigo in various audio-vestibular assessments and in progression to overt MD.Subjects and Method A total of 249 patients with low-tone hearing loss with ear fullness without vertigo was enrolled in this study. Of these patients, 58 patients met criteria for ALHL, which was defined as having an average hearing loss of ≥30 dB at 125, 250, and 500 Hz and ≤20 dB at 2, 4, and 8 kHz. Demographics, electrocochleography (ECoG) abnormality, rate of hearing improvement, vestibular functions, and progression to MD were analyzed.Results An average low-tone hearing loss of ALHL patients was 42.8 dB, which recovered to 18.9 dB following a combined treatment of diuretics and oral steroid therapy. The hearing recovery rate of this group was 87.9% and the ECoG abnormality ratio was 42.5%. Also, 15.5% of ALHL patients eventually progressed to MD.Conclusion This study described demographics and characteristics of ALHL, demonstrating a successful response to the combined treatment of diuretics and oral steroid. Also, this report demonstrated a close relationship between the degree of low-tone hearing loss and ECoG abnormality and observed the progression to MD in ALHL patients. These data can be usefully applied in clinical setting to explain clinical outcomes of ALHL.

Management of Bilateral Acute Low Tone Sensorineural Hearing Loss (ALHL)

“…ALHL can be diagnosed by pure tone audiometry examination. [9][10][11][12] In this instance, the patient complained of buzzing in both ears, feeling full in both ears and losing hearing. The patient made no claims of feeling lightheaded.…”

“…7 According to Kim, most victims are female, with a peak age of 40. 12 ALHL without vertigo was described by Taki et al as a unique type of ISSNHL. Despite this, multiple studies have linked cochlear hydrops and ALHL to the early onset of Meniere's illness.…”

Prognosis of Acute Low‐Tone Hearing Loss Without Vertigo: A Scoping Review

“…One additional study 17 was identified within the references of one of the full‐texts and manually added to the full‐text review. Among all full‐texts reviewed, 41 studies 3–8,10,13,16–18,22–51 were determined to meet the study inclusion and exclusion criteria and these studies subsequently underwent data extraction (Figure 1).…”

Findings of Intravenous Gadolinium Inner Ear Magnetic Resonance Imaging in Patients With Acute Low-Tone Sensorineural Hearing Loss

“…Several other studies have shown that patients with ALHL have an elevated SP/AP ratio on electrocochleography (ECoG), and some progress to Meniere’s disease (MD). Therefore, endolymphatic hydrops (EH), as in MD, has emerged as an important etiology of ALHL [ 6 - 9 ].…”

“…Several other studies have shown that patients with ALHL have an elevated SP/AP ratio on electrocochleography (ECoG), and some progress to Meniere's disease (MD). Therefore, endolymphatic hydrops (EH), as in MD, has emerged as an important etiology of ALHL [6][7][8][9]. The confirmation of actual EH requires a post-mortem histological examination; therefore, this method has limitations in clinical practice when managing living patients.…”