Abstract
Object: We aimed to identify the relationship between vertigo symptoms and the involvement of vestibular dysfunction in sudden sensorineural hearing loss (SSNHL) and the contribution of audiogram classification.Methods: A total of 50 patients with unilateral SSNHL were retrospectively divided into the vertigo group and non-vertigo group depending on the presence of vertigo. The involved vestibular end organs (VEOs) were verified by a battery of vestibular function tests including video head impulse test (vHIT), cervical vestibular-evoked myogenic potential (cVEMP), and ocular VEMP (oVEMP). The correlations of audiogram configurations, initial pure-tone average (PTA), number of involved VEOs, prognosis (complete recovery rate), and vestibular functions were analyzed between the two groups. Additionally, the vestibular functions in a subgroup of profound SSNHL patients were further compared within groups with or without vertigo.Results: Significant differences in the initial audiogram configurations (p = 0.033) and the abnormal rates of the posterior semicircular canal (PSC) (p = 0.035) and oVEMP (p = 0.046) were found between the two groups. The number of involved VEOs was related to the initial PTA in the vertigo group (p = 0.002, r = 0.541) and non-vertigo group (p = 0.042, r = 0.446). The prognosis was related to the abnormal rate of cVEMP and the number of involved VEOs in both vertigo group (p = 0.008, r = 0.482; p = 0.039, r = 0.385, respectively) and non-vertigo group (p = 0.016, r = 0.520; p = 0.022, r = 0.495, respectively), and it was especially related to the audiogram configurations in the vertigo group (p < 0.001, r = 0.692). However, after classification by audiogram configurations, there was no statistical difference in the abnormal rates of all vestibular function tests or the number of involved VEOs between the profound SSNHL patients with or without vertigo.Conclusion: The relationship between the involvement of vestibular dysfunction and vertigo symptoms in patients with SSNHL was significantly different before and after audiogram classification. When evaluating the vestibular dysfunction in SSNHL patients, more attention should be paid to the audiogram configuration.
Highlights
Sudden sensorineural hearing loss (SSNHL) is a serious otological disorder with an annual incidence of 2.4–27 people per 100,000 people [1, 2]
There was a significant difference between the initial audiogram configurations (p = 0.033), indicating that more serious hearing loss was seen in the vertigo group (86.2% presented with profound hearing loss) than the non-vertigo group (47.6% presented with profound hearing loss)
Significant differences in initial audiogram configurations and the abnormal rates of posterior semicircular canal (PSC) and ocular VEMP (oVEMP) were found between two groups, indicating that more serious hearing loss was seen in the vertigo group than non-vertigo
Summary
Sudden sensorineural hearing loss (SSNHL) is a serious otological disorder with an annual incidence of 2.4–27 people per 100,000 people [1, 2]. It is defined as a 30-dB sensorineural hearing loss occurring in three contiguous frequencies, or at least loss in two adjacent frequencies of ≥20 dB and developing over 3 days [3]. 30– 40% of SSNHL patients suffer from vestibular symptoms besides cochlear dysfunction, while additional symptoms of tinnitus and fullness are reported in 80% of cases [7, 8]. Vestibular involvement is more common in patients with profound hearing loss, in the form of dizziness, unsteadiness, or even rotatory vertigo [9]. The pathophysiology of this condition has not been identified, but several reports have been proposed
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