Abstract
Objective: To observe the otolithic function in sudden sensorineural hearing loss (SSHL) patients in different age groups by using vestibular evoked myogenic potentials (VEMPs). Methods: One hundred and seventy unilateral SSHL patients were divided into 5 age groups. The 170 affected ears belonged to study group. The opposite healthy ears of 170 patients and 138 normal ears of 69 age and sex-matched normal people at different ages were set as control groups. Ocular VEMP (oVEMP) and cervical VEMP (cVEMP) both evoked by air-conducted sound (ACS) were employed for vestibular otolithic function assessment. Results: The response rates of cVEMP and oVEMP were lower and abnormal rates were higher in affected ears of SSHL patients compared to the opposite healthy ears and normal control ears in all age groups, except patients over 60 years. The response rates of VEMPs significantly declined with increasing age, not only in normal control ears, but also in affected and healthy ears of SSHL patients. But, the abnormal rates of VEMPs showed no significant difference in affected ears at different ages. Conclusions: Dysfunction of vestibular otolithic organs in SSHL patients presented respective features at different ages. It is necessary to consider the age when the clinicians determine the otolithic condition of patients based on the VEMPs.
Highlights
Sudden sensorineural hearing loss (SSHL) is defined as a sudden onset of more than 30 dB sensorineural hearing loss in at least three consecutive audiometric frequencies for unknown causes, which occurs within 3 days or less [1]
We suggest that the reference value of air-conducted sound (ACS)-vestibular evoked myogenic potentials (VEMPs) in assessing the otolithic function was limited in patients over 60 years old, maybe changing a more powerful stimulation method such as bone-conducted vibration (BCV) or electrical stimulation could be considered to solve this problem
The results above indicated that vestibular otolithic damage expressed by absent VEMPs was relatively less in younger patient than older patients with SSHL, but abnormal VEMPs behaved as thresholds elevated and latencies prolonged were more common in younger patients
Summary
Sudden sensorineural hearing loss (SSHL) is defined as a sudden onset of more than 30 dB sensorineural hearing loss in at least three consecutive audiometric frequencies for unknown causes, which occurs within 3 days or less [1]. Several national surveys have estimated the incidence of SSHL at between five and 30 cases per 100,000 per year [2]-[4]. The German guideline of SSHL in 2011 has shown an incidence as high as 160 - 400 cases per 100,000 per year [5]. Pressure, mood swings, irregular life, and sleep disorders are generally considered as the main inducing factors of SSHL [7]. With the emphasis on vestibular function assessment, many researchers have studied the features of vestibular disorders in SSHL patients. It was found that vestibular otolith organs could be impaired in SSHL patients, and the otolithic dysfunction could be detected by vestibular evoked myogenic potentials (VEMPs) [9][11]
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