Abstract
Idiopathic sudden sensorineural hearing loss (ISSNHL) refers to a loss of hearing, most commonly unilateral, that occurs suddenly (≤72 h) with no identifiable cause or etiology. To date, there is no standard protocol to predict prognosis (hearing recovery) for patients with ISSNHL. However, studies have shown that changes in otoacoustic emissions (OAEs) often occur prior to changes in audiometric hearing thresholds. OAEs originate from the electrochemical motility of the outer hair cells (OHC) and reflect the integrity of the inner ear, specifically the cochlear amplifier. Therefore, OAEs may be useful as a prognostic predictive factor in patients with ISSNHL from the initial onset of symptoms through recovery. A systematic review of the literature was undertaken to assess the relationship between pure tone thresholds, OAEs, and subjective hearing improvement and/or recovery. Fourteen studies were identified for inclusion, and they overwhelmingly support the inclusion of OAEs in the protocol to monitor ISSNHL recovery. This finding supports the development of a standard diagnostic protocol that includes OAEs to predict patient hearing outcomes.
Highlights
Sensorineural hearing loss (SNHL) is defined as loss of sensitivity due to dysfunction in the cochlea or auditory nervous system, without comorbid dysfunction of the outer or middle ear systems.Sudden sensorineural hearing loss (SSNHL), known as sudden deafness (SD), refers to a loss of hearing that occurs suddenly, either at once or within seventy-two hours or less
Canale et al evaluated the use of Distortion product otoacoustic emissions (DPOAEs), Transient evoked otoacoustic emissions (TEOAEs), and spontaneous otoacoustic emissions (SOAEs), and while they supported their use as an indicator of inner ear functional status, the authors did not support their use in predicting hearing improvement, for cases of LFSNHL [25]
The relationship between pre-treatment presence/absence of SOAEs, DPOAEs, and TEOAEs and thresholds was not significant; The study supports that otoacoustic emissions (OAEs) can be an indicator of inner ear functional state, but they cannot be used as a prognostic test in cases of LFSNHL
Summary
Sensorineural hearing loss (SNHL) is defined as loss of sensitivity due to dysfunction in the cochlea or auditory nervous system, without comorbid dysfunction of the outer or middle ear systems. Sudden sensorineural hearing loss (SSNHL), known as sudden deafness (SD), refers to a loss of hearing that occurs suddenly, either at once or within seventy-two hours or less. SSNHL is described as a hearing loss greater than or equal to 30 dB HL over at least three consecutive frequencies and is most commonly unilateral [1]. All audiometric configurations (flat, rising, sloping) have been reported in individuals with SSNHL [2]. Individuals with SSNHL may attribute their hearing loss to common conditions, such as allergies, a sinus infection, or occluding earwax, which may delay them from seeking medical treatment.
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