Relationship between the drainage pattern of the dural venous sinuses and hearing recovery in patients with sudden sensorineural hearing loss

Jung Woo Park,Woongsang Sunwoo,Dong Hyun Kim,Tae Kyu Kang

doi:10.1038/s41598-020-62946-4

Jung Woo Park, Woongsang Sunwoo + Show 2 more

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https://doi.org/10.1038/s41598-020-62946-4

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Abstract

Although cochlear venous insufficiency has been considered to cause sudden sensorineural hearing loss (SSHL), there is insufficient clinical evidence to support this hypothesis. We sought to determine whether there is a correlation between draining patterns of the dural venous sinuses and the side of the affected ear in SSHL, as well as hearing recovery. The medical records of 109 patients diagnosed with unilateral SSHL were retrospectively reviewed. Magnetic resonance images and pure tone audiometry were performed in all patients. We measured the dominance of the inferior petrosal sinus (IPS) and transverse-sigmoid sinus (TS/SS) ipsilateral to the affected ear. Most patients were characterized by asymmetric venous drainage (IPS, 53.2%; TS/SS, 81.7%). The dominant side of the IPS or TS/SS was independent of the side of the affected ear for all patients in this study. However, in 35 patients with early recovery within 2 weeks, the dominant side of TS/SS was significantly associated with the side of the affected ear (p = 0.011). Moreover, the dominance of both the IPS and TS/SS influenced hearing outcomes at 3 months. Dominant TS/SS ipsilateral to the affected ear, particularly in the presence of ipsilateral hypoplastic IPS, is associated with a favorable hearing prognosis of SSHL.

Highlights

Cochlear venous insufficiency has been considered to cause sudden sensorineural hearing loss (SSHL), there is insufficient clinical evidence to support this hypothesis
In the remaining 74 patients (NER group; 67.9%), significant hearing improvement was not observed during the 2-week follow-up period, or it did not meet the criteria for recovery
Since the intracranial venous system is often asymmetric and cochlear venous insufficiency has been considered to be one of the causes of SSHL, we chose to focus our study on patients with SSHL to verify whether asymmetries of the intracranial venous drainage could play a role in the etiopathogenesis of SSHL2,3,14,15

Summary

Introduction

Cochlear venous insufficiency has been considered to cause sudden sensorineural hearing loss (SSHL), there is insufficient clinical evidence to support this hypothesis. Considering the venous drainage of the cochlea into the dural sinus, anatomic variability of adjacent sinuses, including the inferior petrosal sinus (IPS), transverse-sigmoid sinuses (TS/SS), or the jugular bulb, may affect the venous drainage of the cochlea and the development of hearing impairment. This theory of venous congestion is supported by the fact that the dural sinuses frequently have asymmetric drainage in the normal population. No study has explored the relationship between draining patterns of the venous dural sinuses and affected ear and related outcomes in patients with SSHL. The present study sought to investigate whether there is a correlation between draining patterns of the IPS and TS/SS, as demonstrated by 3D MRI and the side of the affected ear in SSHL, as well as recovery from SSHL

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