Abstract
Objective: The aim of this study is to evaluate the possible value of endolymphatic hydrops (EH) in patients with unilateral idiopathic sudden sensorineural hearing loss (UISSNHL) with four types according to audiometry.Methods: Seventy-two patients (40 men and 32 women; age range, 28–78 years; mean age: 50.0 ± 12.9 years) with UISSNHL were admitted retrospectively into this study. Based on the pure tone audiometry before treatment, the hearing loss of all these patients were categorized into four types: low-frequency group (LF-G), high-frequency group (HF-G), flat group (F-G), and total deafness group (TD-G). The average time from symptom onset to the first examination was 6.9 ± 4.4 days (1–20 days). 3D-FLAIR MRI was performed 24 h after intratympanic injection of gadolinium (Gd) within 1 week after the UISSNHL onset. The incidence of EH in the affected ears based on four types of hearing loss were analyzed using the Chi-square test, and the possible relationship with vertigo and prognosis were also assessed.Results: Eleven of 21 patients (52.4%) in LF-G had the highest EH-positive rate, followed by 18.2% in HF-G, 11.8% in F-G, and 17.4% in TD-G. The significant difference was found in the four groups (P = 0.018). The EH rate of LF-G was statistically significantly higher than that of F-G and TD-G (P = 0.009, P =0.014), respectively. After being valued by the volume-referencing grading system (VR scores), the EH level was represented by the sum scores of EH. In LF-G, no statistically significant difference was found in the prognosis of ISSNHL patients between with the EH group and the no EH group (P = 0.586). The symptom “vertigo” did not correlate with EH and prognosis.Conclusions: EH was observed in UISSNHL patients by 3D-FLAIR MRI. EH may be responsible for the pathology of LF-G but not related to prognosis. It might be meaningless to assess EH in other hearing loss types, which might be more related to the blood-labyrinth dysfunction.
Highlights
Sudden sensorineural hearing loss (SSNHL) is defined as a subset of disorder in which hearing loss is sensorineural and occurs within 72 h, affecting ∼5–27 per 100,000 people annually [1]
The purpose of this study is to find the EH distribution in four types of unilateral ISSNHL (UISSNHL) and to preliminarily explore the possible value of EH among different types
The patients with UISSNHL were divided into three groups according to their ages: 60years old
Summary
Sudden sensorineural hearing loss (SSNHL) is defined as a subset of disorder in which hearing loss is sensorineural and occurs within 72 h, affecting ∼5–27 per 100,000 people annually [1]. About 90% of patients with SSNHL have no identifiable cause for the hearing loss [1]. Rather than the possible tumor, trauma, or other causes identifiable according to patients’ history [2], the exact etiology and pathological mechanism of idiopathic sudden sensorineural hearing loss (ISSNHL) have not been clarified [3]. Hypothesis causes of ISSNHL mainly focused on micro-circulation disorders, viral infection, or autoimmune diseases [3]. The possible relationship between EH and hearing loss was mentioned early in 2002 [4]; few articles published to support due to the limited imaging techniques
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