Cause Of Sudden Sensorineural Hearing Loss Research Articles

Sudden sensorineural hearing loss during pregnancy. A case study and literature review

<b>Introduction:</b> Sudden sensorineural hearing loss (SSNHL) is defined as the sudden onset of hearing loss of 30 dB or more, across three consecutive frequencies in a pure-tone audiogram occurring within a 72-hour period. The term “sensorineural” indicates that the cause of the hearing loss lies in disturbances within the cochlea or auditory nerve. SSNHL typically presents as unilateral, transient hearing loss that occurs upon awakening. Bilateral hearing loss occurs in less than 2% of patients. Additionally, patients may report sensations of ear fullness or blockage, tinnitus, dizziness, nausea, and vomiting.<b>Aim:</b> Defining the management of SSNHL in pregnant women.<b>Case report:</b> This article describes the case of a 36-years-old pregnant woman who developed hearing impairment in the left ear in the third trimester along with tinnitus and balance disorders.<b>Discussion:</b> The occurrence of SSNHL in pregnant women is rare and not well understood. Majority of pregnant patients with SSNHL experienced the condition in second or third trimester. Key elements facilitating an accurate diagnosis include: interview and physical examination, hearing tests, balance evaluation, and imaging studies. The exact causes of SSNHL in pregnant women remain unknown. However, hormonal changes during pregnancy can have some contribution to development of this condition. Onset of SSNHL symptoms could resemble Ménière’s disease.<b>Conclusions:</b> Due to rare occurrence of SSNHL in pregnant women, there is no standardized approach to managing this medical issue. Given that most cases of SSNHL are classified as idiopathic, empirical treatment primarily involves steroids.

Sudden Sensorineural Hearing Loss in Patients Aged from 15 to 40 Years.

Objectives: The purpose of this study was to investigate the hearing characteristics and causes of sudden sensorineural hearing loss (SSNHL) in patients aged from 15 to 40 years, focusing on audiological outcomes one year after the diagnosis. Methods: The medical records of individuals with SSNHL who were referred to our tertiary-level audiologic center were reviewed. All patients had undergone comprehensive diagnostic evaluations, including high-resolution 3D-FLAIR delayed magnetic resonance imaging (MRI), cone beam computed tomography (CBCT), and screening for coagulation, infectious, and autoimmune diseases. Results: Overall, 56 patients (mean age 28.1 ± 7.6 years) were included in the study. The hearing threshold in the affected ear improved significantly from 56.0 ± 18.0 dB at the diagnosis to 46.9 ± 22.3 dB after one year (p = 0.02). The degree of hearing loss, audiometric configurations, hearing improvements, and adherence to hearing treatments showed considerable variability among patients. Aural fullness, tinnitus, and hyperacusis were the predominant symptoms associated with SSNHL, and their prevalence decreased significantly over time. The diagnostic protocol led to the identification of the specific cause of SSNHL in 75% (42/56) of patients. The known etiology was found to be otological (39.3%), infectious (21.4%), autoimmune (7.1%), vascular (5.4%), or neoplastic (1.8%). In particular, Menière's disease (n = 12), isolated cochlear endolymphatic hydrops (n = 6), HSV-1 (n = 5), and EBV (n = 4) infections were the most frequent causes of SSNHL. Conclusions: The identification of the specific etiology of SSNHL may facilitate a more personalized approach to management and treatment.

Debutul subliminal al surdităţii neurosenzoriale brusc instalate în hipotiroidism – revizuire a literaturii

Sudden sensorineural hearing loss (SSNHL) is a frequent oc­cur­rence in audiology and otolaryngology. It refers to a sen­so­rineural hearing loss of 30 dB or more across three con­se­cu­tive audiometric frequencies, developing within 72 hours. While the causes of SSNHL vary widely, most cases lack a clear origin. Studies have suggested a po­ten­tial re­la­tion­ship between thyroid dysfunction and the onset of SSNHL, yet establishing a definitive causal link re­mains un­cer­tain. Our review aims to meticulously explore the impact of thyroid function on SSNHL. The treatment for SSNHL with iden­ti­fiable causes typically targets the un­der­lying agent, often resulting in poor hearing outcomes due to inner ear hair cell damage. In cases of idiopathic SSNHL, steroid the­r­apy is the current standard of care. The prognosis for hea­r­ing recovery in idiopathic SSNHL hinges on factors such as the severity of hearing loss, age, presence of vertigo, and le­­­vels of thyroid hormones.

Importance of small vessel disease as a possible cause of sudden sensorineural hearing loss.

Vascular disease like small-vessel disease (SVD) is the most likely cause among the potential causes of Sudden sensorineural hearing loss (SSNHL). Understanding the relationship between SVD and SSNHL is crucial for developing effective prevention and treatment strategies. To confirm the relationship between SVD and SSNHL, the effect of SVD is confirmed by focusing on the duration and recurrence of SSNHL. This article reports a retrospective observational study that investigated the relationship between SVD and SSNHL using the South Korea Health Insurance Review and Assessment Service (HIRA) database from 2010 to 2020. This retrospective observational study included 319,569 SSNHL patients between 2010 and 2020. Participant demographics were controlled using Propensity Score Matching. The hazard ratios (HR) for the effect of SVD on the duration of SSNHL were 1.045 for the group with SVD before the onset of SSNHL and 1.234 for the group with SVD after the onset of SSNHL. SVD was statistically significant for the recurrence of SSNHL, with an odds ratio of 1.312 in the group with SVD compared to the group without SVD. The HR for the period until a recurrence in the group with SVD was 1.062. The study identified SVD as a possible cause of SSNHL and found that the duration of SSNHL increased only in the presence of SVD. SVD also affected the recurrence of SSNHL, with the recurrence rate being 1.312 times higher in the group with SVD.

Sudden Secondary Sensorineural Hearing Loss Following Hand, Foot, and Mouth Disease in an Adult Patient: A Case Report.

Introduction: Sudden sensorineural hearing loss (SSNHL) can present as sudden hearing loss within 72 hours. Studies have shown that viral infection, including direct invasion, indirect reactions, stress responses, and immune-mediated hearing loss, is the main cause of SSNHL. Viral infection may play an important role in SSNHL by causing injury to the inner ear through blood or cerebrospinal fluid. In this article, we describe an adult case of SSNHL following hand, foot, and mouth disease (HFMD). Case Report: A 34-year-old man presented with sudden hearing loss in the right ear 4 days after HFMD onset. Tinnitus, ear fullness, and a slightly heavy head appeared synchronously as accompanying symptoms. Before 6 days, he had a fever for 2 days (the highest temperature was 39.4°C), followed by vesicles in the oral mucosa and papules on the hands and feet after cohabitation with his child diagnosed with HFMD.

Comorbidities and laboratory changes of sudden sensorineural hearing loss: a review.

Sudden sensorineural hearing loss (SSNHL) is defined as an abrupt hearing loss of more than 30 dB in three contiguous frequencies within 72 h. It is an emergency disease requiring immediate diagnosis and treatment. The incidence of SSNHL in Western countries' population is estimated between 5 and 20 per 1,00,000 inhabitants. The etiology of SSNHL remains unknown. Due to the uncertainty of the cause of SSNHL, at present, no specific treatment targets the cause of SSNHL, resulting in poor efficacy. Previous studies have reported that some comorbidities are risk factors for SSNHL, and some laboratory results may provide some clues for the etiology of SSNHL. Atherosclerosis, microthrombosis, inflammation, and the immune system may be the main etiological factors for SSNHL. This study confirms that SSNHL is a multifactorial disease. Some comorbidities, such as virus infections, are suggested to be the causes of SSNHL. In summary, by analyzing the etiology of SSNHL, more targeting treatments should be used to achieve a better effect.

Sudden sensorineural hearing loss as a sequela after recovery from post-COVID pneumonia on an atherosclerotic patient: A single case study

It has recently been discovered that COVID-19 is a major contributor to ear disorders and hearing loss such as high-frequency hearing loss and sudden sensorineural hearing loss (SSNHL). Several causes of SSNHL are cited in the literature, including loud noise, ototoxicity, trauma, metabolic diseases, and viral infections. SSNHL could be sequelae of post-COVID-19 infections in people who have metabolic problems or chronic illnesses and this could be ruled out in previously normal hearing-healthy persons. A 57-year-old male reported to the department of Audiology with the complaint of sudden commencement of reduced hearing sensitivity & ringing sensation in his left ear 2 weeks after a post-COVID history of pneumonia. The onset of hearing loss was sudden and progressive. The client’s medical history revealed that he has CAD -Acute inferio posterior wall Mayo cardial Infarction and has had H/o hyperlipemia for the previous 10 years. A battery of audiological tests was administered over the course of a year, and a diagnosis of severe unilateral sensory neurological hearing loss was made. We attempt to understand the potential mechanism of sudden hearing loss in post-COVID pneumonia patients with atherosclerosis through this single case study. SARS-CoV-2-induced inflammation may influence atherosclerotic plaques which cause prothrombotic alterations in the blood and endothelium of the cochlear region as a result of COVID-19 infection. During COVID pneumonia attack increased blood viscosity with atherosclerosis of the cochlear vessels reduces the blood perfusion of the cochlea and results in hearing impairment.

ETIOLOGICAL ASSESSMENT OF SUDDEN SENSORINEURAL HEARING LOSS: A PROSPECTIVE OBSERVATIONAL STUDY IN KASHMIR

Background: Sudden sensorineural hearing loss (SSNHL) is dened as sensorineural hearing loss of 30 dB or more over at least three consecutive audiometric frequencies that occurs within a 72-hour period. Even though there are several potential causes of SSNHL, however, the majority of patients do not have well established etiology. Methods: The present prospective observational study was conducted in the Post Graduate Department of Otorhinolaryngology and Head and Neck surgery (ORL AND HNS), Government SMHS Hospital Srinagar, which is the associated Hospital of Government Medical College Srinagar & caters patients from whole of the Kashmir division. A total of 115 patients who gave the consent & fullled the inclusion criteria were taken into the study. Results: When the subjects were stratied based on severity of the disorder, ~70% subjects reported mild to moderate SSNHL, while as the rest reported severe forms of SSNHL with ~10% reporting profound SSNHL. Most of cases were idiopathic (57%). Nearly 11% subjects had diabetes mellitus, ~8% had hypertension and an even less number had infectious cause. History of Meinere's Disease was reported in ~4% of subjects and history of fractured temporal bone was presented in ~2% of subjects. Conclusion: The etiology of SSHNL is heterogenic, with majority of cases as idiopathic. For practitioner pinpointing the exact etiology is equally all the more important for targeted treatments. We recommend large sample comprehensive extended studies to further investigate the possible cases associated with this disease.

Bilateral Sudden Sensorineural Hearing Loss Associated with Sepsis: A Case Report and Literature Review

Bilateral sudden sensorineural hearing loss (SSNHL) is rare and usually indicates a serious systemic pathology. We describe an unusual case of bilateral SSNHL caused by sepsis. A 28-year-old female complained of acute-onset bilateral hearing impairment; in addition to otological symptoms, she had a systemic condition that met the criteria for sepsis. We performed a physical examination and laboratory tests to diagnose sepsis. Pure tone audiogram and videonystagmography were performed to evaluate the otological symptoms. Intravenous antibiotics and high-dose methylprednisolone were prescribed for treatment, and audiogram was repeated during that period. The fever subsided and the vital signs were stabilized. The electrolyte imbalance and abnormal urine parameters became normal. Hearing gradually recovered to a normal level on day 7 of hospitalization. In conclusion, sepsis should be considered as a cause of SSNHL. When conducting a detailed examination of patients with bilateral SSNHL, the clinician should consider systemic disease.

Sudden Sensorineural Hearing Loss: A Guide to Causes, Treatment, Problems, and Coping Strategies

Sudden Sensorineural Hearing Loss: A Guide to Causes, Treatment, Problems, and Coping Strategies Christine Isley-Farmer (bio) CARE OF THE PROFESSIONAL VOICE Acomprehensive description of the various types of hearing loss singers can experience, authored by Drs. Amanda Hu and Robert Sataloff, appears in an earlier issue of the Journal of Singing. In it, the following types of hearing loss are discussed: Conductive (CHL), Sensorineural (SNHL), Mixed (MHL), and Occupational (OHL).1 Sudden Sensorineural Hearing Loss (SSNHL) is a designated type of Sensorineural Hearing Loss (SNHL). This article discusses the definition of SSNHL, causes, treatment, problems resulting from SSNHL onset, and coping strategies during treatment and after treatment. Portions of the article are written from a personal perspective, since I was diagnosed with SSNHL in January 2015 and treated until March 2015. DEFINITION OF SSNHL Unlike many cases of hearing loss that progress over a span of time, SSNHL can manifest within a matter of seconds or progress over several days. Incidence of SSNHL is estimated to be 1 in 5,000 Americans each year.2 Any age group can be affected, but incidence seems to be higher in the fifth and sixth decades of life.3 Onset manifests unilaterally in most cases; bilateral or simultaneous bilateral onset is infrequent.4 Associated symptoms with SSNHL onset are tinnitus (ringing in the ear), aural fullness (plugged ear), and vertigo (dizziness). Loss can be frequency range and pantonal.5 Considered an ear emergency, SSNHL requires early intervention. Patients with this condition have a short window to begin treatment. Delaying treatment for longer than two to four weeks after onset results in irreversible hearing loss.6 In my case, SSNHL onset occurred while practicing singing. Sound in the left ear suddenly became muffled. Inserting a wax solvent into the ear several times did not resolve the plugged feeling by the following morning. Believing there might be embedded wax or water in the ear, I went to a walk-in clinic. Blood pressure had spiked to 150, which was abnormal for me. The nurse said she saw a bit of fluid in the ear but no wax. She prescribed a nasal spray and a course of prednisone in case of infection. I was scheduled to judge a competition for the next two days. During the competition, which was over a weekend, [End Page 75] there was no improvement in hearing. Stressing that hearing had suddenly changed and not returned despite treatment, I was able to get an appointment with an ENT on the fifth day after SSNHL onset. The audiometry results (Figure 1) show speech discrimination as 100% in the right ear. Left ear speech discrimination is 12%. Loss of hearing in the left ear is diagnosed as severe to moderately severe at 90+dB. CAUSES OF SSNHL In a research study of SSNHL published in 2010, researchers divided into two research groups. The first group examined 23 articles in which multiple etiologies (causes) were identified; the majority were idiopathic (unknown cause). The second group evaluated SSNHL patients with specific diagnostic tests. The results revealed 71% of the cases to be idiopathic. Other diagnoses ranged from 2.2% to 12.8%, with infectious disease having the highest percentage after idiopathic. Attempts to pinpoint a specific cause or causes for SSNHL in this study remained unconfirmed.7 Since most causes of SSNHL onset are generally idiopathic, patients may undergo screenings and/or treatment for several possible disorders. They are as follows: viral ear infection, vascular impairment, autoimmune disease, inner ear problems, and central nervous system abnormalities. In the latter, an MRI is the most useful method for identifying temporal bone or intracranial pathology when SSNHL is the primary symptom.8 I was referred to a rheumatologist for testing for autoimmune disease and underwent an MRI after SSNHL diagnosis. SSNHL studies at Radebeul Hospital in Germany from January 2004 to December 2009 led to an interesting discovery. Of 489 SSNHL patients with a male to female ratio of 1:1.24, a slight predominance of left side hearing loss in female as opposed to male patients was discovered. Although the cause was unclear, researchers proposed the slight predominance of sudden deafness in the left ear...

Sudden sensorineural hearing loss in children with dual positivity of serum anti-EBV IgM and anti-CMV IgM antibodies: a preliminary study.

Sudden sensorineural hearing loss (SSNHL) is rare in children, and its etiology remains largely unknown, although viral infections seem to play an important role. The aim of this study is to report 5 children who experienced permanent SSNHL and had dual positivity of serum anti-Epstein-Barr virus (EBV) IgM and anti-Cytomegalovirus (CMV) IgM antibodies. The study was conducted in a third-level referral audiological center. The medical charts of children under age 14 who experienced SSNHL without hearing recovery between September 1, 2017 and August 31, 2020, were reviewed. These children had undergone diagnostic evaluations, including brain magnetic resonance imaging, serological testing, thrombophilia and autoimmunity screening, to find possible causes of SSNHL. In all 5 patients identified, anti-EBV IgM, anti-CMV IgM and anti-CMV IgG antibodies were detected by chemiluminescent immunoassay (CLIA) immediately after the diagnosis of SSNHL, which occurred from 2 to 4 weeks after the onset of symptoms attributable to primary EBV infection. No abnormalities were demonstrated by coagulation and immunologic tests. Brain magnetic resonance imaging showed normal findings. This study suggests that primary EBV infection should be considered one of the most likely causes of SSNHL without any hearing recovery in children. Therefore, a routine audiological examination should be recommended for children with virologically confirmed primary EBV infection at approximately 3-4 weeks after onset of symptoms and then repeated with periodic follow-up. Further studies on a wider number of children affected by SSNHL might clarify the possible pathogenetic role of this dual serological positivity.

Association between Sudden Sensorineural Hearing Loss and Lyme Disease.

Objectives: Sudden sensorineural hearing loss (SSNHL) is defined as sensorineural hearing loss of 30 dB or more over at least three adjacent audiometric frequencies occurring within a 72-h period of time. One of the causes of SSNHL could be the progressive inflammatory state caused by an infection. The aim of this study was to assess the prevalence of SSNHL caused by various factors, most importantly those potentially related to Lyme disease. Material and Methods: The study includes a group of 86 patients between the ages of 20 and 70 who were hospitalized due to SSNHL between 2017 and 2018. All of these patients underwent a detailed medical interview and an otolaryngological examination, including audiological and diagnostic tests. Additionally, ELISA and Western blot tests were performed to confirm the diagnosis of Lyme disease. Results: In this group of 86 patients, nine patients presented with positive antibodies toward Borrelia burgdorferi sensu lato. This group was treated with antibiotics and experienced partial or complete regression of their deafness. This may suggest a relationship between SSNHL and Lyme disease. Conclusion: Infections caused by Borrelia burgdorferi may contribute to the development of inflammatory and angiopathic lesions, which are a possible cause of SSNHL. The longer the duration of the infection, the greater the likelihood of permanent and irreversible changes in the vessels of the cochlea or auditory nerve. Therefore, serological tests for Borrelia burgdorferi should be performed during the diagnosis of SSNHL as a possible cause of this illness.

The Effectiveness of Hyperbaric Oxygen Therapy as Salvage Treatment for Sudden Sensorineural Hearing Loss: A Retrospective Study

BackgroundSudden sensorineural hearing loss (SSNHL) is a medical emergency; its etiology is unknown in most cases, The treatment, in turn, is empiric and usually consists of various pharmacological agents, mainly steroids. Hyperbaric oxygen (HBO) therapy is used routinely as salvage therapy for refractory SSNHL. While several studies have demonstrated the effectiveness of HBO therapy as salvage treatment for refractory SSNHL, its results have varied among studies, and its efficacy is still unclear.AimWe aimed to stratify the effect of HBO therapy as salvage treatment after the failure of steroid therapy for SSNHL.MethodThis is a retrospective case series that involved eight SSNHL patients in the past three years at King Faisal Specialist Hospital & Research Centre (KFSHRC) in Riyadh, Saudi Arabia. Patients' records were reviewed and statistical analysis was performed.ResultsEight patients were included in this case series; six of them were males, and the mean age of all patients was 46.88 ±20.9 years. One patient had herpes zoster as the cause of SSNHL and seven patients' disease was of unknown etiology. The mean period for the onset of disease was 4.12 ±2.17 days. One patient was managed with intravenous dexamethasone and the other patients were managed with oral steroids, and all patients were then treated by HBO therapy. Of the patients, two showed significant improvement but the others did not. The cause of SSNHL, age of patients, HBO start and cessation, comorbidities, and disease onset did not affect the improvement in disease in patients (p: ˃0.05).ConclusionModerate-to-severe cases of SSNHL can be improved by HBO treatment along with oral steroids, while this therapy was ineffective in severe and profound cases. No factors could be found to predict improvement in patients.

Role of viral infection in sudden hearing loss.

According to a recent epidemiological survey, the incidence of sudden sensorineural hearing loss (SSNHL) is increasing yearly. The cause of SSNHL is of great interest in research. To date, viral infection, vascular occlusion, abnormal cellular stress responses within the cochlea, and immune-mediated mechanisms are considered the most likely etiologies of this disease. Among these etiologies, the relationship between viral infection and sudden deafness has been unclear. In this review, we mainly discuss the viral hypothesis of SSNHL. There is little research proving or clearly indicating the pathogenesis of this disease. Further research is needed to elucidate the precise etiopathogenesis to better understand SSNHL and establish more suitable treatment to help restore hearing in affected patients.

Sudden Sensorineural Hearing Loss after Pituitary Adenoma Resection—A Case Series with Literature Review

Objective Complications after transsphenoidal surgery for pituitary adenoma have been well documented in the literatures, but the occurrence of delayed sudden sensorineural hearing loss (SNHL) after pituitary adenoma resection is extremely rare. In this study three cases who developed sudden SNHL 3 to 7 days after pituitary adenoma surgery without experiencing cerebrospinal fluid leak or meningitis were presented, and the possible causes of SNHL were discussed. Methods Three cases with sudden hearing loss after transsphenoidal surgery for pituitary adenoma were reviewed. The past medical history, onset of sudden hearing loss, accompanying symptoms such as headache, tinnitus, dizziness and aural fullness, and the post-operative MRI images, therapy, and hearing results were reported. Results Three cases developed profound sudden SNHL on the 3rd to 7th post-operative day, all accompanied by prior headache, tinnitus and dizziness. One patient developed episodic vertigo, ear fullness accompanying with fluctuating hearing loss in the first post-operative month. Two patients had past medical history of arteriosclerosis and coronary heart disease or cerebral infarction. Two of three demonstrated obstructive hydrocephalus on MRI on the first post-operative day. Under treatment with prednisone orally, dexamethasone intratympanic injection, neurotrophic and vasodilatation drugs for 3 to 8 months, hearing of all three improved partially. Obstructive hydrocephalus and ischemia might be responsible for the hearing loss. Conclusion Post-operative obstructive hydrocephalus and ischemia of labyrinthine arteries might lead to the delayed SNHL after transsphenoidal surgery for pituitary adenoma.

Idiopathic sudden sensorineural hearing loss in dialysis patients

Although sudden sensorineural hearing loss (SSNHL) affects chronic kidney disease (CKD) patients more frequently than non-CKD patients, few reports have described SSNHL in dialysis patients. We aimed to review the characteristics of SSNHL in chronic dialysis patients and evaluate treatment responses to steroid therapy. We retrospectively reviewed the records of dialysis patients diagnosed with idiopathic SSNHL at Asan Medical Center between January 2000 and December 2014. Pure tone and speech audiometry analyzes were performed before and 2 weeks and 2 months after treatment onset to evaluate outcomes. Twenty-two patients (11 men, 11 women; mean age: 49.9 ± 11.7 years) were included; 16 (72%) and 6 (28%) had undergone hemodialysis and peritoneal dialysis, respectively, for a median of 49.2 ± 41.4 (1–144) months. End-stage renal disease was most frequently caused by diabetic nephropathy (11 cases), chronic glomerulonephritis (1 case) and unknown factors (7 cases). Common accompanying symptoms included tinnitus (68.2%), ear fullness (45.5%) and vertigo (27.3%). The mean pure tone audiometry threshold at the initial presentation was 82.6 ± 22.4 dB. At 2 months post-steroid treatment, 4 (18.2%), 4 (18.2%) and 6 (27.3%) patients exhibited a complete, partial, or slight recovery, respectively; 8 patients (36.3%) showed no improvement. Although we could not identify the specific cause of SSNHL in this population, our relatively large case series elucidates the precise clinical features of SSNHL in this population and demonstrates the outcomes of steroid treatment.

Characteristic MR findings suggesting presumed labyrinthine hemorrhage

Objectives: To evaluate the magnetic resonance imaging (MRI) findings of labyrinthine hemorrhage as a cause of sudden sensorineural hearing loss (SSNHL).Methods: MRI scans of 59 patients with SSNHL were retrospectively analyzed and compared to clinical features and audiometry data. MR images included pre-enhanced T1-weighted, 3D FLAIR volume isometric turbo spin-echo acquisition (VISTA), post-enhanced T1-weighted and 4-h-delayed enhanced FLAIR VISTA, and 3D thin-section proton density-weighted images.Results: High labyrinth signals were seen on pre-enhanced T1-weighted and 3D FLAIR VISTA images with no enhancement for 6 of 59 (10.2%) patients with SSNHL. In these six patients with presumed inner-ear hemorrhage, high signal intensity was seen in the endolymphatic and perilymphatic portions of the labyrinth on T1-weighted and 3D FLAIR VISTA images. In patients with SSNHL with nonhemorrhagic causes such as vestibular schwannoma or labyrinthitis, high signal or labyrinthine enhancement was seen only in the perilymphatic portion of the labyrinth on pre- or post-enhanced 3D FLAIR VISTA images.Conclusions: MRI using pre-enhanced T1-weighted, 3D FLAIR VISTA, and post-enhanced T1-weighted, 4-h delayed enhanced FLAIR VISTA images is able to identify labyrinthine hemorrhage as the cause of SSNHL. High signals in both the endolymphatic and perilymphatic portions of the labyrinth on pre- or post-enhanced 3D FLAIR VISTA images without enhancement indicate labyrinthine hemorrhage.

Increased risk of sudden sensorineural hearing loss in patients with hepatitis virus infection.

The etiology of sudden sensorineural hearing loss (SSNHL) remains unclear. Possible causes of SSNHL include vascular diseases, viral infection, and autoimmune disorders. Therefore, we investigated whether hepatitis virus infection is correlated with the risk of SSNHL. Using data from the Taiwan Longitudinal Health Insurance Database, we conducted a retrospective matched-cohort study to compare patients diagnosed with hepatitis B or C virus (HBV/HCV) infections from January 1, 2000, to December 31, 2010, (N = 170,942) with frequency-matched controls (N = 512,826) at a ratio of 1:3 by sex, age, and index year. We followed each patient until the end of 2010 and evaluated the incidence of SSNHL. At the end of the follow-up period, 647 (0.38%, 647/170,942) patients developed SSNHL in the HBV/HCV group compared with 978 (0.19%, 978/512,826) in the control groups, with a statistical significance of P < 0.001 (using the log-rank test). The incidence rate ratio of SSNHL was 5.743-fold higher in the HBV/HCV group than in the control group (283.17 vs. 49.31 per 100,000 person-years, P < 0.001). The risk of SSNHL increased with HBV/HCV infection, and an adjusted hazard ratio of 5.103 (95% CI, 4.585–5.678) was determined using Cox proportional hazards regression. This study contributes to the awareness of the increased risk of SSNHL in HBV/HCV-infected populations. Our findings suggest that an underlying viral infection contributes to the development of SSNHL.

Laboratory assessment of sudden sensorineural hearing loss: A case-control study.

Sudden sensorineural hearing loss (SSHL) is an otologic emergency that affects five to 30 subjects per 100,000/year. The cause of SSHL remains unknown or uncertain in 70% to 90% of cases, and treatment decisions are usually made without knowing the etiology. Prospective case-control study. One hundred thirty-one idiopathic SSHL patients were recruited from January 2014 to June 2015 in concordance with the Statements of Clinical Practice Guideline and divided into groups according to the disease severity. A clinical laboratory assessment was completed on blood samples collected from SSHL patients and control subjects. Multivariable regression analysis was performed to investigate the association between laboratory data and SSHL basis. Only a few SSHL patients were positive for autoimmunity or viral infection. Statistically significant (P < .05) higher levels of blood glucose, glycated hemoglobin (HbA1C), lipoprotein (a), and factor VIII were found in SSHL patients compared to controls. Furthermore, blood glucose, HbA1C, uric acid, factor VIII, and homocysteine were significantly associated to disease severity. Gluco-metabolic, lipidic, and coagulative laboratory data support the vascular hypothesis for SSHL and its severity. 3b Laryngoscope, 127:2375-2381, 2017.

Abnormal Magnetic Resonance Imaging Findings in Patients With Sudden Sensorineural Hearing Loss: Vestibular Schwannoma as the Most Common Cause of MRI Abnormality.

The etiology of sudden sensorineural hearing loss (SSNHL) remains unclear in most cases. This study aimed to assess abnormal magnetic resonance imaging (MRI) findings in patients with SSNHL and evaluate the value of MRI in identifying the cause of SSNHL.A retrospective analysis of the charts and MRI findings of 291 patients with SSNHL was performed.In 291 patients, MRI abnormality, which was considered a cause of SSNHL, was detected in 13 patients. Vestibular schwannoma involving the internal auditory canal (IAC) and/or cerebellopontine angle was observed in 9 patients. All 9 patients had intrameatal tumors, and 6 of the 9 patients displayed extrameatal extension of their tumors. The tumor was small (<1 cm) or medium-sized (1.1–2.9 cm) in these 6 patients. Intralabyrinthine schwannoma, labyrinthine hemorrhage, IAC metastasis, and a ruptured dermoid cyst were each observed in 1 patient.The most commonly observed MRI abnormality in patients with SSNHL was vestibular schwannoma, and all of the lesions were small or medium-sized tumors involving the IAC.