Sudden Sensorineural Hearing Loss Patients Research Articles

A Retrospective Comparative Chart Review of Hearing Recovery in Neural and Sensory Type Sudden Sensorineural Hearing Loss Patients.

A Retrospective Comparative Chart Review of Hearing Recovery in Neural and Sensory Type Sudden Sensorineural Hearing Loss Patients.

Cocktail regimen in treatment of sudden sensorineural hearing loss

This study aims to evaluate the efficacy of a cocktail regimen for the treatment of sudden sensorineural hearing loss (SSNHL). A prospective observational study. Tertiary care hospital. Thirty-five patients diagnosed with SSNHL who met the inclusion criteria. The cocktail regimen included intratympanic steroid injections, oral steroids, valacyclovir, and pentoxifylline. The primary outcome was the change in Pure Tone Audiometry (PTA) from pre-treatment to 3 months post-treatment, analyzed by Modified Siegel’s criteria. Of the 35 patients, 26 (74.2%) showed hearing improvement (including complete and partial recovery) at the 3-month follow-up. The mean improvement in PTA was 22.56 dB (SD = 18.4). However, the calculated odds ratios (OR) for treatment efficacy and hearing recovery comparisons were 1.0, with wide confidence intervals, indicating no statistically significant differences between improved and not improved groups. The cocktail regimen showed potential benefits for hearing recovery in SSNHL patients, particularly in cases with less severe initial hearing loss. Nevertheless, the absence of a statistically significant difference in the comparative analyses underscores the need for larger, randomized controlled trials to substantiate these findings.

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.

The Impact of Cardiovascular Risk Factors on the Incidence, Severity, and Prognosis of Sudden Sensorineural Hearing Loss (SSHL): A Systematic Review.

Sudden sensorineural hearing loss (SSHL) is believed to be mainly idiopathic since the cause is not usually identified. Several recent studies have examined the role of cardiovascular risk factors in this disease.The aim of this systematic literature review is to investigate the possible association between acquired and inherited cardiovascular risk factors and the incidence, severity, and prognosis of SSHL. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search of the PubMed database for the period between February 2010 and January 2023 was performed in order to retrieve eligible articles. The analytic cohort included 24 studies. Overall, this systematic review includes a total of 61,060 patients that were encompassed in these studies. According to most studies, the prevalence of dyslipidaemia, diabetes, and ultrasound indices of atherosclerosis was significantly higher in SSHL patients compared to controls. On the other hand, obesity, hypertension, and smoking did not seem to influence the risk of SSHL. Most studies suggest the presence of a correlation between a high cardiovascular risk profile and the risk of developing SSHL. The theory of microvascular impairment in the development of SSHL is indirectly supported by the findings of this review.

Standard and Extend High-Frequency Audiometry in Sudden Sensorineural Hearing Loss: Impacts on Tinnitus and Mental Health.

To analyze the results of auditory assessment in standard (SA) and extended high-frequency (EHF) audiometry, associating the findings with sudden tinnitus and mental health of patients with unilateral sudden sensorineural hearing loss (SSNHL). Prospective, cohort study. Outpatient otology clinic in a tertiary care hospital. Patients experiencing unilateral SSNHL were evaluated with pure-tone audiometry performed at frequencies of 250 to16,000 Hz, tinnitus pitch and loudness matching tests, Tinnitus Handicap Inventory (THI), Analog and Visual Scale (AVS) for bothersome tinnitus, and the Hospital Anxiety and Depression Scale (HADS). Eighteen patients with unilateral SSNHL were assessed. After starting treatment, there was a significant improvement in the SA (71.1 dB to 50 dB; p < 0.001*) and EHF audiometry (64.5 dB to 54.4 dB; p < 0.001*) thresholds at 15 days, and this persisted at 30 days of follow-up. Significant improvements were seen for tinnitus in loudness, VAS, and THI and for mental health in the realms of anxiety and depression by HADS. Despite improvements in SA, persistent EHF hearing loss was accompanied by persistent tinnitus, but it was of diminished loudness. Despite improvement in pure-tone thresholds by SA, a subset of unilateral SSNHL patients did not experience hearing recovery in EHF thresholds and reported persistent tinnitus. We postulate that their diminished anxiety and better mental health may be related to both hearing improvement in standard audiometry and reduction in tinnitus loudness. This pilot prospective study investigates the utility of performing EHF audiometry to better understand outcomes in patients with SSNHL.

Comparison of vestibular evoked myogenic potentials between low and high tone idiopathic sudden sensorineural hearing loss

Objectives: Vestibular evoked myogenic potentials (VEMP) have been reported to be useful in evaluating not only vestibular function but also the prognosis of idiopathic sudden sensorineural hearing loss (ISSNHL) patients. Even though low frequency, high frequency, and all frequency-involved ISSNHL groups tend to show varied clinical characteristics, there is a lack of data using VEMP results to analyze these subgroups. We investigated if the VEMP test is a valuable tool to predict recovery from hearing loss in association with different frequencies. Methods: A total of 26 ISSNHL patients were divided into three different groups impaired with low tone (ascending type), high tone (descending type), and all tones (flat type) based on the initial audiograms. Each group included five, 10, and 11 patents, respectively, and their VEMP results were compared between the three subgroups. Results: Abnormal VEMP results were found in five of the total 26 ISSNHL patients (19.2%). Two (40.0%), one (10.0%), and two (18.1%) patients of low tone, high tone, and all tone hearing loss groups, respectively, showed abnormal VEMP results. However, there was no statistically significant difference between the three groups. Conclusions: Even though VEMP is known as a valuable tool for predicting the prognosis of ISSNHL patients, it does not seem to reflect frequency-sensitive aspects of ISSNHL.

Assessment of Peripheral and Central Auditory Processing after Treatment for Idiopathic Sudden Sensorineural Hearing Loss

Abstract Introduction When cases of idiopathic sudden sensorineural hearing loss (SSNHL) are treated successfully, most clinicians assume the normality and symmetry of the auditory processing. This assumption is based on the recovery of the detection ability on the part of the patients, but the auditory processing involves much more than detection alone. Since certain studies have suggested a possible involvement of the central auditory system during the acute phase of sudden hearing loss, the present study hypothesized that auditory processing would be asymmetric in people who have experienced sudden hearing loss. Objective To assess the physiologic and electrophysiological conditions of the cochlea and central auditory system, as well as behavioral discrimination, of three primary aspects of sound (intensity, frequency, and time) in subjects with normal ears and ears treated successfully for SSNHL. Methods The study included 19 SSNHL patients whose normal and treated ears were assessed for otoacoustic emissions, speech auditory brainstem response, intensity and pitch discrimination, and temporal resolution in a within-subject design. Results The otoacoustic emissions were poorer in the treated ears compared to the normal ears. Ear- and sex-dependent differences were observed regarding otoacoustic emissions and pitch discrimination. Conclusion The asymmetrical processing observed in the present study was not consistent with the hearing threshold values, which might suggest that the central auditory system would be affected regardless of the status of the peripheral hearing. Further experiments with larger samples, different recovery scenarios after treatment, and other assessments are required.

Evaluation of expression levels of microRNA processing elements in patients with sudden sensorineural hearing loss

BackgroundMicroRNAs have a significant role in the function and development of the hearing system. Idiopathic sudden sensorineural hearing loss (SSNHL) is a complicated disorder with no long-established reason. Since microRNAs play imperative roles in every aspect of the neural system, their dysregulation may contribute to the onset of SSNHL. The current study aimed to assess the expression patterns of microRNA processing elements (DROSHA, DICER, and DGCR-8) as the vital factors in microRNA biology that can affect the expression levels of microRNA. This study assessed DROSHA, DICER, and DGCR-8 mRNA expression levels in the peripheral blood mononuclear cells (PBMC) of 50 patients with SSNHL and 50 matched controls. After the isolation of PBMC, total RNA was extracted, and the expression levels of DROSHA, DICER, and DGCR-8 genes were evaluated using quantitative real-time PCR.ResultsThe results illustrated significant up-regulation of DICER and DGCR-8 genes in SSNHL patients at the mRNA level. Furthermore, despite no significant change in DROSHA level, DICER and DGCR-8 were significantly correlated with SSNHL. However, there was no significant correlation between these gene expressions and the clinicopathological features of patients.ConclusionThis study verified for the first time that the DGCR_8 and DICER mRNA expression levels were significantly up-regulated in patients with SSNHL, proposing that microRNAs and their processing pathways play key roles in the progression and development of SSNHL.

Complete blood count changes in sudden sensorineural hearing loss caused by Streptococcus suis bacterial meningitis at Prof. Dr. I.G.N.G. Ngoerah Hospital Denpasar from January 2019 – May 2023

Introduction: Sudden sensorineural hearing loss (SSNHL) is an emergency case that requires immediate and comprehensive management. This condition can be caused by Streptococcus suis bacterial meningitis. Complete blood counts (CBC) examinations are often carried out in SSNHL patients that caused by infection. Some CBC components can be clinical indicators of the severity and prognosis of SSNHL. Objective: To find out the differences in CBC among S. suis bacterial meningitis patients with SSNHL and S. suis bacterial meningitis patients with normal hearing at Prof. Dr. I.G.N.G. Ngoerah Hospital Denpasar from January 2019 – May 2023. Methods: This study used an analytical research design using a retrospective case control method to compare CBC results (hematocrit, NLR, PLR, MLR, RDW and MPV) in 40 cases patients with SSNHL due to S. suis bacterial meningitis and 40 controls patients with S. suis bacterial meningitis patients with normal hearing. Result: In this study, it was found that there is no significant difference between case group compared to control group in terms of CBC results. The mean hematocrit value was 40.67 (± 4.45) in cases and 40.87 (± 4.08) in controls, with p-value 0.842. The mean MPV value was 9.82 (± 1.58) in cases and 9.33 (± 1.78) in controls, with p-value 0.200. The mean NLR value in the case group was 24.46, while in the control group it was 28.79, with p-value 0.124. The mean PLR value in the case group was 200.01, while in the control group it was 247.80, with p-value 0.126. The mean MLR value was 1.33 in cases and 1.19 in controls, with p-value 0.303. The mean RDW value was 12.98 in cases and 12.81 in controls, with p-value 0.950. Conclusion: From 40 people suffering SSNHL due to S. suis bacterial meningitis it was found that most of research subjects are men (75%) and the average age of subjects is 53 years. This study found that there were no significant differences between the results of mean hematocrit, NLR, PLR, MLR, RDW and MPV in patients with SSNHL due to S. suis bacterial meningitis compared to controls.

The therapeutic effect of hyperbaric oxygen therapy in patients with severe to profound idiopathic sudden sensorineural hearing loss

The optimal treatment for sudden sensorineural hearing loss (SSNHL) is unclear. Hyperbaric oxygen therapy (HBOT) has been suggested as a viable option for treatment of SSNHL as it improves vascular dysfunction. In this study, we evaluated the therapeutic effects of HBOT by retrospectively reviewing the records of 2206 patients with SSNHL. 54 who had received HBOT were selected for the HBOT groups, while 59 age-matched controls who had not were selected for the control groups. The HBOT and control groups were divided into subgroups according to intratympanic steroid (ITS) use. Groups A–D had received oral steroids + HBOT, oral steroids only, oral steroids + ITS + HBOT, and oral steroids + ITS, respectively. Of the 113 SSNHL patients, 21 had diabetes mellitus (DM) (2, 0, 9, and 10 patients in Groups A–D, respectively). There was no notable difference in hearing improvement between patients receiving HBOT and those in the control group. However, among diabetic patients, those who underwent HBOT demonstrated a significant improvement in hearing when compared to the control group. The combination of HBOT and steroids could potentially be beneficial for treating severe to profound SSNHL patients with DM.

Increased risk of sudden sensorineural hearing loss in patients with cervical spondylosis

Whether cervical spondylosis (CS) is a risk factor for sudden sensorineural hearing loss (SSNHL) remains unclear. This study used national population-based data to investigate the risk of SSNHL in patients with CS in Taiwan of different ages and sexes. This study used data covering 2 million people in Taiwan, which were obtained from the National Health Insurance Research Database. The data that support the findings of this study are available from National Health Insurance Research Database but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the corresponding authors upon reasonable request and with permission of National Health Insurance Research Database. This retrospective cohort study enrolled 91,587 patients with a newly diagnosed CS between January 2000 and December 2018. Case and control cohorts were matched 1:1 according to age, sex, and comorbidities. SSNHL incidence rate and risk were compared between the groups. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). The mean follow-up period was 8.80 (SD = 4.12) and 8.24 (SD = 4.09) years in the CS and control cohorts, respectively. The incidence rate of SSNHL in the CS cohort (85.28 per 100 000 person-years) was 1.49-fold significantly higher than that in the non-CS cohort (57.13 per 100,000 person-years) (95% CI 1.32–1.68, P < .001). After age, sex, and selected comorbidities were adjusted for, CS exhibited an independent risk factor for SSNHL (adjusted HR = 1.52; 95% CI 1.34–1.71, P < .001). An age-stratified analysis in this study demonstrated a strong and highly significant association between CS and SSNHL in patients aged < 35 years (IRR = 2.28, 95% CI 1.18–4.39, P = .013). This large-scale Taiwanese-population-based retrospective study found that CS was associated with an increased risk of SSNHL. Acute hearing loss in patients with CS, particularly at a young age, should be carefully evaluated, and prompt treatment for SSNHL should be initiated.

Associations between neutrophil-to-lymphocyte/platelet-to-lymphocyte and recovery in sudden sensorineural hearing loss.

Aims: This study investigated the nonlinear associations between neutrophil-to-lymphocyte(NLR)/platelet-to-lymphocyte(PLR) and recovery rates in sudden sensorineural hearing loss(SSNHL). Methods: Total of 244 SSNHL patients were included. The primary outcome was recovery rate. Results: A nonlinear association was detected between NLR and recovery rate usingtheLOWESS method, with a knot of 3. Patients with NLR ≥3 had ahigher recovery rate than NLR <3. Using thelinear-spline function, NLR was significantly associated with high recovery rate when NLR was<3. However, when NLR was≥3, this association became nonsignificant. The trend test showed asimilar result. PLR was not associated with recovery rate. Conclusion: The association between NLR and recovery rate is nonlinear, with a knot of around three. PLR is not associated with recovery rate.

Comparison of Batroxobin Versus the Combination of Batroxobin and Intratympanic Dexamethasone Injection in the Treatment of Sudden Sensorineural Hearing Loss.

Introduction: Sudden sensorineural hearing loss (SSNHL) manifests as an abrupt decline in hearing by at least 30 dB within a 3 day period. Intratympanic dexamethasone injection (ITDI) has gained recognition as a potential treatment for SSNHL. This study aims to investigate the efficacy of combining batroxobin with ITDI (Bat and ITDI) in treating SSNHL patients and its influence on peripheral blood inflammatory indicators. Methods: SSNHL patients were retrospectively categorized into the control group (treated with Bat) and the observation group (treated with Bat and ITDI). The study involved analyzing clinical baseline data, evaluating clinical efficacy, and comparing the total effective rates among SSNHL patients with different audiometric curve types in the observation group. Routine blood tests were performed on peripheral blood samples to calculate the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), and to determine C-reactive protein (CRP) levels. Adverse reactions and complications were closely monitored. Results: Following treatment, both groups displayed improvements in hearing, with the observation group exhibiting a significantly higher total effective rate (75.90%) than the control group (59.78%). For patients with 3 distinct types of sudden hearing loss (high-frequency, flat-frequency, total deafness), Bat and ITDI treatment demonstrated increased total effective rate for patients with different sudden hearing loss types (high-frequency, flat-frequency, and total deafness). Both groups experienced reduced peripheral blood CRP levels and the NLR/PLR values, with the observation group demonstrating lower values. Additionally, across the 4 audio metric subtypes, the levels of peripheral blood CRP, NLR, and PLR decreased in SSNHL patients, and the observation group had a lower incidence of adverse reactions compared to the control group. Conclusions: Bat and ITDI emerge as notably more effective for SSNHL patients, displaying potential for reducing peripheral blood inflammatory indicator levels and mitigating the incidence of adverse reactions or complications, thereby enhancing safety.

Salvage therapy for refractory sudden sensorineural hearing loss (RSSNHL): a systematic review and network meta-analysis.

Approximately 30-50% of sudden sensorineural hearing loss (SSNHL) patients show poor response to systemic steroid therapy. Additionally, the most appropriate treatment for patients with refractory sudden sensorineural hearing loss (RSSNHL) is unknown. This study aimed to explore the best treatment for RSSNHL. Using a frequentist contrast-based model and PRISMA guidelines, this study compared five salvage regimes: intratympanic injection of steroids (ITS), hyperbaric oxygen (HBO) therapy, post auricle steroid injection (PSI), ITS combined with HBO therapy, and continued systemic steroids. We searched the PubMed, EMBASE, Web of Science, and Cochrane Library databases for randomised controlled trials and cohort studies comparing treatment regimens for RSSNHL. Compared with the control group (no additional treatment), PSI and ITS demonstrated significant improvements. The mean hearing gain was greater after PSI (11.1 dB [95% CI, 4.4-17.9]) than after ITS (7.7 dB [95% CI, 4.8-10.7]). When a restricted definition of RSSNHL was used, the ITS + HBO therapy showed the largest difference in improvement for pure tone average compared with the control group (14.5 dB [95% CI, 4.2-25.0]). The administration of either PSI or ITS leads to the greatest therapeutic effect in patients with RSSNHL. However, a consensus on the definition of RSSNHL is needed.

Association Study of CACNA1E Gene Polymorphisms and Sudden Sensorineural Hearing Loss

Background and Objectives The present study aimed to investigate whether single nucleotide polymorphisms (SNPs) in calcium voltage-gated channel subunit alpha1E (CACNA1E) are associated with sudden sensorineural hearing loss (SSNHL).Subjects and Method Eighty-one Korean SSNHL patients and 455 healthy subjects were selected from a single tertiary hospital. Human genomic DNA extracted from the peripheral blood samples and five exon regions of SNPs in CACNA1E were genotyped by direct sequencing.Results In rs357737760, the A/T genotype was present with significantly higher frequency among the SSNHL patients than the T/T (&lt;i&gt;p&lt;/i&gt;=0.0003) genotype. In rs34488539, the C/T genotype was present with significantly higher frequency among SSNHL patients than the C/C genotype (&lt;i&gt;p&lt;/i&gt;=0.0003). In rs4652678, the C/T genotype was present with significantly higher frequency among the SSNHL patients than the T/T genotype (codominant model, &lt;i&gt;p&lt;/i&gt;=0.0079) (dominant model, &lt;i&gt;p&lt;/i&gt;=0.0027) (overdominant model, &lt;i&gt;p&lt;/i&gt;=0.0021). In rs199930, the C/T genotype was present with significantly higher frequency among the SSNHL patients than the C/C genotype (codominant model, &lt;i&gt;p&lt;/i&gt;=0.0081) (dominant model, &lt;i&gt;p&lt;/i&gt;=0.0028) (overdominant model, &lt;i&gt;p&lt;/i&gt;=0.0022). In rs704326, the A/A genotype was present with significantly lower frequency among the SSNHL patients than the G/G genotype (codominant model, &lt;i&gt;p&lt;/i&gt;=0.0003) (recessive model, &lt;i&gt;p&lt;/i&gt;=0.0001).Conclusion We found rs35737760, rs344488539, rs4652678 and rs199930 SNPs of CACNA1E to be highly associated with SSNHL. Only rs704326 SNP of CACNA1E is found with low association with SSNHL.

LINE-1 global DNA methylation, iron homeostasis genes, sex and age in sudden sensorineural hearing loss (SSNHL)

BackgroundSudden sensorineural hearing loss (SSNHL) is an abrupt loss of hearing, still idiopathic in most of cases. Several mechanisms have been proposed including genetic and epigenetic interrelationships also considering iron homeostasis genes, ferroptosis and cellular stressors such as iron excess and dysfunctional mitochondrial superoxide dismutase activity.ResultsWe investigated 206 SSNHL patients and 420 healthy controls for the following genetic variants in the iron pathway: SLC40A1 − 8CG (ferroportin; FPN1), HAMP − 582AG (hepcidin; HEPC), HFE C282Y and H63D (homeostatic iron regulator), TF P570S (transferrin) and SOD2 A16V in the mitochondrial superoxide dismutase-2 gene. Among patients, SLC40A1 − 8GG homozygotes were overrepresented (8.25% vs 2.62%; P = 0.0015) as well SOD2 16VV genotype (32.0% vs 24.3%; P = 0.037) accounting for increased SSNHL risk (OR = 3.34; 1.54–7.29 and OR = 1.47; 1.02–2.12, respectively). Moreover, LINE-1 methylation was inversely related (r2 = 0.042; P = 0.001) with hearing loss score assessed as pure tone average (PTA, dB HL), and the trend was maintained after SLC40A1 − 8CG and HAMP − 582AG genotype stratification (ΔSLC40A1 = + 8.99 dB HL and ΔHAMP = − 6.07 dB HL). In multivariate investigations, principal component analysis (PCA) yielded PC1 (PTA, age, LINE-1, HAMP, SLC40A1) and PC2 (sex, HFEC282Y, SOD2, HAMP) among the five generated PCs, and logistic regression analysis ascribed to PC1 an inverse association with moderate/severe/profound HL (OR = 0.60; 0.42–0.86; P = 0.0006) and with severe/profound HL (OR = 0.52; 0.35–0.76; P = 0.001).ConclusionRecognizing genetic and epigenetic biomarkers and their mutual interactions in SSNHL is of great value and can help pharmacy science to design by pharmacogenomic data classical or advanced molecules, such as epidrugs, to target new pathways for a better prognosis and treatment of SSNHL.

The Association Between Dehydration and the Prognosis of Sudden Sensorineural Hearing Loss.

There is an urgent need to identify undetermined risk factors for sudden sensorineural hearing loss (SSNHL) for the development of effective treatment strategies. SSNHL is likely associated with vascular insufficiency; however, no study has evaluated the relationship between dehydration and SSNHL. This study aimed to investigate the role of dehydration in the development and prognosis of sudden sensorineural hearing loss. Retrospective case-control study. Secondary referral hospital. This was a comparative study that compared dehydration parameters between healthy subjects without SSNHL (n = 94) and patients with SSNHL (n = 94). The study also evaluated the effect of dehydrated conditions on the prognosis of SSNHL. We compared dehydration parameters, such as the blood urea nitrogen-to-creatinine ratio (BUN/Cre) and plasma osmolality (Posm), between matched healthy subjects without SSNHL and patients with SSNHL. To evaluate the effect of dehydrated conditions on the SSNHL prognosis, the SSNHL patients were divided into 2 groups based on the cutoff value obtained from the receiver operating characteristic analysis: hydrated (n = 50; BUN/Cre <21.4) and dehydrated (n = 44; BUN/Cre ≥21.4) groups. Subsequently, the severity and prognosis of SSNHL were analyzed. The dehydration parameters, BUN/Cre and Posm, were significantly higher in patients with SSNHL than in healthy subjects. The initial hearing levels and SSNHL grades were worse in the dehydrated group than in the hydrated group. Moreover, a dehydrated condition (BUN/Cre ≥21.4) was associated with a poor SSNHL prognosis in all models of the multiple logistic regression analysis. The dehydration parameters of BUN/Cre and Posm were higher in patients with SSNHL than in healthy subjects. Additionally, a dehydrated condition (BUN/Cre ≥21.4) was an independent prognostic factor for SSNHL. Level of evidence: Level 4.

The potential relationship between uric acid and the recovery in sudden sensorineural hearing loss

ObjectiveSerum uric acid is proven to be associated with chronic hearing loss, but its effect on Sudden Sensorineural Hearing Loss (SSNHL) is unclear. This study aims to evaluate the prognostic values of serum uric acid levels in SSNHL patients. MethodsThe clinical records of SSNHL patients were retrospectively reviewed. Patients were divided into different groups based on hearing recovery and audiogram type, and uric acid levels were compared. Based on uric acid levels, patients were categorized into normouricemia and hyperuricemia groups, and clinical features and hearing recovery were evaluated. Univariate and multivariate analyses were performed to identify prognostic factors. ResultsIn total, 520 SSNHL patients were included in this study, including 226 females and 294 males. In female patients, 186 patients were included in the normouricemia group, and 40 patients were enrolled in the hyperuricemia group. Significant differences were observed in uric acid levels, Total Cholesterol (TC), rate of complete recovery, and slight recovery between the two groups. In male patients, 237 subjects were categorized into the normouricemia group, and 57 patients were included in the hyperuricemia group. The rate of complete recovery and slight recovery was lower in the hyperuricemia group compared to the normouricemia group. All patients were further divided into good recovery and poor recovery groups based on hearing outcomes. The uric acid levels, initial hearing threshold, rate of hyperuricemia, and TC were lower in the good recovery group than the poor recovery group both in female and male patients. Binary logistic regression results showed that uric acid levels, initial hearing threshold, and hyperuricemia were associated with hearing recovery. ConclusionHyperuricemia might be an independent risk factor for hearing recovery in SSNHL patients. Serum uric acid and initial hearing threshold possibly affected the hearing outcome in males and females with SSNHL. Level of evidenceLevel 4.

Exploring functional connectivity alterations in sudden sensorineural hearing loss: A multilevel analysis

Sudden sensorineural hearing loss (SSNHL) constitutes an urgent otologic emergency, marked by a rapid decline of at least 30 dB across three consecutive frequencies within 72 h. While previous studies have noted brain region alterations encompassing both auditory and non-auditory areas, this research examines functional connectivity changes across integrity, network, and edge levels in SSNHL. The cohort included 184 participants: 107 SSNHL patients and 77 age- and sex-matched healthy controls. Our investigation comprises: (1) characterization of overall functional connectivity degree across 55 nodes in nine networks (p < 0.05, corrected for false discovery rate), exposing integrity level changes; (2) identification of reduced intranetwork connectivity strength within sensory and attention networks (somatomotor network, auditory network, ventral attention network, dorsal attention network) in SSNHL individuals (p < 0.05, Bonferroni corrected), and reduced internetwork connectivity across twelve distinct subnetwork pairs (p < 0.05, FDR corrected); (3) revelation of increased internetwork connectivity in SSNHL patients, primarily spanning dorsal attention network, fronto parietal network, default mode network, and limbic network, alongside widespread reductions in connectivity patterns among the nine distinct resting-state brain networks. The study further uncovers negative correlations between SSNHL duration and intranetwork connectivity of the auditory network (p < 0.001, R = −0.474), and between Tinnitus Handicap Inventory (THI) scores and internetwork connections linking auditory network and dorsal attention network (p < 0.001, R = −0.331). These observed alterations provide crucial insights into the neural mechanisms underpinning SSNHL and extend our comprehension of the brain's network-level responses to sensory loss. By unveiling the intricate interplay between sensory deprivation, adaptation, and cognitive processes, this study lays the groundwork for future research targeting enhanced diagnosis, treatment, and rehabilitation approaches for individuals afflicted by SSNHL.

Functional to structural plasticity in unilateral sudden sensorineural hearing loss: neuroimaging evidence

A cortical plasticity after long-duration single side deafness (SSD) is advocated with neuroimaging evidence while little is known about the short-duration SSDs. In this case-cohort study, we recruited unilateral sudden sensorineural hearing loss (SSNHL) patients and age-, gender-matched health controls (HC), followed by comprehensive neuroimaging analyses. The primary outcome measures were temporal alterations of varied dynamic functional network connectivity (dFNC) states, neurovascular coupling (NVC) and brain region volume at different stages of SSNHL. The secondary outcome measures were pure-tone audiograms of SSNHL patients before and after treatment. A total of 38 SSNHL patients (21 [55%] male; mean [standard deviation] age, 45.05 [15.83] years) and 44 HC (28 [64%] male; mean [standard deviation] age, 43.55 [12.80] years) were enrolled. SSNHL patients were categorized into subgroups based on the time from disease onset to the initial magnetic resonance imaging scan: early- (n = 16; 1-6 days), intermediate- (n = 9; 7-13 days), and late- stage (n = 13; 14-30 days) groups. We first identified slow state transitions between varied dFNC states at early-stage SSNHL, then revealed the decreased NVC restricted to the auditory cortex at the intermediate- and late-stage SSNHL. Finally, a significantly decreased volume of the left medial superior frontal gyrus (SFGmed) was observed only in the late-stage SSNHL cohort. Furthermore, the volume of the left SFGmed is robustly correlated with both disease duration and patient prognosis. Our study offered neuroimaging evidence for the evolvement from functional to structural brain alterations of SSNHL patients with disease duration less than 1 month, which may explain, from a neuroimaging perspective, why early-stage SSNHL patients have better therapeutic responses and hearing recovery.