Sudden Sensorineural Hearing Loss Research Articles

Fluctuating or progressive hearing loss in the middle-to-high frequencies may suggest the neurotologic endotype of perilymphatic fistula without antecedent traumatic events

BackgroundIdiopathic sudden sensorineural hearing loss (ISSNHL) is a common clinical condition. Recent studies indicate that approximately 20% of ISSNHL cases may involve perilymphatic fistula (PLF). The detection of Cochlin-tomoprotein (CTP) in middle-ear lavage samples confirms the diagnosis of PLF.Aims/ObjectivesTo clarify the clinical characteristics of inner ear–related symptoms in patients with PLF who lacked any antecedent traumatic events prior to symptom onset.Materials and methodsWe retrospectively reviewed clinical records and CTP test results in 769 cases from 70 hospitals in Japan.ResultsAmong these cases, 204 had no history of antecedent events. CTP-positive findings were more frequently observed in patients exhibiting fluctuating and/or progressive hearing loss than in those without these symptoms (p < 0.05, Fisher’s exact test). The odds of a positive CTP test did not differ between patients with and without vestibular symptoms, nystagmus, a fistula sign, a popping sensation, or streaming water–like tinnitus (p > 0.05, Fisher’s exact test). The CTP positivity rate was highest in patients with a high-frequency sloping audiogram.Conclusions and significanceFluctuating or progressive hearing loss in the middle-to-high frequencies may reasonably suggest PLF in the absence of antecedent traumatic events.

Acute myocardial infarction after batroxobin treatment of sudden sensorineural hearing loss: Case report.

The drug batroxobin is utilized to enhance microcirculation by reducing fibrinogen levels, making it a treatment option for the acute stage of severe sudden sensorineural hearing loss (SSNHL). However, the efficacy of batroxobin defibrination remains controversial. It is crucial to also consider the potential thrombotic effects of batroxobin. This is the first report of acute myocardial infarction (AMI) in patients after treatment for SSNHL with batroxobin, aiming to enhance its clinical safety profile. A 61-year-old male patient presented with severe SSNHL in the left ear. During hospitalization, the plasma fibrinogen level remained consistently low following batroxobin treatment and subsequently led to AMI. SSNHL, AMI. Percutaneous coronary intervention surgery confirmed thrombus blockage in the middle segment of the right coronary artery, and the symptoms were relieved after thrombus removal. The patient was discharged from the hospital on the 5th day after surgery without any recurrence of AMI up to now. The pharmacology and toxicity of batroxobin are intricate, necessitating careful consideration of potential secondary thrombosis during treatment, particularly regarding fibrinogen levels.

Classification Accuracy of Linear Discriminant Function using Principal Components with Multiple Correlated Variables: A Simulation based Exploration

ABSTRACT Background: Linear Discriminant Analysis (LDA) is a powerful and widely used technique for classification with correlated variables. Principal Components (PCs) group these variables into linear combinations and produce independent variables. The LDA on these PC’s may provide better classification accuracy in clinical diagnostics than on usual measurements. Methodology: Two datasets were utilized for demonstration: one from a Sudden Sensorineural Hearing Loss (SSNHL) case-control study and the other from a Gall Bladder (GB) case-control study. Linear Discriminant Analysis (LDA) was conducted on the actual correlated measured variables for group classification, as well as on the derived principal component variables, to compare their classification accuracies. Performance metrics including Sensitivity, Specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), Classification Accuracy, and F1 Score were assessed. For validation, a third simulated dataset was employed. Additionally, LDA was performed on each dataset using eigenvectors of the control group applied to the cases and vice versa, revealing a strong agreement in classification as measured by the kappa statistic. Results: When LDA was applied to the actual lipid measurements in the SSNHL dataset, the classification accuracy was 57.2%, and the F1 score was 39.7%. However, when LDA was performed using principal components (PCs), the classification accuracy markedly improved to 99.2%, with an F1 score of 98.5%. Similarly, for the GB cancer dataset, the classification accuracy and F1 score were initially 77.2% and 77.3%, respectively. Upon applying LDA with the PCs, these metrics were significantly enhanced to 98.4% and 98.3%, respectively. For the simulated dataset, both the classification accuracy and F1 score were 99.1%. The study also demonstrated that the classification accuracy and F1 score remained consistent regardless of whether the eigenvectors from the cases or controls were used to classify new subjects (Kappa Statistic = 0.962, P < 0.001). Conclusion: In group separation, utilizing principal components significantly improves classification accuracy and overall performance metrics, outperforming the use of the original correlated predictors.

The efficacy of methylprednisolone acetate nanogel in treating patients with sudden sensorineural hearing loss

Intratympanic injection of methylprednisolone acetate is considered to be one of the effective drugs in the treatment of sudden sensorineural hearing loss. In this study, the efficacy of intratympanic injection of methylprednisolone acetate nanogel in patients with sudden sensorineural hearing loss was investigated. It is a double-blind randomized clinical trial in one of Iran’s hospitals. 96 patients diagnosed with sudden sensorineural hearing loss were examined. The intervention group (40 patients) was treated with intratympanic nanogel form of methylprednisolone acetate (four times, one day in between) along with oral prednisolone, and the control group (56 patients) was treated with the usual ampoule form of methylprednisolone acetate along with oral prednisolone. The patients were followed up two weeks and two months after the treatment by checking the audiometric findings. 22.9% of all patients had complete response to treatment and 58.3% partial response to treatment. Complete response to treatment was more common in patients of the intervention group, and non-response to treatment was more common in the control group. The frequency of tinnitus two months after the start of treatment was significantly lower in the intervention group, but the frequency of dizziness was not significantly different between the two groups. In both groups, a significant improvement in audiometric findings was observed after treatment compared to before treatment (p < 0.0001). In both groups, a significant improvement in audiometric findings was observed after treatment compared to before treatment (p < 0.0001), and this improvement rate was slightly higher in the intervention group than in the control group. Combined treatment of systemic steroid with both nanogel and or conventional intratympanic methylprednisolone acetate can be effective in the treatment of sudden sensorineural hearing loss, but the effectiveness of the nanogel form of the drug is slightly higher. Therefore, drug transfer based on nanogels can be considered to achieve better treatment results.

Clinical and audiological profile of patients with sudden sensorineural hearing loss after exposure to recreational noise.

Clinical and audiological profile of patients with sudden sensorineural hearing loss after exposure to recreational noise.

A systematic review of SARS-CoV-2 associated sudden onset sensorineural hearing loss

A systematic review of SARS-CoV-2 associated sudden onset sensorineural hearing loss

Dose-response relationship of aspirin and sudden sensorineural hearing loss risk in type 2 diabetes: Aspirin dosage on SSNHL risk in T2D.

Dose-response relationship of aspirin and sudden sensorineural hearing loss risk in type 2 diabetes: Aspirin dosage on SSNHL risk in T2D.

Sudden sensorineural hearing loss and vertigo following temporomandibular joint arthroscopy: a case report and literature review.

Sudden sensorineural hearing loss and vertigo following temporomandibular joint arthroscopy: a case report and literature review.

Incidence of Tympanic Membrane Perforation Affected by Intratympanic Steroid Injection: A Retrospective Review

Objective: This study aims to determine the incidence of persistent tympanic membrane perforation following intratympanic steroid injection and to identify potential factors associated with delayed healing. Additionally, it aims to estimate the time required for perforation closure in prolonged cases to avoid unnecessary interventions. Materials and Methods: Data from patients who underwent intratympanic steroid injections were reviewed. The primary outcome was the incidence of tympanic membrane perforation lasting beyond four weeks post-injection. Secondary outcomes included identifying factors affecting healing duration and closure time in prolonged cases. Results: Of 295 ears treated between March 2018 and March 2021, 3.39% (10/295) experienced persistent perforation at four weeks. Of these, 1.69% (5/295) required intervention, while the rest healed spontaneously. The median closure time was 12 weeks. All patients with persistent perforation were female. No statistically significant differences were found between groups. Hearing recovery was achieved in 29.1% (74/254) of patients with sudden sensorineural hearing loss. Younger age and non-profound hearing loss were favorable prognostic factors. Conclusion: The incidence of perforation in this study is lower than previously reported but consistent with other literature. Intratympanic steroid injections remain beneficial, outweighing the risks of complications.

Prognostic Factors and Clinical Characteristics in Pediatric Sudden Sensorineural Hearing Loss: A Retrospective Analysis.

To investigate the clinical characteristics and prognostic factors influencing treatment outcomes in pediatric sudden sensorineural hearing loss (PSSNHL). A retrospective analysis was conducted on 63 children (64 ears) diagnosed with PSSNHL from January 2013 to December 2023. All patients received either systemic or intra-tympanic steroid therapy. Data on age, tinnitus presence, audiogram types, and initial hearing thresholds were analyzed using SPSS 25.0. Univariate and multivariate logistic regressions were performed to identify significant prognostic factors. The mean age was 16 years (interquartile range:14-17 years). Median time from symptom onset to treatment was 7 days (interquartile range: 4-13 days). Tinnitus was present in 85.7% of cases. Post-treatment hearing thresholds improved from 84.52 ± 3.29 dB HL to 64.17 ± 4.48 dB HL (p < 0.001). The overall therapeutic efficacy rate was 48.4%. Multivariate analysis identified time from onset to treatment (OR = 0.923; 95% CI: 0.789-0.997; p < 0.01) and initial hearing threshold (OR = 0.939; 95% CI: 0.869-0.981; p < 0.05) as independent prognostic factors. Early intervention and lower initial hearing thresholds are associated with a better prognosis in PSSNHL. Prompt treatment significantly improves outcomes, highlighting the importance of early diagnosis and intervention. Level 4.

Role of hyperbaric oxygen therapy in idiopathic sudden sensorineural hearing loss management: A multicentre experience

Role of hyperbaric oxygen therapy in idiopathic sudden sensorineural hearing loss management: A multicentre experience

Prognosis of Audiologic Recovery From Sudden Sensorineural Hearing Loss Following Corticosteroid Intervention: A Retrospective Chart Review Across Multiple Outcome Measures.

This study aimed to evaluate associations among pretreatment hearing deficit, corticosteroid intervention, and audiologic recovery among patients presenting with sudden sensorineural hearing loss within an integrated health system. Electronic health records within a multicenter integrated health system were queried for clinical encounters with a diagnosis of sudden sensorineural hearing loss in 2021. Patient demographics, audiometric data, and therapeutic steroid intervention were recorded. Audiologic response was defined as a decrease of 15 dB in 4-frequency (500, 1000, 2000, 4000 Hz) pure tone average (PTA). Audiologic recovery, or complete response, was defined as a follow-up PTA (PTA2) of ≤ 25 dB or within 10 dB of 1) baseline or 2) contralateral ear. Logistic regressions were performed to evaluate for predictive factors. A total of 403 patients (mean age 59.27 ± 15.80 years, 57.32% male) met inclusion criteria, of which 355 underwent corticosteroid intervention. The nonsteroid group had a less severe hearing deficit (median PTA1 49.38 dB vs 58.75 dB with steroid group; P < .05). Median PTA improvement was 6.25 dB with steroid therapy and 3.63 dB without (P < .05), but median PTA2 between steroid and nonsteroid users was not significantly different (42.5 dB and 38.13 dB, respectively; P = .821). Steroid intervention within 14 days was predictive of an audiologic response (odds ratio [OR] = 2.33) and recovery (OR = 2.46; both P < .05) compared with patients who did not undergo steroid therapy, whereas delayed steroid intervention was not, regardless of steroid regimen. Severe hearing loss had worse odds of audiologic response (OR = 0.40) or recovery (OR = 0.10; both P < .05) compared with mild hearing loss. Pretreatment hearing deficit and initiation of empiric steroid therapy within 14 days were associated with audiologic prognosis, independent of the corticosteroid regimen. These findings reinforce the benefit of prompt steroid intervention, while further highlighting a need for standardized measures of audiometric outcomes.

Temporal Bone Magnetic Resonance Imaging in Sudden Sensorineural Hearing Loss: Low Frequency Versus Other Types.

Gadolinium-enhanced magnetic resonance imaging (MRI) is the gold standard for diagnosing vestibular schwannoma (VS). This study aimed to compare the incidence of VS among patients with low-frequency, high-frequency, and flat-type sudden sensorineural hearing loss (SSNHL) and to assess the effectiveness of MRI for each SSNHL type. We analyzed 755 patients diagnosed with SSNHL at a single tertiary center between January 2014 and March 2020. All underwent temporal bone MRI. Logistic regression was used to determine the associations of SSNHL types with VS. Additionally, we conducted a correlation analysis to examine the relationship between word recognition scores (WRS) and the size of tumors measured on MRI at the time of diagnosis. Magnetic resonance imaging identified VS in 23 of 755 cases (3.0%). Of the patients, 123 (16.3%) had low-frequency SSNHL; none of these patients had VS. The incidence of VS differed significantly between the low-frequency SSNHL group and other SSNHL types (P < .001). A significant negative correlation was found between initial tumor size and WRS (r2 = 0.2905, P=.008). The prevalence of VS was rare in patients with low-frequency SSNHL. The pattern of hearing loss may provide insights into the likelihood of tumor presence, thereby aiding in more effective audiometric screening and decision-making regarding MRI for detecting VS.

The relation of sudden sensory neural hearing loss with the previous incidence of chronic periodontitis.

Chronic periodontitis (CP) has been linked to an increased risk of sudden sensorineural hearing loss (SSNHL). This study aimed to delineate the causal relationships between CP and SSNHL. Data from 40-year-old participants in the Korean National Health Insurance Service-Health Screening Cohort from 2002 through 2019 were used. The data of 13,769 patients with SSNHL were collected and matched with those of 55,076 control participants in terms of demographic and socioeconomic variables. The incidence of CP before the onset of SSNHL was recorded. The odds ratios (ORs) of CP for SSNHL were analyzed via conditional logistic regression. The ORs for SSNHL were analyzed according to the frequency of CP, ≥ 1, 2, and 3 times within 1 year and ≥ 1 within 2 years. In addition, sensitivity analyses were conducted for all the covariables. CP patients had a higher mean CP occurrence (0.71 within one year, 1.34 within two years) than controls. CP was associated with increased odds of SSNHL (OR = 1.14 [95% confidence intervals (CI) = 1.10-1.19] for CP ≥ 1 within one year, OR = 1.09 [95%CI = 1.03- 1.15] for CP ≥ 2, and OR = 1.09 [95% CI = 1.02-1.17] for CP ≥ 3). CP ≥ 1 within two years was related to a 1.15 (95% CI = 1.10-1.19) times greater odds for SSNHL. Higher SSNHL rate was also observed in subgroups of underweight, overweight, elderly, and comorbid individuals. CP was linked with an elevated incidence of SSNHL. Individuals with comorbidities, advanced age, or abnormal body weight were more likely to have CP with SSNHL.

Association of Circulating Cell-Free Mitochondrial DNA With Sudden Sensorineural Hearing Loss.

To evaluate the association of circulating cell-free mitochondrial DNA (ccf-mtDNA) levels with the severity and treatment outcomes of sudden sensorineural hearing loss (SSNHL). Observational prospective study. Tertiary academic medical center. Plasma samples were collected from patients diagnosed with SSNHL in the morning before steroid treatment, as well as from healthy controls. A quantitative polymerase chain reaction was used to measure ccf-mtDNA levels, expressed as log copy numbers per milliliter. Treatment outcomes were evaluated using hearing gain, percentage of recovery, and Siegel's criteria. The study included 80 subjects, including 50 patients and 30 healthy controls. The mean (SD) plasma ccf-mtDNA level was 8.1 (0.35), which was significantly higher than 7.78 (0.65) controls (95% CI: 0.097-0.542). Patients with good recovery exhibited significantly higher pretreatment ccf-mtDNA levels compared to those with poor recovery (mean [SD] score: 8.29 [0.34] vs 8.02 [0.33]; 95% CI: 0.04-0.48). Ccf-mtDNA levels were positively associated with hearing gain (r = 0.486, 95% CI: 0.227-0.663) and percentage of recovery (r = 0.361, 95% CI: 0.103-0.574). Multivariate analyses revealed that less than 7 days from onset of hearing loss to treatment (odds ratio [OR]: 7.389, 95% CI: 1.324-41.239) and higher ccf-mtDNA levels (OR: 24.634, 95% CI: 1.878-323.163) were independent predictors for good recovery. Plasma ccf-mtDNA levels were elevated in patients with SSNHL and were significantly associated with better treatment outcomes following steroid therapy. These findings suggest that ccf-mtDNA levels may serve as a predictive biomarker for SSNHL treatment outcomes, paving the way for personalized therapeutic strategies.

Statin Use and Reduced Risk of Sudden Sensorineural Hearing Loss in Type 2 Diabetes.

To examine the association between statin use and the risk of sudden sensorineural hearing loss (SSNHL) in patients with type 2 diabetes (T2D), focusing on statin type, dosage, and treatment duration. Retrospective cohort study. Taiwan National Health Insurance Research Database. We analyzed T2D patients diagnosed between 2008 and 2019, stratified into statin users and nonusers of lipid-lowering therapy. Propensity score matching was used to balance baseline characteristics. Multivariable Cox regression, adjusted for competing risks, assessed the association between statin use and SSNHL risk, as well as all-cause mortality. Statin exposure was analyzed based on cumulative and daily doses. The study cohort included 66,120 statin users and 66,120 nonusers. Statin use was associated with a significantly lower SSNHL risk (adjusted hazard ratio [aHR], 0.83; 95% CI, 0.74-0.92; P = .0008) and reduced all-cause mortality (aHR, 0.55; 95% CI, 0.52-0.57; P < .0001). A dose-response relationship was observed, with higher cumulative defined daily doses (cDDDs) linked to progressively lower SSNHL risk. Hydrophilic statins, particularly rosuvastatin, showed stronger protective effects compared to lipophilic statins. Statin use in T2D patients is associated with reduced SSNHL risk and all-cause mortality, with dose-dependent effects. These findings suggest the potential otoprotective benefits of statins and emphasize the importance of personalized therapy for managing both hearing and cardiovascular health in this high-risk population.

Management of Sudden Onset Sensorineural Hearing Loss and the Role of Pentoxyphylline as an Add-on Therapy to Conventional Treatment

Management of Sudden Onset Sensorineural Hearing Loss and the Role of Pentoxyphylline as an Add-on Therapy to Conventional Treatment

Analysis of current research on recurrent sudden sensorineural hearing loss

Analysis of current research on recurrent sudden sensorineural hearing loss

The genetic susceptibility of SOD2 gene polymorphism in sudden sensorineural hearing loss (SSNHL)

The genetic susceptibility of SOD2 gene polymorphism in sudden sensorineural hearing loss (SSNHL)

Neurovascular coupling dysfunction associated with inflammatory factors in sudden sensorineural hearing loss.

Neurovascular coupling dysfunction associated with inflammatory factors in sudden sensorineural hearing loss.