Unilateral Sensorineural Hearing Research Articles

Prediction of hearing recovery in unilateral sudden sensorineural hearing loss using artificial intelligence

Despite the significance of predicting the prognosis of idiopathic sudden sensorineural hearing loss (ISSNHL), no predictive models have been established. This study used artificial intelligence to develop prognosis models to predict recovery from ISSNHL. We retrospectively reviewed the medical data of 453 patients with ISSNHL (men, 220; women, 233; mean age, 50.3 years) who underwent treatment at a tertiary hospital between January 2021 and December 2019 and were followed up after 1 month. According to Siegel’s criteria, 203 patients recovered in 1 month. Demographic characteristics, clinical and laboratory data, and pure-tone audiometry were analyzed. Logistic regression (baseline), a support vector machine, extreme gradient boosting, a light gradient boosting machine, and multilayer perceptron were used. The outcomes were the area under the receiver operating characteristic curve (AUROC) primarily, area under the precision-recall curve, Brier score, balanced accuracy, and F1 score. The light gradient boosting machine model had the best AUROC and balanced accuracy. Together with multilayer perceptron, it was also significantly superior to logistic regression in terms of AUROC. Using the SHapley Additive exPlanation method, we found that the initial audiogram shape is the most important prognostic factor. Machine/deep learning methods were successfully established to predict the prognosis of ISSNHL.

The impairment of speech perception in noise following pure tone hearing recovery in patients with sudden sensorineural hearing loss

To explore whether patients with unilateral idiopathic sudden sensorineural hearing loss (uISSNHL) have normal speech in noise (SIN) perception under different masking conditions after complete recovery of pure tone audiometry. Eight completely recovered uISSNHL patients were enrolled in ISSNHL group, while 8 normal-hearing adults matched with age, gender, and education experience were selected as the control group. Each group was tested SIN under four masking conditions, including noise and speech maskings with and without spatial separation cues. For both ISSNHL and control groups a two-way ANOVA showed a statistically significant effect of masking type (p = 0.007 vs p = 0.012). A significant effect of perceived spatial separation (p < 0.001 vs p < 0.001). A significant interaction between masking type and perceived spatial separation was found (p < 0.001 vs p < 0.001). A paired sample T-test showed that the SIN perception of the control group was statistically significant lower than that of ISSNHL patients only under speech masking without spatial separation cues (p = 0.011). There were still abnormalities in the auditory center shortly after complete recovery in the ISSNHL group (within 2 weeks). However, the auditory periphery and higher-level ability to use spatial cues was normal.

Dynamic Alterations of Functional Connectivity and Amplitude of Low-Frequency Fluctuations in Patients with Unilateral Sudden Sensorineural Hearing Loss

Dynamic Alterations of Functional Connectivity and Amplitude of Low-Frequency Fluctuations in Patients with Unilateral Sudden Sensorineural Hearing Loss

Does sealing the oval window in addition to the round window bring an advantage in reserve therapy of acute idiopathic deafness?

HintergrundBei plötzlich aufgetretener einseitiger hochgradiger sensorineuraler Hörstörung bzw. Ertaubung können Patienten nach frustraner intravenöser Glukokortikoidtherapie einer explorativen Tympanotomie mit Abdeckung des runden und/oder ovalen Fensters (RF und/oder OF) wegen des Verdachts einer Rundfenstermembranruptur mit Perilymphfistel (PLF) oder einer Fissula ante fenestram (FAF) behandelt werden. Die Studie untersucht, ob die zusätzliche Abdeckung des ovalen Fensters im Vergleich zur alleinigen Abdeckung des runden Fensters einen zusätzlichen Hörgewinn bringt.MethodikDie retrospektive Studie untersucht 54 Patienten mit akuter Ertaubung und durchgeführter Tympanoskopie, bei denen Audiogramme von 3 Zeitpunkten (präoperativ, nach Detamponade sowie mindestens 3–6 Monate postoperativ) vorlagen. Bei 28 Patienten erfolgte neben der Rundfensterabdeckung die zusätzliche Abdeckung des ovalen Fensters.ErgebnisEine intraoperativ sichtbare PFL bzw. FAF wurde in keinem Operationsbericht beschrieben. Die Hörschwellen waren im frühen postoperativen Zeitraum bereits hoch signifikant geringer und verbesserten sich im weiteren Verlauf. Zwischen den Subgruppen RF und RF + OF zeigte sich in beiden postoperativen Zeiträumen kein signifikanter Unterschied. Bei 65 % (Kriterien nach Kanzaki) und 74 % (Kriterien nach Siegel) der Patienten konnte postoperativ eine partielle bzw. komplette Hörverbesserung nachgewiesen werden. Beim Vergleich der Patientengruppen mit bzw. ohne postoperative Hörverbesserung zeigten sich keine statistischen Unterschiede bezüglich Geschlecht, Alter, Nebendiagnosen oder Latenz der Operation bis zum Symptombeginn.SchlussfolgerungIn dieser Studie zeigte die zusätzliche Abdeckung des OF keine signifikante Hörverbesserung. Die postoperative Hörverbesserung entspricht den publizierten Spontanremissionsraten. Nur eine prospektive multizentrische Studie mit Kontrollgruppe kann den Stellenwert der Tympanoskopie und mit Rund- bzw. ovaler Fensterabdeckung bei einer akuten hochgradigen sensorineuralen Schwerhörigkeit vor dem Hintergrund der Spontanremissionen klären.

Tek Taraflı Ani İşitme Kayıplı Hastalarda Vestibüler Uyarılmış Miyojenik Potansiyel Bulguları

Tek Taraflı Ani İşitme Kayıplı Hastalarda Vestibüler Uyarılmış Miyojenik Potansiyel Bulguları

Feasibility of constructing a unilateral sudden sensorineural hearing loss machine learning classification model based on diffusion tensor imaging

Objective To explore the feasibility of constructing a machine learning classification model for unilateral sudden sensorineural hearing loss (SSHL) patients and normal controls based on diffusion tensor imaging. Methods Prospective collection of 84 patients with untreated SSHL were recruited from the otolaryngology department of the Union Hospital of Tongji Medical College of Huazhong University of Science and Technology between June 2013 to May 2015 as the SSHL group. Meanwhile, a total of 63 healthy volunteers who were no any ear disease history, and the hearing function were confirmed with pure tone audiometry, were collected as the control group. All subjects underwent a brain DTI scan. The data were divided into the training set and validation set according to the ratio of 7 to 3, that was, the training set contained 58 cases of SSHL patients and 44 control groups, and the validation set included 26 cases of SSHL patients and 19 control groups. A vector which included the DTI parameters such as fractional anisotropy, mean diffusivity, axial diffusivity and radial diffusivity was constructed with the software R. The LASSO regression of machine learning method was used to perform feature dimensionality reduction and construct a classification model. The training set samples were used to map the nomogram based on the multivariate logistic analysis method, the validation set and the AUC were used to evaluate the prediction ability of the nomogram, and the calibration curve was used to evaluate the model. Results From the 200 feature vectors including the fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) values of each brain region, after each dimension reduction process, a total of six features were retained, which were the MD of left superior corona radiate and right superior fronto-occipital fasciculus, the AD of the body of corpus callosum, and the RD of left inferior cerebellar peduncle, left superior corona radiate and right posterior limb of internal capsule. The six features of patients with unilateral SSHL were higher than the control group, and the difference was statistically significant (P<0.05). Based on this, a two-class model is constructed and a nomogram is drawn. The sensitivity, specificity, accuracy and AUC of the training set were 93.1% (54/58), 72.7% (32/44), 84.3% (86/102) and 0.854, respectively; the sensitivity, specificity, accuracy and AUC of validation set were 80.8% (21/26), 84.2% (16/19), 82.2% (37/45), 0.870, respectively. Nomogram could significantly improve the classification efficiency of the control group and patients, and the model with the LASSO method showed a higher prediction curve than other models. Conclusions The machine learning classification model based on DTI metrics can effectively distinguish patients with unilateral sudden sensorineural deafness from healthy control people. Key words: Hearing loss, sensorineural; Diffusion tensor imaging; Machine learning; Classification; Nomogram; Decision curve analysis

Mechanism of neurodevelopment of children with hearing deprivation

100 children with sensorineural hearing loss, who had confirmed hearing impairment, were examined by routine somatoneurological and surdological survey, as well as standard psychomotor development scales (Alberta Infant Motor Scale (AIMS), Denver Developmental Screening Test (DDST), Griffiths Mental Development Scales (GMDS, GMDS-ER) in the city rehabilitation center for children with hearing and speech pathology. Criterion for inclusion in the study were the following: post-conceptual age of the child had to be not more than 36 months at the time of observation; bilateral or unilateral chronic sensorineural hearing loss or deafness and/or the presence of auditory neuropathy, confirmed by objective methods with modern audiological examinations for the core group; the absence of hearing loss, set by the modern objective methods of audiological examination for the comparison group; assessment of psychomotor and speech development of a child with at least two scales from the selection below. The survey results were analyzed using nonparametric statistical methods. Next Bayesian networks were used as efficient, compact, and intuitive way to represent knowledge related to uncertainty. Patterns of mental development, motor skills, speech and social functions in children with hearing impairment were obtained. The technique, which, depending on the factors affecting the trait under study, can help to predict with certainty the likelihood of various normal and deviant development of the child.

Comparison of performance across transcranial contralateral routing of signal, trimmer digital and digital bone-anchored hearing implant (with headbands) in children with unilateral hearing loss

Background: Children with unilateral hearing loss (UHL) of severe profound degree find it challenging to locate a sound source and to comprehend speech in the presence of noise, like in classrooms. The objectives of the present study were to compare the available rehabilitative options for children with UHL and arrive at a probably appropriate option. Methods: Fifteen children with unilateral severe sensorineural or profound hearing loss participated in the study. The sound field thresholds, speech perception in the presence of noise and in quiet were assessed with the digitally programmable bone-anchored hearing implant (BAHI), the trimmer digital BAHI and the transcranial contralateral routing of signal (T-CROS). Results: BAHI and T-CROS both provide significant benefit for the children with UHL. However, the children performed better with the BAHIs than the T-CROS both in quiet and noise in most of the measures. It was also noted that the digitally programmable and the trimmer digital BAHI both gave similar performance. Conclusions: BAHI was a better option in both quiet and noise than the T-CROS as a rehabilitation option for children with UHL. The current study helps in prioritizing the rehabilitation options while considering trial and also helps in narrowing down at the appropriate rehabilitative option for the children with UHL.

Vestibular schwannoma diagnosis: evaluation of a neuro-otological test battery

Objective: Gadolinium-enhanced Magnetic Resonance Imaging (MRI) constitutes the gold standard technique in detecting vestibular schwannomas (VS). The investigation aimed to verify whether it is possible to reach high sensitivity in the early diagnosis of VS, combining Auditory Brainstem Responses (ABRs) with other bedside and electrophysiological neuro-otological tests.Methods: Fifty-five patients suffering from VS smaller than 2 cm in major diameter, detected by gadolinium-enhanced MRI, were submitted to: Pure Tone Audiometry, Speech Audiometry, Vestibular Examination, Caloric Test, Head Shaking Test (HST), Head Impulse Test (HIT), Hyperventilation Test (HT), Vibration Test (VT), ABRs, Cervical Vestibular Evoked Myogenic Potentials (cVEMPs).Results: HST showed pathological results in 34 cases (61.82% sensitivity), HIT in 29 (52.73% sensitivity), HT in 38 (69.09% sensitivity), VT in 27 (49.1% sensitivity), ABRs in 35 (in 12 cases this examination was not conducted because of the high pure tone hearing threshold level, 81.39% sensitivity), cVEMPs in 34 (61.82% sensitivity). If we consider only symptomatic patients (54 out of 55), in all cases we observed at least one pathological test (100% sensitivity).Conclusion: In patients suffering from unilateral or asymmetrical sensorineural hearing loss, we suggest the use of bedside and electrophysiological tests in order to reduce the use of imaging to high suspicion cases of retrocochlear disease, lowering costs and waiting lists.

Vestibular dysfunction in patients with post-mumps sensorineural hearing loss.

To study the possible damage to the vestibular system in patients with post-mumps sensorineural hearing loss. Nineteen patients with recent mumps infection participated in the study. All patients had unilateral profound sensorineural hearing loss or total hearing loss. Patients were subjected to video-nystagmography and vestibular-evoked myogenic potential testing. Eight patients (42.1 per cent) had normal video-nystagmography results and intact vestibular-evoked myogenic potentials on both sides, whereas the other 11 patients (57.9 per cent) had vestibular lesions in the form of marked canal weakness and absent vestibular-evoked myogenic potential responses on the same side as hearing loss. The overall findings indicated a peripheral site for the lesions. The majority of patients with post-mumps sensorineural hearing loss had peripheral vestibular pathology in the same ear as hearing loss. Further research should be directed to saving the inner ear following mumps infection.

Bilateral Hearing Loss as a Presentation of Leptomeningeal Carcinomatosis

Unilateral idiopathic sudden sensorineural hearing loss is often encountered, but bilateral progressive hearing loss is rare. Here we present a case of a 46-year-old man who was diagnosed as the leptomeningeal carcinomatosis (LC) from lung adenocarcinoma. An enhanced magnetic resonance imaging (MRI) showed a strong enhancement effect of bilateral vestibulocochlear nerves. High-resolution T2-weighted imaging additionally revealed the accompanying metastasis in bilateral internal auditory canals (IACs). Hearing loss due to LC started from in higher frequencies and rapidly progressed from unilateral to bilateral. Otoacoustic emission showed the positive response inconsistent with the poor hearing results in pure tone audiometry, but this response disappeared soon with the rapid deterioration of hearing. IAC metastasis with LC caused an irreversible cochlear damage and the hearing of this patient could not recover even after the IAC mass disappeared on MRI. Audiometric evaluation, including PTA and OAE, would provide diagnostic clues and we should proceed with the investigation of brain MRI and CSF cytology urgently to reach the earlier diagnosis of LC.

EHMTI-0320. Orthostatic headache and audiovestibular dysfunction associated with intracranial hypotension

Results Out of the 16 patients with intracranial hypotension, five (31%) had neuro-otological symptoms along with the orthostatic headache. One of them presented with recurrent spontaneous vertigo and tinnitus mimicking meniere’s disease (MD). Oculographic analysis documented abnormal eye movements in 38%, which include spontaneous downbeat nystagmus with variable positional modulation (n = 3, 19%) and positional upbeat nystagmus (n = 3, 19%). During the attack of vertigo in the patient with MD-like symptoms, we observed unidirectional horizontal and torsional nystagmus with normal head impulse test. Bithermal caloric tests were normal in all patients who tested. Audiometry showed unilateral or bilateral sensorineural hearing loss in about half of the patients. Conclusions Our study demonstrates that intracranial hypotension can induce higher frequency of audiovestibular dysfunction, which may be attributed to both irritation or dysfunction of the peripheral labyrinth or vestibulocochlear nerve, and brainstem or cerebellar dysfunction due to brain sagging. No conflict of interest.

Prevalence of labyrinthine ossification in CT and MR imaging of patients with acute deafness to severe sensorineural hearing loss

Objective: To evaluate the prevalence of labyrinthine ossification, and especially cochlear ossification, in a cohort of patients with unilateral sudden deafness or severe sensorineural hearing loss. Design: Retrospective data collection. Study sample: Sixty-four consecutive patients with unilateral sudden deafness or severe sensorineural hearing loss and either high-resolution CT (HRCT) of the temporal bone (isotropic spatial resolution ≤ 0.8 mm; n = 18) or high resolution CISS MRI (isotropic spatial resolution ≤ 1 mm; n = 55) were included. Nine patients underwent both imaging modalities. A standardized reading regarding labyrinthine ossifications was performed by an experienced head and neck radiologist blinded to clinical symptoms. Results: Radiologic signs of cochlear ossification were present in 14 patients (12 CT and 2 MRI). Eight patients showed unilateral and six patients bilateral signs of cochlear ossification. In all except one of the unilateral cases, the deafened ear was affected. Conclusions: Signs of cochlear ossification were found in an unexpectedly high rate (14/64, 22%) of patients with acute deafness. The data suggest HRCT of the temporal bone to be more sensitive to detect labyrinthine ossification than MRI. HRCT of the temporal bone should therefore be considered in patients with impaired recovery of acute deafness to exclude cochlear ossification; if present, and, in cases of early signs, the patient should be evaluated further to facilitate early cochlear implantation before progression impedes electrode insertion, reflecting latest developments considering cochlea implants for single-sided deafness to be effective.

A patient with unilateral idiopathic sudden sensorineural hearing loss

A patient with unilateral idiopathic sudden sensorineural hearing loss

Sudden sensorineural hearing loss associated with internal carotid artery pseudoaneurysm: causal or incidental?

Sudden deafness is acute onset of impaired hearing which develops within hours to few days. The commonly accepted audiometric criterion is a decrease in hearing of ≥ 30 dB, affecting at least three consecutive frequencies. Hearing loss is thought to involve several causative factors, including internal ear circulatory disturbances. We report the case of a female with an internal carotid artery (ICA) pseudoaneurysm in the distal cervical tract and unilateral sudden sensorineural hearing loss (SSNHL). As putative risk vascular factor, the patient had history of migraine since youth. Extensive screenings for autoimmune, rheumatic diseases, virological, and microbiological infections were negative. The patient denied recent cervical trauma. Furosemide and oral prednisone were given with initial benefit and withdrawn in 3 weeks. The patient experienced short-lasting episodes of headache, tinnitus, vertigo. Five weeks after first onset, she underwent magnetic resonance imaging (MRI) angiogram which revealed fusiform dilatation of left ICA in the cervical tract. It can be proposed, but it remains to be proved, that the pseudoaneurysm of the cervical ICA plays a role in the patient SSNHL in relation to turbulent flow or thromboembolism of branches to the inner ear.

Mondini Dysplasia Presenting as Otorrhea without Meningitis

Mondini dysplasia is a rare inner ear malformation that is usually only diagnosed after recurrent meningitis. Surgical intervention is mandatory. This report highlights the case of a patient with Mondini dysplasia who presented with hearing impairment and otorrhea and was diagnosed and treated before the occurrence of meningitis, thus preventing morbidity and neurologic sequelae. Hearing impairment may be the only manifestation of Mondini dysplasia, and the benefit of hearing screening is emphasized. Temporal bone computed tomography should be considered in children with unilateral sensorineural or mixed-type hearing impairment.

Unilateral Sudden Sensorineural Hearing Loss after Spinal Anesthesia for Elective Cesarean Section: A Case Report

The relationship between spinal anesthesia and hearing loss is not well understood, but is thought to be due to leakages of cerebrospinal fluid, which may or may not induce postural puncture headache. Previous studies have reported no risk of hearing loss in patients under 40 or the obstetric population. We present a case of a young woman who experienced severe sudden unilateral hearing loss after spinal anesthesia for elective cesarean section. This case illustrates that young, obstetric patients may experience hearing loss after spinal anesthesia.

Suppression of Tinnitus in a Patient with Unilateral Sudden Hearing Loss: A Case Report

We describe a case of a 67-year-old woman with severe disabling right-sided tinnitus, mild hyperacusis, and headache. The tinnitus was associated with sudden right hearing loss and vertigo, which occurred about 18 months before. Magnetic resonance imaging (MRI) resulted in normal anatomical structures of the cochlea and of the cranial nerves showing a partial empty sella syndrome with suprasellar cistern hernia. Angio-MR revealed a bilateral contact between the anterior-inferior cerebellar artery (AICA) and the acoustic-facial nerve with a potential neurovascular conflict. Surgery was considered unnecessary after further evaluations. The right ear was successfully treated with a combination device (hearing aid plus sound generator). Shortly after a standard fitting procedure, the patient reported a reduction of tinnitus, hyperacusis, and headache which completely disappeared at the follow-up evaluation after 3, 6, and 12 months. This paper demonstrates that the combination device resulted in a complete tinnitus and hyperacusis suppression in a patient with unilateral sensorineural sudden hearing loss. Our paper further supports the restoration of peripheral sensory input for the treatment of tinnitus associated with hearing loss in selected patients.

Unilateral Sudden Sensorineural Hearing Loss After Combined Nasal and Breast Surgery

Unilateral Sudden Sensorineural Hearing Loss After Combined Nasal and Breast Surgery

Retraction: The Clinical Characteristics and Treatment Results of Bilateral Sudden Sensorineural Hearing Loss

Background and Objectives:Most cases of sudden deafness remain idiopathic. The majority of these cases are unilateral in their occurrences, whereas bilateral simultaneous involvement is rarely seen. We analyzed the clinical characteristics and treatment re- sults between bilateral and unilateral sudden sensorineural hearing loss (SSNHL), and considered the possible causes and provided available data for planning the appropriate treatment for bilateral SSNHL. Subjects and Method:Three hundred forty seven patients who visited the Department of Otolaryngology in Ajou University Hospital from June, 1994 to February, 2003 were clas- sified into 3 groups. Of these 347 patients, 16 patients (32 ears) had SSNHL simultaneously in both ears (Group I), 23 patients had SSNHL sequentially in both ears (Group II), and 308 patients had unilateral SSNHL (Group III). We reviewed their charts for pure tone audiometry information, medical history and lipid panel information to compare bilateral SSNHL with unilateral SSNHL. Results:The incidence of simultaneous bilateral SSNHL (Group I) was 4.6% of overall patients with SSNHL. Bi- lateral SSNHL occurs more commonly in patients of older age, with preexisting DM. Lpid panel abnormalities were compared with unilateral SSNHL. The recovery rate of hearing in simultaneous bilateral SSNHL (Group I) was 37.5% for both ears and 62.5% of patients, compared with 56.5% in unilateral SSNHL (Group III). Conclusion:Bilateral SSNHL is a very rare disease and the outcome from treatment is important for patients' quality of life. Recognition of similarities and differences between bi- lateral and unilateral SSNHL can help in counseling and managing the patients. (Korean J Otolaryngol 2005;48:848-53)