Association of Sudden Sensorineural Hearing Loss With Risk of Cardiocerebrovascular Disease: A Study Using Data From the Korea National Health Insurance Service

Update on consensus on diagnosis and treatment of idiopathic sudden sensorineural hearing loss

INTRODUCTION

Idiopathic sudden sensorineural hearing loss (ISSNHL) is a sudden, unexplained unilateral hearing loss.

OBJECTIVES

To update the Spanish Consensus on the diagnosis, treatment and follow-up of ISSNHL.

MATERIAL AND METHODS

After a systematic review of the literature from 1966 to March 2018, on MESH terms «(acute or sudden) hearing loss or deafness», a third update was performed, including 1508 relevant papers.

RESULTS

Regarding diagnosis, 11ISSNHL is clinically suspected, the following diagnostic tests are mandatory: otoscopy, acumetry, tonal audiometry, speech audiometry, and tympanometry, to discount conductive causes. After clinical diagnosis has been established, and before treatment is started, a full analysis should be performed. An MRI should then be requested, ideally performed during the first 15 days after diagnosis, to discount specific causes and to help to understand the physiopathological mechanisms in each case. Although treatment is very controversial, due to its effect on quality of life after ISSNHL and the few rare adverse effects associated with short-term steroid treatment, this consensus recommends that all patients should be treated with steroids, orally and/or intratympanically, depending on each patient. In the event of failure of systemic steroids, intratympanic rescue is also recommended. Follow-up should be at day 7, and after 12 months.

CONCLUSION

By consensus, results after treatment should be reported as absolute decibels recovered in pure tonal audiometry and as improvement in speech audiometry.

Increased Risk of Sudden Sensory Neural Hearing Loss in Osteoporosis: A Longitudinal Follow-Up Study

CONTEXT

The results of a previous population cohort study suggested an association between osteoporosis and sudden sensory neural hearing loss (SSNHL).

OBJECTIVES

To use a nationwide cohort in the Korean population to investigate the risk of SSNHL in patients with osteoporosis.

DESIGN, SETTING, AND PARTICIPANTS

Data entered from 2002 to 2013 were collected from the Korean National Health Insurance Service-National Sample Cohort. A total of 68,241 patients with osteoporosis aged ≥50 years were matched with 68,241 control individuals. The crude (simple) and adjusted hazard ratios (HRs) of SSNHL in those with osteoporosis were analyzed using the Cox proportional hazard model. A subgroup analysis was performed according to age and sex.

RESULTS

The risk of SSNHL was greater in the osteoporosis group than in the control group (adjusted HR, 1.56; 95% CI, 1.37 to 1.78; P < 0.001). The risk of SSNHL in those with osteoporosis was greater in patients aged <60 years, regardless of sex. Women aged ≥60 years had a higher HR for SSNHL in the presence of osteoporosis (women aged 60 to 69 years: adjusted HR, 1.67; 95% CI, 1.34 to 2.08; P < 0.001; women aged ≥70 years: adjusted HR, 1.90; 95% CI, 1.29 to 2.79; P < 0.001).

CONCLUSIONS

The risk of SSNHL was greater for patients with osteoporosis aged ≥50 years. Middle-age adults, as well as the elderly, are at an increased risk of SSNHL in the presence of osteoporosis.