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Yélamos Lorente MÁ, Perez-Carpena P, Lopez-Escamez JA. A Systematic Review on Heritability of Sudden Sensorineural Hearing Loss. Laryngoscope 2024; 134:3447-3457. [PMID: 38270208 DOI: 10.1002/lary.31308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/23/2023] [Accepted: 01/03/2024] [Indexed: 01/26/2024]
Abstract
OBJECTIVE To assess the evidence supporting the heritability and genetic basis of sudden sensorineural hearing loss (SSNHL). DATA SOURCE Records were extracted from PubMed, Scopus, and Cochrane databases. REVIEW METHODS The protocol was registered on PROSPERO (CRD42022357389) and includes a systematic review on the genetic contribution to SSNHL. The search strategy yielded 1.483 articles from electronic databases. After quality assessment, 34 records were selected, including 369.650 patients with SSNHL from nine prevalence studies, two familial aggregation studies, one twin study, and 22 genetic studies. The prevalence of SSNHL was calculated from data on its incidence from population-based studies (period prevalence). To evaluate the heritability of SSNHL, the sibling recurrence risk ratio (λs) was calculated, by comparing the prevalence of SSNHL among siblings within the same generation to the estimated prevalence in the overall population. Genetic variants were grouped, based on the pathological mechanism related to SSNHL. RESULTS The prevalence of SSNHL ranged from 0.1% to 0.0003% in America to 0.12%-0.0093% in Asia. The estimated sibling recurrence risk ratio for SSNHL (λs = 20.8-83.3) supports a significant familial aggregation. Although several genetic variants were reported to be associated with SSHL in controlled studies, neither was replicated in an independent cohort. CONCLUSIONS Evidence supporting heritability of SSNHL is limited to epidemiological studies showing prevalence differences across different populations and familial aggregation. Genetic studies are of low quality and they lack replication cohort to confirm their findings. According to its low prevalence, exome or genome sequencing familial-based studies are needed to identify rare genetic variants in SSNHL. LEVEL OF EVIDENCE NA Laryngoscope, 134:3447-3457, 2024.
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Affiliation(s)
- Mª Á Yélamos Lorente
- Division of Otolaryngology, Department of Surgery, University of Granada, Granada, Spain
- Family and Community Medicine, Zaidin Sur Health Center (Granada), San Cecilio University Hospital, Granada, Spain
| | - Patricia Perez-Carpena
- Division of Otolaryngology, Department of Surgery, University of Granada, Granada, Spain
- Department of Otolaryngology, Instituto de Investigación Biosanitaria, ibs.Granada, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Sensorineural Pathology Programme, Centro de Investigación Biomédica en Red en Enfermedades Raras, CIBERER, Madrid, Spain
| | - Jose A Lopez-Escamez
- Division of Otolaryngology, Department of Surgery, University of Granada, Granada, Spain
- Department of Otolaryngology, Instituto de Investigación Biosanitaria, ibs.Granada, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Meniere's Disease Neuroscience Research Program, Faculty of Medicine & Health, School of Medical Sciences, The Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
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Tomaz A, Peron KA, Suzuki FADB, Monteiro SRG, Chandrasekhar SS, Penido NO. Standard and Extend High-Frequency Audiometry in Sudden Sensorineural Hearing Loss: Impacts on Tinnitus and Mental Health. Otol Neurotol 2024; 45:e366-e375. [PMID: 38511269 DOI: 10.1097/mao.0000000000004168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
OBJECTIVE 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). STUDY DESIGN Prospective, cohort study. SETTING Outpatient otology clinic in a tertiary care hospital. SUBJECTS AND METHODS 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). RESULTS 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. CONCLUSION 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.
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Affiliation(s)
- Andreza Tomaz
- Department of Otolaryngology Head and Neck Surgery, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), São Paulo, Brazil
| | - Kelly Abdo Peron
- Department of Otolaryngology Head and Neck Surgery, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), São Paulo, Brazil
| | - Flavia Alencar de Barros Suzuki
- Department of Otolaryngology Head and Neck Surgery, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), São Paulo, Brazil
| | - Silvia Roberta Gesteira Monteiro
- Department of Otolaryngology Head and Neck Surgery, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), São Paulo, Brazil
| | | | - Norma Oliveira Penido
- Department of Otolaryngology Head and Neck Surgery, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), São Paulo, Brazil
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Sun X, Chen L, Hu N, Xiong W, Wang Y, Lu K, Duan F, Wang H, Wang M. Clinical value of auditory nerve enhancement in idiopathic sudden sensorineural hearing loss: a retrospective study. Front Neurol 2024; 15:1410516. [PMID: 38882699 PMCID: PMC11176423 DOI: 10.3389/fneur.2024.1410516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 05/20/2024] [Indexed: 06/18/2024] Open
Abstract
Background The pathogenesis of idiopathic sudden sensorineural hearing loss remains unclear, and no substantial breakthroughs have been achieved in its treatment. Therefore, we conducted this study with the aim to investigate the clinical features and prognostic factors of patients with idiopathic sudden sensorineural hearing loss and auditory nerve enhancement by using three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) magnetic resonance imaging (MRI) of the inner ear. Methods We retrospectively analyzed the clinical data of adult patients, who experienced sudden unilateral deafness and were admitted to the Department of Otolaryngology, Shandong Provincial ENT Hospital, between December 2020 and July 2021. Patients were divided into an auditory nerve enhancement group and a normal inner ear group, according to 3D-FLAIR MRI findings. Differences in sex, age, side, disease course, underlying diseases, dizziness/vertigo, vestibular function, degree of deafness, hearing classification, and treatment efficacy were analyzed. Results Of the 112 cases of sudden idiopathic deafness, 16.07% exhibited enhancement of the auditory nerve on inner-ear 3D-FLAIR MRI. Statistically significant differences in the degree and type of hearing loss were detected between the two groups (p < 0.05). The rates of abnormal results in the caloric, vestibular-evoked myogenic potential, and video head impulse tests were higher in the auditory nerve enhancement group. The cure rate (11.1%) in patients with auditory nerve enhancement was lower than that in patients with normal inner ear MRI findings (28.7%); however, the difference was not statistically significant. Conclusion Findings from 3D-FLAIR MRI scans of the inner ear indicated that patients with sudden deafness and auditory nerve enhancement experienced severe hearing loss, aggravated vestibular function injury, and a significantly decreased cure rate. Prompt treatment, ideally within 2 weeks of disease onset, can facilitate hearing recovery.
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Affiliation(s)
- Xiao Sun
- Department of Otology Medicine, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Lei Chen
- Department of Otology Medicine, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Na Hu
- Department of Radiology, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Wenping Xiong
- Department of Otology Medicine, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Yingjun Wang
- Department of Otology Medicine, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Kunpeng Lu
- Department of Otology Medicine, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Fujia Duan
- Department of Otology Medicine, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Haibo Wang
- Department of Otology Medicine, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Mingming Wang
- Department of Otology Medicine, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
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Dong A, Peng J, Lin R. Predictive Model for Prognosis of Sudden Sensorineural Hearing Loss by Nomogram. EAR, NOSE & THROAT JOURNAL 2024:1455613241230823. [PMID: 38400530 DOI: 10.1177/01455613241230823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
Objective: To explore the prognostic factors of patients with sudden sensorineural hearing loss (SSNHL), analyze the possible influencing factors, and construct a nomogram for personalized evaluation of their prognosis. Methods: A retrospective study was conducted on 269 patients with SSNHL. The prognostic factors were analyzed by univariate analysis and multivariate logistic regression analysis. The nomogram was constructed based on the results of multivariate logistic regression analysis, and the model was verified by receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA). Results: Among the 269 patients hospitalized, 136 cases were improved (44 cases were cured, 28 cases were markedly effective, 64 cases were effective) and 133 cases were ineffective. After univariate analysis, it was found that age, duration from onset to treatment, audiometric configuration, serum albumin (ALB), and neutrophil-to-lymphocyte ratio (NLR) were associated with hearing outcomes. Duration from onset to treatment and audiometric configuration were independent risk factors when the treatment outcome was divided into ineffective, effective, significant improvement, and complete recovery groups or divided into improvement and ineffective groups after multivariate logistic regression analysis. The factors according to univariate analysis and multivariate logistic regression analysis results were included in the nomogram to construct the prediction models. The area under the ROC curve of model discrimination was 0.752 [95% confidence interval (CI): 0.695-0.808] when the treatment outcome was divided into 2 groups. The calibration curve showed the consistency of the results, and the DCA prediction curve showed good clinical efficacy. The C-index was 0.756 (95% CI: 0.710-0.802) when the treatment outcome was divided into 4 groups. Conclusion: Age, duration from onset to treatment, audiometric configuration, ALB, and NLR are influencing factors for SSNHL. Duration from onset to treatment and audiometric configuration are independent risk factors for SSNHL. The nomogram presents the prognosis of patients with SSNHL in an intuitive, visual, and readable graph, providing clinicians with a personalized assessment.
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Affiliation(s)
- Aidan Dong
- Department of Otolaryngology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jianhua Peng
- Department of Otolaryngology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Renyu Lin
- Department of Otolaryngology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Liu Y, Wu W, Li S, Zhang Q, He J, Duan M, Yang J. Clinical characteristics and prognosis of sudden sensorineural hearing loss in single-sided deafness patients. Front Neurol 2023; 14:1230340. [PMID: 37830094 PMCID: PMC10565856 DOI: 10.3389/fneur.2023.1230340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 09/11/2023] [Indexed: 10/14/2023] Open
Abstract
Background Sudden sensorineural hearing loss (SSNHL) in patients with single-sided deafness (SSD) is rare. The prognosis of the sole serviceable hearing ear is very important for these patients. However, the clinical characteristics and prognosis of SSNHL in SSD patients are not well-documented. Objective This study aimed to investigate the clinical features and treatment outcomes of SSNHL in SSD patients. Methods Clinical data of 36 SSD patients and 116 non-SSD patients with unilateral SSNHL from January 2013 to December 2022 were retrospectively investigated. The clinical characteristics of the SSD patients were analyzed. All SSD patients were treated with intratympanic steroids plus intravenous steroids. Pure-tone average (PTA) and word recognition score (WRS) before and after treatment were recorded. The hearing recovery of SSNHL in SSD patients in comparison with non-SSD patients was explored. Auditory outcomes in SSD patients with different etiologies were also compared. Results Initial hearing threshold showed no significant differences between the SSD group and the non-SSD group (66.41 ± 24.64 dB HL vs. 69.21 ± 31.48 dB HL, p = 0.625). The SSD group had a higher post-treatment hearing threshold (median (interquartile range, IQR) 53.13(36.56) dB HL) than the non-SSD group (median 32.50(47.5) dB HL, p < 0.01). Hearing gains (median 8.75(13.00) dB) and the rate of significant recovery (13.89%) were lower in the SSD group than in the non-SSD group (median 23.75(34.69) dB, 45.69%). The etiology of SSD was classified as SSNHL, special types of infection, chronic otitis media, and unknown causes. SSNHL accounted for the maximum proportion (38.9%) of causes of SSD in the SSD group. Hearing gains were lower in the SSNHL-SSD group than in other causes of the SSD group. A binary logistic regression analysis demonstrated that SSD serves as an indicator of unfavorable hearing recovery outcomes (OR = 5.264, p < 0.01). Conclusion The prognosis of SSNHL in SSD patients is unsatisfactory. SSNHL accounts for the maximum proportion of causes of SSD in this group of patients. For SSD patients caused by SSNHL, less hearing improvement after treatment was expected when SSNHL occurred in the contralateral ear in comparison with SSD patients with other causes.
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Affiliation(s)
- Yupeng Liu
- Department of Otorhinolaryngology-Head & Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Wenjin Wu
- Department of Otorhinolaryngology-Head & Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Shuna Li
- Department of Otorhinolaryngology-Head & Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Qing Zhang
- Department of Otorhinolaryngology-Head & Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Jingchun He
- Department of Otorhinolaryngology-Head & Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Maoli Duan
- Ear Nose and Throat Patient Area, Trauma and Reparative Medicine Theme, Karolinska University Hospital, Stockholm, Sweden
- Division of Ear, Nose and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Jun Yang
- Department of Otorhinolaryngology-Head & Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
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Ding Y, Liu Y, Li D, Hu R, Tian Z, Xie Q. Correlation between pure tone audiometry at all frequencies and distortion product otoacoustic emission of patients with hidden hearing loss. Biotechnol Genet Eng Rev 2023:1-12. [PMID: 37171371 DOI: 10.1080/02648725.2023.2209408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
To explore the correlation between pure tone audiometry at all frequencies and distortion product otoacoustic emission (DPOAE) of hidden hearing loss (HHL). The workers exposed to noise from a factory in Zhangjiakou (noise exposure group, n = 73) and normal young and middle-aged people recruited by society (control group, n = 77) from August 2021 to April 2022 were study subjects, and all of them underwent audiometry in clinic. Compared with the control group, the noise exposure group had significantly higher threshold by extended high-frequency audiometry at all frequencies and higher signal-to-noise ratio threshold (SNR50) (all P < 0.001), and higher amplitude ratio of SP to AP of the waveform induced by short sound at 96, 90, 80 and 70 dB nHL and lower SNR at 6 kHz and above (all P < 0.05). The pure tone audiometry was correlated with DPOAE test results at the frequencies of 6, 8, 9 and 10 kHz (P < 0.001). The results of speech audiometry in noise were related to the average SNR of DPOAE test at each frequency (P = 0.026,r = -0.265). The ratio of SP to AP in electrocochleogram recorded at the intensity of 96 dB nHL was correlated with the average SNR at 6 kHz and above in DPOAE test (P = 0.018,r = -0.461), and with the average auditory threshold at each frequency in extended high-frequency audiometry (P = 0.032, r = 0.421). DPOAE has certain value in detecting HHL.
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Affiliation(s)
- Yongqing Ding
- Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, China
| | - Yachao Liu
- Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, China
| | - Dong Li
- Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, China
| | - Ruili Hu
- Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, China
| | - Zedong Tian
- Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, China
| | - Qi Xie
- Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, China
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Clinical Factors Associated With Prognosis of Tinnitus and Aural Fullness After Sudden Sensorineural Hearing Loss. Otol Neurotol 2023; 44:432-437. [PMID: 36922014 DOI: 10.1097/mao.0000000000003853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
OBJECTIVES We evaluated the long-term prognosis and risk factors associated with tinnitus and aural fullness, which occurred with sudden sensorineural hearing loss. STUDY DESIGN Retrospective cross-sectional review. SETTING Tertiary referral center. PATIENTS Those who visited our clinic for sudden hearing loss from January 2016 to May 2020, diagnosed with sudden sensorineural hearing loss based on pure-tone audiometry, and underwent magnetic resonance imaging to rule out other cause of hearing loss. In total, 106 patients were enrolled in this study. INTERVENTION All patients were treated with oral glucocorticoids. Salvage intratympanic dexamethasone injection therapy was performed for the patients whose hearing was not fully recovered. MAIN OUTCOME AND MEASURES We scored the loudness of tinnitus and the intensity of aural fullness using the numerical rating scale. We used a mixed-effects model for repeatedly measured tinnitus and aural fullness scores. RESULTS The time after the onset of sudden sensorineural hearing loss (SSNHL; β = -0.07; 95% confidence interval, -0.09 to -0.05; p < 0.001) and hearing outcome after treatment (overall p = 0.003) were significant factors associated with the prognosis of tinnitus. Concerning aural fullness, the time after the onset of SSNHL was a significant prognosis factor (β = -0.08; 95% confidence interval, -0.09 to -0.06; p < 0.001), unlike hearing outcome (overall p = 0.261). Pretreatment pure-tone audiometry average threshold and mainly affected frequencies were not significant factors for tinnitus and aural fullness recovery, respectively. CONCLUSION The persistence of tinnitus with SSNHL was significantly affected by hearing recovery after treatment, whereas aural fullness was not associated with hearing recovery. However, both symptoms were improved over time after SSNHL.
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Zhou W, Yuan H, Yang Y, Liu S, Huang J, Zhang H. Nomogram for predicting the prognostic role in idiopathic sudden sensorineural hearing loss. Am J Otolaryngol 2023; 44:103736. [PMID: 36525813 DOI: 10.1016/j.amjoto.2022.103736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/03/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE A nomogram model was constructed to assist in early prediction of idiopathic sudden sensorineural hearing loss (ISSHL) prognosis. Additionally, this study contributed to evaluating and analyzing the usefulness of the nomogram model in ISSHL clinical intervention. METHODS A retrospective analysis was performed concerning 355 ISSHL patients who were hospitalized between June 2021 and August 2022. Single-factor analysis was used to filter variables, which were subsequently used for multivariate analysis to construct a nomogram. The discriminative capability and clinical usefulness of the predictive model were estimated by calculating the area under the curve (AUC), calibration curve, and decision curve analysis (DCA). RESULTS Hearing loss type, duration from onset to treatment, vertigo, periauricular paresthesia, and batroxobin use were included in the nomogram for ISSHL. The predictive model showed fair discrimination values (AUC =0.764; 95%CI: 0.715-0.813) and was well-calibrated, the C-index was 0.746 (95%CI: 0.715-0.793) in the internal validation. DCA indicated that the model was also clinically beneficial when the threshold range was between 0.246 and 0.840. CONCLUSIONS The nomogram prediction model may have potential clinical practicability in effectively assisting clinicians in predicting ISSHL prognosis and optimizing treatment protocols.
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Affiliation(s)
- Wei Zhou
- Department of Otolaryngology, Xinjiang Medical University Affiliated First Hospital, Urumqi, Xinjiang 830054, China
| | - Huajie Yuan
- Department of Otolaryngology, Xinjiang Medical University Affiliated First Hospital, Urumqi, Xinjiang 830054, China
| | - Yuping Yang
- Department of Otolaryngology, Xinjiang Medical University Affiliated First Hospital, Urumqi, Xinjiang 830054, China
| | - Siyuan Liu
- Department of Otolaryngology, Xinjiang Medical University Affiliated First Hospital, Urumqi, Xinjiang 830054, China
| | - Jiye Huang
- Department of Otolaryngology, Traditional Chinese Medicine Hospital of Xinjiang Uygur, Autonomous Region, Urumqi, Xinjiang, China
| | - Hua Zhang
- Department of Otolaryngology, Xinjiang Medical University Affiliated First Hospital, Urumqi, Xinjiang 830054, China.
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Zhu Y, He S, Liao K, Li M, Zhao Z, Jiang H. Clinical Profiles and Prognoses of Adult Patients with Full-Frequency Sudden Sensorineural Hearing Loss in Combination Therapy. J Clin Med 2023; 12:jcm12041478. [PMID: 36836013 PMCID: PMC9966669 DOI: 10.3390/jcm12041478] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/31/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023] Open
Abstract
We aimed to characterize the clinical profiles and short-term outcomes of adult patients with full-frequency idiopathic sudden sensorineural hearing loss (ISSNHL) treated uniformly with combination therapy, and to determine the prognostic predictors for the combination therapy. A total of 131 eligible cases hospitalized in our department from January 2018 to June 2021 were retrospectively reviewed. All enrolled cases received a standardized combination therapy employing intravenous methylprednisolone, batroxobin, and Ginkgo biloba extract during the 12 days of hospitalization. The clinical and audiometric profiles were compared between recovered patients and their unrecovered counterparts. The overall recovery rate was 57.3% in the study. Accompanying vertigo (odds ratio = 0.360, p = 0.006) and body mass index (BMI, odds ratio = 1.158, p = 0.016) were two independent predictors of hearing outcomes of the therapy. The male gender and cigarette-smoking history were marginally associated with good hearing prognosis (p = 0.051 and 0.070, respectively). Patients with BMI ≥ 22.4 kg/m2 had a better chance of hearing recovery (p = 0.02). Conclusions: Accompanying vertigo and low BMI (<22.4 kg/m2) were independently associated with poor prognosis for full-frequency ISSNHL in combination therapy. Male gender and cigarette-smoking history might be considered positive effects on hearing prognosis.
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Yang Y, Gao D, Ma X, Shen J, Zhang Q, Chen X, Zhang Q, Jin Y, Chen J, Duan M, Yang J. Abnormal posterior semicircular canal function may predict poor prognosis in patients with severe and profound ISSNHL. Front Neurol 2023; 14:1123165. [PMID: 36793494 PMCID: PMC9922886 DOI: 10.3389/fneur.2023.1123165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 01/11/2023] [Indexed: 01/31/2023] Open
Abstract
Background Severe and profound idiopathic sudden sensorineural hearing loss (ISSNHL) generally leads to unfavorable prognosis, and has a considerable impact on patient quality of life. However, related prognostic factors remain controversial. Objective To elaborate the relationship between vestibular function impairment and the prognosis of patients with severe and profound ISSNHL, and investigated the relevant factors affecting prognosis. Methods Forty-nine patients with severe and profound ISSNHL were divided into good outcome group [GO group, pure tone average (PTA) improvement > 30 dB] and poor outcome group (PO group, PTA improvement ≤ 30 dB) according to hearing outcomes. The clinical characteristics and the proportion of abnormal vestibular function tests in these two groups were analyzed by univariate analysis, and multivariable logistic regression analysis was performed for parameters with significant differences. Results Forty-six patients had abnormal vestibular function test results (46/49, 93.88%). The number of vestibular organ injuries was 1.82 ± 1.29 in all patients, with higher mean numbers in PO group (2.22 ± 1.37) than in GO group (1.32 ± 0.99). Univariate analysis revealed no statistical differences between the GO and PO groups in terms of gender, age, side of the affected ear, vestibular symptoms, delayed treatment, instantaneous gain value of horizontal semicircular canal, regression gain value of vertical semicircular canal, abnormal rates of oVEMP, cVEMP, caloric test and vHIT in anterior and horizontal semicircular canal, however, significant differences were found in the initial hearing loss and abnormal vHIT of posterior semicircular canal (PSC). Multivariable analysis revealed that only PSC injury was an independent risk factor for predicting the prognosis of patients with severe and profound ISSNHL. Patients with abnormal PSC function had worse initial hearing impairment and prognosis than patients with normal PSC function. The sensitivity of abnormal PSC function in predicting poor prognosis in patients with severe and profound ISSNHL was 66.67%, specificity was 95.45%, and positive and negative likelihood ratios were 14.65 and 0.35, respectively. Conclusion Abnormal PSC function is an independent risk factor for poor prognosis in patients with severe and profound ISSNHL. Ischemia in the branches of the internal auditory artery supplying the cochlea and PSC may be the underlying mechanism.
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Affiliation(s)
- Yang Yang
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Dekun Gao
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Xiaobao Ma
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Jiali Shen
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Qin Zhang
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Xiangping Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Qing Zhang
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Yulian Jin
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Jianyong Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China,*Correspondence: Jianyong Chen ✉
| | - Maoli Duan
- Division of Ear, Nose and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden,Maoli Duan ✉
| | - Jun Yang
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China,Jun Yang ✉
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Chen I, Eligal S, Menahem O, Salem R, Sichel JY, Perez R, Shaul C. Time from sudden sensory neural hearing loss to treatment as a prognostic factor. Front Neurol 2023; 14:1158955. [PMID: 37122288 PMCID: PMC10140592 DOI: 10.3389/fneur.2023.1158955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 03/24/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction The widely accepted treatment for sudden sensorineural hearing loss (SSNHL) is corticosteroid treatment (oral or intratympanic). The main goal of this work is to define the significance of the time between symptom onset and treatment initiation, as well as other prognostic factors, for hearing improvement. Methods This retrospective study included 666 patients treated for SSNHL. Demographic data, audiometry, treatment method, time since symptom onset, and associated symptoms were recorded for each patient. The patients were divided into five groups according to the treatment initiation time-half a week, one week, 2 weeks, 3 weeks, or 4 weeks and over-after symptom onset. The degree of improvement was assessed by comparing the audiometry at the beginning and the end of the treatment. Results The average period of hearing loss from symptom onset to treatment initiation was 10.8 days. Significant differences were found between the groups of half a week, one week, and 2 weeks and the groups of 3 weeks and 4 weeks and over (each separately, p < 0.001). No difference was found between the half-week, one-week, and two-week groups, nor was there a difference between the three-week and four-week-and-over groups. A correlation was found between the treatment initiation time in days and the degree of improvement in hearing for both speech recognition threshold (SRT) and discrimination, R = 0.26 p < 0.001 and R = 0.17 p < 0.001, respectively. No correlation was found for gender, age of the patients, comorbidities, or associated symptoms. Conclusion The threshold for treatment initiation time is up to 2 weeks, after which the amplitude of hearing improvement decreases significantly. The other prognostic factors measured were not found to be statistically significant predictors.
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Chen X, Zheng Z, Xiao L, Liu C, Shen Y, Ma N, Dong H, Yin S, Feng Y. Bone-turnover biomarkers as potential prognostic factors in sudden sensorineural hearing loss: A prospective cohort study. Front Neurol 2022; 13:980150. [PMID: 36090873 PMCID: PMC9453032 DOI: 10.3389/fneur.2022.980150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/10/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesThis study aims to explore the relationship between bone-turnover biomarkers and the recovery of SSNHL to provide clues for further improvements in etiological research and predictors.MethodsThe medical history, hearing thresholds, biomarkers of bone-turnover, and related hormones of 117 SSNHL patients were collected prospectively between August 2018 and December 2021. Linear correlation and logistic regression models were applied to examine the association between bone-turnover biomarkers and the prognosis of SSNHL.ResultsAge, the incidence of vertigo, pure tone average of the impaired frequencies (PTAimpairedfre), and the levels of bone turnover [including alkaline phosphatase (ALP), β-carboxy terminal crosslinked telopeptide of type 1 collagen (β-CTX), and N-terminal-midfragment of osteocalcin (N-MID)] were higher in the nonresponders than responders (P < 0.05). Logistic regression showed that the age (OR = 1.035, P = 0.027), time to treatment (OR = 1.157, P = 0.038), PTAimpairedfre (OR = 1.031, P = 0.008), and β-CTX (OR = 1.004, P = 0.001) were independent risk factors for the prognosis of SSNHL. In the women SSNHL subgroup, age, postmenopause percentage, PTAimpairedfre, the activity of ALP, levels of β-CTX, and N-MID were significantly higher in the nonresponders than the responders (P < 0.05). Compared to the men SSNHL subgroup, β-CTX has a higher correlation coefficient and predictive efficiency in the women SSNHL subgroup, and logistic regression showed that β-CTX (OR = 1.004, P = 0.004) was an independent risk factor for the women SSNHL.ConclusionsBone-turnover biomarkers are risk factors for poor prognosis in SSNHL, especially β-CTX. The differences were significant in women SSNHL, which may be related to the rapid regression of estrogen after menopause that leads to the occurrence of osteoporosis with a high conversion rate.
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Affiliation(s)
- Xiaoyan Chen
- Department of Otolaryngology-Head and Neck Surgery, Otolaryngology Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Zhong Zheng
- Department of Otolaryngology-Head and Neck Surgery, Otolaryngology Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Lili Xiao
- Department of Otolaryngology-Head and Neck Surgery, Otolaryngology Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Chengqi Liu
- Department of Otolaryngology-Head and Neck Surgery, Otolaryngology Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Ying Shen
- Department of Otolaryngology-Head and Neck Surgery, Otolaryngology Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Ning Ma
- Department of Otolaryngology-Head and Neck Surgery, Otolaryngology Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Hongjun Dong
- Department of Otorhinolaryngology, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
- *Correspondence: Hongjun Dong
| | - Shankai Yin
- Department of Otolaryngology-Head and Neck Surgery, Otolaryngology Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shankai Yin
| | - Yanmei Feng
- Department of Otolaryngology-Head and Neck Surgery, Otolaryngology Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Yanmei Feng
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Dova S, Psillas G, Tsaligopoulos M, Nikolaidis V, Stefanidou S, Karagiannis G, Kotsiou M, Kaltzidis T, Markou K. The effectiveness of hyperbaric oxygen therapy on the final outcome of patients with sudden sensorineural hearing loss. Am J Otolaryngol 2022; 43:103564. [DOI: 10.1016/j.amjoto.2022.103564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 06/27/2022] [Accepted: 07/31/2022] [Indexed: 11/29/2022]
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