Influence of a cold front upon the onset of Meniére's disease in Toyama, Japan

Meteorological extremes and their impact on tinnitus-related emergency room visits: a time-series analysis

PURPOSE

Extreme weather events are rising due to the accelerating pace of climate change. These events impact human health and increase emergency room visits (EV) for many morbidities. Tinnitus is a common cause of EVs within otolaryngology in Germany and Austria. The effect of extreme weather conditions on tinnitus-related EVs is unknown.

METHODS

A total of 526 tinnitus-related EVs at a tertiary care hospital in Vienna were identified. A distributed lag non-linear model with a maximum lag period of 14 days was fitted to investigate the immediate and delayed effect of single-day and prolonged (three-day) extreme atmospheric pressure, relative humidity, mean temperature, precipitation and mean wind speed on EV rates. Extreme conditions were defined as the 1st, 5th, 95th, and 99th percentile of the meteorological variables. Relative risk (RR) is defined as risk for tinnitus-related EVs at an extreme condition compared to the risk at the median weather condition. Cumulative RR (cRR) is the total cumulated EV risk for a given time period.

RESULTS

High relative humidity increased same-day RR for tinnitus-related EVs to 1.75. Both low and high atmospheric pressure raised cRR as early as three days after an event to a maximum of 3.24. Low temperatures mitigated cRR within 4 days, while high temperatures tended to increase risk. Prolonged precipitation reduced cRR within one day.

CONCLUSION

Extreme meteorological conditions are associated with tinnitus-related EV rates. Further investigation into potential causative links and underlying pathophysiological mechanisms is warranted.

Correlating atmospheric pressure and temperature with Meniere attack

OBJECTIVE

This paper correlated the Meniere attack with meteorological parameters i.e. atmospheric pressure, temperature, relative humidity and rainfall, to investigate which parameters that trigger the Meniere attack.

METHODS

During the past three years, totally 283 (2015), 351 (2016) and 319 (2017) patients with Meniere's disease (MD) were encountered at a clinic of the university hospital, accounting for 13%, 17% and 16% incidence in relation to overall annual neurotological cases, respectively. The onset of Meniere attack was then correlated with meteorological parameters.

RESULTS

The mean seasonal incidence of Meniere attack in relation to overall seasonal neurotological cases in 2015-2017 were 14.8 ± 2.8% (spring), 17.5 ± 2.2% (summer), 16.0 ± 1.8 % (autumn) and 12.8 ± 2.0% (winter), indicating that summer season had a higher incidence of Meniere attacks than winter season. Onset of Meniere attacks correlated significantly with the atmospheric pressure (r = -0.4484, p = 0.0061) and temperature (r = 0.4736, p = 0.0035), and the atmospheric pressure was highly negatively correlated with the temperature (r = -0.9421, p < 0.0001). In contrast, no correlation was identified between the onset of Meniere attacks and relative humidity or rainfall. The atmospheric pressure in the same month with typhoon compared with that without typhoon revealed a median reduction of 13.1 hectopascal.

CONCLUSION

Atmospheric pressure and temperature are correlated with the onset of Meniere attack. Summer season has a higher incidence of Meniere attack than winter season, likely because low atmospheric pressure in summer may aggravate endolymphatic hydrops, especially when accompanied by typhoons in the northwest Pacific region.

Association between meteorological factors and audiogram configurations in patients with sudden sensorineural hearing loss: a cross-sectional study

OBJECTIVE

We aimed to determine the association between meteorological factors and sudden sensorineural hearing loss (SSNHL) audiogram configurations.

DESIGN

Retrospective review of medical records from 1 October 2007 to 31 December 2018.

SETTING

A tertiary hospital.

PARTICIPANTS

510 patients with SSNHL who had data on the exact date of SSNHL onset and underwent audiological evaluation within 14 days were included.

PRIMARY AND SECONDARY OUTCOME MEASURES

Daily values of meteorological factors, including maximum and minimum temperature, mean temperature and its day-to-day change, diurnal temperature range, atmospheric pressure, mean and maximum wind speed and relative humidity, and seasonal distributions.

RESULTS

Among the 510 patients (259 women (50.8%); mean (SD) age, 46.4 (15.5) years), 108 (21.2%) displayed ascending patterns, 143 (28.0%) displayed descending patterns, 129 (25.3%) displayed flat patterns and 130 (25.5%) displayed profound patterns of audiograms. The diurnal temperature range on the day of SSNHL onset in patients with profound patterns was significantly higher than that in patient with ascending (mean difference (MD), 2.2°C; 95% CI, 0.7°C to 3.7°C; p=0.001) and descending (MD, 1.5°C; 95% CI, 0.1°C to 2.9°C; p=0.031) patterns. The relative humidity was the highest on the day of SSNHL onset in patients with ascending patterns and showed a significant difference compared with that in patients with profound patterns (MD, 8.0%; 95% CI, 0.7% to 15.3%; p=0.026). Seasonal distribution did not differ among patients with different audiogram configurations.

CONCLUSIONS

Profound audiogram patterns correlated with high diurnal temperature range, while ascending audiogram patterns correlated with high relative humidity in patients with SSNHL. No correlation was observed between seasons and audiogram configurations.

Evolution of incidence of audiovestibular disorders during the pandemic COVID-19 period

Purpose

Despite sporadic case reports describing hearing problems in patients with coronavirus disease 2019 (COVID-19), whether COVID-19 affects the audiovestibular system remains unclear. This study assessed the evolution of incidence of audiovestibular disorders during the pandemic COVID-19 period.

Method

Three audiovestibular disorders namely, sudden sensorineural hearing loss (SSHL), autonomic dysfunction, and Meniere’s disease (MD) were analyzed and compared from 2016 to 2020.

Results

The annual new cases at our clinic comprised overall 2107, 1997, 1984, 2068, and 1829 from 2016 to 2020, respectively, and the respectively annual cases of SSHL were 54, 46, 42, 45 and 38. Accordingly, annual incidences of SSHL in relation to overall cases of audiovestibular disorders were 2.6%, 2.3%, 2.1%, 2.2% and 2.1% from 2016 to 2020, respectively, exhibiting a non-significant difference (p > 0.05). In contrast, incidence of autonomic dysfunction in the year 2020 was 15.3%, which revealed significantly higher than 8.5–13.1% from 2016 to 2019 (p < 0.001). Restated, the incidence of autonomic dysfunction in 2020 displayed a significantly higher percentage than the other 4 years. Conversely, the incidence of MD in 2020 was 9.8%, showing a significant decline compared with the other 4 years (12.6–15.6% from 2016 to 2019, p < 0.001),

Conclusion

Evolution of incidence of audiovestibular disorders during the pandemic COVID-19 period revealed increase in the incidence of autonomic dysfunction and decrease in that of MD, while incidence of SSHL remained unchanged from 2016 to 2020. Thus, the SARS-CoV-2 may less affect the audiovestibular system.

Factors Prognostic of Season-Associated Sudden Sensorineural Hearing Loss: A Retrospective Observational Study

Background and Objectives

This study examined whether the prognosis of sudden deafness was dependent on the time of onset and evaluated the factors affecting prognosis during each period.

Subjects and Methods

Patients who developed sudden hearing loss from January 2005 to December 2015 were evaluated retrospectively. Meteorological data were obtained from the official website of the Korea Meteorological Administration. Factors prognostic of hearing recovery rate were analyzed.

Results

The hearing recovery rate of the 318 patients who developed sudden deafness did not differ significantly by month. Mean temperature and daily temperature range at onset of sudden deafness were not associated with recovery rate.

Conclusions

The recovery rate in patients with sudden deafness did not differ markedly by season.

The Weather and Ménière's Disease: A Longitudinal Analysis in the UK

HYPOTHESIS

Changes in the weather influence symptom severity in Ménière's disease (MD).

BACKGROUND

MD is an unpredictable condition that significantly impacts on quality of life. It is suggested that fluctuations in the weather, especially atmospheric pressure may influence the symptoms of MD. However, to date, limited research has investigated the impact of the weather on MD.

METHODS

In a longitudinal study, a mobile phone application collected data from 397 individuals (277 females and 120 males with an average age of 50 yr) from the UK reporting consultant-diagnosed MD. Daily symptoms (vertigo, aural fullness, tinnitus, hearing loss, and attack prevalence) and GPS locations were collected; these data were linked with Met Office weather data (including atmospheric pressure, humidity, temperature, visibility, and wind speed).

RESULTS

Symptom severity and attack prevalence were reduced on days when atmospheric pressure was higher. When atmospheric pressure was below 1,013 hectopascals, the risk of an attack was 1.30 (95% confidence interval: 1.10, 1.54); when the humidity was above 90%, the risk of an attack was 1.26 (95% confidence interval 1.06, 1.49).

CONCLUSION

This study provides the strongest evidence to date that changes in atmospheric pressure and humidity are associated with symptom exacerbation in MD. Improving our understanding of the role of weather and other environmental triggers in Ménière's may reduce the uncertainty associated with living with this condition, significantly contributing to improved quality of life.

Atmospheric Pressure and Onset of Episodes of Menière's Disease - A Repeated Measures Study

Background

External changes of air pressure are transmitted to the middle and inner ear and may be used therapeutically in Menière’s disease, one of the most common vertigo disorders. We analyzed the possible relationship of atmospheric pressure and other meteorological parameters with the onset of MD vertigo episodes in order to determine whether atmospheric pressure changes play a role in the occurrence of MD episodes.

Methods

Patients of a tertiary outpatient dizziness clinic diagnosed with MD were asked to keep a daily vertigo diary to document MD episodes (2004–2009). Local air pressure, absolute temperature and dew point temperature were acquired on an hourly basis. Change in meteorological parameters was conceptualized as the maximum difference in a 24 hour time frame preceding each day. Effects were estimated using additive mixed models with a random participant effect. We included lagged air parameters, age, sex, weekday and season in the model.

Results

A total of 56 persons (59% female) with mean age 54 years were included. Mean follow-up time was 267 days. Persons experienced on average 10.3 episodes during the observation period (median 8). Age and change in air pressure were significantly associated with vertigo onset risk (Odds Ratio = 0.979 and 1.010). We could not show an effect of sex, weekday, season, air temperature, and dew point temperature.

Conclusions

Change in air pressure was significantly associated with onset of MD episodes, suggesting a potential triggering mechanism in the inner ear. MD patients may possibly use air pressure changes as an early warning system for vertigo attacks in the future.

Meteorological conditions related to the onset of idiopathic sudden sensorineural hearing loss

PURPOSE

The objective of this study was to evaluate the effect of meteorological factors on the onset of idiopathic sudden sensorineural hearing loss (ISSHL).

MATERIALS AND METHODS

Meteorological data from 2005 to 2011 were obtained from the web-based "Monthly Weather Reports of the Meteorological Administration" database. Patients with ISSHL who visited our hospital during this same period and presented the precise day on which hearing loss developed were included in this retrospective study. Twelve meteorological factors were analyzed between the days when ISSHL onset was observed as well as the days when ISSHL did not occur. The weather conditions occurring 1-7 days before ISSHL onset were also analyzed to assess any possible delayed effects of meteorological factors on the onset of ISSHL.

RESULTS

During the study period, 607 patients were included for the study. Although mean and maximal wind velocities were higher for the days when ISSHL occurred than the days without ISSHL onset, after adjusting the value for multiple comparisons, we cannot find any significant relationship between any of meteorological factors and the onset of ISSHL. However, in analysis of time lag effect of the weather conditions, we found that there was still a significant difference in maximum wind speed on 5 days before ISSHL onset even after applying Bonferroni correction.

CONCLUSION

The result of this study suggests that stronger wind speed may be related to the occurrence of ISSHL.

Investigation of seasonal variability of vestibular neuronitis

Objective:

To determine if the incidence of vestibular neuronitis displays seasonal variation.

Methods:

A retrospective case review was performed to determine the monthly and quarterly incidence of vestibular neuronitis over a 36-month period. Incidence values were compiled, and the chi-square test and Rayleigh test for circular means were used to assess for uneven distribution and seasonality, respectively.

Results:

Fifty-two patients were diagnosed with vestibular neuronitis during the study period. The 2009–2010 study year showed uneven distribution and evidence of seasonality (R = 7.211, p < 0.001). However, the other two study years did not show statistical significance using either the chi-square test or Rayleigh test. In addition, when incidence values were aggregated across all three years of the study, neither the chi-square test nor Rayleigh test showed statistical significance.

Conclusion:

The present study found minimal evidence of seasonality in the incidence of vestibular neuronitis. These findings are consistent with studies of seasonality observed for other inner-ear disorders thought to be virally mediated.

The effects of weather on the incidence of sudden sensorineural hearing loss: a 5-year population-based study

OBJECTIVE

This study utilizes 5-year population data to examine the association between weather conditions and the incidence of sudden sensorineural hearing loss (SSNHL) in Taiwan with a specific focus on ambient temperature, relative humidity, atmospheric pressure, rainfall and total hours of sunshine.

METHOD

The data, covering the period from 1998 to 2002, is sourced from the Taiwan National Health Insurance Research Database (NHIRD), with a total of 8712 first-time admissions being identified from the database by a principal diagnosis of unspecified sudden hearing loss (ICD-9-CM code 3882). After controlling for time trend effects, this study adopted the autoregressive integrated moving average regression method as a means of evaluating the effects of climatic and monthly factors on SSNHL incidence rates.

RESULTS

Although significant associations were found between ambient temperature, relative humidity and the SSNHL incidence rates for the total population, after adjusting for seasonality, months and trends, the significant relationship between SSNHL incidence rates and the climatic parameters disappeared.

CONCLUSIONS

This study has demonstrated that after adjusting for seasonality, months and trends, there is no significant relationship between monthly SSNHL incidence rates and weather conditions. Therefore, the theory that weather is a triggering factor in SSNHL pathogenesis is not supported by this study.

Surdités brusques idiopathiques

Idiopathic Sudden Sensorineural Hearing Loss (ISSHL) remains one of the major unsolved otologic emergencies. It is characterized by the onset of an unilateral sensorineural hearing loss developing within 24 hours, and averaging on pure tone audiogram at least 30 dB HL for three subsequent octave steps, with no marked vestibular symptoms and no identifiable cause. ISSHL is a syndrome covering several heterogeneous entities resulting from different pathogenetic mechanisms. At this time, the audiogram is the unique tool which may help clinicians to identify these entities and provide a classification based on 5 types of hearing loss. Numerous experimental and clinical studies have investigated the mechanisms by which infectious, ischemic, mechanic or immunologic insults may induce cochlear dysfunction. However, extrapolation to humans and rationale therapeutic approaches to ISSHL remain uncertain. SSHL being a diagnosis of exclusion, retrocochlear and neurologic etiologies should be eliminated. No argument allows to consider ISSHL a therapeutic emergency. More precisely, the experimental data presently available on cochlear physiology suggests that a treatment could have some chance to be effective if undertaken within minutes following the onset of ISSHL, a condition never encountered in daily practice. Conversely, it is not justifiable to impute the absence of hearing recovery to a delay in therapy. The various therapeutic strategies currently recommended are highly empirical and should be questionned in terms of cost-effectiveness, the most common being high-dose corticosteroids. New investigation tests are required for improving our approach to ISSHL.

Weather conditions and sudden sensorineural hearing loss

BACKGROUND: Climatic or meteorological condition changes have been implicated in the pathogenesis of Idiopathic Sudden Sensorineural Hearing Loss (ISSHL). We investigated the seasonal distribution of ISSHL and evaluated the influence of meteorological parameters (such as temperature, humidity, and atmospheric pressure), their variation and covariation on the incidence of the disease. METHODS: A total of 82 cases of ISSHL, admitted to our department over a five-year period, were enrolled in the study. Seasonal distribution of the disease was investigated by dividing the year in four seasons. Meteorological data included daily values of 13 distinct parameters recorded at the meteorological station of the University of Ioannina during this period. A relationship between each meteorological variable and the incidence of ISSHL was investigated by applying (chi2) test on data from 13 contingency tables as well as by using logistic regression and t-test approaches. In addition, the influence of different weather types on the incidence of ISSHL was investigated using Cluster Analysis in order to create eight clusters (weather types) characteristic for the prefecture of Ioannina. RESULTS: The results of the study could not indicate any seasonal distribution of the disease. The incidence of ISSHL could not be significantly correlated either to any distinct meteorological parameter or to any specific weather type. CONCLUSIONS: Meteorological conditions, such as those dominating in the Northwestern Greece, and/or their changes, have no proven effect on the incidence of ISSHL.