Assessment of diagnostic approaches to idiopathic sudden sensorineural hearing loss and their influence on treatment and outcome

Abstract

Methods:The first 400 patients submitted to the Swedish national database for SSNHL were analyzed. Information was collected at the first visit about the patient's past medical history, potential precipitating events traumata, family medical history, hearing loss, current disease, diagnostic protocol and treatment using questionnaires as well as two audiograms for each patient, one at the first visit to the ENT-clinic and one three months later.Results: 65% of these 400 patients underwent hematological tests and 40% had an MRI/CT.22/160 MRI investigated had pathological findings: five acoustic neuromas, one subdural hematoma, one pons infarction, five vascular abnormalities and ten patients had accidental findings not connected to the hearing tracts. 300 of these 400 patients were evaluated as idiopathic sudden sensorineural hearing loss (ISSNHL); 24% of them had one or more pathological tests. No significant correlation was found between either the MRI findings or the laboratory findings with regard to either treatment or hearing recovery in patients with ISSNHL. Conclusion:Results from a database for SSNHL demonstrate no correlation between laboratory findings, treatment and outcome in 400 patients. The patients with pathological tests were not treated differently from those with normal tests or no tests taken. The value of laboratory findings and MRI might increase if the results are categorized to more specific diagnoses.

Effect of comorbid diabetes and hypercholesterolemia on the prognosis of idiopathic sudden sensorineural hearing loss

“…Thereafter, no improvement may occur . Natural history and placebo‐controlled studies have shown hearing improvement rates of 32% to 65% (average: 46.7%) without treatment, typically within 2 weeks of onset of hearing loss …”

“…3 Natural history and placebo-controlled studies have shown hearing improvement rates of 32% to 65% (average: 46.7%) without treatment, typically within 2 weeks of onset of hearing loss. [4][5][6][7] Several studies have discussed the presumed prognostic factors of ISSNHL, which include pretreatment demographic characteristics, accompanying symptoms of vertigo or tinnitus, audiogram patterns, treatment methods, and the time elapsed between the onset of hearing loss and the beginning of the treatment. [8][9][10][11][12] Many medical risk factors of ISSNHL have been proposed in the literature, for example, hypertension (HTN), diabetes mellitus (DM), hypercholesterolemia (Hch), cerebrovascular disease (CVD), coronary artery disease (CAD), chronic kidney disease (CKD), and anemia.…”

Altered Contralateral Auditory Cortical Morphology in Unilateral Sudden Sensorineural Hearing Loss

“…Sudden sensorineural hearing loss (SSNHL), commonly known as sudden deafness, can be associated with tinnitus and vertigo and is defined as mostly unilateral decline of hearing function of more than 30 dB in at least three sequential frequencies over 3 days or less ( 1 ). The incidence of SSNHL was reported to range from 3.9 to 27.5 per 100,000 per year and is considered to be an otologic emergency ( 2 – 4 ). Although some pathophysiological mechanisms have been proposed, the precise cause of SSNHL is still unknown ( 5 ).…”

Vestibular Nerve Atrophy After Vestibular Neuritis – Results from a Prospective High-Resolution MRI Study

“…Diagnosis is one of exclusion: cerebellar infarction, Wallenberg's syndrome or Meniere's disease or a tumor, neurovascular conflict and other issues [1,4,5] have to be ruled out. So far, different diagnostic tests have failed to diagnose VN exactly [6]. According to the inflammation hypothesis, VN may be caused by acute infection with different viruses [7] or by reactivation of latent Herpes virus in the vestibular ganglia [8,9].…”