Association between Vestibular Function and Hearing Outcome in Idiopathic Sudden Sensorineural Hearing Loss

Abstract

Background and ObjectivesTo investigate whether different vestibular function tests such as cervical vestibular evoked myogenic potential (cVEMP) and caloric test were correlated with severity, pattern and prognosis in idiopathic sudden sensorineural hearing loss (ISSNHL).Subjects and MethodsNinety-two patients with unilateral ISSNHL were subjected to complete audiovestibular evaluation. cVEMP and caloric test results were compared with patients' initial and final audiogram. We classified patients in 4 groups as cochlear nerve (C) type, cochlear and superior vestibular nerve (C+S) type, cochlear and inferior vestibular nerve (C+I) type and cochlear, superior vestibular nerve, inferior vestibular nerve (C+S+I) type, for evaluation of the results. cVEMP and caloric tests were compared among the groups.ResultsAbnormal caloric test results and abnormal cVEMP results were found in 50% and 31.6% patients, respectively. Multivariate analysis showed that abnormal caloric result (canal paresis) is a significant negative prognostic factor.ConclusionsInitial vestibular function test can be valuable in predicting the final outcome in patients with ISSNHL.

Vestibular Dysfunctions in Sudden Sensorineural Hearing Loss: A Systematic Review and Meta-analysis

“…Of the remaining 25 investigations, 7 articles were excluded from the final analysis due to duplicated data containing the same participants or to not providing sufficient information to calculate these variables. Finally, a total of 18 eligible articles met our inclusion criteria and were included in the final meta-analysis ( 7 , 8 , 14 , 17 – 19 , 24 – 35 ) (Figure 1 ).…”

“…The main demographic features and clinical characteristics of the patients are listed in Table 1 . Of the 18 studies included, 15 were retrospective studies ( 7 , 14 , 17 – 19 , 24 – 33 ), 2 were prospective studies ( 8 , 35 ), and 1 was a prospective/retrospective study ( 34 ), and the studies covered a total population of 1,468 subjects. The mean age ranged from 44 to 62 years, with the proportion of females ranging from 35 to 74%.…”

“…Concerning the types of vestibular examinations, the caloric test was performed in 16 studies ( 7 , 8 , 14 , 17 – 19 , 24 – 33 ), the cVEMP test was performedin 13 studies ( 7 , 8 , 14 , 17 – 19 , 24 – 28 , 34 , 35 ), and the oVEMP test was performed in 5 studies ( 17 , 24 , 26 , 27 , 34 ). In all 18 investigations, hearing recovery for abnormal and normal caloric response was provided in 7 studies ( 18 , 19 , 27 , 29 – 31 , 33 ), the number of patients with hearing improvement with abnormal and normal cVEMP response was provided in 4 studies ( 18 , 19 , 25 , 27 ), and 1 study provided hearing outcomes for abnormal and normal oVEMP responses ( 27 ). The AHRQ scores ranged from 6 to 11, including 15 high-quality studies and 3 medium-quality studies (Table 2 ).…”

“…Abnormal caloric test results have been reported in 39–74% of patients with SSHL ( 14 – 16 ), and the results of Korres et al and Niu et al indicated that abnormal vestibular examinations are associated with profound hearing loss in SSHL patients ( 7 , 17 ). Iwasaki et al found that the saccule is more often involved than the semicircular canal in SSHL patients with vertigo ( 18 ); however, recent results by Lee et al do not support the hypothesis above, and they found higher rates of lesions in the semicircular canal of SSHL patients ( 19 ). Thus, the vestibulocochlear lesion patterns, the clinical relevance of vertigo in relation to vestibulocochlear lesion location, and the correlation of vestibular organ damage with the prognosis of hearing loss in SSHL have not yet achieved consensus.…”

The specific clinical features of acute sensorineural loss of hearing associated with vertigo

“…Вероятно, поражение вестибулярного рецептора, филогенетически более древней и устойчивой к гипоксии структуры, чем слуховой рецептор, указывает на обширное и малообратимое поражение нейросенсорного эпителия внутреннего уха. Полу- оригинальные статьи ченные результаты согласуются с имеющимися в литературе данными об аномальном калорическом ответе как неблагоприятном прогностическом факторе ОНТ [17].…”