Clinical implications of posterior semicircular canal function in idiopathic sudden sensorineural hearing loss

Byun, Hayoung; Chung, Jae Ho; Lee, Seung Hwan

doi:10.1038/s41598-020-65294-5

Cited by 30 publications

(58 citation statements)

References 31 publications

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“…Furthermore, a significant difference in the abnormal rate of the PSC was found between SSNHL patients with or without vertigo in our study. Studies have also suggested that vestibular dysfunction is likely to extend from organs close to the cochlea to organs farther from the cochlea ( 15 , 27 ). In our opinion, the reason for the inconsistent results may be the different audiogram configurations used for SSNHL patients.…”

Section: Discussionmentioning

confidence: 99%

“…Lim et al demonstrated that the functions of vestibular organs, particularly the utricle and HSC, are associated with disease severity and hearing outcome in patients with SSNHL ( 14 ). Byun et al studied the function of each semicircular canal and saccule using vHIT, cVEMP, and caloric tests, and found that abnormal vHIT gain in the posterior semicircular canal (PSC) appears to be a specific prognostic factor for incomplete hearing recovery in SSNHL ( 15 ). Various inconsistent results were presented regarding involved vestibular dysfunction in patients with SSNHL depending on the presence of vertigo.…”

Section: Introductionmentioning

confidence: 99%

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Contribution of Audiogram Classification in Evaluating Vestibular Dysfunction in Sudden Sensorineural Hearing Loss With Vertigo

et al. 2021

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Object: We aimed to identify the relationship between vertigo symptoms and the involvement of vestibular dysfunction in sudden sensorineural hearing loss (SSNHL) and the contribution of audiogram classification.Methods: A total of 50 patients with unilateral SSNHL were retrospectively divided into the vertigo group and non-vertigo group depending on the presence of vertigo. The involved vestibular end organs (VEOs) were verified by a battery of vestibular function tests including video head impulse test (vHIT), cervical vestibular-evoked myogenic potential (cVEMP), and ocular VEMP (oVEMP). The correlations of audiogram configurations, initial pure-tone average (PTA), number of involved VEOs, prognosis (complete recovery rate), and vestibular functions were analyzed between the two groups. Additionally, the vestibular functions in a subgroup of profound SSNHL patients were further compared within groups with or without vertigo.Results: Significant differences in the initial audiogram configurations (p = 0.033) and the abnormal rates of the posterior semicircular canal (PSC) (p = 0.035) and oVEMP (p = 0.046) were found between the two groups. The number of involved VEOs was related to the initial PTA in the vertigo group (p = 0.002, r = 0.541) and non-vertigo group (p = 0.042, r = 0.446). The prognosis was related to the abnormal rate of cVEMP and the number of involved VEOs in both vertigo group (p = 0.008, r = 0.482; p = 0.039, r = 0.385, respectively) and non-vertigo group (p = 0.016, r = 0.520; p = 0.022, r = 0.495, respectively), and it was especially related to the audiogram configurations in the vertigo group (p < 0.001, r = 0.692). However, after classification by audiogram configurations, there was no statistical difference in the abnormal rates of all vestibular function tests or the number of involved VEOs between the profound SSNHL patients with or without vertigo.Conclusion: The relationship between the involvement of vestibular dysfunction and vertigo symptoms in patients with SSNHL was significantly different before and after audiogram classification. When evaluating the vestibular dysfunction in SSNHL patients, more attention should be paid to the audiogram configuration.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Contribution of Audiogram Classification in Evaluating Vestibular Dysfunction in Sudden Sensorineural Hearing Loss With Vertigo

et al. 2021

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“…The presumed causes of SSNHL include autoimmune inner ear diseases, viral infections, vascular disorders, ototoxic medication, genetic disorders, trauma, and acoustic tumors, but in most cases, the etiology is uncertain [14,22]. As opposed to noise-induced hearing loss, where one can study cochlear synaptopathy in noise-exposed animal models, it is impossible to design animal models to study the pathophysiology of SSNHL.…”

Section: Discussionmentioning

confidence: 99%

Possible Existence of Cochlear Synaptopathy in Patients Completely Recovered from Idiopathic Sudden Sensorineural Hearing Loss

Seo

Lee

Byun

et al. 2022

JCM

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Cochlear synaptopathy refers to a subclinical hearing pathology which could potentially explain hearing difficulties within the normal hearing threshold; it is also called “hidden hearing loss”. We hypothesized that a temporary threshold shift in sudden sensorineural hearing loss (ISSNHL) also affects the function in the synapse. The aim of the study was to evaluate the presence of cochlear synaptopathy in patients who had completely recovered from unilateral SSNHL Nineteen patients who had completely recovered from ISSNHL from January 2018 to June 2021 were assessed. Complete recovery was established by pure tone audiometry (PTA) 3 months after treatment, according to the American Academy of Otolaryngology–Head and Neck Surgery criteria. Subjects completed the pure tone audiometry, speech audiometry and auditory brain stem response (ABR) test, and completed a questionnaire regarding hearing loss after hearing recovery. The ABR amplitudes of wave I and wave V, and the ratio of wave I/V of both ears (recovered side and healthy side) were assessed. A visual analog scale (VAS) and a hidden hearing loss questionnaire were used to evaluate subjective hearing difficulty. The ABR waves I of the recovered ears had a significantly lower amplitude (p = 0.002) than those of the healthy side, whereas there was no difference in wave V (p = 0.985) or in the ratio of wave I/V (p = 0.107). Some patients still felt mild hearing difficulty although their PTA results were normal, but there was no clear relationship between the VAS score, wave I amplitude and speech recognition scores. The present findings point to the possible existence of cochlear synaptopathy in ears that have completely recovered from unilateral sudden sensorineural hearing loss. We suggest that the causes of cochlear synaptopathy and of idiopathic sudden hearing loss may have something in common.

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“…For ISSNHL patients with acute vertigo, some novel characteristics of vestibular lesions have been detected by vHIT recently ( 3 , 10 ). Most of these patients exhibited posterior SCC dysfunction ( 3 , 11 ), which could serve as a specific prognostic tool for predicting poor hearing recovery in patients with ISSNHL ( 12 ). VN, another typical variant of acute vestibular syndrome, shows mainly vestibular impairment in the horizontal and anterior SCC (as in superior VN).…”

Section: Introductionmentioning

confidence: 99%

Video Head Impulse Test Findings in Patients With Benign Paroxysmal Positional Vertigo Secondary to Idiopathic Sudden Sensorineural Hearing Loss

et al. 2022

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Benign paroxysmal positional vertigo (BPPV) is amongst the most common causes of episodic vestibular syndrome. It can be classified as idiopathic and secondary types according to the causative factors, and the underlying mechanism between idiopathic (i-BPPV) and secondary BPPV (s-BPPV) may differ. Idiopathic sudden sensorineural hearing loss (ISSNHL) has been considered as a common inner ear disease that precipitates s-BPPV. Yet, few studies have addressed the functional impairment of the semicircular canal (SCC) system in patients with s-BPPV associated with ISSNHL. Our purpose was to explore the pathophysiological mechanism and investigate the clinical implications of video head impulse test (vHIT) in these patients. Here, the clinical and laboratory data of patients with BPPV secondary to ISSNHL, including the results of vHIT, were retrospectively reviewed, and compared with those of patients with i-BPPV. Pathological vHIT findings (low vestibulo-ocular reflex gain and re-fixation saccade), which mainly affected the posterior SCC, were more common in the s-BPPV group than in the i-BPPV group (41.9 and 0%, respectively). The incidence of horizontal SCC involvement was also higher in the s-BPPV group (45.16 and 16.67%, respectively). Furthermore, patients with s-BPPV showed lower vHIT gains of the posterior and horizontal SCCs in affected ears than in unaffected ears. Compared to i-BPPV, posterior SCC paresis detected by vHIT is more prevalent in BPPV secondary to ISSNHL. This dysfunction may be associated mainly with vestibular impairments caused by ISSNHL, and not with BPPV per se.

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Clinical implications of posterior semicircular canal function in idiopathic sudden sensorineural hearing loss

Cited by 30 publications

References 31 publications

Contribution of Audiogram Classification in Evaluating Vestibular Dysfunction in Sudden Sensorineural Hearing Loss With Vertigo

Contribution of Audiogram Classification in Evaluating Vestibular Dysfunction in Sudden Sensorineural Hearing Loss With Vertigo

Possible Existence of Cochlear Synaptopathy in Patients Completely Recovered from Idiopathic Sudden Sensorineural Hearing Loss

Video Head Impulse Test Findings in Patients With Benign Paroxysmal Positional Vertigo Secondary to Idiopathic Sudden Sensorineural Hearing Loss

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