Diabetes, Cardiovascular Risk Factors and Idiopathic Sudden Sensorineural Hearing Loss: A Case-Control Study

Abstract

Aims/Hypothesis: Idiopathic sudden sensorineural hearing loss (ISSNHL) represents an acute inner ear disorder with an overall incidence of 5–20/100000 individuals per year in western countries. No clear causes for this disease have been found so far, but cochlear ischemia has been hypothesized as one of the etiopathological mechanisms. The aim of our study was to assess the role of diabetes and traditional cardiovascular risk factors in the pathogenesis of ISSNHL. Materials/Methods: Case-control study of 141 patients (75 males/66 females) matched for age and gender. Cases were affected by ISSNHL, defined as a sudden hearing loss ≧30 dB, within 3 frequencies, developing over 72 h. The control group was composed of 271 sex- and age-matched subjects (142 males/129 females) who agreed to participate in this observational study and provided blood samples for laboratory investigations. Cardiovascular risk factors examined were: diabetes mellitus, smoking history, hypercholesterolemia, hypertriglyceridemia and hypertension. Results: On the univariate analysis, diabetes prevalence was higher in the ISSNHL group (15.6%) compared to controls (8.5%) (p = 0.03). Also hypercholesterolemia was significantly more frequent in the ISSNHL group compared to the control population. There were no statistically significant differences between the 2 populations concerning other cardiovascular risk factors. The risk of ISSNHL tended to increase as the number of cardiovascular risk factors increased (p for linear trend = 0.018). Conclusions: Our findings suggest that diabetes mellitus, hypercholesterolemia and a high burden of cardiovascular risk factors are associated with the risk of ISSNHL.

Association of Acute Myocardial Infarction with Sudden Sensorineural Hearing Loss: A Population-Based Case-Control Study

“…Although SSNHL was previously reported to occur only in between 5 and 30 individuals out of every 100,000 persons annually [Schreiber et al, 2010], it is now known to affect up to 300 out of every 10,000 persons [Olzowy et al, 2005;Klemm et al, 2009]. While the etiology of SSNHL remains enigmatic, there is increasing evidence suggesting its association with an underlying cardiovascular mechanism in some patients [Rasmussen, 1949;Fukui et al, 2004;Rudack et al, 2006;Ballesteros et al, 2009;Aimoni et al, 2010;Lin et al, 2012]. It has been reported to be an early sign of stroke [Lee et al, 2002], and in one study by Lin et al [2008] was estimated to result in an increased hazard risk for stroke 5 years following diagnosis with SSNHL.…”

Patent Foramen Ovale as Possible Cause of Sudden Sensorineural Hearing Loss: A Case Report

“…Sudden sensorineural hearing loss (SSNHL) is described as a sensorineural (generally unilateral) hearing defect of at least 30 dB for at least 3 contiguous frequencies with an abrupt onset (within 3 days) [1,2] . The SSNHL incidence is reported to be 5-20 per 100,000, to Th is is an Open Access article licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense), applicable to the online version of the article only.…”

“…Several theories about the pathophysiology of idiopathic SSNHL have been suggested, such as vascular and infective [1][2][3] ; unfortunately, only in few cases is it possible to define a causative agent. A possible cause of SSNHL [4] could be a patent foramen ovale (PFO), as it is a frequent embryological residual of fetal foramen ovale, consisting of a virtual interatrial communication which may permit an anomalous blood flow from the right atrium to the left one whenever a Valsalva maneuver is performed [1][2][3][4][5] . The PFO is a common finding in the general population and may be completely asymptomatic [5] .…”

“…Rarely, patients with PFO may complain of migraine or migrainelike symptoms [5] . Nonetheless, PFO has been associated with an increased risk of cryptogenic ischemic stroke and even more in cases of association with atrial septal aneurysm [1][2][3][4][5] . The supposed pathogenic mechanism is a paradoxical thromboembolism from the venous system to the systemic circulation through the PFO; in addition, a small embolus (1-2 mm) may determine an acute cerebral ischemic event [1][2][3][4][5] .…”

“…Nonetheless, PFO has been associated with an increased risk of cryptogenic ischemic stroke and even more in cases of association with atrial septal aneurysm [1][2][3][4][5] . The supposed pathogenic mechanism is a paradoxical thromboembolism from the venous system to the systemic circulation through the PFO; in addition, a small embolus (1-2 mm) may determine an acute cerebral ischemic event [1][2][3][4][5] . Therefore, the presence of PFO and paradoxical thromboembolism could be considered among vascular causes of SSNHL [1][2][3][4][5] .…”