Endothelial Dysfunction in Idiopathic Sudden Sensorineural Hearing Loss: A Review

Abstract

An endothelial dysfunction has been described in idiopathic sudden sensorineural hearing loss (ISSHL) patients. The purpose of our review was to: i) identify, evaluate and review recent research about cardiovascular risk factors involvement and signs of endothelial dysfunction in ISSHL; ii) implication of these discovering in clinical practice and future research. A Medline literature search was conducted to identify any study on the involvement of endothelial dysfunction in ISSHL, published in the English language in the last decade. The following MEDLINE search terms were used: sudden sensorineural hearing loss (SSHL) and endothelial dysfunction (text words). Additional studies were identified by hand searching the references of original articles and review articles. Studies were not excluded on the basis of the qualitative or quantitative definitions of SSHL, treatment regimens, or outcome measures. Data were extracted from included papers by a reviewer. Information on the patients, investigations, methods, interventions, and outcomes were systematically analyzed. Characteristics and results of all included studies were reviewed systematically. High levels of adhesion molecules, hyperhomocysteinemia and lower folate levels, unbalanced oxidative status, a lower value of flow-mediated dilatation of brachial artery and a reduced percentage of circulating endothelial progenitor cells in patients affected by ISSHL support the hypothesis that this syndrome should be considered as a microcirculation disorder based on endothelial dysfunction and drive clinicians to implement all the traditional strategies used for preventing cardiovascular events, to also reduce the likelihood of ISSHL occurrence.

Sensorineural hearing loss in children with sickle cell anemia and its association with endothelial dysfunction

“…Considering the chronic inflammatory state of SCA, these findings lead us to hypothesize that damage to the vascular endothelial due to SSW in the labyrinthic artery reduces blood flow in the ear; this results in vaso-occlusive processes in the spiral ganglion in the basal part of the cochlea or to the auditory nerve, culminating in SNHL. Similar studies in other types of SNHL show the presence of ED in the auditory system, as evidenced by a lower FMD value [18][19][20]. In addition, there is evidence that high levels of adhesion molecules and unbalanced oxidative status are involved in idiopathic sudden SNHL, which supports the hypothesis that SNHL should be considered as a microcirculation disorder caused by ED [18].…”

“…Similar studies in other types of SNHL show the presence of ED in the auditory system, as evidenced by a lower FMD value [18][19][20]. In addition, there is evidence that high levels of adhesion molecules and unbalanced oxidative status are involved in idiopathic sudden SNHL, which supports the hypothesis that SNHL should be considered as a microcirculation disorder caused by ED [18].…”

“…In the right ear, the HT exhibited differences at 250 Hz (15, median IQR [10][11][12][13][14][15][16][17][18][19][20] vs. 10, median IQR [5][6][7][8][9][10][11][12][13][14][15]; p = 0.003), 500 Hz (10 [10-15] vs. 10 [5][6][7][8][9][10]; p = 0.013), 2 kHz (7.5 [5][6][7][8][9][10][11][12][13][14][15] vs. 5 [5][6][7][8][9][10]; p = 0.034), 4 kHz (10 [5-15] vs. 5 [1.2-10]; p = 0.004), 6 kHz (10 [5-15] vs. 5 [5][6][7][8][9]…”

“…Reduced flow-mediated vasodilatation (FMD) is considered an early marker of vascular alterations in sickle cell disease (SCD) patients [17]. The relationship between endothelial dysfunction (ED) and SNHL is documented in sudden SNHL and idiopathic SNHL, supporting the presence of vascular damage [18][19][20]. Our exploratory study in children and adolescents with SCA showed an association between otoneurological symptoms (vertigo) and decreased FMD of the brachial artery, indicating the presence of ED [21].…”

İdiopatik ani işitme kaybı olan hastaların tiyol/disülfit homeostazisi üzerine hiperbarik oksijen tedavisinin etkisi

“…Quaranta et al reported that patients with ISSNHL had high oxidative stress levels and low antioxidant levels [23]. Gul et al found that the disulfide level and disulfide/native thiol and disulfide/total thiol ratios were significantly lower and the native thiol/total thiol ratio was significantly higher in patients with ISSNHL compared to controls [18].…”