Idiopathic sudden sensorineural hearing loss and ménière syndrome: The role of cerebral venous drainage

Ciccone, Marco Matteo; Scicchitano, Pietro; Gesualdo, Michele; Cortese, Francesca; Zito, Annapaola; Manca, Fabio; Boninfante, Barbara; Recchia, Pasquale; Leogrande, Domenico; Viola, Domenico; Damiani, Mario Francesco; Gambacorta, Valeria; Piccolo, A.; Ceglie, Vincenzo De; Quaranta, Nicola

doi:10.1111/coa.12947

Cited by 22 publications

(17 citation statements)

References 31 publications

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“…A study by Ciccone et al. of patients with idiopathic SSNHL revealed via ultrasound colour Doppler statistically significant reduced minimum, maximum, and mean velocities of the left internal jugular vein and left vertebral vein compared to controls, irrespective of the diseased ear (21). In this study, 11.8% of patients with idiopathic SSNHL compared to 9.7% of the control group ( P = 1.000) exhibited changes consistent with venous abnormalities (i.e.…”

Section: Discussionmentioning

confidence: 98%

“…Furthermore, Ciccone et al. found an association between early markers of atherosclerosis and lower pure-tone averages on audiologic evaluation in patients diagnosed with idiopathic SSNHL (21). Our study found chronic microangiopathic disease in 25.7% of patients with idiopathic SSNHL, which was also found at an identical rate in the control group.…”

Section: Discussionmentioning

confidence: 99%

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Magnetic resonance imaging findings in idiopathic sudden sensorineural hearing loss

et al. 2019

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Background The unpredictability in presenting signs and symptoms of idiopathic sudden sensorineural hearing loss (SSNHL) presents a notable diagnostic challenge for clinicians. Previous studies have confirmed the potentially important role of magnetic resonance imaging (MRI) in the diagnosis and prognostication of idiopathic SSNHL to guide definitive medical therapy, but correlations of these findings with outcomes remain controversial. Purpose To evaluate and identify magnetic resonance imaging (MRI) findings associated with idiopathic sudden sensorineural hearing loss (SSNHL). Material and Methods Sixty-eight patients with a documented diagnosis of idiopathic SSNHL and 20 controls underwent 1.5-T or 3-T MRI of the brain. Age, gender, ethnicity, associated co-morbidities, and audiometry findings were also recorded. Statistical analysis was performed to compare outcome measures between idiopathic SSNHL and control groups. Results The mean age of the cohort was 57 ± 17 years, with a male-to-female ratio of 1:1.1. MRI findings include 25.0% (P = 1.000) with chronic microangiopathic disease, 14.7% (P = 0.165) with temporal bone aberrations, 13.2% (P = 0.165) with facial and/or vestibulocochlear nerve complex changes, 11.8% (P = 1.000) with venous malformations, 8.8% (P = 0.104) with arterial malformations, and 8.8% (P = 0.184) with cerebral and/or brainstem parenchymal disease. Conclusion Arteriovenous malformations and central neurologic disease are not directly associated with idiopathic SSNHL on MRI. However, visualized signal changes of inner ear structures and facial/vestibulocochlear nerve complex support previously postulated theories, which include viral as well as inflammatory processes in the development of idiopathic SSNHL.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging findings in idiopathic sudden sensorineural hearing loss

et al. 2019

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“…Although the pathophysiology of SSHL remains controversial, some asymmetric anatomical conditions may be responsible for the unilateral involvement of SSHL. Since the intracranial venous system is often asymmetric and cochlear venous insufficiency has been considered to be one of the causes of SSHL, we chose to focus our study on patients with SSHL to verify whether asymmetries of the intracranial venous drainage could play a role in the etiopathogenesis of SSHL 2,3,14,15 .…”

Section: Discussionmentioning

confidence: 99%

Relationship between the drainage pattern of the dural venous sinuses and hearing recovery in patients with sudden sensorineural hearing loss

Park

Kim

Kang

et al. 2020

Sci Rep

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Although cochlear venous insufficiency has been considered to cause sudden sensorineural hearing loss (SSHL), there is insufficient clinical evidence to support this hypothesis. We sought to determine whether there is a correlation between draining patterns of the dural venous sinuses and the side of the affected ear in SSHL, as well as hearing recovery. The medical records of 109 patients diagnosed with unilateral SSHL were retrospectively reviewed. Magnetic resonance images and pure tone audiometry were performed in all patients. We measured the dominance of the inferior petrosal sinus (IPS) and transverse-sigmoid sinus (TS/SS) ipsilateral to the affected ear. Most patients were characterized by asymmetric venous drainage (IPS, 53.2%; TS/SS, 81.7%). The dominant side of the IPS or TS/SS was independent of the side of the affected ear for all patients in this study. However, in 35 patients with early recovery within 2 weeks, the dominant side of TS/SS was significantly associated with the side of the affected ear (p = 0.011). Moreover, the dominance of both the IPS and TS/SS influenced hearing outcomes at 3 months. Dominant TS/SS ipsilateral to the affected ear, particularly in the presence of ipsilateral hypoplastic IPS, is associated with a favorable hearing prognosis of SSHL. Sudden sensorineural hearing loss (SSHL) is frequently associated with idiopathic etiology. Several theories concerning causes of SSHL have been proposed, including viral infection and autoimmune disease. Disruption of cochlear blood flow has also been considered as one of the factors explaining the potential pathophysiology of SSHL 1. Studies using an animal model have provided evidence to support vascular impairment as a possible cause of SSHL, since it is not possible to directly measure or visualize small amounts of blood flow in the cochlea using current techniques in humans 1. Similar to retinal vein occlusions, impaired venous return from the cochlear circulation is suspected to cause inner ear disorders 2. However, there are fewer experiments investigating the effect of venous congestion produced in the cochlea, compared to the number of experiments involving occlusion of arteries to the cochlea 2,3. The inferior cochlear vein (ICV) is the main draining vein of the cochlea. The ICV runs within the canal of Cotugno proximal to the cochlear aqueduct. Considering the venous drainage of the cochlea into the dural sinus, anatomic variability of adjacent sinuses, including the inferior petrosal sinus (IPS), transverse-sigmoid sinuses (TS/SS), or the jugular bulb, may affect the venous drainage of the cochlea and the development of hearing impairment. This theory of venous congestion is supported by the fact that the dural sinuses frequently have asymmetric drainage in the normal population. Prior studies have demonstrated that 23-35% and 72% of cases presented asymmetric structure of the IPS and TS/SS, respectively 4. In addition, there have been radiological studies showing significant asymmetry of the jugular bulb 5. Contrast-enhance...

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“…Ciccone et al have confirmed that the ISSHL patients were at a higher cardiovascular risk, which suggests the vascular genesis of cochlear damage. Moreover, asymmetrical alterations in venous extracranial hemodynamics could contribute to the pathogenesis of SSNHL [16]. Besides, they first mentioned that hearing thresholds of the contralateral ear were related to carotid intima-media thickness and flow-mediated dilation of the brachial artery representing subclinical atherosclerosis [13].…”

Section: Discussionmentioning

confidence: 99%

Selected Blood Inflammatory and Metabolic Parameters Predicted Successive Bilateral Sudden Sensorineural Hearing Loss

Zhang

Weng

et al. 2019

Disease Markers

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Objectives. To explore whether peripheral inflammatory, metabolic, and hemostatic parameters could predict the pathogenesis of successive bilateral sudden sensorineural hearing loss (SSNHL). Methods. This study reviewed 33 patients with successive bilateral SSNHL and 215 patients with unilateral SSNHL. Clinical characteristics and hematological parameters were compared, including the inflammatory markers (like neutrophil lymphocyte ratio (NLR), monocyte lymphocyte ratio (MLR), and platelet lymphocyte ratio (PLR)) and metabolic features (including hypertension, triglyceridemia, dyslipidemia, and hyperglycemia), as well as hemostatic indices (including prothrombin time (PT), activated partial thromboplastin time (APTT), and fibrinogen). Results. In the successive bilateral SSNHL group, older average onset age (48.67±15.36 vs. 42.71±13.58, p<0.05), higher male to female ratio (18 : 15 vs. 112 : 103, p>0.05), and poorer therapeutic efficacy (12% vs. 59%, p<0.01) were observed than those in the unilateral SSNHL group. Compared to the unilateral SSNHL group, NLR, MLR, and PLR in the successive bilateral SSNHL group were significantly higher (NLR: 5.72±2.23 vs. 4.45±2.82, p=0.01; MLR: 0.25±0.15 vs. 0.17±0.11, p<0.01; PLR: 190.70±69.79 vs. 148.18±65.67; p<0.01); the LDL level was significantly higher; yet, the HDL level was significantly lower (LDL: 3.79±0.53 vs. 3.49±0.74; HDL: 1.33±0.32 vs. 1.44±0.26; p<0.05 for both); fibrinogen was significantly higher (4.03±0.47 vs. 3.70±0.65; p<0.01). Logistic regression analysis demonstrated that the risk factors for successive bilateral SSNHL included age, NLR, MLR, PLR, LDL, HDL, diabetes, and fibrinogen. However, only NLR, MLR, PLR, diabetes, LDL, and HDL independently predicted successive bilateral SSNHL. Conclusion. Selected blood inflammatory markers combined with metabolic parameters were positively correlated with successive bilateral SSNHL.

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Idiopathic sudden sensorineural hearing loss and ménière syndrome: The role of cerebral venous drainage

Cited by 22 publications

References 31 publications

Magnetic resonance imaging findings in idiopathic sudden sensorineural hearing loss

Magnetic resonance imaging findings in idiopathic sudden sensorineural hearing loss

Relationship between the drainage pattern of the dural venous sinuses and hearing recovery in patients with sudden sensorineural hearing loss

Selected Blood Inflammatory and Metabolic Parameters Predicted Successive Bilateral Sudden Sensorineural Hearing Loss

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