Is There an Overlap between Sudden Neurosensorial Hearing Loss and Cardiovascular Risk Factors?

Abstract

Introduction: Sudden sensorineural hearing loss (SSHL) has been proposed as a symptom of underlying vascular problems. The purpose of this work is to evaluate the genetic and acquired risk factors. Methods: Ninety-nine patients were tested for the presence of common polymorphisms related to thrombophilia (prothrombin and factor V Leiden) in order to assess genetic risk factors, and several parameters classically associated with vascular disorders (cardiovascular events, brain stroke and antiphospholipid syndrome) were evaluated. Additional assessments of personal and familial history risk factors for vascular disorders were performed in each patient. Results: Thrombophilia studies did not demonstrate statistically relevant differences between the patients and control group. However, lipidemia profile and directed personal and familial histories showed positive trends for SSHL. Conclusion: The lack of clear relationships between SSHL and other vascular risk factors suggests multicausality as a predominant disease profile. Although preliminary results point at a vascular involvement in SSHL, a long-term prospective study is necessary to demonstrate that SSHL represents an early vascular symptom.

Cardiovascular and Thromboembolic Risk Factors in Idiopathic Sudden Sensorineural Hearing Loss: A Case-Control Study

“…Moreover, 6 of the 18 were heterozygous carriers of the prothrombin G20210A mutation. Several studies then searched for a genetic association between factor II and/or factor Leiden V mutation and ISSHL with discrepant results [Parscheke et al, 2001;Rudak et al, 2004;Gorur et al, 2005;Marcucci et al, 2005;Cadoni et al, 2006;Capaccio et al, 2007;Yildiz et al, 2008;Ballesteros et al, 2009]. Strikingly, most studies, like our study, were small-sized studies, suggesting that a meta-analysis would perhaps allow a conclusion to be drawn concerning the genetic association of these mutations with ISSHL.…”

“…Despite these studies suggesting a vascular involvement, only a few studies analyzed the association between cardiovascular risk factors and ISSHL, mainly showing that high concentrations of cholesterol, fibrinogen, and homocysteine were arterial risk factors of ISSHL [Marcucci et al, 2005;Capaccio et al, 2007;Ballesteros et al, 2009]. Other reports evaluated the association between ISSHL and genetic polymorphisms of thromboembolic factors, mainly factor V Leiden and prothrombin G20210A variant, with discrepancies in the results [Mercier et al, 1999;Patscheke et al, 2001;Rudack et al, 2004;Görür et al, 2005;Cadoni et al, 2006;Capaccio et al, 2007;Ballesteros et al, 2009].…”

“…Other reports evaluated the association between ISSHL and genetic polymorphisms of thromboembolic factors, mainly factor V Leiden and prothrombin G20210A variant, with discrepancies in the results [Mercier et al, 1999;Patscheke et al, 2001;Rudack et al, 2004;Görür et al, 2005;Cadoni et al, 2006;Capaccio et al, 2007;Ballesteros et al, 2009].…”

Sudden Sensorineural Hearing Loss

“…The clinical presentation of unilateral sudden SNHL is comparable to the clinical presentation of ischemic vascular diseases such as transient ischemic attacks and amaurosis fugax (Ballesteros et al, 2009). Some studies have found that risk factors for ischemic vascular disease, including cigarette smoking, hypertension, and hyperlipidemia, are risk factors for the development of idiopathic SSNHL (Capaccio et al, 2007;Chau et al, 2010), although others have found no association of these risk factors with idiopathic SSNHL (Ballesteros et al, 2009;Cadoni et al, 2005;Einer, Tengborn, Axelsson, & Edstrom, 1994). According to the vascular etiologic theories, the sudden loss of hearing could result from an acute vascular hemorrhage (Colclasure & Graham, 1981;Schuknecht, Igarashi, & Chasin, 1965), occlusion by emboli (Jaffe, 1970), vascular disease (Kirikae, Nomura, Shitara, & Kobayashi, 1962), vasospasm (Mattox & Simmons, 1977), or change in blood viscosity (Ruben et al, 1969;Urban, 1973).…”

“…Due to the small diameter of the vessels within the arterial supply and lack of collateral blood supply, the cochlea is susceptible to injury through a variety of vascular insults. The clinical presentation of unilateral sudden SNHL is comparable to the clinical presentation of ischemic vascular diseases such as transient ischemic attacks and amaurosis fugax (Ballesteros et al, 2009). Some studies have found that risk factors for ischemic vascular disease, including cigarette smoking, hypertension, and hyperlipidemia, are risk factors for the development of idiopathic SSNHL (Capaccio et al, 2007;Chau et al, 2010), although others have found no association of these risk factors with idiopathic SSNHL (Ballesteros et al, 2009;Cadoni et al, 2005;Einer, Tengborn, Axelsson, & Edstrom, 1994).…”