Sudden Sensorineural Hearing Loss Associated With Iron-Deficiency Anemia

Abstract

IMPORTANCE Vascular events play a big part in the development of sudden sensorineural hearing loss (SSNHL), but only those associated with sickle-cell anemia have been previously associated with SSNHL. This study demonstrates an association between SSNHL and prior iron-deficiency anemia (IDA).OBJECTIVE To evaluate the association between IDA and SSNHL using a nationwide population-based database.DESIGN, SETTING, AND PARTICIPANTS In this case-control study in Taiwan, participants with SSNHL (n = 4004) were identified, and controls (n = 12 012) were randomly selected.MAIN OUTCOMES AND MEASURES Conditional logistic regression was used to calculate the ORs (95%CIs) for IDA in participants with SSNHL vs controls.RESULTS Of the 16 016 sampled participants, 533 (3.3%) had previously been diagnosed with IDA, including 172 (4.3%) participants with SSNHL and 361 (3.0%) controls. The χ2 test revealed a significant difference (P < .001) in the prevalence of prior IDA between participants with SSNHL and controls. By conditional logistic regression, we found that the OR for previous IDA among the participants with SSNHL was 1.34 (95%CI, 1.11-1.61) (P < .01)after adjusting for monthly income, geographic region, urbanization level, and comorbidities(ie, hypertension, diabetes, hyperlipidemia, renal disease, and coronary heart disease). The significant relationship between SSNHL and prior IDA was most pronounced among those 44 years or younger (adjusted OR, 1.91; 95%CI, 1.35-2.72) (P < .001) for the participants with SSNHL compared with controls, and the strength of this relationship decreased with age.CONCLUSIONS AND RELEVANCE There is an association between SSNHL and prior IDA.Patients with IDA, especially those younger than 60 years, should be more aggressively surveyed and managed to reduce hearing-related morbidities.

Association between Sudden Sensorineural Hearing Loss and Preexisting Thyroid Diseases: A Nationwide Case-Control Study in Taiwan

“…Numerous etiologies, including infection, otologic disease, and trauma, have been confirmed but most cases are idiopathic [2]. SSNHL may be associated with a variety of underlying comorbidities such as iron deficiency anemia, chronic kidney disease, systemic lupus erythematosus, diabetes mellitus (DM), human immunodeficiency virus, psoriasis, osteoporosis, and chronic otitis media (COM) [3][4][5][6][7][8][9][10].…”

Association of Iron Deficiency Anemia With Hearing Loss in US Adults

“…The etiology is unknown, but a recent study by Chung et al found a significant association between iron deficiency anemia (IDA) and sudden SNHL [OR: 1.34 (95% CI: 1.11–1.61), p<0.01], which was most prominent in patients under 60 years-old. 5 IDA is a subset of anemia in which patients exhibit low hemoglobin, serum ferritin, serum iron, and increased soluble transferrin receptor. In United States adults, IDA is usually a result of blood loss, and usually responds well to reversal of the source of blood loss and oral iron supplementation.…”

Effect of Antioxidant Vitamins as Adjuvant Therapy for Sudden Sensorineural Hearing Loss: Systematic Review Study

“…There are a few postulated pathophysiologies for SSNHL: (1) labyrinthine viral infection -there is a moderate prevalence of recent viral-type illness in SSNHL patients; about 17-33% of SSNHL patients recall a recent viral illness; however, 25% of patients without hearing loss visiting an otolaryngology clinic had experienced a virallike illness within a month [Okamoto et al, 1994]; (2) labyrinthine vascular compromise -the cochlea is an end organ with no collateral vasculature; thrombosis, embolus, vasospasm, or any pathology that results in reduced blood flow to the cochlea is a possible etiology for idiopathic SSNHL [Rudack et al, 2006]; (3) intracochlear membrane ruptures -rupture of either the membranes that separate the inner ear from the middle ear, or the delicate membranes within the cochlea that separate the perilymphatic and endolymphatic spaces could result in SSNHL, by creating a state of relative endolymphatic hydrops or altering the endocochlear potential, respectively [Chung et al, 2014;Goodhill et al, 1973;Simmons, 1968]; (4) immunemediated inner ear disease -the occurrence of SSNHL in autoimmune diseases, such as Cogan syndrome and systemic lupus erythematosus, is well documented, and (5) iron deficiency anemia [Chung et al, 2014]. Iron, in addition to zinc and copper, is essential to break down the free radicals for the enzymatic antioxidants.…”