Sudden Sensorineural Hearing Loss Associated with Slow Blood Flow of the Vertebrobasilar System

Abstract

To determine the characteristics of sudden deafness associated with slow blood flow (SBF) within the vertebrobasilar arteries, we evaluated 57 patients with sudden deafness using magnetic resonance imaging (MRI). We detected SBF in 12 (21%) patients, predominantly men over 50 years of age. A second MRI performed in 5 patients 2 months after the onset of symptoms showed recovery of blood flow. All 12 patients complained of vertigo. Audiological and neurotologic tests suggested that hearing loss mainly involved the inner ear. Our findings suggest that unless central lesions are detected, headache, hypoesthesia of the external ear canal, and electronystagmographic abnormalities are signs of SBF. Because sudden deafness may recur in patients who have SBF, they should be monitored and treated to prevent recurrence.

Sleep Apnea Is Associated with Hearing Impairment: The Hispanic Community Health Study/Study of Latinos

“…34 The cochlea is especially vulnerable anatomically to ischemia and vascular inflammation as it is supplied by an end artery. 35,36 Arteries feeding the stria vascularis, the capillary rich network in lateral wall of cochlea, are relatively sparse at the apex as compared to the base. Therefore, the hair cells in the cochlea at the apex that respond to the lowfrequency sounds may be more susceptible to ischemia.…”

Sudden sensorineural hearing loss and vertigo associated with arterial occlusive disease: three case reports and literature review

“…[2][3][4][5][6]15 SSNHLV is a disease of multifactorial etiology, with vertebrobasilar obstructive disease as one of the main causes. The variability in the prevalence of this condition (1.2 to 21%) is probably due to the different age groups studied; an association between SSNHLV and vertebrobasilar obstructive disease is expected to be more likely among the elderly.…”

“…4 Occipital headache, diplopia, cerebellar ataxia, hemiparesis, facial hypoesthesia, dysphasia and dysphonia may be associated symptoms. 2,3,18 NMR and NMR angiography are the most useful techniques for demonstrating arterial diseases of the vertebrobasilar trunk. [2][3][4][5][6]9,13,17 Although vertebrobasilar arteriography is an invasive procedure, it should be used to confirm vertebrobasilar obstructive disease, thereby avoiding false positive cases detected by NMR and NMR angiography.…”

“…2,3,18 NMR and NMR angiography are the most useful techniques for demonstrating arterial diseases of the vertebrobasilar trunk. [2][3][4][5][6]9,13,17 Although vertebrobasilar arteriography is an invasive procedure, it should be used to confirm vertebrobasilar obstructive disease, thereby avoiding false positive cases detected by NMR and NMR angiography. 1,2 Carotid artery occlusion that induces SS-NHLV is rare, but is possible especially when associated with vertebrobasilar inadequacy.…”

“…[2][3][4][5][6]9,13,17 Although vertebrobasilar arteriography is an invasive procedure, it should be used to confirm vertebrobasilar obstructive disease, thereby avoiding false positive cases detected by NMR and NMR angiography. 1,2 Carotid artery occlusion that induces SS-NHLV is rare, but is possible especially when associated with vertebrobasilar inadequacy. [7][8][9] On the other hand, obstructive vertebrobasilar artery disease with significantly reduced carotid flow (decrease of more than 60%, on echo-Doppler) may impair the microcirculation of the internal auditory artery, thus causing SSNHLV.…”