The Prevalence Of Vestibulocochlear Lesion Patterns In Sudden Sensorineural Hearing Loss
As summarized in Figure 2, lesions of the lateral semicircular canal and superior vestibular pathway were evaluated by the caloric test lesions of the saccule and inferior vestibular pathway were evaluated by the cVEMP test lesions of the utricle and/or superior vestibular pathway were evaluated by the oVEMP test, and the remaining lesions were assigned as cochlear lesions only . We performed a meta-analysis of the prevalence of inner ear damage within the LSC + S, S + I, U + S, and C only subgroups of SSHL independently. There was a combined proportion of 0.44 with a random-effect model in the mean occurrence rate of LSC + S a combined proportion of 0.41 with a random-effect model in the mean occurrence rate of S + I a combined proportion of 0.53 with a fixed-effect model in the mean occurrence rate of U + S and a combined proportion of 0.39 with a fixed-effect model in the mean occurrence rate of C only. Forest plots of the success rates are shown in Figure 3. Asymmetry was observed in the pool of data from the included investigations, indicating that there was some publication bias, as demonstrated by a funnel plot . The results indicated that the prevalence of inner ear organ damage was greatest in the U + S subgroup in SSHL, followed by LSC + S, S + I, and C only.
Table 3. Summary of the meta-analysis for the prevalence of the vestibulocochlear lesion patterns in SSHL.
Help And Support For Sudden Sensorineural Hearing Loss
Recovery from SSHL can be a distressing time and it is important to get as much support as you can. On a day to day basis coping with hearing loss can be daunting and leave you feeling very tired as you have to concentrate so much harder to understand what is being said and navigate the world around you.
In the immediate short term please get in touch with Hearing Link:
- Contact our friendly Helpdesk for personal advice and support.
- We can put you in touch with a specially trained volunteer who will understand what you are going through.
- Consider attending one of our free courses which run throughout the year in different places all over the UK.
- Go online to visit some useful social network forums.
- Find out about safety and assistive devices, including flashing doorbells, smoke alarms, streamers and TV loops.
Sudden Sensorineural Hearing Loss In The Only Hearing Ear: Large Vestibular Aqueduct Syndrome
Onur Ismi
1Department of Otorhinolaryngology, Faculty of Medicine, University of Mersin, Mersin, Turkey
Abstract
Sudden hearing loss in the only hearing ear cases are rarely published in the English literature most of the cases are idiopathic. It is an otologic emergency needing urgent treatment. Delayed diagnosis can interfere with patients social life with interrupting the verbal communication. In this case report we presented a 33-year-old female patient having sudden sensorineural hearing loss in the only hearing ear diagnosed as bilateral large vestibular aqueduct syndrome.
1. Introduction
Sudden sensorineural hearing loss can be described as at least 30dB sensorineural hearing loss in at least three consecutive frequencies within a three-day period . It is an important otolaryngological emergency needing thorough investigation and urgent treatment. SHL occurring in the only hearing ear is a more serious problem, since it increases patients morbidity and the sequel in the only hearing ear can affect the patients social life dramatically with interrupting the verbal communication. SSHL in the only hearing ear cases are rarely published in the English literature and most of these cases are idiopathic. In this case report we presented a large vestibular aqueduct syndrome patient admitting with a sudden hearing loss in the only hearing ear.
2. Case Report
3. Discussion
Competing Interests
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Sudden Sensorineural Hearing Loss
Most sensorineural hearing loss develops over time as the body ages, and its systems begin to run down. However, its also possible to be born with a deficiency in the inner ear cochlea, where our hearing converts sound vibrations to nerve signals our brains can understand.
This is a miraculous world audiologists are only beginning to fully understand properly. To be honest, theres little medical science can do to restore the deficit except to recommend hearing aids. However, in the case of sudden sensorineural hearing loss doctors may be able to repair the condition.
Labs Imaging And Audiometry
Though most SSNHL is idiopathic, there are several other possible etiologies to consider. CPG guidelines strongly recommend against routine, shotgun, laboratory workup as the evidence supporting their use is limited to observational and case-control studies. Within the literature most studies are underpowered and none support that a laboratory test improves management or outcomes., Furthermore, labs have associated cost and potential harms related to false-positive or false-negative results. Laboratory studies should be limited to specific tests cued by pertinent findings in the history or physical examination.
It is recommended that an audiometric evaluation is obtained for SSNHL, or a referral made to a physician that can obtain one, within 14days of presentation and for serial evaluations. Audiometry is the most reliable evaluation for differentiating CHL from sensorineural hearing loss and establishes frequency-specific hearing and word recognition ability. There may be concern regarding the logistic ability for a patient to undergo an audiometric evaluation within the specified time frame. To address this, most, otolaryngology practices have a specific workflow to triage referrals for sudden hearing loss and assure that these patients are seen promptly.
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How Is Sudden Hearing Loss Diagnosed
The sudden loss in hearing occurs within a three-day period and is obvious to you. You may also have loud ringing, dizziness, and/or pressure in the ear. You should see a healthcare provider as soon as possible if you have any of these symptoms. Your healthcare provider will complete a physical examination and review your medical history. A hearing test should be obtained by your healthcare provider but other routine lab tests and X-rays are not usually recommended.
Is There Additional Testing Needed With Ssnhl
Once in a while SSNHL is due to a benign tumor on the nerve that connects the ear to the brain. These tumors are called vestibular schwannomas. Your healthcare provider may order a magnetic resonance imaging scan to look for this tumor if an MRI is safe for you. Another option is a type of hearing test called Auditory Brainstem Response . However, if the ABR is abnormal, your healthcare provider should recommend an MRI.
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Data Sources And Search Strategy
The initial literature review of relevant studies for assessing the correlation of lesion pattern with the clinical manifestation of SSHL, with or without the presence of vertigo, was carried out in the PubMed and EMBASE databases using a combination of keywords, including sudden hearing loss,sudden deafness,caloric test,canal paresis,VEMP, and vestibular-evoked myogenic potential. All pertinent articles or abstracts that were published in English were retrieved with no restrictions on the date of publication. Additional papers were searched for in the reference lists of the identified papers.
Learn What This Condition Is What Can Cause It And What You Should Do If You Experience It
If youve never heard of sudden sensorineural hearing loss, youre not alone! To put it simply, its a lot like what it sounds like: sudden hearing loss in one or both ears, typically brought on by an illness or injury.
Informing yourself about what can cause sudden sensorineural hearing loss , the symptoms you may experience, and what to do if you experience it is the best way to protect yourself against SSHL.
What is sensorineural hearing loss? Sensorineural hearing loss refers specifically to hearing loss of the inner ear and is the most common type of hearing loss. The other main type is conductive hearing loss, which happens in the middle or outer ear. You can also have mixed hearing loss, meaning a combination of sensorineural and conductive hearing loss.
Sensorineural hearing loss can be brought on gradually, by aging or illness, or suddenly, as well discuss below.
What causes sudden sensorineural hearing loss? Unfortunately, experts arent 100% certain what causes SSHL. However, the most general answer is that it occurs when something happens to damage the sensory organs of the inner ear. This could be a viral ear infection, blocked blood circulation, an issue with the immune system, head trauma/an ear injury, side effects from medication to treat a severe illness like cancer, a neurological disorder, or other condition.
Continue exploring our hearing loss blog for more information on protecting your ears, living with hearing loss, and more.
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What Investigations And Referrals Are Indicated For The Initial Workup
Sudden sensorineural hearing loss is an urgent otologic problem, because early treatment is thought to improve prognosis, although the evidence is weak.,, Patients should be referred immediately to an otolaryngologist and should be seen ideally within one week. In the meantime, an audiogram should be obtained to confirm the nature and degree of the hearing loss and to provide a baseline for comparison following treatment . Many audiologists will perform this on an emergent basis however, delay in obtaining an audiogram should not delay referral to otolaryngology. In areas where expeditious audiogram and otolaryngology referrals are not feasible, the family physician should begin treatment.,
Sudden Sensorineural Hearing Loss: What You Need To Know
Hearing loss is a common occurrence as people age. However, if you have a sudden hearing loss in one or both ears, you may be suffering from a type of nerve deafness known as sudden sensorineural hearing loss, or SSHL.
People with SSHL often delay seeking medical help because they believe their hearing loss is caused by allergies, a sinus infection, earwax blocking the ear canal or other common conditions. However, people who develop sudden deafness symptoms, should treat it as a medical emergency and seek medical help as soon as possible ideally in less than 72 hours from the onset of your change in condition. You should ALWAYS go to your nearest Emergency Room for immediate treatment.
But what exactly are the symptoms, causes, and treatments for this incidence? Lets have a look at the specifics together.
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Coping With Sudden Sensorineural Hearing Loss
The three types of hearing loss are sensorineural hearing loss, conductive hearing loss, and mixed hearing loss, according to Johns Hopkins Medicine. Sensorineural hearing loss can happen to anyone and it may progress quickly. You may experience isolation and self-esteem issues as a result, but there are recognized and effective ways to cope.
Sudden Sensorineural Hearing Loss Is Sometimes Misdiagnosed
For most people with hearing loss in Albany, the condition develops gradually. It can take years before you even realize you have a problem.
Once in a while, hearing loss doesnt take long at all to set in it can happen suddenly, without warning.
Naturally, this can be frightening! Even worse?
The condition is sometimes misdiagnosed.
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What Is Sudden Sensorineural Hearing Loss:
As the name implies, sudden sensorineural hearing loss is a sudden loss of hearing in the ear or the hearing nerve that can last up to 72 hours. Meaning that you have up to 72 hours to treat this condition before there is little to no chance of recovery.
It causes a notable hearing loss, usually in one ear, and the degree can vary. Typically, an individuals sudden hearing loss is discovered when they wake up in the morning.
Other signs and symptoms that may accompany a sudden loss of hearing include but are not limited to the following aspects:
- Distortion of sounds in the ear
- Tinnitus, a ringing in one or both of the ears
- A blocked or full feeling in the ear
- Nausea/vomiting. Feelings of anxiety
Analysts claim that one to six people per 5,000 are diagnosed with SSHL each year. Although the real number of new SSHL cases might be substantially higher due to the fact that SSHL often stays undiagnosed. It is most common in adults aged 30-60. Males and females are both under the same risk of SHL.
Common Symptoms Of Sudden Hearing Loss:
The initial indicators of a sudden hearing loss are usually ear pressure and/or tinnitus. Common symptoms might appear all at once or over the course of a few days, typically in one ear, and can vary from mild to severe. Permanent deafness is possible in the worst-case scenarios.
Typically, earache is not a common symptom of a sudden hearing loss. Pain in one ear can be caused by a variety of factors and may suggest the presence of another medical condition. At the same time, the presence of a muffled sound in the ear of dizzy spells could be a sign of it.
The following are the most prevalent signs and symptoms of sudden hearing loss:
- Hearing loss occurs for no apparent reason.
- The absence of earache
- Hearing loss only in one ear
Symptoms that come with it include:
- Dizziness
- Sensation loss in the outer ear
- Pressure in the ears
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What About The Vaccines
So far, data from the CDC’s Vaccine Adverse Events Reporting System does not indicate any link between vaccination and sudden hearing loss. The rate of sudden hearing loss appears to actually be lower among vaccinated people, though researchers from Johns Hopkins School of Medicine say cases could be under-reported. Their results were published in May 2021 in a research letter in the medical journal JAMA OtolaryngologyHead and Neck Surgery.
The Characteristics And Quality Assessments Of The Included Studies
Based on the criteria mentioned above, 145 potentially relevant references were initially identified. Of these, 102 studies were excluded after screening by the title, abstract, or full text. A further 18 studies were removed because they lacked vestibular function examination in SSHL with or without vestibular symptoms. Of the remaining 25 investigations, 7 articles were excluded from the final analysis due to duplicated data containing the same participants or to not providing sufficient information to calculate these variables. Finally, a total of 18 eligible articles met our inclusion criteria and were included in the final meta-analysis .
Figure 1. Flow chart of the study selection for the meta-analysis.
Table 1. Literature reports of selected studies.
Table 2. Quality control of the selected studies according to the criteria of the Agency for Healthcare Research and Quality .
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Vestibular Dysfunctions In Sudden Sensorineural Hearing Loss: A Systematic Review And Meta
- 1Otorhinolaryngology Department, ENT Institute, Affiliated Eye and ENT Hospital of Fudan University, Shanghai, China
- 2Institutes of Biomedical Sciences, Fudan University, Shanghai, China
Background: Sudden sensorineural hearing loss not only involves cochlear function but might also be accompanied by vestibular disturbances. The assessment of vestibular function could be of great relevance in SSHL.
Objective: To investigate the prevalence of vestibulocochlear lesions in SSHL and the correlation of specific vestibular organs with hearing prognosis.
Data sources: A complete literature search of eligible studies in the PubMed and EMBASE databases was performed.
Study selection: For our aim, studies that focused on vestibular examination in the case of SSHL were retrieved, including caloric tests, cervical vestibular-evoked myogenic potential tests, or ocular vestibular-evoked myogenic potential tests.
This study shows the relevance of vestibular damage concomitant with SSHL and that SSHL patients with vertigo are at an increased risk of vestibular organ lesions compared with patients without vertigo. LSC + S lesions thus appear to be a critical variable that influence the possibility of hearing improvement in SSHL.
The Clinical Value Of Vertigo As A Prognostic Indicator Of Lesion Location In Sshl
The clinical value of vertigo in inner ear organ damage was assessed by meta-analysis. Three studies described the occurrence rates of LSC + S lesions in a dichotomous pattern . We adopted a random-effect model with a high heterogeneity to evaluate whether LSC + S in the vertigo group was more likely to be damaged than in the non-vertigo group. The weighted mean OR was 4.89, and the 95% CI was 1.2019.93 with statistical significance .
Figure 5. Forest plots of the synthesized data from the selected studies. Comparison of the occurrence rate of lateral semicircular canal and superior vestibular nerve lesion between the vertigo and non-vertigo groups. Comparison of the occurrence rate of saccule and inferior vestibular nerve lesion between the vertigo and non-vertigo groups. OR, odds ratio MH, MantelHaenszel method random, random-effect method fixed, fixed-effect method.
Only two studies were assessed in the S + I subgroup, and there was a combined OR of 3.58 with a fixed-effect model . There was a statistically significant difference in the occurrence rates of LSC + S and S + I lesions between the vertigo and non-vertigo groups, which suggests that the presence of vertigo is indicative of a positive prognosis of greater vestibular dysfunction. Asymmetry was demonstrated by a funnel plot .
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Joy Victory Managing Editor Healthy Hearing
Joy Victory has extensive experience editing consumer health information. Her training in particular has focused on how to best communicate evidence-based medical guidelines and clinical trial results to the public. She strives to make health content accurate, accessible and engaging to the public.Read more about Joy.
Use Of Antidepressants Increases The Risk Of A Sudden Hearing Loss
A study has found that the increased risk for a sudden sensorineural hearing loss for antidepressant users is 1.36 compared with non-users.
In the study, all classes of antidepressants consistently increased the risk of a sudden sensorineural hearing loss. Patients receiving four classes of antidepressants were associated with a much higher risk of a sudden hearing loss, while those receiving only one or two classes of antidepressants had a lower risk.
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