Review

Authors: Andrew D P Prince, Emily Z Stucken

The family physician's role in recognizing and managing sudden sensorineural hearing loss (SSNHL) is crucial. A recently updated otolaryngologic clinical practice guideline has been released for this emergency syndrome, but dissemination is limited to a specialty journal. As a result, the guidelines may not be widely available in the primary care setting where patients often present. We provide this focused review to clarify and disseminate SSNHL guidelines for the frontline family physician.

Topics: Emergency Service, Hospital; Hearing Loss, Sensorineural; Hearing Loss, Sudden; Humans; Physicians, Family; Primary Health Care

PubMed: 33452100
DOI: 10.3122/jabfm.2021.01.200199

Review

Authors: Maggie Kuhn, Selena E Heman-Ackah, Jamil A Shaikh...

Sudden sensorineural hearing loss (SSNHL) is commonly encountered in audiologic and otolaryngologic practice. SSNHL is most commonly defined as sensorineural hearing loss of 30 dB or greater over at least three contiguous audiometric frequencies occurring within a 72-hr period. Although the differential for SSNHL is vast, for the majority of patients an etiologic factor is not identified. Treatment for SSNHL of known etiology is directed toward that agent, with poor hearing outcomes characteristic for discoverable etiologies that cause inner ear hair cell loss. Steroid therapy is the current mainstay of treatment of idiopathic SSNHL in the United States. The prognosis for hearing recovery for idiopathic SSNHL is dependent on a number of factors including the severity of hearing loss, age, presence of vertigo, and shape of the audiogram.

Topics: Acoustic Stimulation; Audiometry; Auditory Threshold; Hearing; Hearing Loss, Sensorineural; Hearing Loss, Sudden; Humans; Magnetic Resonance Imaging; Predictive Value of Tests; Recovery of Function; Risk Factors; Steroids; Treatment Outcome

PubMed: 21606048
DOI: 10.1177/1084713811408349

Review

Authors: M Charles Liberman, Sharon G Kujawa

Common causes of hearing loss in humans - exposure to loud noise or ototoxic drugs and aging - often damage sensory hair cells, reflected as elevated thresholds on the clinical audiogram. Recent studies in animal models suggest, however, that well before this overt hearing loss can be seen, a more insidious, but likely more common, process is taking place that permanently interrupts synaptic communication between sensory inner hair cells and subsets of cochlear nerve fibers. The silencing of affected neurons alters auditory information processing, whether accompanied by threshold elevations or not, and is a likely contributor to a variety of perceptual abnormalities, including speech-in-noise difficulties, tinnitus and hyperacusis. Work described here will review structural and functional manifestations of this cochlear synaptopathy and will consider possible mechanisms underlying its appearance and progression in ears with and without traditional 'hearing loss' arising from several common causes in humans.

Topics: Animals; Auditory Perception; Auditory Threshold; Cochlear Nerve; Glutamic Acid; Hair Cells, Auditory, Inner; Hearing; Hearing Loss, Noise-Induced; Hearing Loss, Sensorineural; Humans; Nerve Degeneration; Noise; Risk Factors; Synapses; Synaptic Transmission

PubMed: 28087419
DOI: 10.1016/j.heares.2017.01.003

Review

Authors: Nazia Kabani, Shannon A Ross

Congenital cytomegalovirus (cCMV) infection is a leading cause of hearing loss and neurological disabilities in children, with the disease burden and disabilities due to cCMV greater than many other well recognized childhood conditions. A minority of infants with cCMV will have symptoms at birth. Infants with symptomatic cCMV are at higher risk for sequelae than those born without symptoms. The majority of infants with cCMV are asymptomatic at birth, but 10%-15% will develop hearing loss. Although clinical symptoms can help predict which infants will have sensorineural hearing loss, among asymptomatic cCMV there are currently no predictors of adverse outcome. The identification of a biomarker to identify those at highest risk of sequelae is highly desirable to target interventions to those who could potentially benefit. Because there is increasing rationale for establishing both targeted and universal screening programs for cCMV in the United States and worldwide, this is an urgent priority.

Topics: Child; Cytomegalovirus; Cytomegalovirus Infections; Persons with Disabilities; Female; Hearing Loss, Sensorineural; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; Neonatal Screening; Pregnancy; Pregnancy Complications, Infectious; Prognosis; Symptom Assessment

PubMed: 32134480
DOI: 10.1093/infdis/jiz446

Review

Authors: Dorit Samocha-Bonet, Buffy Wu, David K Ryugo...

Diabetes (type 2) and sensorineural hearing loss are common health problems manifested with ageing. While both type 1 and type 2 diabetes have been associated with hearing loss, a causal link has been difficult to establish. Individuals with diabetes have twice the incidence of hearing loss compared to those without diabetes and those with prediabetes have a 30% higher rate of hearing loss. Whether hearing loss is associated with diabetes independent of glycemic control remains to be determined. Hearing loss has its own set of risk factors and shares others with diabetes. This review will summarize the complex relationship between diabetes and sensorineural hearing loss.

Topics: Diabetes Mellitus, Type 2; Hearing Loss; Hearing Loss, Sensorineural; Humans

PubMed: 34384902
DOI: 10.1016/j.arr.2021.101423

Review

Authors: Ryosuke Kitoh, Shin-Ya Nishio, Hiroaki Sato...

OBJECTIVE

Acute sensorineural hearing loss represents a spectrum of conditions characterized by sudden onset hearing loss. The "Clinical Practice Guidelines for the Diagnosis and Management of Acute Sensorineural Hearing Loss" were issued as the first clinical practice guidelines in Japan outlining the standard diagnosis and treatment. The purpose of this article is to strengthen the guidelines by adding the scientific evidence including a systematic review of the latest publications, and to widely introduce the current treatment options based on the scientific evidence.

METHODS

The clinical practice guidelines were completed by 1) retrospective data analysis (using nationwide survey data), 2) systematic literature review, and 3) selected clinical questions (CQs). Additional systematic review of each disease was performed to strengthen the scientific evidence of the diagnosis and treatment in the guidelines.

RESULTS

Based on the nationwide survey results and the systematic literature review summary, the standard diagnosis flowchart and treatment options, including the CQs and recommendations, were determined.

CONCLUSION

The guidelines present a summary of the standard approaches for the diagnosis and treatment of acute sensorineural hearing loss. We hope that these guidelines will be used in medical practice and that they will initiate further research.

Topics: Humans; Hearing Loss, Sensorineural; Hearing Loss, Sudden; Acute Disease; Japan; Neuroma, Acoustic; Hearing Aids

PubMed: 38968877
DOI: 10.1016/j.anl.2024.06.004

Authors: M Marx, E Younes, S S Chandrasekhar...

Sudden sensorineural hearing loss (SSNHL) is a common and alarming symptom that often prompts an urgent visit to an ENT specialist. Treatment of SSNHL remains one of the most problematic issues for contemporary otorhinolaryngology: although many meta-analyses and national guidelines have been issued, management is not standardized in terms of medical treatment, and duration and route of administration. We present several methodological suggestions for the study of treatments for SSNHL. These were developed from the existing level of evidence of the main treatments used in SSNHL by experts who convened at the IFOS 2017 ENT World Congress in Paris, France. All panelists agreed that one of the main limitations present in studies on SSNHL is related to the wide heterogeneity, which characterizes both the initial hearing deficit and the amount of hearing recovery. Although evidence of the efficacy of systemic steroids cannot be considered as strong enough to recommend their use, it is still the most widespread primary therapy and can be considered as the current standard of care. Therefore, systemic steroids stand as an adequate control for any innovative treatment. To reduce the number of subjects we suggest that the inclusion criteria should be restricted to moderate to profound levels of hearing loss. The efficacy of trans-tympanic steroids as a salvage therapy was suggested in several reports on small populations and needs to be confirmed with larger randomized controlled trials.

Topics: Hearing Loss, Sensorineural; Hearing Loss, Sudden; Humans; Internationality

PubMed: 29396226
DOI: 10.1016/j.anorl.2017.12.011

Authors: Yixuan Wang, Hui Liu, Xinlin Nie...

BACKGROUND

The association between the sensorineural hearing loss (SNHL) and triglyceride-glucose (TyG) index remains inadequately understood. This investigation seeks to elucidate the connection between the TyG index and SNHL.

METHODS

In this cross-sectional study, we utilized datasets sourced from the National Health and Nutrition Examination Survey (NHANES). A comprehensive analysis was conducted on 1,851 participants aged 20 to 69, utilizing complete audiometry data from the NHANES database spanning from 2007 to 2018. All enrolled participants had accessible hearing data, and the average thresholds were measured and calculated as both low-frequency pure-tone average and high-frequency pure-tone average. Sensorineural hearing loss (SNHL) was defined as an average pure tone of 20 dB or higher in at least one better ear. Our analysis involved the application of multivariate linear regression models to examine the linear relationship between the TyG index and SNHL. To delineate any non-linear associations, we utilized fitted smoothing curves and conducted threshold effect analysis. Furthermore, we conducted a two-sample Mendelian randomization (MR) study, leveraging genetic data from genome-wide association studies (GWAS) on circulating lipids, blood glucose, and SNHL. The primary analytical method for the MR study was the application of the inverse-variance-weighted (IVW) approach.

RESULTS

In our multivariate linear regression analysis, a substantial positive correlation emerged between the TyG index and SNHL [2.10 (1.80-2.44), p < 0.0001]. Furthermore, using a two-segment linear regression model, we found an L-shaped relationship between TyG index, fasting blood glucose and SNHL with an inflection point of 9.07 and 94 mg/dL, respectively. Specifically, TyG index [3.60, (1.42-9.14)] and blood glucose [1.01, (1.00-1.01)] concentration higher than the threshold values was positively associated with SNHL risk. Genetically determined triglyceride levels demonstrated a causal impact on SNHL (OR = 1.092, p = 8.006 × 10). In addition, blood glucose was found to have a protective effect on SNHL (OR = 0.886, p = 1.012 × 10).

CONCLUSIONS

An L-shaped association was identified among the TyG index, fasting blood glucose, and SNHL in the American population. TyG index of more than 9.07 and blood glucose of more than 94 mg/dL were significantly and positively associated with SNHL risk, respectively.

Topics: Humans; United States; Nutrition Surveys; Cross-Sectional Studies; Mendelian Randomization Analysis; Triglycerides; Glucose; Blood Glucose; Genome-Wide Association Study; Hearing Loss, Sensorineural

PubMed: 38464969
DOI: 10.3389/fendo.2024.1339731

Meta-Analysis

Authors: Xin Li, Zuwei Cao, Feifan Chen...

Autoimmune diseases may cause various kinds of conflicts in and outside the target organ, and some evidence brings forward the suggestion that autoimmune diseases may damage the auditory nerve and cause sensorineural hearing loss. However, this relationship is not clearly defined yet. Therefore, the aim of this study was to assess sensorineural hearing loss in autoimmune diseases through systematic review and metaanalysis. The literature databases of PubMed, Google Scholar, Scopus, Web of knowledge, and Cochrane library were thoroughly searched, and a meta-analysis study was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Eighteen articles were included, involving 27 859 cases affected by autoimmune diseases. The prevalence of sensorineural hearing loss in systemic lupus erythematosus cases was 21.26 [3.80, 38.71]%, which was significant, and pooled analysis of odds ratio observed in individual studies showed that the odds of sensorineural hearing loss prevalence was 12.11 [7.4, 24.12] (P < .001). The prevalence of sensorineural hearing loss in rheumatoid arthritis cases was 16.14 [-9.03, 41.31]%, which was significant, and pooled analysis of odds ratio observed in individual studies showed that the odds of sensorineural hearing loss prevalence was 2.23 [1.84, 2.32] (P < .001). In vitiligo cases, the prevalence of sensorineural hearing loss was 38.80 [22.36, 55.25]%, which was significant, and pooled analysis of odds ratio observed in individual studies showed that the odds of sensorineural hearing loss prevalence was 5.82 [3.74, 9.68] (P < .001). The present study showed that sensorineural hearing loss is significantly related to the autoimmune diseases of systemic lupus erythematosus, rheumatoid arthritis, and vitiligo. Therefore, these cases need a routine evaluation of sensorineural hearing loss.

Topics: Humans; Vitiligo; Autoimmune Diseases; Hearing Loss, Sensorineural; Lupus Erythematosus, Systemic; Arthritis, Rheumatoid

PubMed: 37528591
DOI: 10.5152/iao.2023.22991

Authors: Srdjan M Vlajkovic, Peter R Thorne

The sense of hearing enables us to enjoy sounds and music and engage with other people [...].

Topics: Ear, Inner; Hearing Loss, Sensorineural; Humans

PubMed: 34073285
DOI: 10.3390/ijms22115647