Is there a relation between sudden sensorineural hearing loss and white matter lesions?

Eur Arch Otorhinolaryngol. 2019 Nov;276(11):3043-3049. doi: 10.1007/s00405-019-05593-4. Epub 2019 Aug 13.

Abstract

Purpose: Sudden sensorineural hearing loss (SSNHL) has similarities to conditions with vascular etiologies such as myocardial infarction and cerebral stroke. Thus, it could be considered as an early sign of a vascular disease and not only a specific local condition. Chronic hypoperfusion in the brain districts leads to a chronic ischemic damage, called cerebral small vessel disease (CSVD), detectable with brain magnetic resonance imaging (MRI).

Methods: The authors used CSVD to establish the presence of vascular risk factors in individuals with SSNHL and used the Fazekas score scale to classify them.

Results: Our study showed that individuals with SSNHL aged between 48 and 60 years have 26% more probability to have a Fazekas score higher than 1 compared to the general population. Individuals younger than 28 years showed a statistically significant negative correlation to have a Fazekas score higher than 0. The higher is the Fazekas score, the less is the probability of hearing recovery. The medium hearing-recovery probability is 46%. This decreases by 16% for every increase of score in the Fazekas scale. In the present study, the recovery probability decreased from 80% in individuals younger than 48 years with a score of 0 to 14% in individuals with a Fazekas scores of 3 and 4.

Conclusions: The authors assessed a higher prevalence of CSVD compared to the general population in patients aged between 48 and 60 years with SSNHL. Moreover, they assessed that the presence of CSVD is related to a decreased probability of recovery, as it has already been demonstrated for stroke.

Keywords: Brain MRI; Cerebral gliosis; Recover probability; Sudden sensorineural hearing loss; Vascular risk factors.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Brain / diagnostic imaging
  • Brain / pathology*
  • Case-Control Studies
  • Cerebral Small Vessel Diseases / complications*
  • Cerebral Small Vessel Diseases / diagnostic imaging
  • Cerebral Small Vessel Diseases / epidemiology
  • Cochlear Diseases / etiology*
  • Female
  • Hearing Loss, Sensorineural / etiology*
  • Hearing Loss, Sudden / etiology*
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • White Matter / diagnostic imaging
  • White Matter / pathology*
  • Young Adult