Research in Vestibular Science

Case Report

Bilateral Sudden Hearing Loss Caused by Basilar Artery Dissection: A Case Report: Ho Byung Lee, Jieun Roh, Hyun Min Lee, Jae-Hwan Choi; Res Vestib Sci. 2021;20(4):151-155. Published online December 15, 2021; DOI: https://doi.org/10.21790/rvs.2021.20.4.151

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Abstract PDF: Bilateral sudden sensorineural hearing loss (SNHL) is rare, but a possible symptom of vertebrobasilar ischemia. A 69-year-old female patient with hypertension and atrial fibrillation presented with bilateral sudden hearing loss and vertigo without other neurological symptoms. On examination, she had left-beating horizontal nystagmus with positive head impulse on the left side. Pure tone audiometry revealed severe SNHL on both sides. Brain computed tomography angiography showed a dissection in the proximal portion of the basilar artery (BA) with occlusion of the mid-BA and bilateral anterior inferior cerebellar arteries (AICA), which confirmed on transfemoral cerebral angiography (TFCA). Left common carotid angiography demonstrated retrograde blood flow into the BA and right AICA via the left posterior communicating artery. During TFCA, her right hearing loss dramatically improved. Nine days later, follow-up TFCA showed an improvement of antegrade flow of the BA and AICA. We suggest that vertebrobasilar ischemia can be suspected in patients with bilateral sudden SNHL who present with risk factors for stroke.

Original Articles

Clinical Characteristics of Sudden Sensorineural Hearing Loss Accompanying Benign Paroxysmal Positional Vertigo: Sung Min Park, Bin Kwon, Sung Won Li, Seok Min Hong, Sung Kyun Kim; Res Vestib Sci. 2020;19(2):71-78. Published online June 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.2.71

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1 Crossref

Objectives
Idiopathic unilateral sudden sensorineural hearing loss (SSNHL) with simultaneous benign paroxysmal vertigo (BPPV) is known to be associated with poor hearing recovery. We aimed to investigate clinical findings in patients with SSNHL with BPPV and analyze prognostic factors including presence of BPPV related to hearing outcome.
Methods
We retrospectively reviewed the electronic medical data of 14 patients with concurrent SSNHL and BPPV (combined group). We selected 52 patients without BPPV as a control group who have matched initial threshold of pure tone audiometry and age of each patient in the combined group. We evaluated clinical characteristics of all participants and compared hearing outcomes between the 2 groups. A multivariate logistic regression analysis was performed to investigate the factors related to hearing recovery.
Results
Initial mean pure tone audiometry (PTA) threshold of combined group was 90.36±26.2 dB. Posterior canal was most commonly involved (n=7, 50%), and 8 (57%) patients showed abnormal video head impulse test results. There was no significant difference between hearing recovery rates of combined and control group (p=0.237) and mean pure tone audiometry threshold changes were not significantly different between the 2 groups (p=0.942). Old age (≥60 years), high initial PTA threshold (＞90 dB), and obesity (body mass index ≥ 25 kg/m²) were poor prognostic predictors.
Conclusions
There was no difference between hearing outcomes of combined group and profound SSNHL only group. BPPV was not a significant prognostic factor of SSNHL patients.

Citations

Citations to this article as recorded by

Which Is More Important for the Prognosis of Sudden Sensorineural Hearing Loss with Vertigo, Canal Paresis or Benign Paroxysmal Positional Vertigo?
Yong-Hwi An, Hyun Joon Shim
Research in Vestibular Science.2021; 20(3): 101. CrossRef

The Value of Posterior Semicircular Canal Function in Predicting Hearing Recovery of Sudden Sensorineural Hearing Loss: Jung-Woo Shin, Sang Woo Kim, Youn Woo Kim, Wook Jang, Bo He Kim, Yun-Sung Lim, Seok-Won Park, Chang Gun Cho, Joo Hyun Park; Res Vestib Sci. 2019;18(4):103-110. Published online December 15, 2019; DOI: https://doi.org/10.21790/rvs.2019.18.4.103

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Abstract PDF

Objectives
Postulated etiologies for idiopathic sudden sensorineural hearing loss (SSNHL) include viral cochleitis, microvascular events. If SSNHL is caused by vascular compromise of common cochlear artery that supplies cochlea and posterior semicircular canal (PC), PC also can be damaged with cochlea. We aim to evaluate the prognostic value of PC function in relation to hearing recovery of SSNHL.
Methods
Seventy-six patients who were diagnosed and treated for SSNHL and who underwent video head impulse test (vHIT) and follow-ups for more than 3 months were reviewed retrospectively. We defined impairment of PC function as lower PC gain (＜0.7) or definite overt/covert saccade in vHIT. Patients were divided into 3 groups: group 1, SSNHL without dizziness; group 2, SSNHL with dizziness and impaired PC function; group 3, SSNHL with dizziness, but intact PC function. Hearing thresholds were repeatedly measured on the initial visit, 1 week, 1 month, and 3 months after treatment. Treatment outcome was analyzed by comparing hearing recovery rate using Siegel’s criteria and posttreatment audiometric changes among 3 groups.
Results
Thirty-two (29.6%), 33 (30.6%), and 43 patients (39.8%) were included into the groups 1, 2, and 3, respectively. The hearing recovery rate of the group 2 (39.4%) was significantly lower than that of groups 1 (65.6%) and 3 (65.1%) (p=0.043). Pre- and posttreatment changes of the PTA threshold was significantly lower in group 2 than group 1 (p=0.009). The change of speech discrimination in each group were not different.
Conclusions
Our findings suggest that the presence of PC impairment may be a poor prognostic sign for hearing recovery in patients with SSNHL.

Citations

Citations to this article as recorded by

Artificial Neural Network-Assisted Classification of Hearing Prognosis of Sudden Sensorineural Hearing Loss With Vertigo
Sheng-Chiao Lin, Ming-Yee Lin, Bor-Hwang Kang, Yaoh-Shiang Lin, Yu-Hsi Liu, Chi-Yuan Yin, Po-Shing Lin, Che-Wei Lin
IEEE Journal of Translational Engineering in Healt.2023; 11: 170. CrossRef
Vestibular mapping in Ramsay-Hunt syndrome and idiopathic sudden sensorineural hearing loss
Joon-Pyo Hong, Jung-Yup Lee, Min-Beom Kim
European Archives of Oto-Rhino-Laryngology.2023; 280(12): 5251. CrossRef
A Comparative Analysis of the Vestibulocochlear Function in Patients with Isolated Semicircular Canal Hypofunction Using a Video Head Impulse Test
Yu Jung Park, Min Young Lee, Ji Eun Choi, Jae Yun Jung, Jung Hwa Bahng
Research in Vestibular Science.2023; 22(2): 34. CrossRef
Video head impulse test for the assessment of vestibular function in patients with idiopathic sudden sensorineural hearing loss without vertigo
N Battat, O J Ungar, O Handzel, R Abu Eta, Y Oron
The Journal of Laryngology & Otology.2023; 137(12): 1374. CrossRef
Vestibular mapping assessment in idiopathic sudden sensorineural hearing loss
Hee Won Seo, Jae Ho Chung, Hayoung Byun, Seung Hwan Lee
Ear & Hearing.2022; 43(1): 242. CrossRef
Association of Metabolic Syndrome with Sensorineural Hearing Loss
Hwa-Sung Rim, Myung-Gu Kim, Dong-Choon Park, Sung-Soo Kim, Dae-Woong Kang, Sang-Hoon Kim, Seung-Geun Yeo
Journal of Clinical Medicine.2021; 10(21): 4866. CrossRef

Case Report

A Case of Sensorineural Hearing Loss and Vertigo during Epidural Nerve Block: Byeong Min Lee, Jin hong Noh, Seong Ki Ahn, Hyun Woo Park; Res Vestib Sci. 2018;17(4):170-174. Published online December 21, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.4.170

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Abstract PDF: Epidural anesthesia has significantly advanced in neuraxial anesthesia and analgesia. It is used for surgical anaesthesia and treatment of chronic pain. Hearing loss during or after epidural anesthesia is rare, and it is known to occur by the change of the intracranial pressure. Cerebrospinal fluid is connected with perilymph in the cochlear and vestibule that is important to hearing and balance. If the intracranial pressure is abruptly transferred to the inner ear, perilymph can be leak, that called perilymphatic fistula, dizziness, and hearing loss can occur suddenly. We report a 65-year-old woman who presented with acute onset dizziness and hearing loss during the epidural nerve block for back pain, wherein we speculated a possibility of perilymphatic fistula as the mechanism of hearing loss and dizziness. The mechanism of dizziness and hearing loss was suspected with perilymphatic fistula.

Original Article

Incidence of Progression into Ménière Disease from Idiopathic Sudden Sensorineural Hearing Loss: Midterm Follow-up Study: Byeong Min Lee, Jin Hyun Seo, Hyun Woo Park, Hyun Jin Lee, Dong Gu Hur, Seong Ki Ahn; Res Vestib Sci. 2018;17(3):95-101. Published online September 18, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.3.95

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Abstract PDF: Objectives
Ménière disease is a clinical syndrome characterized by the four major symptoms of episodic vertigo, sensorineural hearing loss, tinnitus, and aural fullness. Sensorineural hearing loss, especially low frequency, is the characteristic type of audiogram in Ménière's disease. However, it is difficult to distinguish idiopathic sudden sensorineural hearing loss (ISSNHL) with vertigo from the first attack of Ménière disease. The purpose of this study was to investigate the incidence of progression into Ménière Disease from low frequency ISSNHL.
Methods
Two hundred eighty-three patients were included in this study. We classified the patients with ISSNHL according to the hearing loss in audiogram and analyzed how many of them actually progressed to Ménière disease based on diagnosis criteria.
Results
Among the 240 patients, 37.1% (89 patients) were confirmed low frequency ISSNHL and 14.6% (13 patients) of them were diagnosed with Meniere disease.
Conclusions
This study showed that the progression from low frequency ISSNHL to Ménière disease was higher than other frequency ISSNHL, as in other studies.

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