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Sudden deafness: is it viral?

Saumil N Merchant1, Marlene L Durand, Joe C Adams

  • 1Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA. saumil_merchant@meei.harvard.edu

ORL; Journal for Oto-Rhino-Laryngology and Its Related Specialties
|February 1, 2008
PubMed
Summary
This summary is machine-generated.

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Idiopathic sudden sensorineural hearing loss (ISSHL) is not commonly caused by viral infections. Current evidence suggests abnormal cellular stress responses within the cochlea may be a more likely cause of this hearing condition.

Area of Science:

  • Otolaryngology
  • Virology
  • Pathophysiology

Background:

  • Idiopathic sudden sensorineural hearing loss (ISSHL) has multiple proposed etiopathogeneses.
  • The viral hypothesis is a prominent theory, but its supporting evidence requires critical evaluation.

Purpose of the Study:

  • To critically review the evidence supporting the viral hypothesis of ISSHL.
  • To evaluate alternative theories, including vascular occlusion, labyrinthine membrane breaks, immune mechanisms, and cellular stress responses.

Main Methods:

  • Comprehensive literature review of epidemiological, serological, clinical, antiviral therapy, morphological, histopathological, and animal experimental studies.
  • Analysis of evidence against the established criteria for viral causation (Henle-Koch postulates).

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Main Results:

  • Published evidence does not satisfy most Henle-Koch postulates for viral causation of ISSHL.
  • Vascular occlusion, labyrinthine membrane breaks, and immune-mediated mechanisms are unlikely common causes.
  • Abnormal cellular stress responses within the cochlea are proposed as a potential primary mechanism.

Conclusions:

  • The viral hypothesis for ISSHL is not well-supported by current evidence.
  • Alternative mechanisms, particularly abnormal cochlear cellular stress, warrant further investigation for ISSHL pathogenesis.