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A Comparative Study Using Vestibular Mapping in Sudden Sensorineural Hearing Loss With and Without Vertigo.

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Summary

Sudden sensorineural hearing loss (SSNHL) with vertigo often involves posterior semicircular canal (PSCC) dysfunction, while SSNHL without vertigo typically affects the saccule. These patterns correlate with hearing recovery outcomes.

Keywords:
sudden sensorineural hearing lossvertigovestibular mapping

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Area of Science:

  • Otolaryngology
  • Neuroscience
  • Audiology

Background:

  • Sudden sensorineural hearing loss (SSNHL) is a complex condition affecting hearing and balance.
  • Understanding vestibular organ involvement in SSNHL is crucial for diagnosis and treatment.
  • Vertigo presence in SSNHL may indicate distinct underlying pathophysiology.

Purpose of the Study:

  • To identify specific impairment patterns in peripheral vestibular organs in patients with SSNHL.
  • To differentiate these patterns based on the presence or absence of vertigo.
  • To correlate vestibular impairment patterns with hearing recovery prognosis.

Main Methods:

  • Retrospective analysis of 152 SSNHL patients from a tertiary referral center.
  • Utilized video head impulse test, vestibular evoked myogenic potential, and pure-tone audiometry.
  • Employed hierarchical cluster analysis to define vestibular impairment patterns.

Main Results:

  • SSNHL with vertigo (SSNHL_V) showed a distinct pattern involving the posterior semicircular canal (PSCC).
  • SSNHL without vertigo (SSNHL_N) demonstrated an independent saccular impairment pattern.
  • PSCC dysfunction was most frequent in SSNHL_V (56.2%), while saccular dysfunction was most frequent in SSNHL_N (20.3%).
  • Partial/no hearing recovery was associated with PSCC dysfunction, whereas complete recovery correlated with saccular dysfunction.

Conclusions:

  • Isolated PSCC dysfunction is associated with SSNHL accompanied by vertigo and poor hearing prognosis.
  • Isolated saccular dysfunction is linked to SSNHL without vertigo and a better chance of complete hearing recovery.
  • Tailored treatment strategies for SSNHL may be necessary based on the presence of vertigo and identified vestibular impairment patterns.