White matter lesions in brain MRI and cardiovascular risk factors in sudden sensorineural hearing loss patients: A
Shadman Nemati1, Negar Hosseinpoor2, Mehrgan Khanhakimi2
1Department of Otolaryngology and Head and Neck Surgery, Otolaryngology Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Background:
Sudden Sensorineural Hearing Loss (SSNHL) is an otologic emergency characterized by a rapid decrease in hearing threshold. The etiology of SSNHL is often unclear, with potential links to vascular pathologies. This study investigates the association between white matter lesions (WMLs) observed in brain MRI and cardiovascular risk factors in SSNHL patients.
Methods:
This case-control study involved 34 SSNHL patients and 34 matched controls, none of them had migraine. Both groups underwent pure tone audiometry and brain MRI. WMLs were assessed using the Fazekas scale. Cardiovascular risk factors, including hypertension, diabetes, dyslipidemia, BMI, and smoking, were documented.
Results:
While none of the cardiovascular risk factors showed a significant difference between the two groups, the presence of WMLs was significantly higher in the SSNHL group compared to controls (79.4 % vs. 32.4 %; p < 0.001). More specifically, 24 patients (70.6 %) and 10 controls (29.4 %) had periventricular white matter (PVWM) lesions, while 20 patients (58.8 %) and 8 controls (23.5 %) had deep white matter (DWM) lesions. Logistic regression analysis revealed that increased grades of PVWM lesions were associated with a 5.7-fold higher likelihood of moderate or greater hearing loss (p = 0.033). The degree of DWM lesions, according to the Fazekas scale, demonstrated a significant correlation with hearing recovery rate.
Conclusion:
White matter lesions (WMLs) are significantly associated with sudden sensorineural hearing loss (SSNHL), with higher grades of PVWM lesions increasing the likelihood of severe hearing loss and DWM lesions correlating with hearing recovery. These associations seem to be independent of cardiovascular risk factors.
Insights
White matter lesions (WMLs) are more common in sudden sensorineural hearing loss (SSNHL) patients and linked to hearing loss severity and recovery. These findings are independent of cardiovascular risk factors.
Area of Science:
- Neurology
- Otolaryngology
- Radiology
Background:
- Sudden Sensorineural Hearing Loss (SSNHL) is an otologic emergency with unclear etiology, potentially linked to vascular issues.
- This study explores the connection between brain white matter lesions (WMLs) and cardiovascular risk factors in SSNHL patients.
Purpose of the Study:
- To investigate the association between WMLs on brain MRI and cardiovascular risk factors in SSNHL patients.
- To determine if WMLs correlate with hearing loss severity and recovery in SSNHL.
Main Methods:
- A case-control study comparing 34 SSNHL patients with 34 matched controls.
- Brain MRI with Fazekas scale assessment for WMLs (periventricular and deep) and audiometry.
- Documentation of cardiovascular risk factors: hypertension, diabetes, dyslipidemia, BMI, and smoking.
Main Results:
- WMLs were significantly more prevalent in SSNHL patients (79.4%) than controls (32.4%).
- Higher grades of periventricular WMLs (PVWM) increased the likelihood of moderate or greater hearing loss (OR 5.7).
- Deep WMLs (DWM) correlated significantly with the rate of hearing recovery.
Conclusions:
- WMLs are significantly associated with SSNHL, independent of common cardiovascular risk factors.
- PVWM lesions are linked to hearing loss severity, while DWM lesions impact hearing recovery in SSNHL.
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