Carotidartery stenosis and auditory dysfunction: A systematic review of mechanisms and interventions

Carotid artery stenosis (CAS), caused by atherosclerotic narrowing of the carotid arteries, has been increasingly recognized as a possible contributor to auditory dysfunction, particularly hearing loss. Several studies have demonstrated an association between CAS and hearing impairment, suggesting that the link is multifactorial and may involve reduced cochlear perfusion, oxidative stress, and vascular-anatomical interactions within the auditory system.

This systematic review followed the PRISMA 2020 guidelines and was registered in PROSPERO (CRD420251130269). A comprehensive search was performed in PubMed, Scopus, Web of Science, and Google Scholar for peer-reviewed clinical studies, systematic reviews, and experimental research investigating the association between CAS and hearing impairment using audiometry, Doppler ultrasound, angiography, or MRI. The methodological quality of the included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal tool.

Twenty-six eligible studies met the inclusion criteria. The selected literature comprised clinical and experimental studies evaluating the relationship between CAS and auditory dysfunction. High-frequency sensorineural hearing loss and persistent tinnitus were frequently observed before neurological or cerebrovascular symptoms. Doppler ultrasonography and MRI were consistently used to assess vascular and auditory parameters, improving diagnostic accuracy.

This review supports growing evidence that carotid artery stenosis may represent a potential risk factor for hearing impairment. Audiological symptoms such as hearing loss and tinnitus could serve as early indicators of cerebral ischemia. Routine carotid artery screening is recommended for patients with unexplained auditory complaints. In severe cases, surgical or endovascular revascularization (endarterectomy or stenting) may improve both cerebrovascular outcomes and auditory function.