Sensorineural hearing loss with delayed onset of vertigo

Area of Science:

• Otolaryngology
• Neurology
• Vestibular Disorders

Background:

• Sensorineural hearing loss with delayed onset of vertigo is a condition where episodic vertigo occurs years after unilateral hearing loss.
• This syndrome presents in ipsilateral (vertigo from the poorer hearing ear) and contralateral (vertigo from the better hearing ear) forms.
• The syndrome has only been recognized in the last two decades.

Purpose of the Study:

• To detail clinical experiences with 17 patients presenting with the ipsilateral form of sensorineural hearing loss with delayed onset of vertigo.
• To analyze the relationship between hearing loss onset and vertigo onset.
• To evaluate the efficacy of ablative vestibular surgery for disabling symptoms.

Main Methods:

• Retrospective case series of 17 patients with ipsilateral sensorineural hearing loss and delayed vertigo.
• Analysis of the time interval between hearing loss and vertigo onset.
• Bithermal caloric testing to identify the affected labyrinth in patients undergoing surgery.
• Surgical intervention (ablative vestibular surgery) for 13 patients with disabling vertigo.

Main Results:

• The interval between hearing loss and vertigo onset varied widely, ranging from 1 to 60 years.
• The cause of the initial hearing loss did not correlate with the development or timing of vertigo.
• Bithermal caloric testing successfully identified the offending labyrinth in most surgical candidates.
• Ablative vestibular surgery eliminated episodic vertigo in all 13 patients who underwent the procedure.

Conclusions:

• Sensorineural hearing loss with delayed onset of vertigo is a distinct syndrome with variable latency.
• Ablative vestibular surgery is an effective treatment for eliminating disabling vertigo in this condition.
• Treatment decisions for vertigo surgery should be guided by symptom severity.