Sudden sensorineural hearing loss and hemostatic mechanisms

Area of Science:

• Otorhinolaryngology
• Hematology
• Pathophysiology

Background:

• Sudden hearing loss (SHL) is a complex condition with multifactorial causes.
• Pathologic hemostatic mechanisms, involving blood clotting and fibrinolysis, have been hypothesized as potential contributors to SHL.
• Understanding the role of hemostasis in SHL is crucial for developing targeted diagnostic and therapeutic strategies.

Purpose of the Study:

• To investigate the potential causal role of abnormal hemostatic mechanisms in the pathogenesis of sudden hearing loss.
• To evaluate specific hemostatic parameters in patients with SHL compared to healthy controls.

Main Methods:

• Prospective study involving 32 patients diagnosed with sudden hearing loss and 28 matched healthy controls.
• Venous blood samples were analyzed for general blood parameters and specific hemostatic markers.
• Hemostatic parameters included plasminogen activator inhibitor 1 and D-dimers.

Main Results:

• Twenty-five out of 32 SHL patients exhibited aberrations in specific hemostasis parameters.
• Seven patients showed increased plasminogen activator inhibitor 1 activity, linked to diminished fibrinolysis, particularly in overweight individuals.
• Seven older patients had elevated D-dimers, a fibrin degradation product, with most having a history of cardiovascular disease.

Conclusions:

• While isolated hemostatic pathway abnormalities were observed in SHL patients, they do not appear to be decisively important in the condition's pathogenesis.
• Pathologic hemostasis is unlikely to be a primary driver for sudden deafness.
• Further research may be needed to explore other potential etiologies of sudden hearing loss.