Skip to main content

Advertisement

SpringerLink
Log in

Is there a relation between sudden sensorineural hearing loss and white matter lesions?

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

A Correction to this article was published on 10 September 2019

This article has been updated

Abstract

Purpose

Sudden sensorineural hearing loss (SSNHL) has similarities to conditions with vascular etiologies such as myocardial infarction and cerebral stroke. Thus, it could be considered as an early sign of a vascular disease and not only a specific local condition. Chronic hypoperfusion in the brain districts leads to a chronic ischemic damage, called cerebral small vessel disease (CSVD), detectable with brain magnetic resonance imaging (MRI).

Methods

The authors used CSVD to establish the presence of vascular risk factors in individuals with SSNHL and used the Fazekas score scale to classify them.

Results

Our study showed that individuals with SSNHL aged between 48 and 60 years have 26% more probability to have a Fazekas score higher than 1 compared to the general population. Individuals younger than 28 years showed a statistically significant negative correlation to have a Fazekas score higher than 0. The higher is the Fazekas score, the less is the probability of hearing recovery. The medium hearing-recovery probability is 46%. This decreases by 16% for every increase of score in the Fazekas scale. In the present study, the recovery probability decreased from 80% in individuals younger than 48 years with a score of 0 to 14% in individuals with a Fazekas scores of 3 and 4.

Conclusions

The authors assessed a higher prevalence of CSVD compared to the general population in patients aged between 48 and 60 years with SSNHL. Moreover, they assessed that the presence of CSVD is related to a decreased probability of recovery, as it has already been demonstrated for stroke.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Change history

  • 10 September 2019

    In the original publication, fifth author’s surname was incorrectly published as “Diacinto”. The correct surname should read as “Diacinti”.

References

  1. Chau JK, Lin JR, Atashband S, Irvine RA, Westerberg BD (2010) Systematic review of the evidence for the etiology of adult sudden sensorineural hearing loss. Laryngoscope 120(5):1011–1021. https://doi.org/10.1002/lary.20873

    Article  PubMed  Google Scholar 

  2. Fusconi M, Chistolini A, de Virgilio A, Greco A, Massaro F, Turchetta R, Benincasa AT, Tombolini M, de Vincentiis M (2012) Sudden sensorineural hearing loss: a vascular cause? Analysis of prothrombotic risk factors in head and neck. Int J Audiol 51(11):800–805. https://doi.org/10.3109/14992027.2012.705904

    Article  PubMed  Google Scholar 

  3. Lin RJ, Krall R, Westerberg BD, Chadha NK, Chau JK (2012) Systematic review and meta-analysis of the risk factors for sudden sensorineural hearing loss in adults. Laryngoscope 122(3):624–635. https://doi.org/10.1002/lary.22480

    Article  PubMed  Google Scholar 

  4. Koo M, Hwang JH (2015) Risk of sudden sensorineural hearing loss in patients with common preexisting sensorineural hearing impairment: a population-based study in Taiwan. PLoS One 10(3):e0121190. https://doi.org/10.1371/journal.pone.0121190

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Suckfull M, Wimmer C, Reichel O, Mees K, Schorn K (2002) Hyperfibrinogenemia as a risk factor for sudden hearing loss. Otol Neurotol 23(3):309–311

    Article  PubMed  Google Scholar 

  6. Ralli M, Altissimi G, Di Stadio A, Mazzei F, Turchetta R, Cianfrone G (2017) Relationship between hearing function and myasthenia gravis: a contemporary review. J Int Med Res 45(5):1459–1465. https://doi.org/10.1177/0300060516672124

    Article  CAS  PubMed  Google Scholar 

  7. Di Stadio A, Dipietro L, Ralli M, Meneghello F, Minni A, Greco A, Stabile MR, Bernitsas E (2018) Sudden hearing loss as an early detector of multiple sclerosis: a systematic review. Eur Rev Med Pharmacol Sci 22(14):4611–4624. https://doi.org/10.26355/eurrev_201807_15520

    Article  PubMed  Google Scholar 

  8. Mancini P, Atturo F, Di Mario A, Portanova G, Ralli M, De Virgilio A, de Vincentiis M, Greco A (2018) Hearing loss in autoimmune disorders: prevalence and therapeutic options. Autoimmun Rev 17(7):644–652. https://doi.org/10.1016/j.autrev.2018.01.014

    Article  PubMed  Google Scholar 

  9. Ciorba A, Hatzopoulos S, Bianchini C, Iannini V, Rosignoli M, Skarzynski H, Aimoni C (2015) Idiopathic sudden sensorineural hearing loss: cardiovascular risk factors do not influence hearing threshold recovery. Acta Otorhinolaryngol Ital 35(2):103–109

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Alford BR, Shaver EF, Rosenberg JJ, Guilford FR (1965) Physiologic and histopathologic effects of microembolism of the internal auditory artery. Ann Otol Rhinol Laryngol 74(3):728–748. https://doi.org/10.1177/000348946507400314

    Article  CAS  PubMed  Google Scholar 

  11. Jaffe BF (1975) Hypercoagulation and other causes of sudden hearing loss. Otolaryngol Clin N Am 8(2):395–403

    CAS  Google Scholar 

  12. Gussen R (1976) Sudden deafnfess of vascular origin: a human temporal bone study. Ann Otol Rhinol Laryngol 85(1 Pt 1):94–100. https://doi.org/10.1177/000348947608500117

    Article  CAS  PubMed  Google Scholar 

  13. Ullrich H, Kleinjung T, Steffens T, Jacob P, Schmitz G, Strutz J (2004) Improved treatment of sudden hearing loss by specific fibrinogen aphaeresis. J Clin Apher 19(2):71–78. https://doi.org/10.1002/jca.20001

    Article  PubMed  Google Scholar 

  14. Lin HC, Chao PZ, Lee HC (2008) Sudden sensorineural hearing loss increases the risk of stroke: a 5-year follow-up study. Stroke 39(10):2744–2748. https://doi.org/10.1161/STROKEAHA.108.519090

    Article  PubMed  Google Scholar 

  15. Kuo CL, Shiao AS, Wang SJ, Chang WP, Lin YY (2016) Risk of sudden sensorineural hearing loss in stroke patients: a 5-year nationwide investigation of 44,460 patients. Med (Baltimore) 95(36):e4841. https://doi.org/10.1097/MD.0000000000004841

    Article  Google Scholar 

  16. Redleaf MI, Bauer CA, Gantz BJ, Hoffman HT, McCabe BF (1995) Diatrizoate and dextran treatment of sudden sensorineural hearing loss. Am J Otol 16(3):295–303

    CAS  PubMed  Google Scholar 

  17. Rajati M, Azarpajooh MR, Mouhebati M, Nasrollahi M, Salehi M, Khadivi E, Nourizadeh N, Hashemi F, Bakhshaee M (2016) Is sudden hearing loss associated with atherosclerosis? Iran J Otorhinolaryngol 28(86):189–195

    PubMed  PubMed Central  Google Scholar 

  18. Kano K, Tono T, Ushisako Y, Morimitsu T, Suzuki Y, Kodama T (1994) Magnetic resonance imaging in patients with sudden deafness. Acta Otolaryngol Suppl 514:32–36

    Article  CAS  PubMed  Google Scholar 

  19. Oron Y, Elgart K, Marom T, Roth Y (2014) Cardiovascular risk factors as causes for hearing impairment. Audiol Neurootol 19(4):256–260. https://doi.org/10.1159/000363215

    Article  PubMed  Google Scholar 

  20. Aimoni C, Bianchini C, Borin M, Ciorba A, Fellin R, Martini A, Scanelli G, Volpato S (2010) Diabetes, cardiovascular risk factors and idiopathic sudden sensorineural hearing loss: a case–control study. Audiol Neurootol 15(2):111–115. https://doi.org/10.1159/000231636

    Article  CAS  PubMed  Google Scholar 

  21. Agrawal Y, Platz EA, Niparko JK (2009) Risk factors for hearing loss in US adults: data from the National Health and Nutrition Examination Survey, 1999 to 2002. Otol Neurotol 30(2):139–145. https://doi.org/10.1097/MAO.0b013e318192483c

    Article  PubMed  Google Scholar 

  22. Fisch U, Dobozi M, Greig D (1972) Degenerative changes of the arterial vessels of the internal auditory meatus during the process of aging. A histological study. Acta Otolaryngol 73(2):259–266

    Article  CAS  PubMed  Google Scholar 

  23. Kidwell CS, Rosand J, Norato G, Dixon S, Worrall BB, James ML, Elkind MS, Flaherty ML, Osborne J, Vashkevich A, Langefeld CD, Moomaw CJ, Woo D (2017) Ischemic lesions, blood pressure dysregulation, and poor outcomes in intracerebral hemorrhage. Neurology 88(8):782–788. https://doi.org/10.1212/WNL.0000000000003630

    Article  PubMed  PubMed Central  Google Scholar 

  24. Wardlaw JM, Smith C, Dichgans M (2019) Small vessel disease: mechanisms and clinical implications. Lancet Neurol 18(7):684–696. https://doi.org/10.1016/S1474-4422(19)30079-1

    Article  PubMed  Google Scholar 

  25. Hainsworth AH (2019) White matter lesions in cerebral small vessel disease: underperfusion or leaky vessels? Neurology 92(15):687–688. https://doi.org/10.1212/WNL.0000000000007258

    Article  PubMed  Google Scholar 

  26. Li Q, Yang Y, Reis C, Tao T, Li W, Li X, Zhang JH (2018) Cerebral small vessel disease. Cell Transplant 27(12):1711–1722. https://doi.org/10.1177/0963689718795148

    Article  PubMed  PubMed Central  Google Scholar 

  27. Abraham HM, Wolfson L, Moscufo N, Guttmann CR, Kaplan RF, White WB (2016) Cardiovascular risk factors and small vessel disease of the brain: blood pressure, white matter lesions, and functional decline in older persons. J Cereb Blood Flow Metab 36(1):132–142. https://doi.org/10.1038/jcbfm.2015.121

    Article  PubMed  PubMed Central  Google Scholar 

  28. Ciorba A, Bianchini C, Crema L, Ceruti S, Ermili F, Aimoni C, Pelucchi S (2019) White matter lesions and sudden sensorineural hearing loss. J Clin Neurosci 65:6–10. https://doi.org/10.1016/j.jocn.2019.04.037

    Article  PubMed  Google Scholar 

  29. Fazekas F, Wardlaw JM (2013) The origin of white matter lesions: a further piece to the puzzle. Stroke 44(4):951–952. https://doi.org/10.1161/STROKEAHA.111.000849

    Article  PubMed  Google Scholar 

  30. Schmidt R, Schmidt H, Haybaeck J, Loitfelder M, Weis S, Cavalieri M, Seiler S, Enzinger C, Ropele S, Erkinjuntti T, Pantoni L, Scheltens P, Fazekas F, Jellinger K (2011) Heterogeneity in age-related white matter changes. Acta Neuropathol 122(2):171–185. https://doi.org/10.1007/s00401-011-0851-x

    Article  PubMed  Google Scholar 

  31. Attanasio G, Russo FY, Di Porto E, Cagnoni L, Masci E, Ralli M, Greco A, De Vincentiis M (2018) Prediction of hearing recovery in sudden deafness treated with intratympanic steroids. Acta Otorhinolaryngol Ital 38(5):453–459. https://doi.org/10.14639/0392-100X-1614

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Fazekas F, Offenbacher H, Fuchs S, Schmidt R, Niederkorn K, Horner S, Lechner H (1988) Criteria for an increased specificity of MRI interpretation in elderly subjects with suspected multiple sclerosis. Neurology 38(12):1822–1825. https://doi.org/10.1212/wnl.38.12.1822

    Article  CAS  PubMed  Google Scholar 

  33. Ohlemiller KK, Gagnon PM (2004) Cellular correlates of progressive hearing loss in 129S6/SvEv mice. J Comp Neurol 469(3):377–390. https://doi.org/10.1002/cne.11011

    Article  PubMed  Google Scholar 

  34. Russolo M, Bianchi M (1988) Prognosis and therapy of early acute idiopathic auditory failure. Audiology 27(4):215–226

    Article  CAS  PubMed  Google Scholar 

  35. de Leeuw FE, de Groot JC, Oudkerk M, Witteman JC, Hofman A, van Gijn J, Breteler MM (2002) Hypertension and cerebral white matter lesions in a prospective cohort study. Brain 125(Pt 4):765–772. https://doi.org/10.1093/brain/awf077

    Article  PubMed  Google Scholar 

  36. de Leeuw FE, de Groot JC, Achten E, Oudkerk M, Ramos LM, Heijboer R, Hofman A, Jolles J, van Gijn J, Breteler MM (2001) Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study. The Rotterdam Scan Study. J Neurol Neurosurg Psychiatry 70 (1):9–14. doi:10.1136/jnnp.70.1.9

    Article  CAS  Google Scholar 

  37. Liu Y, Zhang M, Chen Y, Gao P, Yun W, Zhou X (2018) The degree of leukoaraiosis predicts clinical outcomes and prognosis in patients with middle cerebral artery occlusion after intravenous thrombolysis. Brain Res 1681:28–33. https://doi.org/10.1016/j.brainres.2017.12.033

    Article  CAS  PubMed  Google Scholar 

  38. Lucitti JL, Mackey JK, Morrison JC, Haigh JJ, Adams RH, Faber JE (2012) Formation of the collateral circulation is regulated by vascular endothelial growth factor-A and a disintegrin and metalloprotease family members 10 and 17. Circ Res 111(12):1539–1550. https://doi.org/10.1161/CIRCRESAHA.112.279109

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Chalothorn D, Faber JE (2010) Formation and maturation of the native cerebral collateral circulation. J Mol Cell Cardiol 49(2):251–259. https://doi.org/10.1016/j.yjmcc.2010.03.014

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Giurgiutiu DV, Yoo AJ, Fitzpatrick K, Chaudhry Z, Leslie-Mazwi T, Schwamm LH, Rost NS (2015) Severity of leukoaraiosis, leptomeningeal collaterals, and clinical outcomes after intra-arterial therapy in patients with acute ischemic stroke. J Neurointerv Surg 7(5):326–330. https://doi.org/10.1136/neurintsurg-2013-011083

    Article  PubMed  Google Scholar 

  41. Chen YF, Kuo YS, Wu WC, Tang SC, Jiang SF (2018) Association between leukoaraiosis and cerebral blood flow territory alteration in asymptomatic internal carotid artery stenosis. Clin Radiol 73 (5):502 e509–e502, e514. https://doi.org/10.1016/j.crad.2017.12.006

    PubMed  Google Scholar 

  42. Pham M, Bendszus M (2016) Facing time in ischemic stroke: an alternative hypothesis for collateral failure. Clin Neuroradiol 26(2):141–151. https://doi.org/10.1007/s00062-016-0507-2

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Ciorba A, Aimoni C, Crema L, Maldotti F, Napoli N, Guerzoni F, Govoni V (2015) Sudden hearing loss and the risk of subsequent cerebral ischemic stroke. B-ENT 11(3):205–209

    CAS  PubMed  Google Scholar 

Download references

Funding

This study was performed without funding.

Author information

Authors and Affiliations

  1. Department of Sense Organs, Sapienza University of Rome, Rome, Italy

    Massimo Fusconi, Giuseppe Attanasio, Isotta Musy, Massimo Ralli, Giovanni Ralli & Antonio Greco

  2. Clinic for Ear, Nose and Throat Medicine, Uniklinik of Tuebingen, Albstrasse 93, 70597, Stuttgart, Germany

    Flavia Capitani

  3. Department of Economics and Statistics, University of Naples Federico II, Complesso Universitario di Monte Sant’Angelo, Naples, Italy

    Edoardo Di Porto

  4. Department of Radiological Sciences, Oncology and Anatomo-Pathology, University Sapienza, Rome, Italy

    Davide Diacinti

  5. Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy

    Marco de Vincentiis

  6. Department of Neurology and Psichiatry, Neuroradiology Section, University Sapienza, Rome, Italy

    Claudio Colonnese

  7. IRCCS Neuromed, Pozzilli, IS, Italy

    Claudio Colonnese

Authors
  1. Massimo Fusconi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Giuseppe Attanasio
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Flavia Capitani
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Edoardo Di Porto
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Davide Diacinti
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Isotta Musy
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Massimo Ralli
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Giovanni Ralli
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Antonio Greco
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Marco de Vincentiis
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Claudio Colonnese
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Flavia Capitani.

Ethics declarations

Conflict of interest

All the authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The original version of this article was revised: In the original publication, fifth author's surname was incorrectly published as “Diacinto”. The surname is corrected in original article as “Diacinti”.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fusconi, M., Attanasio, G., Capitani, F. et al. Is there a relation between sudden sensorineural hearing loss and white matter lesions?. Eur Arch Otorhinolaryngol 276, 3043–3049 (2019). https://doi.org/10.1007/s00405-019-05593-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-019-05593-4

Keywords

Search

Navigation