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. 2023 Mar 1;44(3):e171-e177.
doi: 10.1097/MAO.0000000000003813. Epub 2023 Jan 21.

Cerebral Small Vessel Disease in Elderly Patients with Sudden Sensorineural Hearing Loss

Fieke K Oussoren, Roeland B van Leeuwen  1 , Tjard R Schermer  2 , Louise N F Poulsen  3 , Joost J Kardux  2 , Tjasse D Bruintjes
Affiliations

Cerebral Small Vessel Disease in Elderly Patients with Sudden Sensorineural Hearing Loss

Fieke K Oussoren et al. Otol Neurotol. .

Abstract

Background: The cause of sudden sensorineural hearing loss (SSNHL) is uncertain in a significant number of patients. A vascular etiology has been proposed because SSNHL increases the risk of developing a stroke. Cardiovascular risk factors can cause cerebral small vessel disease (CSVD). The presence of CSVD in turn raises the risk of stroke.

Aim: The aim of this study was to compare the presence of CSVD and cardiovascular risk factors in elderly patients with idiopathic SSNHL (iSSNHL) to a control cohort.

Method: Patients with iSSNHL of 50 years and older were compared with a control cohort with patients suspected of trigeminal neuralgia or vestibular paroxysmia. The primary outcome was the difference in the number of white matter hyperintensities using the ordinal Fazekas scale. Secondary outcomes were the presence of brain infarctions on MRI and the difference in cardiovascular risk factors.

Results: In the SSNHL cohort, Fazekas score 2 was most frequently seen compared with Fazekas 1 in the control cohort. The distribution of Fazekas scores did not differ significantly. The sum of the Fazekas scores were 13,925 and 14,042 for iSSNHL and controls, respectively ( p = 0.908). Brain infarctions were seen in 8 patients with iSSNHL (n = 118) and in 13 patients in the control cohort (n = 118) ( p = 0.361). None of the cardiovascular risk factors were more frequently seen in the iSSNHL cohort.

Conclusion: Patients with iSSNHL did not exhibit more CSVD on MRI than controls. This result is in contrast with previous literature demonstrating a higher risk of stroke in patients with iSSNHL than in controls. A prospective analysis with a larger study population is therefore warranted.

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Figures

FIG. 1
FIG. 1
Fazekas scale for MRI imaging. The figure displays hyperintensities in the deep white matter (upper row) and periventricular white matter (lower row) (24).
FIG. 2
FIG. 2
Distribution of Fazekas scores. Fazekas score two was most frequently seen in the iSSNHL cohort compared with Fazekas score 1 in the control cohort. A Mann–Whitney U test resulted in a p value of 0.908, demonstrating a nonsignificant difference in Fazekas score distribution.
FIG. 3
FIG. 3
Fazekas scores and mean hearing threshold in dB for each frequency are displayed. Outcomes of the Jonckheere–Terpstra test for each frequency are displayed after p in the graft.
See this image and copyright information in PMC

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