Microvascular cerebral disease in sudden sensorineural hearing loss: An etiological clue?

• Main Author: Gama, Rita
• Publication Date: 2020
• Other Authors: Ribeiro, Leandro, Araújo, André, Valente, Pedro, Sousa, Manuel, Castro, Fernanda, Condé, Artur
• Format: Article
• Language: por
• Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
• Download full: https://doi.org/10.34631/sporl.806
• topic: sudden hearing loss; sensorineural hearing loss; cerebral small vessel diseases; surdez súbita; surdez neurossensorial; doença cerebral de pequenos vasos

Objectives: To evaluate brain magnetic resonance imaging (MRI) in patients diagnosed with sudden sensorineural hearing loss (SSHL), in order to verify whether the presence of certain imaging changes is more prevalent in these patients, as well as to detect any correlations between these changes and cardiovascular risk factors or levels of response to treatment. Study design: Retrospective observational case-control. Materials and methods: The MRI of 40 patients diagnosed with SSHL in the last 6 years was analyzed, as well as 20 control MRIs selected from the ENT consultation, who underwent cerebral NMR for a reason unrelated to cochleovestibular alterations. The presence of chronic microangiopathic disease was detected through the presence of subcortical and/or periventricular white matter lesions (WML). The cardiovascular risk factors considered were the presence of diabetes mellitus, hypertension, dyslipidemia and smoking habits. For the purpose of analyzing the response to the implemented treatment, the index of recovery of hearing thresholds after treatment was calculated, considering the Siegel criteria. Results: The presence of WML was found to have a significantly higher incidence in patients with SSHL (52.5%) compared to controls (25%) (p = 0.043). A lower rate of complete recovery of hearing thresholds was found in patients with WML (14.3%) compared to patients without such changes (42.1%) (p = 0.049), with the probability of total recovery being 4,367 times higher in patients without WML compared to patients with WML. There was also a statistically significant correlation between the presence of WML and the existence of cardiovascular risk factors such as hypertension, dyslipidemia and smoking (p = 0.028, 0.004 and 0.049, respectively). Conclusions: These results may support the hypothesis of microvascular involvement in SSHL. Thus, SSHL can emerge as an eventual factor that reveals cerebrovascular disease.