Serum Albumin Levels as a Potential Marker for the Predictive and Prognostic Factor in Sudden Sensorineural Hearing Loss: A Prospective Cohort Study

Objectives: As a common otology emergency, sudden sensorineural hearing loss (SSNHL) has a great impact on quality of life. The diagnosis and treatment of SSNHL remain challenging. This study aims to identify and investigate the association of liver functions with SSNHL.Methods: A total of 135 SSNHL patients and 135 sex- and age-matched controls were prospectively enrolled. The baseline and clinical characteristics, along with liver function levels of participators, were collected. Linear correlation, logistic regression, and receiving operator characteristic curve analysis tests were applied to examine the association between liver function levels and SSNHL.Results: There were no differences in baseline characteristics between SSNHL and control groups. The albumin (ALB) level of the SSNHL group was significantly lower than that in the control group (p < 0.001). The logistic regression showed that the low ALB level may be a predictive factor of SSNHL with an adjusted OR of 0.809 (95% CI, 0.742–0.882, p < 0.001). By comparing the indicators of different prognosis groups, we found that the effective group had a significantly lower hearing impair onset and higher ALB (p = 0.001) and AGR (p = 0.003) levels than the ineffective group. Logistic regression revealed that the hearing level onset (OR, 0.976; 95% CI, 0.956–0.997; p = 0.026) and ALB level (OR, 1.181; 95% CI, 1.071–1.301; p = 0.001) showed strong associations with treatment outcome.Conclusions: Lower ALB levels, within the normal ranges, were associated with the occurrence and unfavorable outcome of SSNHL. However, further research on the underlying mechanisms needs to be conducted.

Download Full-text

The Roles Played by Blood Inflammatory Parameters in Sudden Sensorineural Hearing Loss

Ear Nose & Throat Journal ◽

10.1177/0145561320960355 ◽

2021 ◽

pp. 014556132096035

Author(s):

Yan Guo ◽

Jisheng Liu

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Control Group ◽

Therapeutic Effects ◽

Hearing Level ◽

Neutrophil Lymphocyte Ratio ◽

Reactive Protein ◽

Inflammatory Parameters

Objective: The etiology of sudden sensorineural hearing loss (SSNHL) remains unknown; inflammation may be one cause. We retrospectively studied SSHNL cases in terms of the inflammatory parameters involved. Methods: We reviewed 169 SSNHL cases. The control group contained 132 patients with vocal cord polyps. The C-reactive protein (CRP) level, CRP/serum albumin (Alb) ratio, and neutrophil/lymphocyte ratio (NLR) were compared between the 2 groups. The relationships between these parameters and the time to treatment after SSHNL onset, hearing level, and therapeutic effects were also analyzed. Results: The CRP level, CRP/Alb ratio, and NLR were higher in SSNHL patients than in controls, but only the NLR differed significantly between the 2 groups. We found no significant differences between patients with different hearing levels, those evaluated at various times after SSNHL onset, and those with different outcomes. Conclusion: The NLR is a reliable SSNHL diagnostic marker. The CRP level and CRP/Alb ratio are not useful indicators.

Download Full-text

Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio: Novel Markers for Diagnosis and Prognosis in Patients with Idiopathic Sudden Sensorineural Hearing Loss

Disease Markers ◽

10.1155/2014/702807 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 38

Author(s):

Young Joon Seo ◽

Jun hui Jeong ◽

Jae Young Choi ◽

In Seok Moon

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Neutrophil To Lymphocyte Ratio ◽

Control Group ◽

Platelet To Lymphocyte Ratio ◽

Binary Logistic Regression Model ◽

Lymphocyte Ratio ◽

Potential Marker

Background.We aim to provide useful evidence about the association of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with idiopathic sudden sensorineural hearing loss (ISSNHL) and its possibility of emerging as a cheap, reliable, and independent prognostic marker of ISSNHL.Methods.348 patients diagnosed with ISSNHL were included in our retrospective data analysis. Blood samples and the hearing assessments of the patients were carried out. Then, the patients were divided into 2 groups as “recovered” and “unrecovered” according to their response to the treatment.Results.Both mean NLR and PLR values of the ISSNHL patients were significantly higher than the control group (bothP<0.001). The NLR value was5.98±4.22in the unrecovered group and3.50±3.38in the recovered group (P<0.001). After adjustment in a binary logistic regression model, only NLR value was associated with the recovery of ISSNHL (P=0.001).Discussion.We demonstrated for the first time that NLR and PLR values were significantly high in ISSNHL patients. Also the NLR level might be taken into account as a novel potential marker to predict the patients’ prognosis in terms of recovery.

Download Full-text

Plasma levels of endothelial cell-specific molecule-1 and pentraxin-3 in idiopathic sudden sensorineural hearing loss

The Journal of Laryngology & Otology ◽

10.1017/s002221511800186x ◽

2018 ◽

Vol 132 (11) ◽

pp. 995-999 ◽

Cited By ~ 2

Author(s):

F Gündoğan ◽

A Bayram ◽

M Kalkan ◽

İ Özcan

Keyword(s):

Hearing Loss ◽

Endothelial Cell ◽

Sensorineural Hearing Loss ◽

Group Treatment ◽

Plasma Levels ◽

Pure Tone Audiometry ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Control Group ◽

Pentraxin 3

AbstractObjectivesTo evaluate the plasma levels of endothelial cell-specific molecule-1 (ESM-1) and pentraxin-3 (PTX-3) in patients with idiopathic sudden sensorineural hearing loss, and to compare the pre- and post-treatment levels in patients responsive and non-responsive to therapy.MethodsThe study included 108 subjects: 51 with idiopathic sudden sensorineural hearing loss and 57 controls. For ESM-1 and PTX-3 analyses, blood samples were collected before and three months after treatment initiation in the idiopathic sudden sensorineural hearing loss group and once for the control group. Treatment response was evaluated three months after therapy initiation with pure tone audiometry, and the patients were divided into two groups: responsive and non-responsive to treatment.ResultsSerum ESM-1 levels were significantly higher in the idiopathic sudden sensorineural hearing loss group than the control group, whereas the difference was not significant for PTX-3. In the responsive and non-responsive groups, ESM-1 and PTX-3 levels were not statistically different before and after treatment.ConclusionTo our knowledge, this is the first study investigating plasma ESM-1 and PTX-3 levels in idiopathic sudden sensorineural hearing loss. Increased plasma ESM-1 levels may confirm endothelial dysfunction involvement in idiopathic sudden sensorineural hearing loss pathogenesis, which could be associated with vascular impairment.

Download Full-text

A Prognostic Marker in Idiopathic Sudden Sensorineural Hearing Loss: Serum Calprotectin

Clinical and Experimental Otorhinolaryngology ◽

10.21053/ceo.2019.00283 ◽

2020 ◽

Vol 13 (1) ◽

pp. 36-40

Author(s):

İhsan Kuzucu ◽

Tuba Çandar ◽

Deniz Baklacı ◽

İsmail Güler ◽

Rauf Oğuzhan Kum ◽

...

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Response To Treatment ◽

Control Group ◽

Study Group ◽

Cross Sectional ◽

Historical Cohort ◽

The Relationship

Objectives. Calprotectin, a protein released by neutrophils, has been used in many studies as a biomarker showing the presence of inflammation. In this study, it was aimed to investigate the relationship between serum calprotectin level and response to the treatment of idiopathic sudden sensorineural hearing loss (ISSHL).Methods. The present study is a prospective, cross-sectional historical cohort study. The study group consisted of 44 patients with ISSHL, and the control group consisted of 41 healthy volunteers without ear pathology. At the same time, patients in the study group were divided into three groups according to the response to ISSHL treatment (recovered, partially recovered, unrecovered). The relationship between the groups was statistically evaluated in terms of serum calprotectin levels.Results. The mean serum calprotectin value was 75.67±19.48 ng/mL in the study group and 50.24±29.14 ng/mL in the control group (P=0.001). Serum calprotectin value according to the severity of hearing loss in the mild, moderate and severe was 66.20±8.82, 70.35±16.77, and 91.23±19.73 ng/mL, respectively. Serum calprotectin value in the severe group was significantly higher compared to the moderate and mild groups (P=0.004, P=0.001, respectively). Serum calprotectin value according to the treatment response in the recovered, partially recovered and unrecovered groups was 63.36±11.54, 80.17±12.06, and 85.33±22.33 ng/mL, respectively. Serum calprotectin value in the recovered group was significantly lower compared to the partially recovered and unrecovered groups (P=0.002, P=0.001, respectively).Conclusion. Serum calprotectin value informs the clinician about both the severity of hearing loss and the response to treatment. Hence, serum calprotectin can be used as an important biomarker in ISSHL patients for the determination of the prognosis of disease.

Download Full-text

Better late than never: initial experience of intra-arterial pulsed-urokinase-injection as a salvage therapy for refractory sudden sensorineural hearing loss

Interventional Neuroradiology ◽

10.1177/15910199211056819 ◽

2021 ◽

pp. 159101992110568

Author(s):

Yang Cui ◽

Wenzhao Liang ◽

Mengxue Li ◽

Zhongyu Zhao ◽

Xinzhao Jiang ◽

...

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Salvage Therapy ◽

Conventional Therapy ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Control Group ◽

Before And After ◽

Patient Database ◽

Vascular Origin

Background and Purpose Cochlear vascular micro-thrombosis has been hypothesized as one of the pathogenic mechanisms for sudden sensorineural hearing loss (SSNHL) refractory to regular management. This study aimed to evaluate the feasibility and safety of intra-arterial pulsed-injection urokinase (IAPU) as a salvage therapy for SSNHL after the failure of conventional therapy. Methods We retrospectively reviewed our patient database to identify refractory SSNHL patients between November 2017 and July 2020. Study outcomes before and after the IAPU therapy were compared between IAPU and conventional therapy groups. Results Sixty-seven moderate-profound SSNHL patients (29 in IAUP group, 38 in control group) were included in this study. Compared to the control group, patients in the IAPU group showed more significant improvement in pure tone average (PTA) (34.2 ± 23.5 vs. 10.7 ± 13.1, p < 0.001) and degree of hearing recovery (total: 20.7% vs. 5.3%, partial: 24.1% vs. 10.5%, mild: 27.6% vs. 13.2% and non: 27.6% vs. 71.1%) 2 weeks after admission. In the IAPU group, a significant improvement of PTA (86.6 ± 11.5 vs. 54.6 ± 20.1 dB, p < 0.005) was observed on the first day after IAPU treatment. Conclusion In carefully selected SSNHL cases with a highly suspected vascular origin, IAPU is a safe and effective therapy when conventional treatments have failed. Despite the encouraging findings of our work, large studies are needed to better investigate the strengths and limitations of this salvage therapy.

Download Full-text

Correlations of MIF polymorphism and serum levels of MIF with glucocorticoid sensitivity of sudden sensorineural hearing loss

Journal of International Medical Research ◽

10.1177/0300060519893870 ◽

2019 ◽

Vol 48 (4) ◽

pp. 030006051989387

Author(s):

Wen-Yan Zhu ◽

Xin Jin ◽

Yong-Chi Ma ◽

Zhi-Biao Liu

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Serum Levels ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Control Group ◽

Glucocorticoid Sensitivity ◽

Resistant Group ◽

Factor Α ◽

Sensitive Group

Objective This study explored the relationship between macrophage migration inhibitory factor (MIF) gene polymorphism (−173G/C) and glucocorticoid sensitivity in sudden sensorineural hearing loss (SSNHL). Methods A total of 120 patients with SSNHL were divided into a glucocorticoid-sensitive group and a glucocorticoid-resistant group. A group of 93 healthy individuals served as the control group. Serum MIF levels of the participants were measured and MIF genotyping was performed. Results The frequency of the MIF −173C allele was significantly higher in glucocorticoid-sensitive patients than in glucocorticoid-resistant patients. Serum MIF levels were significantly higher in SSNHL patients than in healthy controls, and higher in the glucocorticoid-sensitive group than in the glucocorticoid-resistant group of SSNHL patients, which was unexpected. Compared with patients with the GG genotype, patients with the −173C allele (GC and CC genotypes) had significantly higher levels of serum MIF and superoxide dismutase activity and lower levels of tumor necrosis factor-α and malondialdehyde. Conclusion The MIF −173G/C polymorphism is associated with glucocorticoid sensitivity in SSNHL patients. The C allele can result in higher MIF production, reduced oxidative stress, and greater glucocorticoid sensitivity.

Download Full-text

Thyroid-Related Hormone Levels in Clinical Patients With Moderately Severe-to-Profound Sudden Sensorineural Hearing Loss: A Prospective Study

Frontiers in Neurology ◽

10.3389/fneur.2021.753270 ◽

2021 ◽

Vol 12 ◽

Author(s):

Zhong Zheng ◽

Ying Shen ◽

Liang Xia ◽

Lili Xiao ◽

Yuanyuan Sun ◽

...

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Venous Blood ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Favorable Outcome ◽

Control Group ◽

Hormone Levels ◽

Hearing Recovery ◽

Tsh Levels

Objectives: Sudden sensorineural hearing loss (SSNHL) is a common otological emergency, causing a measure of hearing loss and affecting the quality of life. This study aims to investigate the association of thyroid-related hormone levels with moderately severe-to-profound SSNHL.Methods: The study included 70 patients with moderately severe-to-profound SSNHL and 100 age- and sex-matched healthy controls. Peripheral venous blood samples were taken from the participants, and their thyroid-related hormone levels were measured at admission and 1 week after treatment.Results: In moderately severe-to-profound SSNaHL patients, the concentrations of total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), and thyroid-stimulating hormone (TSH) (all P < 0.05) were significantly lower than in the control group. The TT3, TT4, FT3, and TSH levels were significantly higher in the effective group than in the ineffective group (all P < 0.05). Linear correlation analysis revealed that TSH level (R = 0.707, P < 0.05) elevation after treatment successfully predicted a favorable outcome of hearing recovery. Logistic regression analyses suggested low FT3 and TSH levels to be independent occurrence predictors, while the increase of TSH level may be an independent favorable outcome predictor.Conclusions: The results suggest that low FT3 and TSH levels are risk factors for moderately severe-to-profound SSNHL. By discovering the positive association between TSH elevation and hearing recovery, along with the potential novel predictors of FT3 and TSH, our study may contribute valuable insights to the research and treatment of moderately severe-to-profound SSNHL.

Download Full-text

Association of αENaC p. Ala663Thr Gene Polymorphism With Sudden Sensorineural Hearing Loss

Frontiers in Genetics ◽

10.3389/fgene.2021.659517 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jialei Chen ◽

Jing He ◽

Jing Luo ◽

Shixun Zhong

Keyword(s):

Hearing Loss ◽

Gene Polymorphism ◽

Sensorineural Hearing Loss ◽

Allele Frequency ◽

Low Frequency ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Control Group ◽

Increased Risk ◽

Significant Difference

Objective: The etiology of sudden sensorineural hearing loss (SSNHL) is still unknown. It has been demonstrated that normal endolymph metabolism is essential for inner ear function and that epithelial sodium channels (ENaC) may play an important role in the regulation of endolymphatic Na+. This study aimed to explore the potential association between αENaC p. Ala663Thr gene polymorphism and SSNHL.Methods: Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to examine the genotype and allele frequency of the αENaC p. Ala663Thr polymorphism in 20 cases of low-frequency SSNHL (LF-SSNHL), 19 cases of high-frequency SSNHL (HF-SSNHL), 31 cases of all frequency SSNHL (AF-SSNHL), 42 cases of profound deafness SSNHL (PD-SSNHL), and 115 normal controls.Results: The T663 allele was found to be significantly associated with an increased risk of LF-SSNHL (p = 0.046, OR = 2.16, 95% CI = 1.01–4.62). The TT genotype and T663 allele, on the other hand, conferred a protective effect for PD-SSNHL (AA vs. TT: p = 0.012, OR = 0.25, 95% CI = 0.08–0.74; A vs. T: p = 0.001, OR = 0.36, 95% CI = 0.21–0.61). However, there was no statistically significant difference in genotype or allele frequency between the two groups (HF-SSNHL and AF-SSNHL) and the control group.Conclusion: The αENaC p. Ala663Thr gene polymorphism plays different roles in different types of SSNHL.

Download Full-text

Hyperbaric oxygen therapy in treatment of sudden sensorineural hearing loss: finding for the maximal therapeutic benefit of different applied pressures

Undersea and Hyperbaric Medicine ◽

10.22462/10.12.2019.12 ◽

2019 ◽

pp. 665-672

Author(s):

Zdenka Krajčovičová ◽

◽

Vladimír Meluš ◽

Rastislav Zigo ◽

Iveta Matišáková ◽

...

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Therapeutic Effect ◽

Hyperbaric Oxygen ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Control Group ◽

Low Frequencies ◽

Therapeutic Benefits ◽

Hbo2 Therapy

We compared the efficacy of hyperbaric oxygen (HBO2) therapy used in the treatment of sudden sensorineural hearing loss (SSNHL) as a supplementary therapy to the first-line medical treatment according to the different applied pressures used in HBO2 treatment while maintaining the same number of sessions, periodicity and exposure times. We evaluated data from 115 patients suffering from SSNHL within seven days of hearing loss: 35 patients received the standard treatment protocol (control group), and 80 individuals were treated with additional application of HBO2 therapy pressured to 2.0 ATA (H2.0; n=49) or 2.5 ATA (H2.5; n=31), respectively. Treatment success was assessed using pre- and post-treatment audiograms. We found significant differences in both HBO2 groups compared to the control group. In low frequencies the most significant differences can be seen in both H2.0 and H2.5. In spoken speech frequencies only the H2.0 group was statistically significant. In high frequencies the therapeutic benefits were the lowest. Furthermore, we found a notable difference in the therapeutic effect of HBO2 therapy according to the different applied pressure. At low frequencies, the use of 2.5 ATA pressure was more efficient. However, in the higher frequency ranges, the better hearing gains were obtained at the 2.0 ATA pressure. Our results support the possibility of optimizing treatments individually, depending on the type and frequency range of hearing impairment (shape of the audiogram) in favor of using the 2.0 ATA. This is important in terms of an individual approach to each patient as well as to minimize the burden of a patient in order to obtain the maximum therapeutic effect.

Download Full-text

Efficacy of Hyperbaric Oxygen on Idiopathic Sudden Sensorineural Hearing Loss and Its Correlation with Treatment Course: Prospective Clinical Research

Audiology and Neurotology ◽

10.1159/000518615 ◽

2021 ◽

pp. 1-7

Author(s):

Chao Huang ◽

Ge Tan ◽

Jing Xiao ◽

Guihua Wang

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Hyperbaric Oxygen ◽

Hearing Threshold ◽

Pure Tone Audiometry ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Control Group ◽

Related Factors ◽

Group B

Objectives: This study was conducted to explore the effectiveness of hyperbaric oxygen (HBO) in the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL) and recommend the appropriate course of treatment. Methods: 102 patients (105 diseased ears) with ISSNHL were recruited from the Department of Neurology and Otorhinolaryngology, West China Fourth Hospital, Sichuan University, between January 2018 and September 2020. Of them, 45 patients (group A) received intravenous steroid (IVS), and the remaining patients (group B) received IVS and HBO therapy (HBOT). Pure-tone audiometry (PTA) was performed twice at baseline and 10 days after treatment. Patients in group B were subdivided into group 1 (≤10 sessions) and group 2 (>11 sessions) to verify the correlation between the efficacy and course of HBOT, at the follow-up endpoint, the PTA was performed again. The multivariate logistical regression model was used to analyze the related factors of prognosis. Results: Compared with the control group, significantly larger hearing gains and better hearing recovery rate were observed in the IVS + HBOT group (p < 0.05). The time of treatment and course of HBOT were significantly correlated with the hearing threshold after treatment (p < 0.05) and had no significant relationship with tinnitus and age (p > 0.05). Conclusion: HBOT + IVS is an effective method for ISSNHL, especially for the recovery of low-frequency hearing and initial hearing levels of severe and profound. Tinnitus is the most common concomitant symptom of ISSNHL, and prolonging the course of HBOT did not significantly improve it. Initiating HBOT within 7 days for 10–25 sessions of treatment was more beneficial.

Download Full-text