Jugular valve function and petrosal sinuses pressure: a computational model applied to sudden sensorineural hearing loss

Reports of extra-cranial venous outflow disturbances have recently been linked to sudden sensorineural hearing loss (SSNHL). Aims of the present study are: i) to quantify, with mathematical model, the impact of jugular valve function on the pressure of the superior and inferior petrosal sinuses (SPS, IPS) and the main auricolar veins; ii) to verify the feasibility of the application of mathematical model in the clinical setting in terms of consistency respect to the usual measures of SSNHL outcome. Extra-cranial venous outflow and post analysis were respectively blindly assessed by echo colour-Doppler (ECD) and a validated mathematical model for the human circulation. The pilot study was conducted on 1 healthy control and in a group of 4 patients with different outcome of SSNHL. The main finding was the significant increased pressure calculated in the SPS and IPS of patients with ipsilateral jugular obstruction due to not mobile valve leaflets (6.55 mmHg), respect to the other subjects without extracranial complete obstruction (6.01 mmHg), P=0.0006. Moreover, we demonstrated an inverted correlation between the extrapolated pressure values in the SPS/IPS and the mean flow measured in the correspondent internal jugular vein (r= –0.87773; r-squared= 0.7697; P=0.0009). The proposed mathematical model can be applied to venous extra-cranial ECD investigation in order to derive novel clinical information on the drainage of the inner ear. Such clinical information seems to provide coherent parameters potentially capable to drive the prognosis. This innovative approach was proven to be feasible by the present pilot investigation and warrants further studies with an increased sample of patients.

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The impact of vestibular symptoms and electronystagmography results on recovery from sudden sensorineural hearing loss

Journal of Basic and Clinical Physiology and Pharmacology ◽

10.1515/jbcpp-2020-0354 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Gaelle Vofo ◽

Marrigje Aagje de Jong ◽

Michal Kaufman ◽

Julia Meyler ◽

Ron Eliashar ◽

...

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Small Sample Size ◽

Small Sample ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Caloric Test ◽

Routine Identification ◽

The Impact ◽

Caloric Tests

Abstract Objectives Idiopathic sudden sensorineural hearing loss (SSNHL) represents a frequently encountered otological entity, of various types and severity, with an array of associated symptoms including vertigo. This is a devastating life-changing condition with a blurry prognosis. The objective of this study was to determine the clinical association of vestibular impairment by electronystagmography (ENG) and caloric tests, and their ability to predict prognosis. Methods An observational, crossectional study was carried out amongst patients admitted with SSNHL. Each consenting patient had an audiometry test performed on admission as well as ENG and caloric tests. Treatment included oral steroids and carbogen with intratympanic steroids used only as salvage treatment. Follow-up was completed after 6 months when hearing gains were evaluated. Finally, an association was sought between the rate of recovery and ENG and caloric test results. Results Of 35 patients included, marked recovery was seen in patients without vertigo when compared to those with vertigo (p=0.003). A statistically significant association was found between the presence of vertigo and hearing deterioration (p=0.008). More so, normal electronystagmography results were associated with marked recovery (p=0.04). Conclusions The vestibular end organs are both subjectively and objectively affected in SSNHL as demonstrated by the abnormal ENG and caloric tests in our study despite the small sample size. Concomitant vestibular involvement carries poorer prognosis and routine identification may help foresee the recovery of patients with SSNHL and as such, aid in patient counseling. ENG and caloric tests are easily available and may be recommended for all patients with SSNHL.

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Impact of COVID-19 on Presentation of Sudden Sensorineural Hearing Loss at a Single Institution

Otolaryngology ◽

10.1177/0194599820974685 ◽

2020 ◽

pp. 019459982097468

Author(s):

Divya A. Chari ◽

Ayush Parikh ◽

Elliott D. Kozin ◽

Meaghan Reed ◽

David H. Jung

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Time Frame ◽

Absolute Number ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Academic Center ◽

Number Of Patients ◽

Increased Risk ◽

The Impact

The coronavirus disease 2019 (COVID-19) pandemic resulted in widespread unprecedented changes to the health care system. Herein, we sought to assess the impact of the viral outbreak on clinical presentations of sudden sensorineural hearing loss (SSNHL) at a single academic center. Our results demonstrate a decrease in the absolute number of patients presenting with SSNHL to our institution during the initial onset of the COVID-19 pandemic compared to an analogous time frame 1 year prior. However, the ratio of patients with SSNHL compared to total patients evaluated was largely similar during the 2 time periods. Based on data from our institution, the COVID-19 virus does not appear to confer a significantly increased risk for the development of SSNHL.

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