Otology & Neurotology最新文献

{"title":"Hearing Device Coil Placement Lateral to the Temporalis: An Alternative to Flap Thinning for Cochlear and Transcutaneous Bone-Anchored Implants.","authors":"Ashley M Nassiri, Nicholas R Randall, Brian J Johnson, Matthew L Carlson","doi":"10.1097/MAO.0000000000004387","DOIUrl":"10.1097/MAO.0000000000004387","url":null,"abstract":"","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e49-e50"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proinflammatory Cytokine Profiles in Menière's Disease and Vestibular Migraine.","authors":"Neil P Monaghan, Sunny Shah, Brian A Keith, Shaun A Nguyen, Danforth A Newton, John E Baatz, Carol L Wagner, Habib G Rizk","doi":"10.1097/MAO.0000000000004372","DOIUrl":"10.1097/MAO.0000000000004372","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the levels of inflammatory cytokines and symptom survey scores in patients diagnosed with Menière's disease or vestibular migraine from a single center by a single neurotologist compared to control subjects with no history of dizziness or migraine.</p><p><strong>Study design: </strong>Cross-sectional pilot study.</p><p><strong>Setting: </strong>Single-center tertiary referral center in Charleston, SC.</p><p><strong>Patients: </strong>Patients were recruited from the neurotology clinic at a tertiary referral center. Patients with definite Menière's disease or definite vestibular migraine as defined by the Barany consensus criteria were eligible. Control subjects presented to clinic without dizziness, vertigo, fluctuating hearing loss, or a history of migraine.</p><p><strong>Main outcome measures: </strong>Questionnaire scores include DHI, SF-20, CFQ, PHQ-9, PSWQ, GAD-7, NVI, DCS, VM-PATHI, and MD-POSI. Circulating and in vitro levels of cytokines include ENA-78, GROα, IFN-α2a, IFN-γ, IL-10, IL-1α, IL-1β, IL-1RA, IL-2, IL-4, IL-5, IL-6, IL-8, MCP-1, MCP-2, MDC, MIP-1α, MIP-1β, and TNF-α. Cytokine levels were compared with effect size analysis.</p><p><strong>Results: </strong>There were 20 Menière's disease, 20 vestibular migraine, and 10 control patients enrolled in this study. Episode frequencies ranged from three per week to two to five per year in the MD group and daily to 1 every 2 to 3 months in the VM group. When patient-derived PBMC samples were compared to vestibular migraine, TNF-α ( d = -0.427 [-0.879, 0.025]) and IFN-γ ( d = -0.818 [-1.313, -0.323]) were found to be higher in Menière's disease, whereas ENA-78 ( d = -0.652 [-1.361, 0.056]) was found to be lower. No differences were found when cytokines were measured following stimulation with LPS.</p><p><strong>Conclusions: </strong>This pilot study suggests Menière's disease patients may have higher levels of TNF-α and IFN-γ and lower levels of ENA-78 than vestibular migraine patients when measured following in vitro release from patient-derived PBMC. Increased sample size, optimized blood draw timing, and more specific PBMC stimulation may help us further elucidate inflammatory pathways implicated in these disorders.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"88-95"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities among Different Countries in Access for Diagnosis and Treatment of Pediatric Sensorineural Hearing Loss.","authors":"Jacquelyn DeVries, Catherine S Birman, Natalie Loundon, Melissa MacAskil, Nathália Manhães Távora, Robinson Koji Tsuji, Linea Cheung, Elina Kari, Daniela Carvalho","doi":"10.1097/MAO.0000000000004382","DOIUrl":"10.1097/MAO.0000000000004382","url":null,"abstract":"<p><strong>Objective: </strong>Timely diagnosis and management of pediatric sensorineural hearing loss (SNHL) is essential for best outcomes. This study evaluated the differences of health access among cochlear implant (CI) centers of countries with different health care systems.</p><p><strong>Study design: </strong>Retrospective.</p><p><strong>Setting: </strong>Multicenter, tertiary pediatric CI referral center in four different countries: United States (USA), France (FR), Australia (AUS), and Brazil (BR).</p><p><strong>Patients: </strong>Pediatric (age 0-21 years (0-16 years AUS)) patients receiving CI between January 2017 and December 2019.</p><p><strong>Interventions: </strong>CI.</p><p><strong>Main outcome measures: </strong>Primary outcome measures included age at milestones in CI process and age at implantation.</p><p><strong>Results: </strong>There were 1,673 patients who underwent CI surgery at four multinational designated institutions were identified (n = 143 AUS; 153 BRA; 1,158 FR; and 219 USA). Median age at time of hearing loss diagnosis ( p < 0.0001), median age at hearing aid (HA) fitting ( p < 0.0001), and CI evaluation ( p < 0.0001) differed between countries. However, age at CI surgery was not significantly different between countries. Time from diagnosis to HA fitting was impacted by country ( p < 0.0001) and language ( p = 0.01) but not by private compared with public insurance. There were 512 children with available data regarding onset of hearing loss as prelingual n = 358 (70%) and postlingual n = 154 (30%). In patients with prelingual severe to profound hearing loss, country and race/ethnic origin affected age at diagnosis ( p < 0.0001, p = 0.001), HA fitting ( p < 0.0001, p < 0.001), candidacy evaluation ( p = 0.0001, p = 0.02), and CI surgery ( p = 0.0027, p = 0.001).</p><p><strong>Conclusions: </strong>Age at pediatric CI was comparable across the CI centers compared in the four countries. This is encouraging given the effect of neuroplasticity on pediatric CI outcomes, despite different health care expenditures and delivery systems in the four countries. Improvement in care access for certain populations may decrease disparities in pediatric CI access worldwide.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e1-e8"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automatic Final-Product Assessment of Virtual Reality Mastoidectomy Performance: A Validity and Reliability Study.","authors":"Peter Trier Mikkelsen, Mads Sølvsten Sørensen, Pascal Senn, Andreas Frithioff, Steven Arild Wuyts Andersen","doi":"10.1097/MAO.0000000000004346","DOIUrl":"10.1097/MAO.0000000000004346","url":null,"abstract":"<p><strong>Objective: </strong>Assessment is key in modern surgical education to monitor progress and document sufficient skills. Virtual reality (VR) temporal bone simulators allow automated tracking of basic metrics such as time, volume removed, and collisions. However, adequate performance assessment further includes compound rating of the stepwise bony excavation, and exposure and preservation of soft tissue structures. Such complex assessment requires further development of automated assessment routines in the VR simulation environment. In this study, we present the integration of automated mastoidectomy final-product assessment with validation against manual rating.</p><p><strong>Methods: </strong>At two international temporal bone courses, 33 ORL trainees performed anatomical mastoidectomies in the Visible Ear (VR) Simulator with automatic performance assessment using a newly implemented rating routine based on the modified Welling Scale. Automated assessment was compared with manual ratings by experts using absolute agreement, intraclass correlation, and generalizability analysis to establish validity and reliability.</p><p><strong>Results: </strong>The overall average agreement between manual and automatic assessment was 83.9% compared with the inter-rater agreement of 88.9%. A majority of items (15 out of 26) showed high agreement between automated and manual rating (>85%). Intraclass correlation coefficients were found to be high. Generalizability analysis with D-studies found that five repetitions per participant are needed for a G coefficient >0.8, which is considered necessary for high-stakes assessments.</p><p><strong>Conclusion: </strong>We have demonstrated the feasibility, validity, and reliability of an automatic assessment system integrated into a VR temporal bone simulator. This can prove to be an important tool for future self-directed training with skills certification.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"96-103"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aberrant Sylvian Vein Diverticulum and Tegmen Dehiscence-Induced Venous Pulsatile Tinnitus Phenotype Can Be Treated Via Transtemporal Surgery: A Case Report with 4D-Flow Magnetic Resonance Imaging.","authors":"Yue-Lin Hsieh, Xu Liu, Fei Dai, Shenjiang Wang, Xiuli Gao, Deyuan Wen, Wuqing Wang","doi":"10.1097/MAO.0000000000004383","DOIUrl":"10.1097/MAO.0000000000004383","url":null,"abstract":"<p><strong>Objective: </strong>To report the first successful surgical treatment of a rare subtype of venous pulsatile tinnitus (PT) caused by aberrant sylvian vein and tegmen dehiscence (SVTD) with a diverticulum and soft tissue enclosing the middle ear ossicles.</p><p><strong>Patients: </strong>A 35-year-old female participant presented with more than 10-year left-side PT due to SVTD diverticulum.</p><p><strong>Interventions: </strong>The participant underwent transtemporal surgery with a lateral minimally invasive approach to the epitympanum and aditus ad antrum after finding SVTD and diverticulum.</p><p><strong>Main outcome measures: </strong>Contrast-enhanced CT, various magnetic resonance (MR) techniques, including the 4D-flow MR method, and transcanal recording examinations were utilized. The Tinnitus Handicap Inventory (THI) was employed to quantify the surgical efficacy in treating PT.</p><p><strong>Results: </strong>PT was successfully resolved following resurfacing of the diverticulum located on the medial wall of the epitympanic space, with the patient achieving a THI score of 0. The 4D-flow MR indicated that the mean and largest velocities at the dehiscence area were 20.8 cm/s and 54.9 cm/s, respectively. The main frequency of PT fluctuated below 750 hz.</p><p><strong>Conclusion: </strong>SVTD diverticulum-induced venous PT can be successfully treated via the transtemporal pathway. Additionally, this finding underscores the importance to carefully examine tegmen dehiscence and the exposed vasculature when managing venous PT.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e28-e33"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Diseases and Sensorineural Hearing Loss-A Systematic Review of the Literature.","authors":"Anna N Berezovsky, Mana Espahbodi, Samantha L LaPrade, David R Friedland, Michael S Harris","doi":"10.1097/MAO.0000000000004380","DOIUrl":"10.1097/MAO.0000000000004380","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the relationship of cardiovascular disease (CVD) and sensorineural hearing loss (SNHL).</p><p><strong>Databases reviewed: </strong>Ovid MEDLINE, Web of Science, Scopus, and Cochrane.</p><p><strong>Methods: </strong>A systematic review was performed. Studies were identified using Ovid MEDLINE, Web of Science, Scopus, and Cochrane from 1946 to 2023. Per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, abstracts were screened for primary review. Full texts were reviewed for secondary review.</p><p><strong>Results: </strong>There were 3,440 unique abstracts screened. After primary review of abstracts and secondary full text review, 68 articles were included. The relationship between SNHL and the following CVDs, risk factors, and interventions were ascertained: coronary artery bypass graft (CABG) surgery, coronary artery disease (CAD), carotid stenosis (CS), myocardial infarction (MI), percutaneous coronary intervention (PCI), other arteriosclerosis, cerebral small vascular disease, cerebrovascular accident (CVA), transient ischemic attack (TIA), peripheral vascular disease (PVD), hyperlipidemia (HLD), hypertension (HTN), and diabetes mellitus (DM). CABG and CAD were consistently associated with SNHL. DM was associated with SNHL, but HTN and HLD were not consistently associated.</p><p><strong>Conclusions: </strong>There is a complex relationship between CVDs and SNHL. CABG and CAD were consistently associated with SNHL. DM was associated with SNHL, but other CVD risk factors (HTN and HLD) did not appear to consistently correlate with SNHL, raising consideration that SNHL is a later finding in those with CVD.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"23-30"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal Bone Gunshot Wounds: A Multi-institutional Retrospective Study.","authors":"Natalie L Demirjian, David Grande, Terence E Imbery, Thomas Muelleman, Erika M Walsh, Cameron C Wick, Nicholas A Dewyer","doi":"10.1097/MAO.0000000000004351","DOIUrl":"10.1097/MAO.0000000000004351","url":null,"abstract":"<p><strong>Objective: </strong>To investigate management practices and outcomes in a retrospective cohort of patients who have sustained temporal bone gunshot wounds (TBGSW).</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>Five participating hospitals.</p><p><strong>Patients: </strong>Twenty-two patients met inclusion criteria: experienced a TBGSW, survived ≥30 days following the injury, and were evaluated and managed by a neurotologist between 2019 and 2023.</p><p><strong>Interventions: </strong>No specific interventions were performed for the purposes of this study.</p><p><strong>Main outcome measures: </strong>Characteristics, evaluation, management, and outcomes of TBGSW survivors.</p><p><strong>Results: </strong>Patients were found to have a mean age of 33 ± 18 years and were predominantly male (18/22, 81.8%). Majority of patients (17/22, 77.3%) had mastoid injury. Most patients (14/22, 63.6%) had some evidence for vascular injury, most frequently the internal carotid artery (9/22, 40.9%). Almost three-quarters (17/22, 77.3%) of patients had clinical exam findings of facial nerve injury, which was the most common indication for surgery. Otologic surgery was performed in 72.7% (16/22), with delayed adverse events most commonly including cholesteatoma and external auditory canal stenosis. Though evidence for hearing impairment was clinically present in at least 15 of 22 patients (68.2%), hearing rehabilitation was pursued in only two patients.</p><p><strong>Conclusion: </strong>With increasing numbers of TBGSW survivors, there is a growing need for practicing neurotologists to be familiar with the wide spectrum of injury patterns and possible complications to inform clinical management in these patients. Early neurotologic assessment and follow-up beyond the acute period is crucial to minimize morbidity in this high-risk cohort.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"104-111"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma Concentration as a Proxy for Perilymph Drug Levels: Preclinical and Clinical Dexamethasone Measures with a Long-Acting Formulation for Precise Delivery to the Round Window Membrane.","authors":"Benson T Jung, Jafri Kuthubutheen, Jeffrey D Sharon, Alan C Foster, Signe Erickson, Hugo Peris, Eugene De Juan, Charles J Limb, Kathleen Cogan Farinas, Jeremy Turner, Amanda Henton, Alec Salt","doi":"10.1097/MAO.0000000000004336","DOIUrl":"10.1097/MAO.0000000000004336","url":null,"abstract":"<p><strong>Objective: </strong>To use animal pharmacokinetic data and FluidSIM modeling to estimate human dexamethasone perilymph concentrations from plasma concentration measurements over time following a single intratympanic administration of SPT-2101.</p><p><strong>Study design: </strong>Perilymph and plasma dexamethasone concentrations were measured in guinea pigs and African green monkeys over 3 to 6 weeks post-intratympanic administration of SPT-2101. Plasma concentrations of dexamethasone were measured in Ménière's disease patients post-intratympanic administration of SPT-2101. FluidSIM was trained on the correlations of animal plasma and animal perilymph levels, allowing the human perilymph drug time course for SPT-2101 to be predicted from measured human plasma dexamethasone concentrations.</p><p><strong>Setting: </strong>Tertiary care neurotology clinic in Perth, Australia.</p><p><strong>Patients: </strong>Nine adults with unilateral definite Ménière's disease per Barany Society criteria.</p><p><strong>Intervention: </strong>Intratympanic SPT-2101, a single injection of a long-acting gel formulation of dexamethasone precisely delivered at the round window.</p><p><strong>Main outcome measure: </strong>Estimated dexamethasone levels in human perilymph following a single administration of SPT-2101 at the round window over time.</p><p><strong>Results: </strong>Perilymph dexamethasone concentrations were above estimated therapeutic levels for up to 35 days in guinea pigs and at least 21 days in African green monkeys. In human subjects, plasma dexamethasone concentrations were detected for 2 weeks post-administration. Animal middle ear, plasma and perilymph drug interrelationships were compared to FluidSIM simulations, providing rationale for correlating dexamethasone concentrations in the respective compartments. Comparable simulations of human plasma concentrations predicted perilymph dexamethasone therapeutic levels in humans for 23-55 days.</p><p><strong>Conclusions: </strong>Sustained release dexamethasone from SPT-2101 precisely delivered at the round window provides prolonged and durable estimated perilymph concentrations in clinical subjects.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"80-87"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Vestibular Rehabilitation as Effective for Persistent Postural-Perceptual Dizziness as for Chronic Unilateral Vestibular Hypofunction?","authors":"Akiyuki Yamato, Chihiro Yagi, Akira Kimura, Ryota Kai, Meiko Kitazawa, Tatsuya Yamagishi, Shinsuke Ohshima, Shuji Izumi, Takao Imai, Hidenori Inohara, Arata Horii","doi":"10.1097/MAO.0000000000004397","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004397","url":null,"abstract":"<p><strong>Objective: </strong>To compare the feasibility and outcomes of vestibular rehabilitation (VR) for persistent postural-perceptual dizziness (PPPD) with those for chronic unilateral vestibular hypofunction (UVH).</p><p><strong>Study design: </strong>Prospective study.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>Nineteen consecutive patients with chronic UVH lasting for >3 months and 15 with PPPD.</p><p><strong>Interventions: </strong>The VR program consisted of gaze stabilization exercises, static or dynamic balance exercises and gait training, and habituation exercises that exposed patients to a provocative stimulus. Patients were asked to perform VR for at least 20 min a day.</p><p><strong>Main outcome measures: </strong>Status of VR (i.e., continuation/discontinuation) and outcomes were assessed 1 month after the introduction of VR using the Dizziness Handicap Inventory for handicaps in daily life due to dizziness, the Niigata PPPD Questionnaire (NPQ) for symptom exacerbations of PPPD, and the Hospital Anxiety and Depression Scale for anxiety and depression.</p><p><strong>Results: </strong>No patients in the chronic UVH group discontinued VR, whereas six patients in the PPPD group discontinued VR owing to symptom exacerbations, showing a significant difference. VR did not decrease any symptom scale, except for the NPQ-motion subscore, in patients with PPPD who continued VR, whereas it decreased all clinical symptom scales, except for the NPQ-motion subscore, in patients with chronic UVH.</p><p><strong>Conclusions: </strong>Patients with PPPD had a higher rate of VR discontinuation than those with chronic UVH, and VR was less effective in patients with PPPD who even continued treatment than in those with chronic UVH. Therefore, VR on PPPD should be optimized.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Intriguing Clinical Profiles of Autoimmune Inner Ear Diseases in Sudden Sensorineural Hearing Loss.","authors":"Thunyawarin Arunthanachaikul, Sornwit Osothsinlp, Saisuree Nivatwongs, Pongthorn Narongroeknawin","doi":"10.1097/MAO.0000000000004391","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004391","url":null,"abstract":"<p><strong>Introduction: </strong>Sudden sensorineural hearing loss (SSNHL) is idiopathic in 70-90% of cases with 10-30% linked to vascular injuries, viral infections, or autoimmune inner ear disease (AIED). AIED contributes to less than 1% of all hearing losses, categorized into primary, affecting only the inner ear, and secondary, associated with systemic autoimmune diseases (SAID). This study examines the prevalence and features of AIED in SSNHL in a tertiary referral center.</p><p><strong>Materials and methods: </strong>We conducted a prospective study from November 2021 to December 2022 including SSNHL patients who exhibited symptoms like hearing loss or tinnitus. Evaluations included tympanometry, pure tone audiometry, and blood tests, with suspected AIED cases further assessed by rheumatologists using Lobo's diagnostic criteria. Treatment responses were monitored through regular audiometry updates.</p><p><strong>Results: </strong>Out of 694 SSNHL patients, 43 (6.2%) were diagnosed with AIED, of which 36 (83.7%) had primary AIED and 7 (16.3%) had secondary AIED linked to conditions like Sjögren's syndrome and systemic lupus erythematosus. Treatment response was seen in 19.4% of primary and 42.9% of secondary AIED cases.</p><p><strong>Conclusion: </strong>The prevalence of AIED in SSNHL patients was found to be 6.2%, with a notable fraction also suffering from SAID. Responses to treatment were positive in about a third of these cases, highlighting the importance of interdisciplinary management for this rare yet significant cause of SSNHL.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}