Yu Huiqian, Li Huawei
Otorhinolaryngology Department, ENT Institute, Affiliated Eye and ENT Hospital of Fudan University, Shanghai, China.
Institutes of Biomedical Sciences, Fudan University, Shanghai, China.
Front Neurol. 2018 Feb 5;9:45. doi: 10.3389/fneur.2018.00045. eCollection 2018.
Sudden sensorineural hearing loss (SSHL) not only involves cochlear function but might also be accompanied by vestibular disturbances. The assessment of vestibular function could be of great relevance in SSHL.
To investigate the prevalence of vestibulocochlear lesions in SSHL and the correlation of specific vestibular organs with hearing prognosis.
A complete literature search of eligible studies in the PubMed and EMBASE databases was performed.
For our aim, studies that focused on vestibular examination in the case of SSHL were retrieved, including caloric tests, cervical vestibular-evoked myogenic potential (cVEMP) tests, or ocular vestibular-evoked myogenic potential (oVEMP) tests.
Of the 18 studies included, a caloric test was performed in 16 studies, cVEMP in 13 studies, and oVEMP in 5 studies, and together the studies included a total population of 1,468 subjects. The scores on the Agency for Healthcare Research and Quality (AHRQ) questionnaire ranged from 6 to 11. These results indicated that the most commonly damaged vestibular organ in SSHL was the utricle and superior vestibular pathway (U + S) followed by the lateral semicircular canal and superior vestibular pathway (LSC + S), the saccule and inferior vestibular pathway (S + I), and the cochlea only (C only). The meta-analysis indicated that SSHL patients with vertigo have a statistically increased risk of vestibular organ lesions compared with those without vertigo, including the LSC + S subgroup (OR = 4.89, 95% CI = 1.20-19.93, = 80%, = 0.03) and the S + I subgroup (OR = 3.58, 95% CI = 1.61-7.95, = 0%, = 0.002). The pooled possibility of hearing recovery within the LSC + S lesion group was less than half that of the non-LSC + S lesion group (OR = 0.24, 95% CI = 0.11-0.52, = 68%, = 0.0003).
This study shows the relevance of vestibular damage concomitant with SSHL and that SSHL patients with vertigo are at an increased risk of vestibular organ lesions compared with patients without vertigo. LSC + S lesions thus appear to be a critical variable that influence the possibility of hearing improvement in SSHL.
突发性感音神经性听力损失（SSHL）不仅涉及耳蜗功能，还可能伴有前庭功能障碍。前庭功能评估在SSHL中可能具有重要意义。
探讨SSHL中前庭蜗病变的患病率以及特定前庭器官与听力预后的相关性。
对PubMed和EMBASE数据库中符合条件的研究进行了全面的文献检索。
为实现我们的目标，检索了聚焦于SSHL病例前庭检查的研究，包括冷热试验、颈前庭诱发肌源性电位（cVEMP）测试或眼前庭诱发肌源性电位（oVEMP）测试。
纳入的18项研究中，16项进行了冷热试验，13项进行了cVEMP测试，5项进行了oVEMP测试，这些研究共纳入1468名受试者。医疗保健研究与质量机构（AHRQ）问卷得分范围为6至11分。这些结果表明，SSHL中最常受损的前庭器官是椭圆囊和上前庭通路（U + S），其次是外半规管和上前庭通路（LSC + S）、球囊和下前庭通路（S + I），以及仅耳蜗（仅C）。荟萃分析表明，与无眩晕的SSHL患者相比，有眩晕的患者前庭器官病变风险在统计学上增加，包括LSC + S亚组（OR = 4.89，95%CI = 1.20 - 19.93，I² = 80%，P = 0.03）和S + I亚组（OR = 3.58，95%CI = 1.61 - 7.95，I² = 0%，P = 0.002）。LSC + S病变组听力恢复的合并可能性不到非LSC + S病变组的一半（OR = 0.24，95%CI = 0.11 - 0.52，I² = 68%，P = 0.0003）。
本研究表明了SSHL伴发前庭损伤的相关性，且与无眩晕的患者相比，有眩晕的SSHL患者前庭器官病变风险增加。因此，LSC + S病变似乎是影响SSHL听力改善可能性的关键变量。
