Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Siriraj Sleep Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Otolaryngol Head Neck Surg. 2023 Aug;169(2):201-209. doi: 10.1177/01945998221120777. Epub 2023 Jan 29.
To evaluate the associations between obstructive sleep apnea (OSA) and sensorineural hearing loss (SNHL) and the effects of continuous positive airway pressure (CPAP) therapy on SNHL.
Ovid Medline, Embase, and Scopus databases.
A systematic search was done for studies investigating relationships between OSA and SNHL in adults, with manual searches for additional references. The final update was done on December 22, 2021. The Risk of Bias Assessment Tool for Nonrandomized Studies was applied for quality assessments.
The 20 included studies had a total of 34,442 participants (66% male; mean age, 46.6 years). The OSA group had a significantly worse mean hearing threshold level (HTL) than the control group for midfrequency ranges (500, 1000, 2000 Hz; mean difference, 4.00 dB; 95% CI, 2.40-5.61) and high-frequency ranges (4000, 8000 Hz; mean difference, 6.24 dB; 95% CI, 2.99-9.49). An association between OSA and SNHL was found. When compared with controls, patients with OSA had an odds ratio of 1.52 (95% CI, 1.12-2.06) for midfrequency hearing impairment and 1.19 (95% CI, 1.05-1.34) for high-frequency hearing impairment. However, we did not find significant improvements in midfrequency HTL after CPAP therapy.
HTL was significantly poorer among participants with OSA (especially in severe cases) than non-OSA controls. Studies on patients with OSA with SNHL treated with CPAP did not show significant improvements in midfrequency HTL. Further studies are warranted on these issues.
评估阻塞性睡眠呼吸暂停(OSA)与感音神经性听力损失(SNHL)之间的关联,以及持续气道正压通气(CPAP)治疗对 SNHL 的影响。
Ovid Medline、Embase 和 Scopus 数据库。
系统检索了成人 OSA 与 SNHL 之间关系的研究,并进行了额外参考文献的手工检索。最终更新日期为 2021 年 12 月 22 日。应用非随机研究的偏倚风险评估工具进行质量评估。
20 项纳入研究共纳入 34442 名参与者(66%为男性;平均年龄 46.6 岁)。与对照组相比,OSA 组中频范围(500、1000、2000 Hz)和高频范围(4000、8000 Hz)的平均听阈水平(HTL)明显更差(平均差异,4.00 dB;95%置信区间,2.40-5.61;平均差异,6.24 dB;95%置信区间,2.99-9.49)。发现 OSA 与 SNHL 之间存在关联。与对照组相比,OSA 患者中频听力障碍的优势比为 1.52(95%置信区间,1.12-2.06),高频听力障碍的优势比为 1.19(95%置信区间,1.05-1.34)。然而,我们没有发现 CPAP 治疗后中频 HTL 有显著改善。
与非 OSA 对照组相比,OSA 患者(尤其是重度 OSA 患者)的 HTL 明显更差。对接受 CPAP 治疗的 OSA 合并 SNHL 患者的研究并未显示中频 HTL 有显著改善。需要进一步研究这些问题。