Ushio Munetaka, Kitazawa Yoshihisa, Tamura Yuya, Yoshida Tomoe, Uchiyama Michiko, Takanami Taro, Tanaka Toshitake, Ikemiyagi Yoshihiro, Ikemiyagi Fuyuko, Ohta Yasushi
Otolaryngology, Toho University Sakura Medical Center, Sakura, JPN.
Otolaryngology, Kitazawa Ear Nose Throat Clinic, Tokyo, JPN.
Cureus. 2023 Nov 25;15(11):e49400. doi: 10.7759/cureus.49400. eCollection 2023 Nov.
Vascular disorders and viral infections are the presumed etiologies of idiopathic sudden sensorineural hearing loss (ISSNHL) and acute sensorineural hearing loss, with no identifiable cause. However, no clinical test for estimating the extent of vascular involvement in ISSNHL has been reported despite its potential impact on prognosis and treatment. We investigated the correlation between the cardio-ankle vascular index (CAVI), which reflects arterial stiffness and elasticity, and hearing improvement to ascertain its usefulness as an additional indicator of ISSNHL prognosis and etiology.
We enrolled 182 patients diagnosed with definite ISSNHL. The percentage of mild ISSNHL patients and that of patients experiencing no change were compared between the high-CAVI and low-CAVI groups. Age, initial and final pure-tone average (PTA) values, CAVI, presence or absence of vertigo, and medical histories were retrospectively reviewed and included in univariate and multivariate analyses.
The percentage of mild ISSNHL patients was smaller in the high-CAVI group than in the low-CAVI group, whereas the percentage of patients experiencing no change was smaller in the high-CAVI group than in the low-CAVI group, although patients in the high-CAVI group were significantly older than those in the low-CAVI group. The Cox proportional hazard model revealed that high CAVI, hypertension, younger age, and initial PTA <90 dB were associated with hearing improvement.
ISSNHL in patients with high CAVI was more severe but had a better prognosis than that in those with low CAVI. CAVI may help evaluate diseases of vascular and other etiologies, as well as ISSNHL.
血管疾病和病毒感染被认为是特发性突发性感音神经性听力损失（ISSNHL）和急性感音神经性听力损失的病因，这些听力损失没有可识别的原因。然而，尽管血管受累程度对ISSNHL的预后和治疗可能有影响，但尚无关于评估其在ISSNHL中血管受累程度的临床测试报道。我们研究了反映动脉僵硬度和弹性的心脏-脚踝血管指数（CAVI）与听力改善之间的相关性，以确定其作为ISSNHL预后和病因的附加指标的有用性。
我们纳入了182例确诊为明确ISSNHL的患者。比较了高CAVI组和低CAVI组中轻度ISSNHL患者的百分比以及无变化患者的百分比。回顾性分析年龄、初始和最终纯音平均（PTA）值、CAVI、是否存在眩晕以及病史，并将其纳入单因素和多因素分析。
高CAVI组中轻度ISSNHL患者的百分比低于低CAVI组，而高CAVI组中无变化患者的百分比低于低CAVI组，尽管高CAVI组患者的年龄明显大于低CAVI组。Cox比例风险模型显示，高CAVI、高血压、年轻年龄和初始PTA<90 dB与听力改善相关。
高CAVI患者的ISSNHL比低CAVI患者更严重，但预后更好。CAVI可能有助于评估血管和其他病因的疾病以及ISSNHL。
