González-García Miriam, Prieto-Sánchez-de-Puerta Lucía, Domínguez-Durán Emilio, Sánchez-Gómez Serafín
Department of Otolaryngology, Hospital Universitario Virgen Macarena, Seville, Spain.
Department of Otolaryngology, Hospital QuironSalud "Infanta Luisa", Seville, Spain.
Ear Hear. 2025;46(1):8-15. doi: 10.1097/AUD.0000000000001576. Epub 2024 Sep 10.
Hearing recovery following idiopathic sudden sensorineural hearing loss (ISSNHL) is influenced by various prognostic factors, and the presence of acute vestibular syndrome (AVS) may adversely impact auditory outcomes. Evaluating vestibular function in SSNHL patients could offer insights into predicting hearing recovery. This systematic review aims to assess whether the presence of AVS exacerbates the audiological prognosis of ISSNHL.
A comprehensive systematic review was conducted using databases such as PubMed, Cochrane Library, EMBASE, and Scopus, encompassing articles published in the last decade. Included were retrospective and prospective case-control and cohort studies, as well as randomized clinical trials. Meta-analysis was performed based on the findings from these studies.
Among 386 articles identified, six addressed the systematic review's question, all being retrospective studies. These articles collectively involved 393 patients for the meta-analysis. Vestibular function assessment methods varied widely, posing challenges for direct comparisons. The likelihood of unfavorable hearing outcomes was 2.29 times higher in patients with associated AVS. Hearing recovery was 3.22 times more likely to be worse in patients with altered cervical vestibular evoked myogenic potentials-air-conducted sound. Abnormal caloric test results showed no significant association with worse hearing prognosis, although patients with unaltered caloric tests demonstrated a significantly greater improvement in pure-tone audiometry.
Hearing recovery from ISSNHL appears to be diminished in patients with associated AVS and abnormal vestibular test results.
特发性突发性感音神经性听力损失（ISSNHL）后的听力恢复受多种预后因素影响，急性前庭综合征（AVS）的存在可能对听觉结果产生不利影响。评估SSNHL患者的前庭功能可为预测听力恢复提供见解。本系统评价旨在评估AVS的存在是否会加重ISSNHL的听力学预后。
使用PubMed、Cochrane图书馆、EMBASE和Scopus等数据库进行了全面的系统评价，涵盖过去十年发表的文章。纳入的有回顾性和前瞻性病例对照研究、队列研究以及随机临床试验。根据这些研究的结果进行荟萃分析。
在检索到的386篇文章中，有6篇涉及该系统评价的问题，均为回顾性研究。这些文章共纳入393例患者进行荟萃分析。前庭功能评估方法差异很大，难以进行直接比较。伴有AVS的患者听力不良结果的可能性高2.29倍。颈前庭诱发肌源性电位-气导声改变的患者听力恢复较差的可能性高3.22倍。尽管冷热试验结果未改变的患者纯音听力测定改善明显，但冷热试验结果异常与听力预后较差无显著关联。
伴有AVS且前庭测试结果异常的ISSNHL患者听力恢复似乎较差。
