Characterization of vestibular insult associated with sudden sensorineural hearing loss

Abstract EN

Background: Sudden sensorineural hearing loss is considered a labyrinthine crisis, where the vestibular system is exposed to damage as well as the cochlea.

Many trials have been made to prove the existence of such damage, in this study; we have utilized the VEMP and vHIT to characterize this vestibular insult and classify it into distinguishable patterns.

Aim: To characterize the vestibular insult associated with sudden sensorineural hearing loss (SSNHL) using vestibular evoked myogenic potential (VEMP) and video head impulse test (vHIT).

Patients and Methods: This crosssectional descriptive study was carried out on 31 patients with SSNHL presenting to Audiovestibular Medicine outpatient clinic in SCU hospital from April 2017 to Sep.

2018.

Subjects with unilateral sudden diminution of hearing >30 dB in three or more consecutive frequencies were included.

A full audiological evaluation was done in addition to the VEMP both (cervical & ocular) and vHIT.

Results were analyzed and combined into four main different patterns by authors.

Results: Among 31 subjects with SSNHL, 7 patients (22%) had Type 1 (cochlear insult but no vestibular pattern), 14 patients, (45%) had Type II (otolithic involvement: saccule and/or utricle), 6 patients (19%) had type III (otolithic and semicircular canals involvement) and 4 patients (12%) had type IV (complete vestibular loss).

Conclusion: Vestibular insult in SSNHL was categorized into four types.

Seventy eighty percent of patients had otolithic organ affection (Type I, II and III) while SCC insult was present in only 32% of patients (Type II, and III) with SSNHL