Page 9 - Revista SPORL - Vol 58. Nº2
P. 9
Can sudden sensorineural hearing loss predict
stroke? A long-term study
Antonio Rodríguez-Valiente Cristina García-Sebastián José Ramón García-Berrocal
ABSTRACT INTRODUCTION ARTIGO ORIGINAL ORIGINAL ARTICLE
Introduction: Previous studies suggest that vascular diseases Sudden deafness or sudden hearing loss (SHL) is a
as stroke may occur in a high percentage of patients with sensorineural hearing loss which develops suddenly
idiopathic sudden sensorineural hearing loss. over a period of hours or a few days (72 hours or
Objective: To report the relationship between SHL and stroke less)1,2. It varies in severity from mild to total deafness,
in order to be used as an early risk marker for stroke. and is true emergency in Otorhinolaryngology and
Material and Methods: We carried out a long-term follow- Neurotology.
up study of all idiopathic sudden sensorineural hearing loss SHL can be due to head trauma, vascular diseases, viral
patients admitted to a tertiary referral center, between January infections, immune response inside the inner ear or
1994 and December 2006. All the patients were followed can appear without obvious cause or warning. Despite
up on an outpatient basis until March 2019. Work-up study thorough investigation of its etiology, a specific cause
included history, otomicroscopy, audiometry, tympanometry, is identifiable in less than 5% of SHL cases. Attempts
laboratory, and the development of vascular diseases, and to look for a consensus in the management of SHL are
specifically stroke. Stroke and transient ischemic attack were recommended3. Patients with SHL may also experience
defined according to the WHO criteria. tinnitus or vertigo.
Results: A total of 214 patients were diagnosed with idiopathic Although the incidence of stroke presenting as SHL
sudden hearing loss, and 64 patients were assessed for stroke. is very low, stroke is a serious situation that must be
Stroke after idiopathic sudden hearing loss was reported in identified and treated as soon as possible. Stroke has an
7 patients. Lacunar stroke or small-artery occlusion was the important socioeconomic impact. The annual incidence
most frequent form of stroke presentation. The majority of for all cerebrovascular events is 187 per 100,000 in
cases occurred within the first 10 years after idiopathic sudden Spain4. This incidence of stroke is moderate compared
hearing loss, although two cases occurred at 14 and 20 years. to other European countries.
Conclusion: There seems to be a relationship between SHL Two studies developed in Taiwan showed that stroke
and stroke, especially in patients with cardiovascular risk appeared in 12.7% patients with SHL within 5 years
factors. We recommend a longer follow-up in such a patients of onset of the SHL5 and prior stroke was the most
since stroke may develop several years after the onset of the important risk factor for stroke after SHL6. Two other
hearing loss episode. studies carried out in the Republic of Korea found
Keywords: Sensorineural hearing loss; Sudden hearing loss; a hazard ratio of stroke 2.02 times7 and 1.22 times8
Stroke; Vascular diseases; Risk factors. greater for patients with SHL.
We carried out a long-term follow-up study to report
Antonio Rodríguez-Valiente the relationship between SHL and stroke. A comparison
Service of Otorhinolaryngology. Puerta de Hierro Majadahonda Universitary Hospital between the incidence of stroke in the general
population and after SHL was performed in order to be
Cristina García-Sebastián used as an early risk marker for stroke.
Service of Otorhinolaryngology. Puerta de Hierro Majadahonda Universitary Hospital
MATERIAL AND METHODS
José Ramón García-Berrocal We conducted a retrospective analysis of all patients
Service of Otorhinolaryngology. Puerta de Hierro Majadahonda Universitary Hospital affected by SHL attended in a tertiary referral center,
between January 1994 and December 2006. All the
Correspondência patients were followed up on an outpatient basis until
Antonio Rodríguez-Valiente March 2019.
Service of Otorhinolaryngology Inclusion criteria included: (a) SHL, defined as a sudden
Puerta de Hierro Majadahonda Universitary Hospital sensorineural hearing loss of greater than 30 dB over 3
Joaquín Rodrigo 2 contiguous pure-tone frequencies occurring within 72
28222 Majadahonda hours; (b) the time from hearing loss to treatment must
Madrid, Spain be within 14 days; (c) no history of ear diseases; (d) no
arova777@gmail.com specific causes for the SHL after proper investigation.
Tel. +34 1 1917220 Exclusion criteria included: (a) SHL of known cause; (b)
Fax. +34 1 1917884
VOL 58 . Nº2 . JUNHO 2020 57
Artigo recebido a 5 de Fevereiro de 2020. Aceite para publicação a 25 de Junho de 2020.
