Doppler ultrasonography of the vertebrobasilar circulation in patients with sudden sensorineural hearing loss.
BACKGROUND
The etiology of sudden sensorineural hearing loss (SSNHL) is still unclear and is most probably diverse.


OBJECTIVE
To determine the relationship between vertebrobasilar circulation and hearing in patients with SSNHL treated with pentoxifylline.


METHODS
Case-control study of 32 consecutive patients with SSNHL.


METHODS
Patients with onset of SSNHL within 72 hours were treated with pentoxifylline infusions for 10 days. Transcranial Doppler (TCD) ultrasonography of vertebrobasilar circulation and hearing levels were examined at the onset of SSNHL (before treatment), after 10 days of therapy, and after 3 months.


METHODS
Hearing levels and TCD ultrasonographic findings at the onset of SSNHL, after 10 days, and after 3 months.


RESULTS
Patients with SSNHL had more frequent pathologic TCD ultrasonographic findings compared with a normal population. Thirteen patients with SSNHL had normal TCD ultrasonographic findings, eight had borderline findings, and six had pathologic findings, and in five patients, initially, pathologic TCD ultrasonographic findings improved during therapy. Patients with normal TCD ultrasonographic findings had an average hearing improvement of 17 dB, whereas patients with borderline and pathologic TCD ultrasonographic findings had 3 and 0 dB of average hearing improvement, respectively. The greatest improvement (28 dB) was noticed in patients who showed improvement in TCD ultrasonographic findings.


CONCLUSIONS
Although the number of patients is small, our results led to the conclusion that SSNHL has vascular etiology, at least in some patients. Consequently, the therapy for SSNHL should depend on etiology; that is, vasoactive medications should be reserved for patients with supposed vascular etiology. TCD ultrasonography could have a role in the decision regarding the optimal treatment of SSNHL.
Grgić
Marko
M
Department of Otolaryngology and Head and Neck Surgery, University Hospital Sestre Milosrdnice, Zagreb, Croatia.
Petric
Vlado
V
Grgić
Marija Pastorcić
MP
Demarin
Vida
V
Pegan
Boris
B
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D001488:Basilar Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D002245:Carbon Dioxide / Q000627:therapeutic use; D016022:Case-Control Studies; D003051:Cochlea / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000628:therapy; D003639:Hearing Loss, Sudden / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016898:Interferon-alpha / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000627:therapeutic use; D012720:Severity of Illness Index; D018608:Ultrasonography, Doppler / Q000379:methods*; D014665:Vasodilator Agents / Q000627:therapeutic use; D014711:Vertebral Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology*
D000893:Anti-Inflammatory Agents; D000925:Anticoagulants; D007166:Immunosuppressive Agents; D016898:Interferon-alpha; D014665:Vasodilator Agents; D002245:Carbon Dioxide; C011700:carbogen; D010100:Oxygen