Association between hearing loss and saccular dysfunction in older individuals.
OBJECTIVE
1) Describe the association between hearing loss and dysfunction of each of the 5 vestibular end-organs--the horizontal, superior, and posterior semicircular canals; saccule; and utricle--in older individuals. 2) Evaluate whether hearing loss and vestibular end-organ deficits share any risk factors.


METHODS
Cross-sectional study.


METHODS
Academic medical center.


METHODS
Fifty-one individuals age 70 years or older.


METHODS
Audiometry, head-thrust dynamic visual acuity (htDVA), sound-evoked cervical vestibular-evoked myogenic potential (cVEMP), and tap-evoked ocular VEMP (oVEMP).


METHODS
Audiometric pure-tone averages (PTA), htDVA LogMAR scores as a measure of semicircular canal function in each canal plane, and cVEMP and oVEMP amplitudes as a measure of saccular and utricular function, respectively.


RESULTS
We observed a significant correlation between hearing loss at high frequencies and reduced cVEMP amplitudes (or reduced saccular function; r = -0.37, p < 0.0001) in subjects age 70 years or older. In contrast, hearing loss was not associated with oVEMP amplitudes (or utricular function), or htDVA LogMAR scores (or semicircular canal function) in any of the canal planes. Age and noise exposure were significantly associated with measures of both cochlear and saccular dysfunction.


CONCLUSIONS
The concomitant decline in the cochlear and saccular function associated with aging may reflect their common embryologic origin in the pars inferior of the labyrinth. Noise exposure seems to be related to both saccular and cochlear dysfunction. These findings suggest a potential benefit of screening individuals with presbycusis-particularly those with significant noise exposure history-for saccular dysfunction, which may contribute to fall risk in the elderly.
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
Maria Geraldine
MG
Zuniga
Roni E
RE
Dinkes
Marcela
M
Davalos-Bichara
John P
JP
Carey
Michael C
MC
Schubert
W Michael
WM
King
Jeremy
J
Walston
Yuri
Y
Agrawal
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001301:Audiometry, Pure-Tone; D001844:Bone Conduction; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D034381:Hearing Loss / Q000209:etiology / Q000473:pathology*; D006317:Hearing Loss, Noise-Induced / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D008297:Male; D012307:Risk Factors; D012444:Saccule and Utricle / Q000473:pathology* / Q000503:physiopathology; D012665:Semicircular Canals / Q000473:pathology; D012959:Socioeconomic Factors; D013067:Speech Perception / Q000502:physiology; D015837:Vestibular Diseases / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D058585:Vestibular Evoked Myogenic Potentials / Q000502:physiology; D014724:Vestibular Function Tests; D014792:Visual Acuity / Q000502:physiology