title: Ischemia as a potential etiologic factor in idiopathic unilateral sudden sensorineural hearing loss: Analysis of posterior circulation arteries.
abstract: The association between idiopathic sudden sensorineural hearing loss (ISSNHL) and the radiologic characteristics of the vertebrobasilar artery is unclear. We hypothesized that the degree and direction of vertebrobasilar artery curvature in the posterior circulation contribute to the occurrence of ISSNHL. We consecutively enrolled patients diagnosed with unilateral ISSNHL in two tertiary hospitals. Magnetic resonance images were performed in all patients to exclude specific causes of ISSNHL, such as vestibular schwannoma, chronic mastoiditis, and anterior inferior cerebellar artery infarct. We measured the following parameters of posterior circulation: vertebral and basilar artery diameter, the degree of basilar artery curvature (modified smoker criteria), and vertebral artery dominance. Pure tone audiometries were performed at admission and again 1 week and 3 months later. A total of 121 ISSNHL patients (mean age, 46.0 ± 17.3 years; 48.8% male) were included in these analyses. The proportion of patients with the left side hearing loss was larger than the proportion with the right side hearing loss (left, 57.9%; right, 42.1%). The majority of patients were characterized by a left dominant vertebral artery and right-sided basilar artery curvature. The direction of the basilar artery curvature was significantly associated with hearing loss lateralization (p = 0.036). Age and sex matched multivariable analyses revealed the absence of diabetes and right-sided basilar artery curvature as significant predictors for left sided hearing loss. There was no statistical difference between atherosclerotic cardiovascular risk score (high versus low) and hearing outcomes at 3 months. In ISSNHL, the laterality of hearing loss was inversely associated with the direction of basilar artery curvature. Our results, therefore, indicate the importance of vascular assessment when evaluating ISSNHL.
authors.affiliation: Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon, South Korea.
authors.forename: Chulho
authors.initials: C
authors.lastname: Kim
authors.affiliation: Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon, South Korea.
authors.forename: Jong-Hee
authors.initials: JH
authors.lastname: Sohn
authors.affiliation: Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon, South Korea.
authors.forename: Min Uk
authors.initials: MU
authors.lastname: Jang
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Hallym University Medical Center, Chuncheon, South Korea.
authors.forename: Sung-Kwang
authors.initials: SK
authors.lastname: Hong
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Hallym University Medical Center, Chuncheon, South Korea.
authors.forename: Joong-Seob
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Hallym University Medical Center, Chuncheon, South Korea.
authors.forename: Hyung-Jong
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon, South Korea.
authors.forename: Hui-Chul
authors.initials: HC
authors.lastname: Choi
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Hallym University Medical Center, Chuncheon, South Korea. Electronic address: zoonox@nate.com.
authors.forename: Jun Ho
authors.initials: JH
authors.lastname: Lee
mesh_terms: D000328:Adult; D001158:Arteries / Q000503:physiopathology*; D001488:Basilar Artery / Q000502:physiology*; D005260:Female; D034381:Hearing Loss / Q000503:physiopathology*; D006319:Hearing Loss, Sensorineural / Q000209:etiology* / Q000503:physiopathology*; D003639:Hearing Loss, Sudden / Q000209:etiology* / Q000503:physiopathology*; D006801:Humans; D007511:Ischemia / Q000150:complications* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013256:Steroids / Q000737:chemistry
chemical_list: D013256:Steroids
keywords: Atherosclerosis; Basilar artery; Etiology; Ischemia; Sudden hearing loss