Effect of steroid therapy on saccule and semicircular canals function in patients with unilateral sudden sensorineural hearing loss

  • Fahimeh Esmaeili ORCID Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
  • Mansoureh Adel Ghahraman ORCID Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
  • Reza Hoseinabadi ORCID Mail Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
  • Shohreh Jalaie ORCID Biostatistics, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
  • Ardavan Tajdini ORCID Department of Otolaryngology, Head and Neck Surgery, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
Keywords:
Unilateral sudden sensorineural hearing loss; vestibular evoked myogenic potentials; saccule; semicircular canals; video head impulse test

Abstract

Background and Aim: In unilateral sudden sensorineural hearing loss (SSNHL), the vestibular system may be involved in addition to the auditory system. Several hearing assessments have shown that the disease course and the patient's improvement, at least two step of vestibular assessments can help in better control of the patient's balance function. The aim of this study was to evaluate the results of cervical vestibular evoked myogenic potentials (cVEMP) and video head impulse test (vHIT) used for assessment of saccule and semicircular canals before and after steroid therapy.
Methods: Twenty three patients with SSNHL were evaluated for auditory and vestibular function before and after steroid therapy. The results of cVEMP and vHIT were compared between intact and impaired ears and between pretest/posttest stages before and after treatment.
Results: For 26.08% of patients, the cVEMP response was absent in the affected ear, but after treatment it was reported for all patients. There was a significant difference in vestibulo-ocular reflex (VOR) gain for both posterior and anterior semicircular canals of affected ear before and after treatment, but it was not significantly different after treatment as VOR gain increased.
Conclusion: Dysfunction of nervous and vestibular systems in SSNHL is possible. Steroid therapy can improve the vestibular function and hearing of these patients. Therefore, vestibular evaluation can be used to determine the extent of lesions in SSNHL.

References

1. Schreiber BE, Agrup C, Haskard DO, Luxon LM. Sudden sensorineural hearing loss. The Lancet. 2010;375(9721):1203-11. doi: 10.1016/S0140-6736(09)62071-7
2. Kuhn M, Heman-Ackah SE, Shaikh JA, Roehm PC. Sudden sensorineural hearing loss: a review of diagnosis, treatment, and prognosis. Trends Amplif. 2011;15(3):91-105. doi: 10.1177/1084713811408349
3. Plontke SK. Diagnostics and therapy of sudden hearing loss. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2018;16:Doc05. doi: 10.3205/cto000144
4. Rauch SD, Halpin CF, Antonelli PJ, Babu S, Carey JP, Gantz BJ, et al. Oral vs intratympanic corticosteroid therapy for idiopathic sudden sensorineural hearing loss: a randomized trial. JAMA. 2011;305(20):2071-9. doi: 10.1001/jama.2011.679
5. Flint PW, Haughey BH, Robbins KT, Thomas JR, Niparko JK, Lund VJ, et al. Cummings otolaryngology - head and neck surgery e-book. 6th ed. Philadelphia: Sanders Elsevier; 2014.
6. Topuz E, Yigit O, Cinar U, Seven H. Should hyperbaric oxygen be added to treatment in idiopathic sudden sensorineural hearing loss? Eur Arch Otorhinolaryngol. 2004;261(7):393-6. doi: 10.1007/s00405-003-0688-6
7. Michiba T, Kitahara T, Hikita-Watanabe N, Fukushima M, Ozono Y, Imai R, et al. Residual tinnitus after the medical treatment of sudden deafness. Auris Nasus Larynx. 2013;40(2):162-6. doi: 10.1016/j.anl.2012.06.007
8. Yu H, Li H. Vestibular dysfunctions in sudden sensorineural hearing loss: a systematic review and meta-analysis. Front Neurol. 2018;9:45. doi: 10.3389/fneur.2018.00045
9. Iwasaki S, Takai Y, Ozeki H, Ito K, Karino S, Murofushi T. Extent of lesions in idiopathic sudden hearing loss with vertigo: study using click and galvanic vestibular evoked myogenic potentials. Arch Otolaryngol Head Neck Surg. 2005;131(10):857-62. doi: 10.1001/archotol.131.10.857
10. Ben-David J, Luntz M, Podoshin L, Sabo E, Fradis M. Vertigo as a prognostic sign in sudden sensorineural hearing loss. Int Tinnitus J. 2002;8(2):127-8.
11. Filipo R, Covelli E, Balsamo G, Attanasio G. Intratympanic prednisolone therapy for sudden sensorineural hearing loss: A new protocol. Acta Otolaryngol. 2010;130(11):1209-13. doi: 10.3109/00016481003793766
12. Maheu M, Houde MS, Landry SP, Champoux F. The effects of aging on clinical vestibular evaluations. Front Neurol. 2015;6:205. doi: 10.3389/fneur.2015.00205
13. Duchoud L, Maire R. [The video Head Impulse Test in the vertiginous patient]. Rev Med Suisse. 2017;13(577):1694-7. French.
14. McCaslin DL, Jacobson JP. Vestibular-Evoked Myogenic Potentials (VEMPs), in Jacobson JP, Shepard NT, editors. Balance function assessment and management. 2nd ed. San Diego: Plural Publishing; 2016. p. 533-80.
15. Hougaard DD, Abrahamsen AR. Functional testing of all six semicircular canals with video head impulse test systems. J Vis Exp. 2019;(146). doi: 10.3791/59012
16. Xiao–tong Z, Bin S, Wen–Juan Z, Min X, Jun–rong W. Concurrent symptoms and disease conditions in sudden deafness. J Otol. 2010;5(1):20-3. doi: 10.1016/S1672-2930(10)50004-7
17. Fujimoto C, Egami N, Kinoshita M, Sugasawa K, Yamasoba T, Iwasaki S. Involvement of vestibular organs in idiopathic sudden hearing loss with vertigo: an analysis using oVEMP and cVEMP testing. Clin Neurophysiol. 2015;126(5):1033-8. doi: 10.1016/j.clinph.2014.07.028
18. Stamatiou G, Gkoritsa E, Xenellis J, Riga M, Korres S. Semicircular canal versus otolithic involvement in idiopathic sudden hearing loss. J Laryngol Otol. 2009;123(12):1325-30. doi: 10.1017/S0022215109990715
19. Hong SM, Byun JY, Park CH, Lee JH, Park MS, Cha CI. Saccular damage in patients with idiopathic sudden sensorineural hearing loss without vertigo. Otolaryngol Head Neck Surg. 2008;139(4):541-5. doi: 10.1016/j.otohns.2008.07.003
20. Korres S, Stamatiou GA, Gkoritsa E, Riga M, Xenelis J. Prognosis of patients with idiopathic sudden hearing loss: role of vestibular assessment. J Laryngol Otol. 2011;125(3):251-7. doi: 10.1017/S0022215110002082
21. Peng L, Chen R, Yuan H, Liang J. [The value of otolith function test in the prognosis of sudden sensorineural hearing]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016;30(4):272-6. Chinese.
22. Chen CN, Young YH. Differentiating the cause of acute sensorineural hearing loss between Ménière's disease and sudden deafness. Acta Otolaryngol. 2006;126(1):25-31. doi: 10.1080/00016480510012363
23. Bansal S, Sinha SK. Assessment of VOR gain function and its test-retest reliability in normal hearing individuals. Eur Arch Otorhinolaryngol. 2016;273(10):3167-73. doi: 10.1007/s00405-016-3951-3
24. Pogson JM, Taylor RL, Young AS, McGarvie LA, Flanagan S, Halmagyi GM, et al. Vertigo with sudden hearing loss: audio-vestibular characteristics. J Neurol. 2016;263(10):2086-96. doi: 10.1007/s00415-016-8214-0
25. Yao Q, Xu C, Wang H, Shi H, Yu D. Video head impulse test results suggest that different pathomechanisms underlie sudden sensorineural hearing loss with vertigo and vestibular neuritis: Our experience in fifty-two patients. Clin Otolaryngol. 2018;43(6):1621-4. doi: 10.1111/coa.13196
26. Kitahara T, Kondoh K, Morihana T, Okumura S, Horii A, Takeda N, et al. Steroid effects on vestibular compensation in human. Neurol Res. 2003;25(3):287-9. doi: 10.1179/0161641031012013641
27. Moskowitz D, Lee K, Smith HW. Steroid use in idiopathic sudden sensorineural hearing loss. The Laryngoscope. 1984;94(5):664-6. doi: 10.1288/00005537-198405000-00016
28. Stachler RJ, Chandrasekhar SS, Archer SM, Rosenfeld RM, Schwartz SR, Barrs DM, et al. Clinical practice guideline: sudden hearing loss. Otolaryngol Head Neck Surg. 2012;146(3_Suppl):S1-35. doi: 10.1177/0194599812436449
Published
2020-02-02
How to Cite
1.
Esmaeili F, Adel Ghahraman M, Hoseinabadi R, Jalaie S, Tajdini A. Effect of steroid therapy on saccule and semicircular canals function in patients with unilateral sudden sensorineural hearing loss. Aud Vestib Res. 29(1):32-38.
Section
Research Article(s)