Role of viral infection in sudden hearing loss

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Abstract

According to a recent epidemiological survey, the incidence of sudden sensorineural hearing loss (SSNHL) is increasing yearly. The cause of SSNHL is of great interest in research. To date, viral infection, vascular occlusion, abnormal cellular stress responses within the cochlea, and immune-mediated mechanisms are considered the most likely etiologies of this disease. Among these etiologies, the relationship between viral infection and sudden deafness has been unclear. In this review, we mainly discuss the viral hypothesis of SSNHL. There is little research proving or clearly indicating the pathogenesis of this disease. Further research is needed to elucidate the precise etiopathogenesis to better understand SSNHL and establish more suitable treatment to help restore hearing in affected patients.

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Lassa fever–induced sensorineural hearing loss: A neglected public health and social burden

Elizabeth J. Mateer, Cheng Huang, Nathan Shehu … (2018)

Although an association between Lassa fever (LF) and sudden-onset sensorineural hearing loss (SNHL) was confirmed clinically in 1990, the prevalence of LF-induced SNHL in endemic countries is still underestimated. LF, a viral hemorrhagic fever disease caused by Lassa virus (LASV), is endemic in West Africa, causing an estimated 500,000 cases and 5,000 deaths per year. Sudden-onset SNHL, one complication of LF, occurs in approximately one-third of survivors and constitutes a neglected public health and social burden. In the endemic countries, where access to hearing aids is limited, SNHL results in a decline of the quality of life for those affected. In addition, hearing loss costs Nigeria approximately 43 million dollars per year. The epidemiology of LF-induced SNHL has not been characterized well. The complication of LF induced by SNHL is also an important consideration for vaccine development and treatments. However, research into the mechanism has been hindered by the lack of autopsy samples and relevant small animal models. Recently, the first animal model that mimics the symptoms of SNHL associated with LF was developed. Preliminary data from the new animal model as well as the clinical case studies support the mechanism of immune-mediated injury that causes SNHL in LF patients. This article summarizes clinical findings of hearing loss in LF patients highlighting the association between LASV infection and SNHL as well as the potential mechanism(s) for LF-induced SNHL. Further research is necessary to identify the mechanism and the epidemiology of LF-induced SNHL.

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Treatment of sudden sensorineural hearing loss: I. A systematic review.

Anne Elizabeth Conlin, Lorne S Parnes (2007)

To identify, evaluate, and review randomized controlled trials (RCTs) on the treatment of sudden sensorineural hearing loss (SSHL). A MEDLINE search and hand search were conducted to identify RCTs published between January 1966 and February 2006 in the English language on the treatment of SSHL. Search terms included hearing loss, sensorineural (MeSH term), sensorineural hearing loss (text words), and sudden deafness (text words). Prospective RCTs on the treatment of patients diagnosed as having SSHL. One independent observer extracted study data. Validity was evaluated using standard criteria. Characteristics and results were reviewed systematically. A total of 21 RCTs were identified regarding various treatments, including systemic and intratympanic steroids; antiviral and hemodilution agents; mineral, vitamin, and herbal preparations; batroxobin; carbogen; and hyperbaric oxygen. All studies used audiometric outcome measures. Only 2 studies used identical criteria to define SSHL. The method of randomization was described in 2 studies. Validity scores ranged from 2 to 8 (of 9). Positive results were reported favoring systemic steroids, intratympanic steroids, batroxobin, magnesium, vitamin E, and hyperbaric oxygen, although there were serious limitations in each study with a positive finding. There was no difference in audiometric outcomes reported across all studies of antiviral and hemodilution agents and no difference in one study of systemic steroids vs placebo. To our knowledge, no valid RCT exists to determine effective treatment of SSHL. Systemic steroids cannot be considered the gold standard of treatment of SSHL, given the severe limitations of the landmark study supporting their use.

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Correlations of inflammatory biomarkers with the onset and prognosis of idiopathic sudden sensorineural hearing loss.

M Masuda, Sho Kanzaki, Jun Kikuchi … (2012)

We investigated whether inflammatory biomarkers and stress are involved in the pathophysiology of idiopathic sensorineural hearing loss (ISHL). Individual cohort study. Two tertiary centers. Forty-three ISHL and 10 non-ISHL patients seen in our ENT departments from 2004 to 2010 within a week from the onset of new symptoms and without steroid administration before visiting our departments. Multiple audiologic evaluations, blood tests including leukocyte counts, natural killer cell activity (NKCA), interleukin 6 (IL-6), tumor necrosis factor, high-sensitivity CRP (hCRP), and the General Health Questionnaire were used to evaluate the systemic stress and inflammatory response. Correlations between biomarkers and ISHL severity and prognosis were evaluated by statistical analysis. In the ISHL patients, a neutrophil count above the reference range was associated with severe hearing loss and poor prognosis, and was accompanied by low NKCA and high IL-6. In the non-ISHL patients, these associations were not present. The abnormal neutrophil count was independent of preexisting vascular diseases. The abnormal counts responded to treatment and decreased into the reference range. Neutrophil counts above the reference range of a facility will be a useful indicator of poor prognosis of ISHL. Synchronism of different types of NF-κB activation pathways could be required to cause severe ISHL. An NKCA decrease, an acute neutrophil count increase, and an IL-6 increase can induce NF-κB activation in the cochlea and cause severe ISHL. Further epidemiologic surveys should be conducted to evaluate whether stressful life events increase the risk of severe ISHL onset.

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Author and article information

Journal

Journal ID (nlm-ta): J Int Med Res

Journal ID (iso-abbrev): J. Int. Med. Res

Journal ID (publisher-id): IMR

Journal ID (hwp): spimr

Title: The Journal of International Medical Research

Publisher: SAGE Publications (Sage UK: London, England )

ISSN (Print): 0300-0605

ISSN (Electronic): 1473-2300

Publication date (Electronic): 27 May 2019

Publication date (Print): July 2019

Volume: 47

Issue: 7

Pages: 2865-2872

Affiliations

[1 ]ENT institute, Eye & ENT Hospital of Fudan University, Shanghai, China

[2 ]ENT institute, Eye & ENT Hospital of Fudan University, Shanghai, China; Hearing Medicine Key Laboratory, National Health and Family Planning Commission, Shanghai, China

Author notes

[*]

These authors contributed equally to this article.

[*]Tian-yu Zhang, ENT institute, Eye and ENT Hospital of Fudan University, Shanghai 200031, China; Hearing Medicine Key Laboratory, National Health and Family Planning Commission, 83 Fenyang Road, Shanghai 200031, China. Email: ty.zhang2006@ 123456aliyun.com

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Xin Chen https://orcid.org/0000-0002-4041-9960

Article

Publisher ID: 10.1177_0300060519847860

DOI: 10.1177/0300060519847860

PMC ID: 6683896

PubMed ID: 31130031

SO-VID: 4e467c77-871c-40ee-a0ba-8d487815d81c

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Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

Role of viral infection in sudden hearing loss

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International Journal of Medicine and Medical Research

Most cited references 46

Lassa fever–induced sensorineural hearing loss: A neglected public health and social burden

Treatment of sudden sensorineural hearing loss: I. A systematic review.

Correlations of inflammatory biomarkers with the onset and prognosis of idiopathic sudden sensorineural hearing loss.

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