Quality Indicators for the Diagnosis and Management of Sudden Sensorineural Hearing Loss

Global trend analysis, mechanistic insights and future directions of autoimmune ear diseases: Based on comprehensive findings over the past 20 years

BACKGROUND

In recent years, Autoimmune diseases (ADs) and hearing loss are both significant public health burdens worldwide. An increasing number of studies are focusing on the potential link between these two diseases and exploring how hearing loss can be prevented and treated in the context of autoimmune diseases. In response to this focus, it is very necessary to conduct bibliometric analysis and molecular mechanism exploration to provide guidance for the exploration of basic mechanisms and clinical management.

METHOD

Studies focusing on hearing loss and autoimmune disease were extracted from the Web of Science Core Collection database from 2000 to 2024. Bibliometric and visual analysis of the collected publications was conducted using VOSviewer and CiteSpace. The investigation of molecular pathways associated with diseases was carried out in the GeneCards and STRING databases.

RESULTS

A total of 696 papers met the inclusion and exclusion criteria and were chosen for further research. The number of papers on hearing loss and autoimmune diseases is increasing every year. These papers were mainly from 65 countries, led by the United States, China and Italy. These investigations included 3505 authors in total, with Greco A contributing the most publications. Harvard Medical School and Sapienza University Rome were the two institutions with the highest number of publications. Otology & Neurotology was the journal with the highest number of publications. The most common keywords include " sensorineural hearing loss", "endolymphatic hydrops", "management" and "autoimmune", which represent current and prospective future research trends and target topics in the field. Among them, the highest proportion of hearing loss in autoimmune ear diseases is sensorineural hearing loss, and the highest proportion of primary autoimmune ear diseases is Autoimmune inner ear disease. In addition, A total of 295 potential targets common to both diseases were also identified. Their pathogenesis involves cancer pathways, infectious disease pathways, cell senescence, epithelial and myocyte proliferation, hypoxia response, and inflammatory response.

CONCLUSION

This bibliometric analysis reveals global research trends on hearing loss in the context of autoimmune diseases. Based on this, combined with preliminary bioinformatics analysis, a potential yet close link between the autoimmune diseases and hearing loss has been demonstrated. The current study highlights the need to fully consider the common genetic and pathophysiological mechanisms of these two types of diseases to promote interdisciplinary research and the development of personalized treatments for this clinical focus, with particular attention to the elderly population with comorbidity diseases. A deeper understanding of disease mechanisms has also led to advances in the clinical management of autoimmune ear diseases, including diagnosis and treatment.

Predictors of computed tomography imaging in patients presenting with sudden hearing loss

Objective

Sudden sensorineural hearing loss (SSNHL) is a rare presentation requiring timely diagnosis and treatment. Despite recommendations against obtaining computed tomography (CT) imaging of the head in clinical practice guidelines, this investigation is often completed in patients with sudden hearing loss. The aim of this study was to determine the proportion of patients undergoing CT imaging of the head for SSNHL at our center and identify predictive factors for the use of CT imaging.

Methods

Retrospective chart review of adult patients referred for SSNHL to two academic otology/neurotology practices between January 2018 and May 2021. Patient demographics, comorbid medical conditions, associated symptoms, location of initial presentation, audiologic results, and completed imaging studies were collected. Statistical analysis was performed with SPSS software.

Results

Ninety-eight patients with audiologically confirmed SSNHL were included. Twenty-two patients (22.4%) underwent CT imaging as an investigation for SSNHL. The presence of vertigo (odds ratio 6.90; 95% confidence interval 2.43, 19.56) and presentation to the emergency room (odds ratio 8.71; 95% confidence interval 3.02, 25.16) were significantly associated with undergoing CT imaging. These two variables were statistically significant independent predictors of CT imaging on multivariate regression analysis (p = .01, p = .001, respectively).

Conclusion

A significant proportion of patients with SSNHL undergo low-yield CT imaging of the head, particularly patients presenting to the emergency room with vertigo. These results highlight an opportunity for focused education and quality improvement initiatives.Level of evidence: 4.

Clinical Efficacy of Retroauricular Injection of Methylprednisolone Sodium Succinate in the Treatment of Sudden Deafness with Type 2 Diabetes

Background

The etiology of sudden deafness is still unclear. In recent years, people's life rhythm is getting faster and faster. Fatigue, environment, diet, psychology, and other factors have increased the morbidity rate of sudden deafness and improved the quality of life of patients. And work efficiency is greatly affected.

Aims

A study to investigate the clinical efficacy of postauricular injection of methylprednisolone sodium succinate in the treatment of sudden deafness with type 2 diabetes.

Materials and Methods

Sixty patients with sudden deafness who were treated in our hospital from January 2018 to October 2020 were selected as the subjects of this prospective study and divided into 30 cases each in the comparison group and the observation group according to the random number remainder grouping method. The comparison group was treated conventionally, and the observation group was treated with postauricular injection of methylprednisolone sodium succinate on the basis of the comparison group. Patients in the two groups were observed and compared on the 3rd, 6th, and 9th days after treatment with pure-tone hearing threshold checks and regular monitoring of blood glucose, blood rheology, and other indexes.

Results

On the 7th, 14th, and 30th days after treatment, the pure-tone audiometric thresholds of the two groups were gradually decreased, and the changes in the pure-tone audiometric thresholds in the observation group were greater than those in the control group. After lunch on the 6th day and after lunch on the 9th day, it was lower than that in the control group, and the difference was statistically significant (P < 0.05). 30 days after treatment, the blood viscosity, fibrin, and platelet aggregation rate of the observation group were significantly lower than those of the control group. After treatment, the clinical efficacy rate of the observation group was 96%, which was significantly higher than that of the control group, 80%, and the above differences were statistically significant (P < 0.05).

Conclusion

Treatment with postauricular injection of methylprednisolone sodium succinate has shown better therapeutic recovery in patients with sudden deafness, improved pure-tone hearing threshold, reduced risk of blood glucose elevation, and improved clinical outcomes for patients with sudden deafness, providing some reference for the treatment of patients with sudden deafness.