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Hearing Disorders: Diagnosis, Management, and Future Opportunities

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Otolaryngology".

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 32902

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Dr. George K. Psillas

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1st Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital, 546 36 Thessaloniki, Greece
Interests: hearing rehabilitation; middle and inner ear; ear surgery; cochlear implantation; auditory brainstem responses; facial nerve electrophysiology
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Dear Colleagues,

It is my pleasure to invite you and members of your research group to submit an article for a Special Issue titled “Hearing Disorders: Diagnosis, Management, and Future Opportunities”.

Hearing loss represents one of the largest disabilities, which affects more than 5% of the world's population. Different types of hearing loss, including conductive and sensorineural hearing loss, may lead to serious hearing impairments in children and adults. Diagnosis and management continue to be a challenge for hearing disorders such as chronic otitis media, otosclerosis, cholesteatoma, congenital or acquired sensorineural hearing loss, sudden sensorineural hearing loss, autoimmune or metabolic hearing loss, and otogenic facial palsy. Electrophysiology and neuroscience approaches are needed in order to better elucidate the diagnostic dilemmas in the field of otology and neurotology. New treatment options will be discussed to improve potential methods of hearing restoration. We especially encourage submissions concerning hearing aids, cochlear/vestibular/auditory brainstem implantation, middle ear surgery, and stapedotomy.

Prof. Dr. George Psillas
Guest Editor

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Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

middle ear surgery
otosclerosis
sensorineural hearing loss
sudden hearing
cochlear implant

Related Special Issue

Hearing Disorders: Diagnosis, Management, and Future Opportunities: Part II in Journal of Clinical Medicine (10 articles)

Published Papers (13 papers)

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Editorial

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3 pages, 194 KiB

Open AccessEditorial

Autoimmune Hearing Loss: A Diagnostic Challenge

by George Psillas, Grigorios George Dimas, Christos Savopoulos and Jiannis Constantinidis

J. Clin. Med. 2022, 11(15), 4601; https://doi.org/10.3390/jcm11154601 - 7 Aug 2022

Viewed by 1622

Abstract

Autoimmune hearing loss (AIHL) is a clinical disease and may involve the deposition of immune complexes in the labyrinth vessels, the activation of the complement system, the functional alteration in T-cell subpopulations, or an inflammation process in the inner ear [...] Full article

(This article belongs to the Special Issue Hearing Disorders: Diagnosis, Management, and Future Opportunities)

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11 pages, 1466 KiB

Open AccessArticle

Correlation of Neutrophil-to-Lymphocyte Ratio and the Dilation of the Basilar Artery with the Potential Role of Vascular Compromise in the Pathophysiology of Idiopathic Sudden Sensorineural Hearing Loss

by Dae-Woong Kang, Seul Kim and Woongsang Sunwoo

J. Clin. Med. 2022, 11(19), 5943; https://doi.org/10.3390/jcm11195943 - 8 Oct 2022

Cited by 3 | Viewed by 1433

Abstract

Idiopathic sudden sensorineural hearing loss (SSNHL) currently lacks a clear etiology, as well as an effective treatment. One of the most probable explanations for SSNHL is impairment of the cochlear blood flow. However, dissimilar to a fundoscopic examination, direct observation of cochlear blood vessels is not possible. To indirectly support an ischemic etiology of SSNHL, we investigated whether the degree of initial hearing loss is associated with two atherosclerotic risk factors: dilatation of the basilar artery (BA) and a chronic subclinical inflammatory status measured by the neutrophil-to-lymphocyte ratio (NLR). This retrospective study collected data from 105 consecutive patients diagnosed with idiopathic SSNHL. Then, the patients were divided into two groups according to their NLR as “abnormally high NLR (>3.53, n = 22)” and “NLR within the normal range (0.78–3.53, n = 83)”. The BA diameter and severity of initial hearing loss were significantly correlated with each other in the abnormally high NLR group (p < 0.001). However, there was no significant correlation between initial hearing loss and the BA diameter in the normal NLR group (p = 0.299). Therefore, the NLR may serve as a marker for SSNHL of vascular etiology and a rationale for magnetic resonance imaging examinations based on the pathophysiology. Full article

(This article belongs to the Special Issue Hearing Disorders: Diagnosis, Management, and Future Opportunities)

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7 pages, 413 KiB

Open AccessArticle

Analysis of the Results of Cytomegalovirus Testing Combined with Genetic Testing in Children with Congenital Hearing Loss

by Yuan Jin, Xiaozhou Liu, Sen Chen, Jiale Xiang, Zhiyu Peng and Yu Sun

J. Clin. Med. 2022, 11(18), 5335; https://doi.org/10.3390/jcm11185335 - 11 Sep 2022

Cited by 1 | Viewed by 1510

Abstract

To improve the etiological diagnosis of congenital hearing loss by combining whole-exome sequencing (WES) with cytomegalovirus (CMV) testing and to explore the potential benefits of adding CMV screening to newborn hearing screening, 80 children under 2 years of age with bilateral sensorineural hearing loss were recruited. Peripheral venous blood was extracted from the children for WES analysis. Saliva after mouthwash and the first urine in the morning were collected and used as samples to quantify CMV DNA copy number in urine and saliva by qPCR; among the 80 children with congenital deafness, 59 (74%) were found to have genetic variants that may cause congenital deafness, including 44 with GJB2 or SLC26A4 gene variant, 1 with STRC gene variant, and 14 with other genetic variants. A total of 12 children carried deafness gene variants associated with a syndrome; CMV test results showed that in two children, the CMV DNA copy number in saliva was >1000/mL, which indicates that they were CMV-positive, and their genetic test results were negative. A neonatal CMV test combined with genetic screening can improve the etiological diagnosis rate of congenital deafness, and the direct evidence of neonatal CMV infection deserves further verification. Full article

(This article belongs to the Special Issue Hearing Disorders: Diagnosis, Management, and Future Opportunities)

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16 pages, 1164 KiB

Open AccessArticle

Functional Outcomes and Quality of Life after Cochlear Implantation in Patients with Long-Term Deafness

by Attila Ovari, Lisa Hühnlein, David Nguyen-Dalinger, Daniel Fabian Strüder, Christoph Külkens, Oliver Niclaus and Jens Eduard Meyer

J. Clin. Med. 2022, 11(17), 5156; https://doi.org/10.3390/jcm11175156 - 31 Aug 2022

Cited by 6 | Viewed by 1669

Abstract

Background: Hearing-related quality of life (QoL) after cochlear implantation (CI) is as important as audiological performance. We evaluated the functional results and QoL after CI in a heterogeneous patient cohort with emphasis on patients with long-term deafness (>10 years). Methods: Twenty-eight patients (n = 32 implanted ears, within n = 12 long-term deaf ears) implanted with a mid-scala electrode array were included in this retrospective mono-centric cohort study. Speech intelligibility for monosyllables (SIM), speech reception thresholds (SRT₅₀) and QoL with Nijmegen Cochlear Implant Questionnaire (NCIQ) were registered. Correlation of SIM and QoL was analyzed. Results: SIM and SRT₅₀ improved significantly 12 months postoperatively up to 54.8 ± 29.1% and 49.3 ± 9.6 dB SPL, respectively. SIM progressively improved up to 1 year, but some early-deafened, late implanted patients developed speech understanding several years after implantation. The global and all subdomain QoL scores increased significantly up to 12 months postoperatively and we found a correlation of SIM and global QoL score at 12 months postoperatively. Several patients of the “poor performer” (SIM < 40%) group reported high improvement of hearing-related QoL. Conclusions: Cochlear implantation provides a benefit in hearing-related QoL, even in some patients with low postoperative speech intelligibility results. Consequently, hearing-related QoL scores should be routinely used as outcome measure beside standard speech understanding tests, as well. Further studies with a prospective multi-centric design are needed to identify factors influencing post-implantation functional results and QoL in the patient group of long-term deafness. Full article

(This article belongs to the Special Issue Hearing Disorders: Diagnosis, Management, and Future Opportunities)

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17 pages, 1453 KiB

Open AccessArticle

A Prospective Study of Etiology and Auditory Profiles in Infants with Congenital Unilateral Sensorineural Hearing Loss

by Marlin Johansson, Eva Karltorp, Kaijsa Edholm, Maria Drott and Erik Berninger

J. Clin. Med. 2022, 11(14), 3966; https://doi.org/10.3390/jcm11143966 - 7 Jul 2022

Cited by 3 | Viewed by 1922

Abstract

Congenital unilateral sensorineural hearing loss (uSNHL) is associated with speech-language delays and academic difficulties. Yet, controversy exists in the choice of diagnosis and intervention methods. A cross-sectional prospective design was used to study hearing loss cause in twenty infants with congenital uSNHL consecutively recruited from a universal neonatal hearing-screening program. All normal-hearing ears showed ≤20 dB nHL auditory brainstem response (ABR) thresholds (ABRthrs). The impaired ear median ABRthr was 55 dB nHL, where 40% had no recordable ABRthr. None of the subjects tested positive for congenital cytomegalovirus (CMV) infection. Fourteen subjects agreed to participate in magnetic resonance imaging (MRI). Malformations were common for all degrees of uSNHL and found in 64% of all scans. Half of the MRIs demonstrated cochlear nerve aplasia or severe hypoplasia and 29% showed inner ear malformations. Impaired ear and normal-hearing ear ABR input/output functions on a group level for subjects with ABRthrs < 90 dB nHL were parallel shifted. A significant difference in interaural acoustic reflex thresholds (ARTs) existed. In congenital uSNHL, MRI is powerful in finding a possible hearing loss cause, while congenital CMV infection may be relatively uncommon. ABRs and ARTs indicated an absence of loudness recruitment, with implications for further research on hearing devices. Full article

(This article belongs to the Special Issue Hearing Disorders: Diagnosis, Management, and Future Opportunities)

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11 pages, 958 KiB

Open AccessArticle

Video Head Impulse Test (vHIT): Value of Gain and Refixation Saccades in Unilateral Vestibular Neuritis

by George Psillas, Ioanna Petrou, Athanasia Printza, Ioanna Sfakianaki, Paris Binos, Sofia Anastasiadou and Jiannis Constantinidis

J. Clin. Med. 2022, 11(12), 3467; https://doi.org/10.3390/jcm11123467 - 16 Jun 2022

Cited by 8 | Viewed by 2582

Abstract

The aim of this study was to evaluate gain and refixation saccades (covert and overt) using a video head impulse test (vHIT) in the horizontal and vertical planes in patients after the onset of unilateral acute vestibular neuritis (AVN). Thirty-five patients were examined in the acute stage of AVN and at follow-up (range, 6–30 months); a control group of 32 healthy subjects also participated. At onset, the mean gain was significantly lower on the affected side in all of the semi-circular canal planes, mainly in the horizontal canal plane, and saccades (covert and overt) were more prevalent in the horizontal compared to the vertical canal planes. Multi-canal affection occurred more frequently (80% for gain, 71% for saccades) than isolated canal affection. At follow-up, which ranged from 6 to 30 months, the gain was recovered in all of the canals (anterior in 50%, horizontal in 42.8%, and posterior canal in 41.1% of cases), while covert and overt saccades were reduced in the horizontal and vertical planes. However, covert saccades were still recorded in a greater proportion (69%) than overt saccades (57%) in the horizontal plane and at a lower rate in the vertical planes. The compensatory mechanisms after AVN mainly involve the horizontal canal, as the refixation saccades—especially covert ones—were more frequently recorded in the horizontal than vertical canals. Full article

(This article belongs to the Special Issue Hearing Disorders: Diagnosis, Management, and Future Opportunities)

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13 pages, 2279 KiB

Open AccessArticle

Hearing Benefits of Clinical Management for Meniere’s Disease

by Yi Zhang, Chenyi Wei, Zhengtao Sun, Yue Wu, Zhengli Chen and Bo Liu

J. Clin. Med. 2022, 11(11), 3131; https://doi.org/10.3390/jcm11113131 - 31 May 2022

Cited by 2 | Viewed by 2676

Abstract

Meniere’s disease is a progressive hearing–disabling condition. Patients can benefit from strict clinical management, including lifestyle and dietary counseling, and medical treatment. A prospective cohort study was carried out with 154 patients with definite Meniere’s disease, with an average age of 43.53 ± 11.40, and a male to female ratio of 0.97:1. The pure-tone thresholds of all 165 affected ears, over a one-year clinical management period, were analyzed. After one year, 87.27% of patients had improved or preserved their hearing at a low frequency, and 71.51% at a high frequency. The hearing threshold at frequencies from 250 Hz to 2000 Hz had improved significantly (p < 0.001, p < 0.001, p < 0.001, p < 0.01), and deteriorated slightly at 8000 Hz (p < 0.05). Of all the patients, 40.00% had a hearing average threshold that reached ≤25 dB HL after the clinical management period, among whom 27.27% were patients in stage 3. The restoration time was 2.5 (1.0, 4.125) months, with a range of 0.5–11.0 months, and the restoration time was longer for stage 3 than for stages 1 and 2 (u = −2.542, p < 0.05). The rising curves improved the most (p < 0.05), with most becoming peaks, whereas most peaks and flats remained the same. Patients who were initially in the earlier stages (95% CI 1.710~4.717, OR 2.840, p < 0.001), have an increased odds ratio of hearing by an average of ≤25 dB HL. Age (95% CI 1.003~1.074, OR 1.038, p = 0.031), peak curve (95% CI 1.038~5.945, OR = 2.484, p = 0.041), and flat curve (95% CI 1.056~19.590, OR = 4.549, p = 0.042), compared with the rising curve, increase the odds ratio of hearing on average by >25 dB HL. Most patients can have their hearing preserved or improved through strict clinical management, and sufficient follow-up is also essential. Stage 3 patients also have the potential for hearing improvement, although the restoration time is longer than in the early stages. The initial hearing stage, age, and audiogram pattern are related to the hearing benefits. Full article

(This article belongs to the Special Issue Hearing Disorders: Diagnosis, Management, and Future Opportunities)

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14 pages, 1019 KiB

Open AccessArticle

Candidacy for Cochlear Implantation in Prelingual Profoundly Deaf Adult Patients

by Ghizlene Lahlou, Hannah Daoudi, Evelyne Ferrary, Huan Jia, Marion De Bergh, Yann Nguyen, Olivier Sterkers and Isabelle Mosnier

J. Clin. Med. 2022, 11(7), 1874; https://doi.org/10.3390/jcm11071874 - 28 Mar 2022

Cited by 5 | Viewed by 2204

Abstract

Cochlear implantation is usually not recommended for prelingual profoundly deaf adults, although some of these patients might benefit from it. This study aims to define the candidates for cochlear implantation in this population. This retrospective study reviewed 34 prelingual profoundly deaf patients who had received a cochlear implant at 32 ± 1.7 years old (16–55), with at least 1 year of follow-up. Speech perception and quality of life were assessed before and 3, 6, and 12 months after cochlear implantation, then every year thereafter. According to the word speech intelligibility in quiet (WSI) 1 year after implantation, two groups were identified: good performer (GP) with WSI ≥ 50% (n = 15), and poor performer (PP) with WSI ≤ 40% (n = 19). At the 1 year mark, mean WSI improved by 28 ± 4.6% (−20–100) (p < 0.0001). In GP, the intelligibility for words and sentences, communication and quality of life scales improved. In PP, the communication scale improved, but not auditory performance or quality of life. GP and PP differed pre-operatively in speech production, communication abilities, and WSI in best-aided conditions. In prelingual profoundly deaf adults, a dramatic auditory performance benefit could be expected after cochlear implantation if the patients have some degree of speech intelligibility in aided conditions and have developed oral communication and speech production. Full article

(This article belongs to the Special Issue Hearing Disorders: Diagnosis, Management, and Future Opportunities)

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10 pages, 913 KiB

Open AccessArticle

Clinical and Genetic Characteristics of Finnish Patients with Autosomal Recessive and Dominant Non-Syndromic Hearing Loss Due to Pathogenic TMC1 Variants

by Minna Kraatari-Tiri, Maria K. Haanpää, Tytti Willberg, Pia Pohjola, Riikka Keski-Filppula, Outi Kuismin, Jukka S. Moilanen, Sanna Häkli and Elisa Rahikkala

J. Clin. Med. 2022, 11(7), 1837; https://doi.org/10.3390/jcm11071837 - 26 Mar 2022

Cited by 2 | Viewed by 1772

Abstract

Sensorineural hearing loss (SNHL) is one of the most common sensory deficits worldwide, and genetic factors contribute to at least 50–60% of the congenital hearing loss cases. The transmembrane channel-like protein 1 (TMC1) gene has been linked to autosomal recessive (DFNB7/11) and autosomal dominant (DFNA36) non-syndromic hearing loss, and it is a relatively common genetic cause of SNHL. Here, we report eight Finnish families with 11 affected family members with either recessively inherited homozygous or compound heterozygous TMC1 variants associated with congenital moderate-to-profound hearing loss, or a dominantly inherited heterozygous TMC1 variant associated with postlingual progressive hearing loss. We show that the TMC1 c.1534C>T, p.(Arg512*) variant is likely a founder variant that is enriched in the Finnish population. We describe a novel recessive disease-causing TMC1 c.968A>G, p.(Tyr323Cys) variant. We also show that individuals in this cohort who were diagnosed early and received timely hearing rehabilitation with hearing aids and cochlear implants (CI) have reached good speech perception in noise. Comparison of the genetic data with the outcome of CI rehabilitation increases our understanding of the extent to which underlying pathogenic gene variants explain the differences in CI rehabilitation outcomes. Full article

(This article belongs to the Special Issue Hearing Disorders: Diagnosis, Management, and Future Opportunities)

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10 pages, 537 KiB

Open AccessArticle

Prognostic Factors Associated with Recovery from Recurrent Idiopathic Sudden Sensorineural Hearing Loss: Retrospective Analysis and Systematic Review

by So Young Jeon, Dae Woong Kang, Sang Hoon Kim, Jae Yong Byun and Seung Geun Yeo

J. Clin. Med. 2022, 11(5), 1453; https://doi.org/10.3390/jcm11051453 - 7 Mar 2022

Cited by 4 | Viewed by 2633

Abstract

Although idiopathic sudden sensorineural hearing loss (ISSNHL) is uncommon, recurrent ISSNHL is even rarer. The knowledge about factors associated with patient recovery from recurrent episodes is needed to counsel and treat the patients. Medical records of patients admitted for high dose oral steroid therapy for recurrent ISSNHL between January 2009 and December 2021 were reviewed. Their demographic and clinical characteristics, co-morbid symptoms, and audiologic results were analyzed. The 38 patients admitted for treatment of recurrent ISSNHL included 14 men and 24 women. Recovery rates after the first and recurrent episodes of ISSNHL were 78.9% and 63.2%, respectively. Patients who recovered after recurrent episodes showed significantly higher rates of ear fullness symptoms and early treatment onset than those who did not recover (p < 0.05 each). Of the 30 patients who recovered after the first episode, those who had ear fullness symptoms (p < 0.05, odds ratio (OR) 0.1, 95% confidence interval (CI) 0.01–0.76) and who showed a lower initial hearing threshold (p < 0.05, OR 1.06, 95% CI 1.01–1.12) during the recurrent episode showed significantly better or similar recovery than after the first episode. Ear fullness symptoms and less initial hearing loss were associated with a more favorable prognosis after intial than after recurrent ISSNHL. Full article

(This article belongs to the Special Issue Hearing Disorders: Diagnosis, Management, and Future Opportunities)

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11 pages, 378 KiB

Open AccessArticle

Association of Metabolic Syndrome with Sensorineural Hearing Loss

by Hwa-Sung Rim, Myung-Gu Kim, Dong-Choon Park, Sung-Soo Kim, Dae-Woong Kang, Sang-Hoon Kim and Seung-Geun Yeo

J. Clin. Med. 2021, 10(21), 4866; https://doi.org/10.3390/jcm10214866 - 22 Oct 2021

Cited by 10 | Viewed by 2239

Abstract

The prevalence of sensorineural hearing loss has increased along with increases in life expectancy and exposure to noisy environments. Metabolic syndrome (MetS) is a cluster of co-occurring conditions that increase the risk of heart disease, stroke and type 2 diabetes, along with other conditions that affect the blood vessels. Components of MetS include insulin resistance, body weight, lipid concentration, blood pressure, and blood glucose concentration, as well as other features of insulin resistance such as microalbuminuria. MetS has become a major public health problem affecting 20–30% of the global population. This study utilized health examination to investigate whether metabolic syndrome was related to hearing loss. Methods: A total of 94,223 people who underwent health check-ups, including hearing tests, from January 2010 to December 2020 were evaluated. Subjects were divided into two groups, with and without metabolic syndrome. In addition, Scopus, Embase, PubMed, and Cochrane libraries were systematically searched, using keywords such as “hearing loss” and “metabolic syndrome”, for studies that evaluated the relationship between the two. Results: Of the 94,223 subjects, 11,414 (12.1%) had metabolic syndrome and 82,809 did not. The mean ages of subjects in the two groups were 46.1 and 43.9 years, respectively. A comparison of hearing thresholds by age in subjects with and without metabolic syndrome showed that the average pure tone hearing thresholds were significantly higher in subjects with metabolic syndrome than in subjects without it in all age groups. (p < 0.001) Rates of hearing loss in subjects with 0, 1, 2, 3, 4, and 5 of the components of metabolic syndrome were 7.9%, 12.1%, 13.8%, 13.8%, 15.5% and 16.3%, respectively, indicating a significant association between the number of components of metabolic syndrome and the rate of hearing loss (p < 0.0001). The odds ratio of hearing loss was significantly higher in subjects with four components of metabolic syndrome: waist circumference, blood pressure, and triglyceride and fasting blood sugar concentrations (p < 0.0001). Conclusions: The number of components of the metabolic syndrome is positively correlated with the rate of sensorineural hearing loss. Full article

(This article belongs to the Special Issue Hearing Disorders: Diagnosis, Management, and Future Opportunities)

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14 pages, 1839 KiB

Open AccessArticle

Clinical and Cytokine Profile in Patients with Early and Late Onset Meniere Disease

by Maria-Del-Carmen Moleon, Estrella Martinez-Gomez, Marisa Flook, Andreina Peralta-Leal, Juan Antonio Gallego, Hortensia Sanchez-Gomez, Maria Alharilla Montilla-Ibañez, Emilio Dominguez-Durán, Andres Soto-Varela, Ismael Aran, Lidia Frejo and Jose A. Lopez-Escamez

J. Clin. Med. 2021, 10(18), 4052; https://doi.org/10.3390/jcm10184052 - 7 Sep 2021

Cited by 17 | Viewed by 2526

Abstract

Background: Meniere disease (MD) is an inner ear disorder associated with comorbidities such as autoimmune diseases or migraine. This study describes clinical and cytokine profiles in MD according to the age of onset of the condition. Methods: A cross-sectional study including 83 MD patients: 44 with early-onset MD (EOMD, <35 years old), and 39 with late-onset MD (LOMD, >50 years old), 64 patients with migraine and 55 controls was carried out. Clinical variables and cytokines levels of CCL3, CCL4, CCL18, CCL22, CXCL,1 and IL-1β were compared among the different groups. Results: CCL18 levels were higher in patients with migraine or MD than in controls. Elevated levels of IL-1β were observed in 11.4% EOMD and in 10.3% LOMD patients and these levels were not dependent on the age of individuals. EOMD had a longer duration of the disease (p = 0.004) and a higher prevalence of migraine than LOMD (p = 0.045). Conclusions: Patients with EOMD have a higher prevalence of migraine than LOMD, but migraine is not associated with any cytokine profile in patients with MD. The levels of CCL18, CCL3, and CXCL4 were different between patients with MD or migraine and controls. Full article

(This article belongs to the Special Issue Hearing Disorders: Diagnosis, Management, and Future Opportunities)

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Review

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Risk Factors for Recurrence of Benign Paroxysmal Positional Vertigo. A Clinical Review

by Ioanna Sfakianaki, Paris Binos, Petros Karkos, Grigorios G. Dimas and George Psillas

J. Clin. Med. 2021, 10(19), 4372; https://doi.org/10.3390/jcm10194372 - 24 Sep 2021

Cited by 19 | Viewed by 6409

Abstract

Benign paroxysmal positional vertigo (BPPV) is one of the most common peripheral vestibular dysfunctions encountered in clinical practice. Although the treatment of BPPV is relatively successful, many patients develop recurrence after treatment. Our purpose is to evaluate the mean recurrence rate and risk factors of BPPV after treatment. A review of the literature on the risk factors of BPPV recurrence was performed. A thorough search was conducted using electronic databases, namely Pubmed, CINAHL, Academic Search Complete and Scopus for studies published from 2000 to 2020. Thirty studies were included in this review with 13,358 participants. The recurrence rate of BPPV ranged from 13.7% to 48% for studies with follow-up <1 year, and from 13.3% to 65% for studies with follow-up ≥2 years. Pathophysiologic mechanisms and implication of each of the following risk factors in the recurrence of BPPV were described: advanced age, female gender, Meniere’s disease, trauma, osteopenia or osteoporosis, vitamin D deficiency, diabetes mellitus, hypertension, hyperlipidemia, cardiovascular disease, migraine, bilateral/multicanal BPPV, cervical osteoarthrosis and sleep disorders. Patients with hyperlipidemia and hypertension had the highest recurrence rates of BPPV, 67.80% and 55.89%, respectively, indicating that vascular comorbidities increase the risk of BPPV recurrence. In addition, more than half of patients (53.48%) with diabetes mellitus and BPPV experienced recurrence of BPPV. Knowledge and awareness of risk factors for recurrence of BPPV are essential for the assessment and long-term prognosis of patients. Identification of these relapse risk factors may enhance the ability of clinicians to accurately counsel patients regarding BPPV and associated comorbidities. Full article

(This article belongs to the Special Issue Hearing Disorders: Diagnosis, Management, and Future Opportunities)

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