Search Results (153)

Background: Superior semicircular canal dehiscence (SSCD) is characterized by a bony defect of the superior semicircular canal (SSC), leading to vestibular and auditory symptoms. A process of spontaneous “auto-plugging,” in which the overlying dura mater progressively occludes the SSC, may replicate the effects of surgical canal plugging but remains under-recognized. The present study reports diverse clinical, instrumental, and 3d High Resolution MRI findings in patients with SSCD and subsequently confirmed to present with spontaneous complete or partial auto-plugging. Methods: We retrospectively reviewed 11 patients with SSCD diagnosed on high-resolution CT and suspected auto-plugging based on clinical atypia and large dehiscence (>4 mm). Patients underwent comprehensive neurotological assessment, including pure-tone audiometry, vestibular testing, and HR MRI with 3D labyrinthine reconstructions to identify partial or complete auto-plugging. Auto-plugging was classified as partial (Canalis semicircularis superior depressus) or complete (absence of endolymph fluid signal; Canalis semicircularis superior obturatus). Results: Among 13 ears with auto-plugging, 6 were partial and 7 complete. The mean SSCD size in auto-plugged ears was 5.5 mm. Most ears had normal or near-normal vestibular function on VHIT, with minimal air-bone gaps and preserved VEMP responses. Imaging demonstrated varying degrees of dural contact with the SSC, confirming partial or complete canal occlusion. Conclusions: Spontaneous auto-plugging of the SSC is a plausible, under-recognized phenomenon that may reproduce functional effects of surgical plugging. Dedicated 3D labyrinthine MRI enhances detection and characterization. Prospective multimodal studies are needed to clarify the pathophysiology, progression, and clinical implications, optimizing patient selection for surgical versus conservative management. Full article

Background/Objectives: Shift work in healthcare professionals affects performance in high cognitive processing, especially in complex environments. However, the beneficial effects that working in complex environments may have on auditory–cognitive processing remain unknown. These professionals face increased challenges in decision-making due to factors such as noise exposure and sleep disturbances, which may lead to the development of enhanced auditory–cognitive resources. This study aims to investigate the associations between shift work and auditory–cognitive processing in middle-aged healthcare workers. Methods: Thirty middle-aged healthcare workers were equally allocated to a shift worker (SW) or a fixed-schedule worker (FSW) group. Performance on a cognitive test, and in pure-tone audiometry, speech in quiet and noise, and listening effort were used to explore whether correlations were specific to shift work. Results: Exploratory analyses indicated that shift workers tended to perform better in visuospatial/executive function, memory recall, memory index, orientation, and total MoCA score domains compared to fixed-schedule workers. In the SW group, hearing thresholds correlated with memory recall and memory index. In the FSW group, hearing thresholds correlated with orientation, memory index, and total MoCA score, while listening effort correlated with naming, and speech intelligibility in quiet correlated with total MoCA scores. Conclusions: These exploratory findings suggest that shift work may be linked to distinct auditory–cognitive patterns, with potential compensatory mechanisms in visuospatial/executive functions and memory among middle-aged healthcare workers. Larger, longitudinal studies are warranted to confirm whether these patterns reflect true adaptive mechanisms. Full article

Background: Recreational noise exposure from personal listening devices (PLDs) may lead to hidden hearing loss (HHL), affecting auditory nerve function despite normal pure-tone audiometry (PTA) and otoacoustic emissions (OAE). Subclinical auditory damage at the synaptic level often goes undetected by conventional assessments, emphasizing the need for more sensitive measures. Recorded click ABR in the presence of various levels of ipsilateral maskers for the better identification of auditory damage at the synaptic level. These results could help to develop a better objective diagnostic tool that can detect hidden hearing loss. Objective: To examine the effects of PLD usage on extended high-frequency audiometric thresholds and on click-evoked auditory brainstem responses (ABR) with and without ipsilateral masking in individuals with normal hearing. Materials and Methods: Thirty-five young adults aged 18–35 years (18 PLD users, 17 controls) with clinically normal hearing were recruited. Extended high-frequency audiometry (EHFA) was conducted from 9 to 16 kHz. Click-evoked ABRs were recorded at 80 dB nHL under unmasked and ipsilateral broadband noise-masked conditions at 50, 60, and 70 dB SPL. ABR analyses included absolute and relative amplitude (V/I) and latencies of waves I, III, and V. Results: PLD users demonstrated significantly elevated extended high-frequency thresholds compared to controls. ABR analyses revealed reduced Wave I amplitudes across stimulus conditions in PLD users, while Wave V amplitudes were largely preserved, resulting in consistently higher V/I amplitude ratios under masked conditions. No group differences were observed for Wave III amplitudes or absolute/interpeak latencies, except for a modest prolongation of I–III latency at one masker level in PLD users. Conclusions: Conventional audiological tests may not detect early auditory damage; however, extended high-frequency audiometry and ABR with ipsilateral masking demonstrate greater sensitivity in identifying noise-induced functional changes within the auditory brainstem pathways. Full article

Background and Objectives: This study aimed to investigate the influence of continuous positive airway pressure in patients with obstructive sleep apnoea on hearing and the possibility of recovering cochlear receptor cells. Materials and Methods: Forty-two patients with obstructive sleep apnoea (OSA) were assigned to the study group. Patients underwent pure-tone audiometry and transient-evoked (TEOAE) and distortion-product (DPOAE) otoacoustic emissions before starting continuous positive airway pressure (CPAP) therapy and six months after CPAP therapy. Subjects were further divided into the following two groups: those who adequately used the therapy and those who did not adhere to treatment recommendations. Results: There is no significant difference in hearing thresholds for specific frequencies after six months of CPAP therapy. There is no significant difference in TEOAE and DPOAE SNR values at any frequency after 6 months of CPAP therapy. There is no significant difference in hearing threshold results for specific frequencies as a function of subject co-operation with treatment. After therapy, there is a significant difference in the SNR values in TEOAEs at 2 kHz and 4 kHz in subjects of the OSA target group, depending on co-operation, being higher in co-operative subjects, while there are no significant differences at other frequencies. There is a significant difference in the SNR results in DPOAEs, where they are higher in co-operative subjects at 1000, 6000, 7000 and 8000 Hz. Conclusions: The use of continuous positive airway pressure as a therapy for OSA has no effect on hearing and cochlear receptor cell recovery. Co-operation with CPAP treatment does not affect hearing threshold, but does affect cochlear receptor cell function, which is better at mid and higher frequencies in those who co-operate. These findings underscore the clinical significance of treatment adherence. Consistent adherence is associated with measurable improvements in hearing, particularly at higher frequencies, which cannot typically be evaluated in routine clinical practice using standard pure-tone audiometry. Our results emphasise the importance of promoting compliance with CPAP therapy not only for cardiovascular and neurological protection, but also for maintaining hearing health. Full article

Background/Objectives: Hearing loss is a prevalent sensory impairment in older adults, linked to reduced quality of life, cognitive decline, and social isolation. While it usually begins in the high-frequency range, some individuals present with isolated low-frequency hearing loss (LFHL). The long-term prognostic implications of such frequency-specific patterns remain unclear. This study aimed to evaluate the risk of long-term hearing deterioration by initial hearing loss type: LFHL, high-frequency hearing loss (HFHL), and combined-frequency hearing loss (CFHL). Methods: We retrospectively analyzed pure-tone audiometry (PTA) data from 10,261 patients who underwent at least two pure-tone audiometry assessments between 2011 and 2022 at a tertiary hospital. Each ear was treated as an independent observation. Hearing loss was defined as a threshold > 20 dB HL at 250, 500, 4000, or 8000 Hz. Participants were classified into normal hearing (NH), LFHL, HFHL, and CFHL groups. The outcome was a final four-frequency pure-tone average (4PTA) ≥ 40 dB HL. Logistic regression adjusted for age and sex was used, with subgroup analyses by follow-up duration. Results: HFHL (OR = 1.66, 95% CI: 1.47–1.89) and CFHL (OR = 2.23, 95% CI: 1.97–2.53) showed significantly higher risks of hearing loss compared with NH. LFHL did not show a significant increase (OR = 0.94, 95% CI: 0.76–1.16). These results were consistent across follow-up durations, with CFHL showing the most extensive deterioration. Conclusion: HFHL is a strong predictor of long-term auditory decline, and risk is further elevated with CFHL. In contrast, isolated LFHL was not associated with increased risk, suggesting relatively favorable outcomes. Frequency-specific classification may aid risk stratification and long-term monitoring strategies. Full article

Background: Despite the widespread use of antibiotics, acute mastoiditis (AM) and related complications resulting from acute purulent otitis media continue to occur, predominantly in children. Although numerous studies have focused on the pathogenesis, aetiological agents, and treatment of AM, comprehensive investigations of the long-term outcomes of AM and the physiological consequences of surgical intervention in the temporal bone are lacking. Methods: Thirty patients who had undergone mastoidectomy for acute mastoiditis at a median age of 2.12 years were invited for evaluation at least five years postoperatively. The assessment included the Chronic Otitis Media Questionnaire 12, clinical examination with otomicroscopy, extended high-frequency pure-tone audiometry, distortion product otoacoustic emissions, middle ear impedance testing, and a newly developed protocol for noninvasive mastoid function measurement. Results were compared with a control group of 30 ears and with a group of 30 ears treated solely with tympanostomy for acute otitis media at risk of mastoiditis. Results: Although mean Chronic Otitis Media Questionnaire 12 scores were below 1 point, patients who had undergone mastoidectomy reported slightly greater difficulties with hearing in both quiet and noisy environments, along with an increased perception of tinnitus and unpleasant sensations around the ear. Otomicroscopy revealed minor structural changes in the test groups, which were absent from the control group. Pure-tone audiometry demonstrated approximately 10 dB higher thresholds at high and extended high frequencies, with similar findings observed in the distortion product otoacoustic emissions. Middle ear impedance testing indicated elevated stapedius reflex thresholds in the mastoidectomy group, while other parameters showed no statistically significant differences. Mastoid function testing demonstrated preserved pressure-buffering capacity but reduced thermal insulation of the vestibular organ under extreme thermal stimulation—an occurrence rarely encountered in daily life. Conclusions: In the long term, most patients recovering from acute mastoiditis exhibit only minor functional and structural sequelae, and the impact of mastoidectomy appears negligible compared with less invasive surgical interventions. Full article

Background/Objectives: This study evaluated the feasibility of predicting bone conduction (BC) thresholds and classifying air–bone gap (ABG) status using only air conduction (AC) data obtained from pure tone audiometry (PTA). Methods: A total of 60,718 PTA records from five tertiary hospitals in the Republic of Korea were utilized. Input features included AC thresholds (0.25–8 kHz), age, and sex, while outputs were BC thresholds (0.25–4 kHz) and ABG classification based on 10 dB and 15 dB criteria. Five machine learning models—deep neural network (DNN), long short-term memory (LSTM), bidirectional LSTM (BiLSTM), random forest (RF), and extreme gradient boosting (XGB)—were trained using 5-fold cross-validation with Synthetic Minority Over-sampling Technique (SMOTE). Model performance was evaluated based on accuracy, sensitivity, precision, and F1 score under ±5 dB and ±10 dB thresholds for BC prediction. Results: LSTM and BiLSTM outperformed DNN in predicting BC thresholds, achieving ~60% accuracy within ±5 dB and ~80% within ±10 dB. For ABG classification, all models performed better with the 10 dB criterion than the 15 dB. Tree-based models (RF, XGB) achieved the highest classification accuracy (up to 0.512) and precision (up to 0.827). Confidence intervals for all metrics were within ±0.01, indicating stable results. Conclusions: AI models can accurately predict BC thresholds and ABG status using AC data alone. These findings support the integration of AI-driven tools into clinical audiology and telemedicine, particularly for remote screening and diagnosis. Future work should focus on clinical validation and implementation to expand accessibility in hearing care. Full article

Background/Objectives: Obstructive Eustachian tube dysfunction (OETD) is common in adults and may lead to middle-ear conditions such as atelectasis and cholesteatoma. The ETDQ-7 questionnaire is used to assess symptom severity. Balloon dilation of the Eustachian tube (BDET) is a minimally invasive treatment with variable outcomes. This review evaluates the safety and effectiveness of BDET. Methods: A systematic review was conducted following PRISMA 2020 guidelines. Four databases (PubMed, Scopus, Cochrane, Web of Science) were searched using ETD- and BDET-related terms, with the last search on 11 April 2025. Randomized trials were selected based on predefined criteria, and data were extracted by two independent reviewers. Discrepancies were resolved by consensus. Results: This systematic review included 14 studies on BDET published between 2013 and 2025. BDET improved otoscopic findings, Valsalva maneuver (VM) performance, and tympanometry (TMM), particularly within the first 6 weeks. ETDQ-7 scores generally indicated symptom improvement, though pure tone audiometry (PTA) showed no significant changes. Most procedures were performed under general anesthesia, with some studies showing similar outcomes under local anesthesia. Combining BDET with other interventions produced mixed results. Reported complications were rare. Conclusions: BDET is a safe, low-risk procedure that effectively reduces tympanic membrane retraction and improves VM and TMM results. While it relieves ETD symptoms in many patients, evidence for long-term efficacy and impact on PTA is limited. Full article

Objective: To evaluate the outcomes of a modified infratemporal fossa approach (ITFA) that preserves the posterior external auditory canal (EAC) in patients with tumors in the infratemporal fossa and skull base, focusing on postoperative hearing and facial nerve function. Methods: This retrospective study included nine patients who underwent ITFA with posterior EAC preservation for tumor removal while minimizing facial nerve rerouting. All surgeries were performed by a single surgeon. Preoperative and postoperative hearing levels, facial nerve function, tumor characteristics, and surgical outcomes were analyzed. Air-bone gaps (ABG) were assessed using pure tone audiometry, and facial nerve function was assessed using the House–Brackmann grading system. Results: The cohort consisted of eight female patients and one male patient, with a mean tumor size of 3.0 cm. Surgical outcomes were promising, with no statistically significant increase in postoperative ABG and well-preserved facial nerve function. Only one patient developed postoperative grade II facial palsy. A residual tumor was identified in one case with extensive meningioma, which has remained stable, and no recurrence or regrowth was noted during the follow-up period (mean: 3.7 years). The modified approach minimized complications related to conductive hearing loss and facial nerve dysfunction. Conclusions: The modified ITFA with posterior EAC preservation provides a promising alternative to conventional ITFA for managing deep-seated tumors. It preserves both hearing and facial nerve function while ensuring adequate tumor resection. Full article

Background/Objectives: Cochlear “injury” is thought to be a significant cause of tinnitus in patients with hearing loss. Interestingly, individuals with normal hearing may also experience tinnitus. This study evaluates otoacoustic distortion product emissions (DPOAEs) in individuals with normal hearing who experience tinnitus perception. Methods: In this prospective study, the tinnitus group (TG) consisted of 34 subjects with tinnitus (four unilaterally) and normal hearing (threshold ≤ 25 dBHL at 0.25–8 kHz). The control group (CG) comprised 10 healthy volunteers (20 ears) without tinnitus and normal hearing. Medical history was recorded, and all participants underwent a complete otolaryngological examination, pure tone audiometry, and DPOAE recording (DP-gram, L1 = 55 dB, L2 = 65 dB, for F2: 619–10,000 Hz). Moreover, participants in the TG completed a detailed tinnitus history (with self-rated loudness scoring) and the Tinnitus Handicap Inventory (Greek-version THI-G) and underwent tinnitus analysis. Results: The recorded mean DPOAE values during the DP-gram of the CG were significantly larger in amplitude at low (t-test, Bonferroni-corrected p < 0.09) and high frequencies (t-test, Bonferroni-corrected p < 0.02) compared with the TG. Tinnitus assessment showed tinnitus pitch matching at the frequency area in the DP-gram, where the acceptance recording criteria were not met. There were no statistically significant differences in tinnitus onset, self-rated loudness scores of >70, and severe disability (THI-G > 58) for TG subjects in whom DPOAEs were not recorded at frequencies of ≤1000 Hz. Participants with abnormal DPOAEs at around 4000 Hz had tinnitus of sudden onset and severe disability (THI-G > 58). Finally, those with pathological recordings of DPOAEs at ≥6000 Hz had gradual onset tinnitus (Pearson Chi-square test, p < 0.05). Conclusions: DPOAEs in normal hearing individuals with tinnitus show lower amplitudes in low and high frequencies compared with normal hearing individuals without tinnitus. The tinnitus matched-frequency coincided with the frequency area where DPOAEs were abnormal. Full article

Objectives: Tinnitus, defined as the perception of sound without an external stimulus, is a complex condition with unclear etiology. Emerging evidence suggests a link between vascular dysfunction, particularly arterial stiffness, and tinnitus. This study aimed to evaluate vertebral artery stiffness in patients with idiopathic subjective tinnitus and assess the utility of Doppler ultrasonography as a non-invasive diagnostic tool. Materials and Methods: In this prospective study, 31 patients with idiopathic tinnitus (11 males, 20 females; mean age: 50.42 ± 9.64 years) and 24 healthy controls (12 males, 12 females; mean age: 39.67 ± 10.63 years) underwent comprehensive clinical evaluations, including pure tone audiometry, blood tests, and vertebrobasilar Doppler ultrasonography. Vertebral artery stiffness index (VAS), resistive index (RI), and pulsatility index (PI) were measured bilaterally. Results: A total of 31 patients with idiopathic subjective tinnitus and 24 healthy controls were evaluated. The mean age was significantly higher in the tinnitus group compared to controls (50.42 ± 9.64 vs. 39.67 ± 10.63 years, p < 0.001). Lipid profile analysis revealed significantly higher levels of total cholesterol (193.6 ± 47.28 vs. 167.5 ± 28.99 mg/dL, p = 0.021), LDL (149.4 ± 37.9 vs. 106.1 ± 10.7 mg/dL, p < 0.005), and triglycerides (202.2 ± 83.5 vs. 148.6 ± 26.4 mg/dL, p < 0.005) in tinnitus patients. Doppler ultrasonography demonstrated significantly higher vertebral artery stiffness values in the tinnitus group (left: 2.87 ± 0.72 vs. 2.12 ± 0.22; right: 2.99 ± 0.77 vs. 2.14 ± 0.5; both p < 0.005). Similarly, pulsatility index (PI) was significantly elevated in patients compared to controls (left: 2.45 ± 1.2 vs. 1.2 ± 0.43; right: 2.49 ± 1.02 vs. 1.19 ± 0.42; both p < 0.005). No significant differences were observed in resistive index (RI) or vertebral artery diameters between groups. Among tinnitus patients, PI and VAS were significantly higher on the side corresponding to reported tinnitus symptoms (p < 0.05), suggesting a lateralized vascular contribution. Conclusions: The findings suggested a potential relationship between idiopathic subjective tinnitus and vertebral artery stiffness. We demonstrated the utility of Doppler ultrasonography, a cost-effective and non-invasive imaging modality, for evaluating vascular parameters in tinnitus patients, paving the way for broader clinical applications. By uncovering a significant association between vertebral artery stiffness and tinnitus, our findings suggest that vascular health assessments could enhance diagnostic and therapeutic strategies for tinnitus management. Full article

Background/Objectives: Menière’s disease (MD) is a debilitating disorder with episodic and variable ear symptoms. Diagnosis can be challenging, and evidence for therapeutic approaches is low. Furthermore, patients show a unique and fluctuating configuration of audiovestibular impairment. As a psychometric instrument to assess hearing-specific disability is currently lacking, we evaluated a short form of the Speech, Spatial, and Qualities of Hearing Scale (SSQ) in a cohort of patients with MD. Methods: Data was collected in the context of a multicenter prospective patient registry intended for the long-term follow up of MD patients. Hearing was assessed by pure tone and speech audiometry. The SSQ was applied in the German language version with 17 items. Results: In total, 97 consecutive patients with unilateral MD with a mean age of 56.2 ± 5.0 years were included. A total of 55 individuals (57.3%) were female, and 72 (75.0%) were categorized as having definite MD. The average total score of the SSQ was 6.0 ± 2.1. Cronbach’s alpha for internal consistency was 0.960 for the total score. We did not observe undue floor or ceiling effects. SSQ values showed a statistically negative correlation with hearing thresholds and a statistically positive correlation with speech recognition scores of affected ears. Conclusions: The short form of the SSQ provides insight into hearing-specific disability in patients with MD. Therefore, it may be informative regarding disease stage and rehabilitation needs. Full article

Background/Objectives: Tonal thresholds, typically assessed through pure-tone audiometry (PTA), are central to the audiological evaluation of Ménière’s disease (MD). However, they fail to capture the complexity of real-life speech perception. This study aimed to characterize the relationship between PTA and speech recognition performance in unilateral MD and to determine whether a measurable dissociation exists between hearing sensitivity and verbal processing. We also evaluated frequency-specific audiometric patterns and potential threshold cut-off values associated with speech recognition decline. Methods: A total of 254 ears from 127 patients were included in the study across three groups: the Ménière group (affected and unaffected ears, n = 64 each) and the control group (n = 63). The pure-tone thresholds, speech recognition threshold (SRT), and the maximum word recognition scores (Rmax) were assessed in all participants. Results: Although the Ménière affected and control groups showed comparable pure-tone average (PTA) values (46.33 vs. 38.13 dB, p = 0.439), the affected group demonstrated significantly poorer speech performance (Rmax: 76.25% vs. 87.49%, p < 0.001; SRT: 50.64 vs. 38.45 dB, p = 0.009). The Ménière unaffected group exhibited near-ceiling performance (Rmax: 99.38%, SRT: 18.33 dB) and a mean PTA of 19.59 dB. A strong correlation between PTA and SRT was observed only in the Ménière affected group (r = 0.942, p < 0.001), whereas correlations were moderate in the unaffected (r = 0.671, p < 0.001) and control (r = 0.728, p < 0.001) groups. The ROC analysis revealed that PTA predicted impaired speech recognition with high accuracy in unaffected (AUC = 0.956, p < 0.001) and control (AUC = 0.829, p < 0.001) ears but far less so in affected ears (AUC = 0.784; all p < 0.001), confirming a functional tonal–verbal dissociation in MD. Conclusions: This study demonstrates a functional audiometric dissociation in unilateral Ménière’s disease. Affected ears show poorer speech recognition and require higher intensities despite similar PTA values. The predictive link between thresholds and verbal performance is disrupted. These findings support the need for combined tonal and speech-based assessment in clinical practice. Full article

Introduction: This study aimed to compare different scoring methods, such as phoneme, syllable, and word-based scoring, during word recognition in noise testing and their interaction with hearing loss severity. These scoring methods provided a structured framework for refining clinical audiological diagnosis by revealing underlying auditory processing at multiple linguistic levels. We highlight how scoring differences inform differential diagnosis and guide targeted audiological interventions. Methods: Pure tone audiometry and word-in-noise testing were conducted on 100 subjects with a wide range of hearing loss severity. Speech recognition was scored using phoneme, syllable, and word-based methods. All procedures were designed to reflect standard diagnostic protocols in clinical audiology. Discriminant function analysis examined how these scoring methods differentiate the degree of hearing loss. Results: Results showed that each method provides unique information about auditory processing. Phoneme-based scoring has pointed out basic auditory discrimination; syllable-based scoring can capture temporal and phonological processing, while word-based scoring reflects real-world listening conditions by incorporating contextual knowledge. These findings emphasize the diagnostic value of each scoring approach in clinical settings, aiding differential diagnosis and treatment planning. Conclusions: This study showed the effect of different scoring methods on hearing loss differentiation concerning severity. We recommend the integration of phoneme-based scoring into standard diagnostic batteries to enhance early detection and personalize rehabilitation strategies. Future research must involve studies about integration with other speech perception tests and applicability across different clinical settings. Full article

Background and Objectives: Systemic small-vessel vasculitis (SV) represents a group of rare autoimmune disorders with varied etiologies and clinical manifestations. Audiovestibular involvement in SV may present with a broad spectrum of symptoms, often complicating diagnosis and management. This study aimed to evaluate auditory function and speech perception in individuals diagnosed with SV and to investigate associations with disease-specific clinical parameters. Materials and Methods: A total of 40 patients diagnosed with SV (mean age: 48.9 years; range: 28–65 years) were recruited for comprehensive audiological assessment. The evaluation protocol included otoscopic examination, tympanometry, pure-tone audiometry, and speech audiometry. Statistical analysis was conducted using R software (version 4.3.1), and significance was set at p < 0.05. Results: Diagnoses included granulomatosis with polyangiitis (52.5%), eosinophilic granulomatosis with polyangiitis (27.5%), necrotizing vasculopathy (12.5%), and microscopic polyangiitis (7.5%). Mean disease duration was 4.14 years. Hearing complaints were reported by 77.5%; in 20%, they were the initial symptoms. Audiometry identified hearing loss in 50% of patients—predominantly sensorineural (33.8%), followed by mixed (13.7%) and conductive (2.5%) types. Hearing loss was most frequent in necrotizing vasculopathy (60%) and among ANCA-positive individuals (53.7%). Conclusions: Sensorineural hearing loss is common in SV, particularly in ANCA-positive patients, highlighting the need for routine hearing assessment in SV management. Full article