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Idiopathic sudden sensorineural hearing loss and ménière syndrome: The role of cerebral venous drainage
Author(s) -
Ciccone M. M.,
Scicchitano P.,
Gesualdo M.,
Cortese F.,
Zito A.,
Manca F.,
Boninfante B.,
Recchia P.,
Leogrande D.,
Viola D.,
Damiani M.,
Gambacorta V.,
Piccolo A.,
De Ceglie V.,
Quaranta N.
Publication year - 2018
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/coa.12947
Subject(s) - medicine , supine position , sensorineural hearing loss , prospective cohort study , tinnitus , hearing loss , cardiology , surgery , audiology
Objectives To evaluate the influence of cerebral venous drainage on the pathogenesis of idiopathic sudden sensorineural hearing loss ( ISSHL ) and Ménière syndrome ( MD ). Design Observational, prospective, cohort study. Setting ENT and Cardiology Departments (University of Bari, Policlinico Hospital, Bari, Italy). Participants We enrolled 59 consecutive patients (32 males, mean age 53.05 + 15.37 years): 40 ISSHL and 19 MD . Main outcome measure All patients underwent physical examination, biochemical evaluation (glycemic and lipid profile, viral serology, C reactive protein, etc), audiometric (tonal, vocal, vestibular evoked myogenic potentials and auditory brainstem response test) and impedentiometric examination. The pure tone average ( PTA ) was calculated for the following frequencies: 250, 500, 1000, 2000, 3000, 4000, 8000. An echo‐color Doppler evaluation of the venous cerebral veins, internal jugular ( IJV ) and vertebral veins ( VV ) at supine and 90° position was performed. Results No morphological alterations were found both in patients and controls. There were no signs of stenosis, blocked flow, membranes, etc. We found lower minimum, mean and maximum velocities in distal IJV s ( P = .019; P = .013; P = .022; respectively) and left VV s ( P = .027; P = .008; P = .001; respectively) in supine (0°) position in both MD and ISSHL patients as compared to controls. The same was for orthostatic position (90°). We found negative correlations between the velocities in extracranial veins and PTA values: therefore, the worst the audiometric performance of the subjects, the lower the velocities in the venous cerebral drainage. Conclusions Idiopathic sudden sensorineural hearing loss and Ménière syndrome patients showed altered venous flow in IJV s and VV s as compared to controls, independently from posture. This different behavior of venous tone control can influence the ear performance and may have a role in the pathogenesis of both diseases.