Sudden hearing loss possible sign of vascular problems? Researchers see increased risk in those over sixty

In recent years, sudden hearing loss is often mentioned as a possible sign of vascular problems in the brain. In patient files of general practitioners researchers from Radboudumc, LUMC and Gelre Ziekenhuizen found an increased risk only in people over sixty. Should treatment be adjusted accordingly?

Of every 100,000 people in the Netherlands, five to twenty are struck by sudden deafness each year. Sometimes this is due to an infection, an autoimmune disease, trauma or medication use, but in the vast majority of cases the cause remains unknown. Consequently, current treatment with corticosteroids, based on the idea that it is probably inflammation following a viral infection, often proves ineffective.

Corticosteroids or blood thinner

Quite recently, the idea has been floated that part of sudden deafness is due to vascular problems. A blockage of the blood supply to the auditory nerve could explain the hearing loss in some of the patients. If this is true, it has implications for treatment. In these particular cases, treatment with blood thinners may be more effective. The sudden hearing loss could also be considered a sign of more vascular problems, with an increased TIA or stroke risk. Although some studies have identified vascular problems as a cause of sudden deafness, they often rely on non-medical research data.

Electronic patient records

Tjard Schermer (epidemiologist at Radboudumc), Fieke Oussoren (physician-researcher at LUMC) and their colleagues from Gelre Ziekenhuizen in Apeldoorn therefore used coded data from electronic patient records from Radboudumc's general practitioner database from Jan. 1, 2011, to Dec. 31, 2021. They found nearly 500 patients aged 18 years and older who met the definition of sudden deafness and compared them with nearly 2,000 controls.

Over-sixties

Schermer: "In both groups, we analyzed how many people had a stroke or TIA up to five years after sudden deafness. We took it as a marker of vascular problems in the brain. Comparing both groups we saw no difference, but as we looked more specifically at people over 60 with sudden deafness we actually noticed a difference. In our study, they had an increased stroke or TIA risk. Not only compared to the control group but also compared to those with sudden deafness younger than 60."

Risk management?

If those over 60 with sudden deafness are indeed at increased risk of a TIA or stroke, treatment with blood thinners may be considered. Schermer points out that cardiovascular risk management is sometimes already considered in Germany after sudden hearing loss, but for now he remains cautious. "Before doing so, more research that confirms our results is needed," Schermer says.

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Paper in Scientific Reports:  Assessing risk of stroke after idiopathic sudden sensorineural hearing loss using data from general practice - Fieke K. Oussoren, Tjard R. Schermer, Leonie R. Horn, Roeland B. van Leeuwen & Tjasse D. Bruintjes.

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