Sudden hearing loss possible sign of vascular problems? – Researchers only see an increased risk in people over the age of sixty

In recent years, sudden hearing loss has often been mentioned as a possible sign of vascular problems in the brain. Researchers from Radboud University Medical Center, LUMC and Gelre Hospitals found an increased risk in general practitioners’ patient files only among people over sixty. Should the treatment be adjusted accordingly?

Every year, five to twenty people out of every 100,000 Dutch people are struck by sudden deafness. Sometimes this is due to an infection, an autoimmune disease, trauma or medication, but in the vast majority of cases the cause remains unknown. Current treatment with corticosteroids, based on the idea that it is probably inflammation after a viral infection, often proves to be ineffective.

Corticos or blood thinners

Quite recently the idea has been put forward that some of the sudden deafness is due to vascular problems. A blockage of the blood supply to the auditory nerve could explain the hearing loss in some patients. If this is correct, it will have consequences for the treatment. In these specific cases, treatment with blood thinners may be more effective. The sudden hearing loss can also be regarded as a sign of more vascular problems, with an increased risk of a TIA or cerebral infarction. Although some studies have identified vascular problems as a cause of sudden deafness, they are often based on non-medical research data.

Electronic patient records

Tjard Schermer (epidemiologist at the Radboud university medical center), Fieke Oussoren (physician-researcher at the LUMC) and their colleagues from Gelre Hospitals in Apeldoorn therefore used coded data from electronic patient files from the general practitioner database of the Radboud university medical center for the period January 1, 2011 to December 31, 2021. They found almost 500 patients aged 18 years and older who met the definition of sudden deafness and compared them with almost 2000 controls.

People over sixty

Schermer: “In both groups we analyzed how many people had had a cerebral infarction or TIA five years after sudden deafness. We took that as a benchmark for vascular problems in the brain. Then we actually see no difference between the group with sudden deafness and the control group. But if we look more specifically at people over sixty with sudden deafness, we do see a difference. In our study, they have an increased risk of a cerebral infarction or TIA. This applies to both the control group and the group with sudden deafness who are younger than 60 years old.”

Risk management?

If people over 60 with sudden deafness do indeed have an increased risk of a TIA or stroke, treatment with blood thinners can be considered. Schermer points out that in Germany cardiovascular risk management is sometimes considered after sudden hearing loss, but for the time being he remains cautious. “Before you do this, more research is needed that confirms our results,” says Schermer.

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Publication 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.