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EDITORIAL article

Front. Neurol.
Sec. Neuro-Otology
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1520018
This article is part of the Research Topic Sudden deafness View all 19 articles

Editorial: Sudden Deafness

Provisionally accepted
Maoli Duan Maoli Duan 1,2*Jun Yang Jun Yang 3*Yupeng Liu Yupeng Liu 3*Lisheng Yu Lisheng Yu 4
  • 1 Department of Clinical Science, Intervention and Technology, Karolinska Institutet (KI), Stockholm, Sweden
  • 2 Division of Ear, Nose and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet (KI), Stockholm, Stockholm, Sweden
  • 3 Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, Shanghai Municipality, China
  • 4 Department of Otolaryngology Head and Neck Surgery, peopleĀ“s Hospital, Beijing University, Beijing, China, Beijing, China

The final, formatted version of the article will be published soon.

    Sudden sensorineural hearing loss (SSNHL) is an otologic emergency characterized by a rapid onset of hearing loss, typically within 72 hours, affecting three or more consecutive frequencies by 30 dB or more (1). The global incidence of SSNHL ranges from 5 to 400 per 100,000 individuals annually, with a rising trend worldwide (2).Although viral infections, autoimmune diseases, and vascular abnormalities are acknowledged as potential etiological factors, the pathophysiology of SSNHL remains unclear in the majority of cases (3). Current treatment strategies focus on the use of corticosteroids-either systemic or intratympanic-as the primary therapy to reduce inflammation and restore hearing (4). Additional treatments such as hyperbaric oxygen therapy, traditional Chinese medicine (TCM), and vasodilators have been explored but with inconsistent evidences. However, the effectiveness of alternative therapies continues to be the subject of ongoing debate. Accurately predicting hearing recovery is essential for patient counseling, as factors such as delayed treatment initiation, vestibular function impairment, and comorbid health conditions are associated with poorer prognoses. This Research Topic "Sudden Deafness" consists of 16 original articles and two reviews. We summarized these articles within the following categories: overview of SSNHL in China, comorbidities and laboratory changes, special types of SSNHL, therapeutic regimen and prognostic factors. Further understanding of SSNHL through this research topic will benefit SSNHL patients and their families, thus decreasing the economic load for the society. Chen et al provides a comprehensive overview of the contemporary clinical approaches to diagnosing and treating SSNHL in China. The study evaluated the factors influencing these practices, such as hospital grade and regional economic differences.The study highlighted the heterogeneity in SSNHL diagnosis and treatment in China.There is a need for more standardized practices and higher-quality RCT studies to ensure better outcomes. The widespread use of post-auricular injections and combination therapies in China is noted as a distinct practice, which may inform future international research and treatment guidelines. The established effective treatment for SSNHL involves the systemic administration and intratympanic injection of corticosteroids. However, the efficacy of alternative administration methods, including post auricular injections, repetitive systemic corticosteroid administration, and TCM, requires further investigation. Xie et al investigated whether adding intratympanic or post auricular subperiosteal corticosteroid injections to systemic corticosteroid treatment improves hearing recovery in patients with SSNHL. The study found no significant difference in hearing recovery between the groups, indicating that local corticosteroid injections do not significantly improve outcomes when added to systemic corticosteroids. Yamamoto et al compared patients who received repetitive treatment with those who only received one round of therapy. Although the final hearing outcomes did not differ significantly between the groups, early and sufficient corticosteroid dosing was found to be crucial for better hearing recovery. Although repetitive corticosteroid therapy may play a supplementary role, the study emphasizes the importance of early, aggressive treatment to improve outcomes. Zhao et al used network pharmacology and molecular docking techniques to investigate the molecular mechanisms by which the TCM Erlongjiaonang (ELJN) acts in the treatment of SSNHL. The study suggests that ELJN may reduce inflammation and improve inner ear blood circulation, providing a molecular basis for its effectiveness in treating SSNHL. The prognosis of SSNHL is generally influenced by factors including the patient's age, the severity of the initial hearing loss, the timing of treatment initiation, and the presence of vestibular function impairment. Prior research examining the correlation between vestibular function impairment and the prognosis of SSNHL remains limited.Chen et al explored the prognosis of patients with SNHL who also had inner ear malformations involving the lateral semicircular canal (LSCC). Compared with patients without LSCC malformation, the recovery outcomes were poorer, with only 40% of patients LSCC malformation showing hearing improvement. The study suggests that LSCC malformation is a risk factor for poor prognosis in SSNHL. Shen et al examined the functional status of the vestibular otolith and conductive pathways in unilateral SSNHL patients using vestibular evoked myogenic potentials (VEMPs). The study found that patients with normal VEMPs had better hearing recovery than those with abnormalities. The study highlights the importance of evaluating both the otolith and vestibular nerve pathways to predict hearing outcomes. Yang et al investigated the relationship between vestibular function and prognosis in patients with severe and profound SSNHL. The findings suggest that vestibular ischemia caused by corresponding vascular circulation disorder affect both the cochlea and posterior semicircular canal, may contribute to poor outcomes in these patients. These studies focus on the impact of vestibular function and inner ear abnormalities on the prognosis of patients with SSNHL, emphasizing the need for comprehensive vestibular assessment to better understand and predict recovery outcomes. In addition, cardiovascular disease, diabetes, hypercholesterolemia and hypertension have been found to be poor prognostic factors. However, randomized double blind placebo control study has not been investigated until now. Thus, it is difficult to say that these factors affect SSNHL´s prognosis.

    Keywords: sudden deafness, sensorineural hearing loss, diagnosis, Treatment, Comorbility

    Received: 30 Oct 2024; Accepted: 31 Oct 2024.

    Copyright: Ā© 2024 Duan, Yang, Liu and Yu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Maoli Duan, Department of Clinical Science, Intervention and Technology, Karolinska Institutet (KI), Stockholm, Sweden
    Jun Yang, Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200092, Shanghai Municipality, China
    Yupeng Liu, Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200092, Shanghai Municipality, China

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