Comparative study of SSNHL with and without tinnitus: audiologic and hematologic differences

Abstract

Background and Objectives

Tinnitus is one of the most common symptoms of sudden sensorineural hearing loss (SSNHL), with the incidence of tinnitus in patients with SSNHL ranging from 60% to 90%. Little is known, however, about the specific audiologic and hematologic factors that may be associated with the development of tinnitus. To better understand the relationship between tinnitus and SSNHL, the present study compared audiologic and hematologic factors in SSNHL patients with tinnitus and without tinnitus.

Subjects and Method

The present study compared 120 patients with SSNHL with tinnitus and 59 patients with SSNHL without tinnitus at their initial examination. Their audiology and hematologic test results were analyzed, and hearing recovery was determined by comparing the hearing thresholds before and after treatment.

Results

120 patients with tinnitus showed longer III and V latency in auditory brainstem response (ABR) tests, lower signal-to-noise ratios (SNR) at 2 kHz in transient evoked otoacoustic emissions (TEOAE) tests, and lower response rates at 2 kHz in distortion product otoacoustic emissions (DPOAE) tests of the affected ear (p < 0.05 each) than the 59 patients without tinnitus. However, there were no significant between-group differences in the mean hearing threshold and hearing recovery rate of the affected ear. Patients with tinnitus had significantly worse mean hearing thresholds and hearing thresholds at 4 kHz in the nonaffected ear. The percentages of monocytes and large unstained cells (%LUCs) were higher in the group without tinnitus (p < 0.05), although there were no significant between-group differences in inflammatory markers, such as neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR).

Conclusion

Tinnitus accompanying SSNHL may be associated with baseline hearing level, as well as being an indicator of damage to outer hair cells and auditory nerves. Additional studies are needed to evaluate hematologic data in SSNHL patients with and without tinnitus.

背景和目的：耳鸣是突发性感觉神经性听力损失（SSNHL）最常见的症状之一。SSNHL 患者中, 耳鸣的发生率为 60% 至 90%。然而, 我们对可能与耳鸣的发生相关的特定听力学和血液学因素知之甚少。 为了更好地了解耳鸣和 SSNHL 之间的关系, 本研究比较了 有耳鸣和无耳鸣的SSNHL患者的听力学和血液学因素。

对象和方法：本研究在初次检查时比较了 120 名有耳鸣的 SSNHL 患者和 59 名无耳鸣的 SSNHL 患者。分析了他们的听力学和血液学测试结果, 通过比较治疗前和治疗后的听力阈值来确定听力恢复情况。

结果：与 59 名无耳鸣患者相比, 120 名耳鸣患者在听性脑干反应（ABR）测试中表现出较长的 III 和 V 潜伏期, 在瞬态诱发耳声发射 (TEOAE) 测试中 表现出较低的2kHz 时信噪比 (SNR), 在失真产物耳声发射 (DPOAE) 测试中受累耳表现出较低的 2kHz 时响应率（ p<0.05）。然而, 在受累耳的平均听力阈值和听力恢复率方面, 并没有出现重大的组间差异。耳鸣患者的未受累耳的平均听阈和 4kHz 听阈明显较差。 无耳鸣组的单核细胞和未染色大细胞 (%LUC) 的百分比较高（p<0.05）, 尽管在炎症标志物方面, 例如中性粒细胞与淋巴细胞比率 (NLR)、单核细胞与淋巴细胞比率(MLR) 和血小板与淋巴细胞比率 (PLR), 组间差异不显著, 。

结论：伴随 SSNHL 的耳鸣可能与基线听力水平相关, 而且还是外毛细胞和听觉神经受损的指标。 需要进一步的研究来评估有和没有耳鸣的 SSNHL 患者的血液学数据。

Keywords:

• SSNHL
• tinnitus
• audiology
• hematology

Author contributions

Conceptualization, S.G.Y; methodology and data collection, J.M.K; formal analysis, data curation, H.W.R, S.H.K, S.S.K, and J.Y.B; writing, J.M.K and S.G.Y. All authors have read and agreed to the final version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (NRF 2018R1A6A1A03025124). This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HV22C0233). The funders had no role in study design, data collection, data analysis, data interpretation, or writing of the report.