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Franz L, Frosolini A, Parrino D, Badin G, Piccoli V, Poli G, Bertocco AG, Spinato G, de Filippis C, Marioni G. Balance control and vestibular disorders in pregnant women: A comprehensive review on pathophysiology, clinical features and rational treatment. Sci Prog 2025; 108:368504251343778. [PMID: 40405708 PMCID: PMC12103688 DOI: 10.1177/00368504251343778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2025]
Abstract
During pregnancy, women experience substantial anthropometric, cardiovascular, hormonal and psychological changes that affect several organs involving the circulatory, respiratory, gastrointestinal, musculoskeletal, dermatological and sensory systems. The main aim of this review was to analyse the available literature on postural strategies throughout pregnancy in both static and dynamic conditions. The secondary aim was to assess and discuss the current knowledge regarding vestibular disorders during pregnancy. Pregnant women with vestibular disorders need appropriate and safe treatments to resolve or reduce symptoms without risks for mother and foetus. Our protocol was registered on PROSPERO (CRD42024622122). A literature search was conducted screening PubMed, Scopus and Web of Science databases. After duplicates removal and exclusion of records due to coherence with the inclusion/exclusion criteria, 41 articles relevant to the topic were examined. Although some studies claimed no changes in postural behaviour during pregnancy, most of the available evidence seems to demonstrate significant modifications in posture and balance metrics, with multiple mechanisms. Physiological changes that occur in the mother's body during pregnancy have been considered as a possible substrate for developing vestibular disorders. Dizziness and vertigo were reported in pregnancy in small, low-quality studies. Benign paroxysmal positional vertigo, vestibular neuritis, Ménière disease, vestibular migraine and vestibular schwannoma have all been documented in pregnant women. To overcome reported limitations, prospective studies, preferably multicentre and involving third-level audio-vestibular centres are mandatory in order to define rational diagnostic and treatment approaches for vestibular disorders to protect the safety of the mother and foetus.
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Affiliation(s)
- Leonardo Franz
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy
| | - Andrea Frosolini
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Daniela Parrino
- Department of Otorhinolaryngology Head and Neck Surgery, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Giulio Badin
- Otolaryngology Unit, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Valentina Piccoli
- SC Ostetricia e Ginecologia, Azienda Sanitaria Friuli Occidentale, Pordenone, Italy
| | - Giovanni Poli
- Otolaryngology Unit, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Anna Giulia Bertocco
- Otolaryngology Unit, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Giacomo Spinato
- Otolaryngology Unit, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Cosimo de Filippis
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy
| | - Gino Marioni
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy
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Eom T, Jeong B, Kim SH, Kim DJ, Lee IW, Lee HM, Kim HG. Incidence and characteristics of sudden sensorineural hearing loss during pregnancy and the postpartum period: A nationwide population-based study using customized cohort data. Am J Otolaryngol 2025; 46:104600. [PMID: 39847844 DOI: 10.1016/j.amjoto.2025.104600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 12/29/2024] [Accepted: 01/13/2025] [Indexed: 01/25/2025]
Abstract
PURPOSE This study aimed to investigate the incidence and characteristics of sudden sensorineural hearing loss (SSNHL) in pregnant and non-pregnant women using the Korean National Health Insurance Service customized cohort data. MATERIALS AND METHODS We defined the delivery group as women aged 15-49 years with International Classification of Diseases 10th Revision codes O80-O84 indicating delivery between January 2013 and December 2019. The control group was selected from individuals in the same age range without a history of delivery during the same period. SSNHL was defined as having an H91.2 diagnostic code and having undergone audiometry at least once. The incidence and characteristics of SSNHL were compared between the two groups from 2015 to 2018. RESULTS The incidence of SSNHL per 1000 individuals was lower in the delivery group (1.08-1.17) compared to the control group (1.52-1.80) each year. In the delivery group, SSNHL occurred most frequently in the 30-34 age group during the third trimester of pregnancy and the postpartum period. The proportion of patients with SSNHL with comorbidities such as hypertension, diabetes, and dyslipidemia was higher in the delivery group than in the control group. CONCLUSIONS Using the longest follow-up period and the largest population in South Korea, we found that pregnancy and childbirth did not increase the risk of SSNHL, which is consistent with the results of previous population-based studies. Our findings provide insights into the etiology of SSNHL and highlight the need for further research to better understand the underlying mechanisms and risk factors associated with SSNHL.
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Affiliation(s)
- Taeung Eom
- Major of Statistics and Data Science, Pukyong National University, Busan, Republic of Korea
| | - Byungjun Jeong
- Major of Statistics and Data Science, Pukyong National University, Busan, Republic of Korea
| | - Seok-Hyun Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Dong-Jo Kim
- BS Sum Otorhinolaryngology Clinic, Busan, Republic of Korea
| | - Il-Woo Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Hyun Min Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
| | - Hwi Gon Kim
- Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
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Qian H, Yang H. Risk Factors, Complications, and Treatment Modalities for Sudden Sensorineural Hearing Loss in Pregnant Women: A Systematic Review and Meta-analysis. Noise Health 2024; 26:205-213. [PMID: 38904824 PMCID: PMC11530101 DOI: 10.4103/nah.nah_62_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Sudden sensorineural hearing loss (SSNHL) during pregnancy is a rare condition and has not been much studied. The study aimed to perform a systematic review and meta-analysis of the risk factors, complications, and treatment modalities for SSNHL in pregnant women. MATERIALS AND METHODS PubMed, Web of Science, Scopus, ProQuest, and Google Scholar were used for the literature search. The Cochrane technique for assessing risk of bias was used for the article quality appraisal, and RevMan 5.4 was used for conducting the meta-analysis. Standard mean difference (SMD) and odds ratios with a 95% confidence interval (95% CI) were utilized. Heterogeneity and publication bias were assessed using the I-square (I2) test statistic and the Egger's test, respectively. RESULTS AND DISCUSSION The seven primary studies employed prospective and retrospective study designs. The meta-analysis showed that there were fewer risk variables for SSNHL in the experimental group compared with those in the control group (SMD = -0.45 to 3.24, 95% CI = -3.063.63 to 2.16-2.85), indicating that the analysis revealed an insignificant difference. However, the treated patients presented hearing improvement, suggesting a significant analysis (SMD = -0.6710.20, 95% CI = -1.2713.51 to -0.066.88). Furthermore, after therapy, substantial differences were observed in SMD between the two groups (SMD = -0.7415.18, 95% CI = -1.2423.85 to -0.256.40) in favor of the experimental group patients, based on the analysis results of four included studies. However, the I2-value of 0% showed that the heterogeneity was low. CONCLUSION SSNHL during pregnancy is a notably rare condition with an unknown cause. However, hormonal fluctuations, particularly increased levels of estrogen and progesterone during pregnancy, have been frequently implicated as potential triggers for SSNHL.
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Affiliation(s)
- Haibin Qian
- Department of Obstetrics and Gynecology, Wenzhou Center Hospital, Wenzhou, Zhejiang 325000, China
| | - Huaqin Yang
- Department of Obstetrics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang 318000, China
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Audio-vestibular disorders and pregnancy: A systematic review. Am J Otolaryngol 2021; 42:103136. [PMID: 34182351 DOI: 10.1016/j.amjoto.2021.103136] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 06/13/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE During pregnancy a woman's body undergoes many physiological changes that involve all systems and organs, including sensory ones. We conducted this systematic review to highlight current evidence and treatment options in pregnant women with audio-vestibular disorders. MATERIALS AND METHODS A search was made on the following databases: PubMed, PubMed Central, Web of Science and Scopus. This research protocol was deposited in the PROSPERO Database. RESULTS After application of inclusion-exclusion criteria, 30 manuscripts were included in the review. Many authors (14/15) found a slight alteration of audiometric tests during pregnancy, with a reported recovery postpartum in most of the studies (5/7). Regarding sudden sensorineural hearing loss (SSNHL), we found four articles for a total of 69 patients: the treatment of choice was intravenous Dextran 40 and intra-tympanic corticosteroids. Most included studies (4/6) found neither clinical nor epidemiological associations between otosclerosis and pregnancy in large-based sample studies. Few investigations regarded Eustachian tube function and vertigo. CONCLUSIONS According to our results, many variations of hearing acuity during pregnancy are slight and transient and require only clinical observation. In large samples, otosclerosis appeared not to be associated with pregnancy. Clinicians should consider intra-tympanic steroids in managing SSNHL during pregnancy. Further more accurate research is needed to deepen and clarify the association between pregnancy and audio-vestibular disorders.
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Kim HS, Lee KM, Han SW, Cho GJ, Hwang HS. Risk factors associated with idiopathic sudden sensorineural hearing loss in pregnant South Korean women: a nationwide population-based study. J Matern Fetal Neonatal Med 2021; 35:7389-7394. [PMID: 34256656 DOI: 10.1080/14767058.2021.1949443] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Sudden sensorineural hearing loss (SSNHL) is rare in pregnancy and can be attributed to pregnancy-induced changes in hormone levels that increase thrombogenic risk and alter cochlear microcirculation with consequent development of sudden deafness. The study aimed to analyze the risk factors associated with SSNHL in pregnant South Korean. METHODS A retrospective study of the incidence and risk factors associated with SSNHL before pregnancy enrolled 401,470 Korean women who delivered between January 2010 and December 2014. All participants underwent a pre-pregnancy national health screening examination through the National Health Insurance Corporation. We investigated the risk factors in 459 pregnant women with sudden sensorineural hearing loss and in 401,011 pregnant women without SSNHL through the pre-pregnancy national health screening examination and adverse perinatal outcome. RESULTS No statistically significant intergroup differences were observed in the maternal age, parity, method of delivery, gestational age at delivery, body mass index, blood pressure, as well as fasting blood glucose and cholesterol levels. After adjusting for maternal age, the pre-pregnancy body mass index was associated with an increased risk of sensorineural hearing loss in pregnancy (adjusted odds ratio 1.52, 95% confidence interval 1.04-2.22). The sensorineural hearing loss did not increase the risk for gestational hypertension, preterm birth (<37 weeks' gestation), small- and large-for-gestational-age infants, postpartum hemorrhage, placenta previa, and placental abruption. CONCLUSION SSNHL can occur throughout pregnancy and is associated with maternal pre-pregnancy obesity. Notably, it does not increase risks during delivery or cause adverse perinatal outcomes.
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Affiliation(s)
- Hee-Sun Kim
- Department of Obstetrics and Gynecology, Dongguk University Ilsan Hospital, Goyang, South Korea
| | - Kyu-Min Lee
- School of Industrial Management Engineering, Korea University, Seoul, South Korea
| | - Sung Won Han
- School of Industrial Management Engineering, Korea University, Seoul, South Korea
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, South Korea
| | - Han-Sung Hwang
- Department of Obstetrics and Gynecology, Konkuk University School of Medicine, Seoul, South Korea
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Qian Y, Kang H, Hu G, Zhong S, Zuo W, Lei Y, Xu Z, Chen T, Zeng J. Sudden sensorineural hearing loss during pregnancy: etiology, treatment, and outcome. J Int Med Res 2021; 49:300060521990983. [PMID: 33630715 PMCID: PMC7925942 DOI: 10.1177/0300060521990983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To analyze the etiologies, treatments, and outcomes of sensorineural hearing loss (SSNHL) during pregnancy. STUDY DESIGN Retrospective chart review of 25 pregnant patients treated for SSNHL between January 2012 and September 2019. Forty-nine age matched non-pregnant women with severe and profound hearing loss diagnosed with SSNHL during the same period served as controls. Data were recorded on age, symptoms, onset of hearing loss, audiometric results, treatments, and outcomes. RESULTS The mean age was 29.6 years (range 23-38 years). Intratympanic steroids (ITS) were administered in 15 (60.0%) pregnant women with SSNHL. Three women were treated with postauricular steroids only, while another woman was treated with intravenous ginkgo leaf extract and dipyridamole. The remaining six women received no medications. More than half (8/15, 53.3%) of pregnant women with SSNHL receiving ITS experienced hearing improvement. Pregnant women with profound hearing loss who received no medication had no hearing improvement. Most pregnant women with SSNHL (12/15, 80.0%) had higher fibrinogen levels than controls (mean values 3.77±0.71 g/L and 2.54±0.48 g/L, respectively). CONCLUSION Fibrinogen could be a risk factor for SSNHL during pregnancy. ITS may benefit pregnant women with severe and profound SSNHL.
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Affiliation(s)
- Yi Qian
- Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing City, China
| | - Houyong Kang
- Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing City, China
| | - Guohua Hu
- Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing City, China
| | - Shixun Zhong
- Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing City, China
| | - Wenqi Zuo
- Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing City, China
| | - Yan Lei
- Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing City, China
| | - Zhengyan Xu
- Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing City, China
| | - Tao Chen
- Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing City, China
| | - Jihong Zeng
- Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing City, China
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Lyu YL, Zeng FQ, Zhou Z, Yan M, Zhang W, Liu M, Ke ZY. Intratympanic dexamethasone injection for sudden sensorineural hearing loss in pregnancy. World J Clin Cases 2020; 8:4051-4058. [PMID: 33024762 PMCID: PMC7520784 DOI: 10.12998/wjcc.v8.i18.4051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/23/2020] [Accepted: 08/12/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND As sudden sensorineural hearing loss (SSNHL) rarely occurs in pregnant women, there is a lack of knowledge and relevant research on its management.
AIM To investigate the effect of intratympanic dexamethasone injection in the treatment of pregnant patients with SSNHL.
METHODS A retrospective chart review was made for the period between June 2017 and August 2019 at our Department of Otorhinolaryngology-Head and Neck Surgery. Pregnant women who met the criteria for SSNHL were included and grouped based on the therapeutic modalities. The treatment group received intratympanic dexamethasone (2.5 mg) q.o.d. for a total of four times, while the control group received no medication other than bed rest and medical observations. All the patients were under close care of obstetricians. Pure-tone audiograms were performed before and after treatment.
RESULTS Eleven patients who met the inclusion criteria were assigned to the treatment group (n = 7) and the control group (n = 4). The mean age of patients was 31.2 ± 3.8 years; the right ear was affected in seven (63.64%) cases. Two patients (18.2%) suffered from vertigo, 10 (90.9%) suffered from tinnitus and 6 (54.5%) suffered from aural fullness. The time from onset to clinic visit was relatively short, with a mean time of 1.3 ± 0.9 d. All the women were within the second or third trimester; the average gestation period was 26.0 ± 6.2 wk. The pure-tone averages at onset between the two groups were similar. After one wk of therapy, the treatment group had a curative rate of 57.1% and a significantly better hearing threshold and greater improvement compared to the control group (all P < 0.05). Some patients experienced transient discomfort from intratympanic injections that disappeared after getting rest, while none had permanent complications. All patients delivered healthy full-term neonates with an average Apgar score of 9.7 ± 0.5.
CONCLUSION Intratympanic dexamethasone injections can be used as a first-line therapy in pregnant women with SSNHL.
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Affiliation(s)
- Yan-Lu Lyu
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Fan-Qian Zeng
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Zhou Zhou
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Min Yan
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Wei Zhang
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Ming Liu
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
| | - Zhao-Yang Ke
- Department of Otorhinolaryngology–Head and Neck Surgery, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong Province, China
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Young YH. Contemporary review of the causes and differential diagnosis of sudden sensorineural hearing loss. Int J Audiol 2019; 59:243-253. [DOI: 10.1080/14992027.2019.1689432] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Yi-Ho Young
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
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Xie S, Wu X. Clinical management and progress in sudden sensorineural hearing loss during pregnancy. J Int Med Res 2019; 48:300060519870718. [PMID: 31452412 PMCID: PMC7593668 DOI: 10.1177/0300060519870718] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Sudden sensorineural hearing loss (SSNHL) is a relatively rare, but distressing, disease in pregnant women. Little is known about the causes, clinical manifestations, treatments, and prognosis of SSNHL. Some hypotheses have been proposed to explain the pathophysiological mechanism of SSNHL, but most of them have not been identified. This article reviews the existing literature to present a summary of this clinical problem. Most patients suffer from SSNHL in the second or third trimester, and show moderate to profound hearing loss. The interval between the initial treatment and onset of hearing loss is less than 10 days in most patients. Some patients with SSNHL show tinnitus, vertigo, or dizziness, and fullness of the ear. Although some patients have a tendency for self-cure, treatment with intravenous dextran 40 combined with intratympanic corticosteroids is probably a safe and effective therapeutic strategy for pregnant patients with SSNHL. Further clinical research is necessary to identify the best therapeutic strategy for these patients.
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Affiliation(s)
- Shaobing Xie
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University, Changsha, Hunan, PR China.,Key Laboratory of Otolaryngology Major Diseases Research of Hunan Province, Changsha, Hunan, PR China
| | - Xuewen Wu
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University, Changsha, Hunan, PR China.,Key Laboratory of Otolaryngology Major Diseases Research of Hunan Province, Changsha, Hunan, PR China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, PR China
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Xu M, Jiang Q, Tang H. Sudden sensorineural hearing loss during pregnancy: clinical characteristics, management and outcome. Acta Otolaryngol 2019; 139:38-41. [PMID: 30664387 DOI: 10.1080/00016489.2018.1535192] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Sudden sensorineural hearing loss (SSNHL) may occur during pregnancy with a rare prevalence, and little is known about it. AIMS To retrospectively analyze cases of SSNHL during pregnancy and investigate their clinical characteristics, management and outcome. MATERIAL AND METHODS Records of 30 SSNHL patients during pregnancy were reviewed, including age, localization, duration from onset to treatment, gestation period, accompanying symptoms, initial hearing threshold, final hearing threshold, audiogram, treatment and outcome. RESULTS Twenty-four patients (80.0%) suffered SSNHL in the second trimester or the last trimester with a high rate of tinnitus (70.0%). The initial hearing threshold was 63.4 ± 25.1 dB, and most audiograms were flat and profound. The overall recovery rate was 60.0%, including complete recovery (33.3%) and partial recovery (26.7%). Further, 16 patients received adjuvant intratympanic steroid showed a better audiologic outcome (improvement 27.1 ± 16.4 vs. 15.7 ± 12.0 dB, p = .042) than those who had not. CONCLUSIONS AND SIGNIFICANCE SSNHL during pregnancy often occurred in the second trimester or the last trimester with a severe hearing loss, the most audiogram configurations are flat and profound. Dextran-40 is a safe and beneficial therapy for SSNHL patients during pregnancy and adjuvant intratympanic steroid increase the probability of hearing recovery.
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Affiliation(s)
- Ming Xu
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of University of South China, Hengyang, China
| | - Qingshan Jiang
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of University of South China, Hengyang, China
| | - Hongbo Tang
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of University of South China, Hengyang, China
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Fu Y, Jing J, Ren T, Zhao H. Intratympanic dexamethasone for managing pregnant women with sudden hearing loss. J Int Med Res 2018; 47:377-382. [PMID: 30328358 PMCID: PMC6384472 DOI: 10.1177/0300060518802725] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the effect and safety of intratympanic dexamethasone in pregnant women with idiopathic sudden sensorineural hearing loss (ISSNHL). METHODS We performed a prospective study on pregnant women who suffered from ISSNHL and were treated in our clinic during 2016. The patients received intratympanic treatment three to four times a week. A pure tone audiogram (PTA) was performed before treatment and patients were followed up until 2 months after treatment was finished. RESULTS A total of six pregnant women were included. All of the patients tolerated intratympanic treatment well. The mean improvement in hearing was 48 ± 7.33 dB. There were no complications, including permanent perforation of the ear drum or middle ear infection. Each patient delivered a healthy newborn. CONCLUSION Intratympanic dexamethasone is effective and safe for treating pregnant women with ISSNHL. Further randomized, controlled studies on this treatment need to be performed.
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Affiliation(s)
- Yaoyao Fu
- ENT Institute, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Jianghua Jing
- ENT Institute, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Tongli Ren
- ENT Institute, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Hui Zhao
- ENT Institute, Eye & ENT Hospital of Fudan University, Shanghai, China
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12
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Zhang BY, Young YH. Sudden Deafness during Antepartum versus Postpartum Periods. ORL J Otorhinolaryngol Relat Spec 2017; 79:274-281. [DOI: 10.1159/000478936] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 06/21/2017] [Indexed: 12/12/2022]
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Wu PH, Cheng PW, Young YH. Inner ear disorders in 68 pregnant women: a 20-year experience. Clin Otolaryngol 2016; 42:844-846. [PMID: 27299361 DOI: 10.1111/coa.12693] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2016] [Indexed: 11/30/2022]
Affiliation(s)
- P-H Wu
- Department of Otolaryngology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - P-W Cheng
- Department of Otolaryngology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Y-H Young
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
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Yen TT, Lin CH, Shiao JY, Liang KL. Pregnancy is not a risk factor for idiopathic sudden sensorineural hearing loss: A nationwide population-based study. Acta Otolaryngol 2016; 136:446-50. [PMID: 27052963 DOI: 10.3109/00016489.2015.1123292] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
CONCLUSION Sudden sensorineural hearing loss (SSNHL) in pregnancy is rare. It usually occurs in the third trimester. SSNHL in pregnancy does not increase risks during delivery or subsequent stroke. OBJECTIVES This study aimed to investigate the incidence and to determine the factors associated with SSNHL in pregnancy. METHOD Data were retrieved from Taiwan's National Health Insurance Database (NHIRD), covering the years 2000-2009. Patients admitted for SSNHL during pregnancy were enrolled. An age-matched controlled cohort was randomly selected from pregnant women without SSNHL in the NHIRD. The clinical characteristics of both cohorts were collected for further analyses. RESULTS Thirty-three patients with SSNHL in pregnancy were enrolled. The estimated incidence of SSNHL in pregnancy in Taiwan was 2.71 per 100,000 pregnancies. The incidence of SSNHL in pregnancy was lower than that of the general female population. The incidence of SSNHL in the third trimester was higher compared to the other two. The incidence of SSNHL occurring in the 30-39 years old age group was higher than other groups. Women with better socioeconomic status had a higher incidence of SSNHL. There were no identified systemic diseases before SSNHL. Two patients had pre-eclampsia and one patient had premature delivery. Nevertheless, SSNHL in pregnancy did not increase the risk for stroke.
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Affiliation(s)
- Ting-Ting Yen
- a Department of Otolaryngology , Taichung Veterans General Hospital , Taichung , Taiwan
- b Graduate Institute of Natural Healing Sciences, Nanhua University , Cha-Yi , Taiwan
- c Department of Medicine , National Yang-Ming Medical University , Taipei , Taiwan
| | - Ching-Heng Lin
- d Department of Medical Research , Taichung Veterans General Hospital , Taichung , Taiwan
| | - Jiun-Yih Shiao
- a Department of Otolaryngology , Taichung Veterans General Hospital , Taichung , Taiwan
- c Department of Medicine , National Yang-Ming Medical University , Taipei , Taiwan
| | - Kai-Li Liang
- a Department of Otolaryngology , Taichung Veterans General Hospital , Taichung , Taiwan
- c Department of Medicine , National Yang-Ming Medical University , Taipei , Taiwan
- e School of Medicine, Chung Shan Medical University , Taichung , Taiwan
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Abstract
AbstractBackground:Acute hearing loss is a distressing albeit rare occurrence in pregnancy. Due to its infrequent presentation, little is known of its cause, and the best management is unclear.Objective:To present a summary of current knowledge regarding sudden hearing loss in pregnancy and its management, by reviewing the published literature.Data sources:The following electronic databases: PubMed (MEDLINE), Ovid (MEDLINE), all EBM Reviews (Cochrane DSR, ACP Journal Club, DARE and CCTR) and Embase; plus a hand search of reference lists of retrieved papers.Study selection and data extraction:All papers retrieved using key word searches for ‘sudden hearing loss and pregnancy’ and ‘sudden deafness and pregnancy’ were reviewed. Due to the scarcity of literature, all studies identified were included in this review.Data synthesis and conclusions:All retrieved papers were reviewed. Sudden hearing loss is a rare occurrence during pregnancy, leading to a dearth of literature due to limited clinical experience. Audiological investigation findings for such patients remain equivocal. Recovery can be spontaneous during the postpartum period. In patients who require medical treatment, a dextran 40 infusion can be employed. There remains scope for further research, in the form of larger studies, to ascertain the best management option for this clinical problem.
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Abstract
Sudden sensorineural hearing loss (SSNHL) may occur during pregnancy, but its prevalence is very low. It is conjectured that SSNHL is closely related to the changes in the cardiovascular system, hematological system, endocrine system, and/or some other systems due to pregnancy. These changes possibly evoke disorders of cochlear circulation or cochlear fluid homeostasis leading to SSNHL. Two SSNHL cases were observed in our clinic, and their clinical features were analyzed. In one patient the SSNHL was likely to be related to the disturbance of cochlear fluid homestasis and in the other it might be induced by some disorders in cochlear circulation. Based on their distinct clinic profiles, we defined a new disease, called "pregnancy-induced sudden sensorineural hearing loss," similar to the definition of "pregnancy-induced hypertension." This study also deepened our understanding of the etiology of SSNHL.
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Affiliation(s)
- Zhi-Qiang Hou
- Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, Beijing, China
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Cochlear implant recipients' hearing sensation as manifested by their maps during pregnancy and postpartum. Otol Neurotol 2010; 31:923-5. [PMID: 20502375 DOI: 10.1097/mao.0b013e3181e3d75a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate possible changes in hearing sensation as manifested in the maps' psychoacoustic parameters, threshold (T), and most comfortable (C/M) levels among cochlear implant (CI) female recipients during pregnancy and after delivery. SETTING University-affiliated tertiary referral center. DESIGN : Retrospective study. METHOD Two MedEl device and 3 Nucleus device users' medical records were reviewed for age at the time of implantation, cause of deafness, type of anesthesia used during delivery, and maps' parameters (T and C/M levels) during pregnancy and after childbirth. RESULTS Two CI recipients underwent uncomplicated cesarean deliveries under spinal anesthesia, and 3 others had natural delivery without anesthesia. There were no changes in map values during pregnancy, delivery, and the postpartum period in 4 of 5 CI recipients. Only 1 CI recipient showed significant increase in T levels that was resolved after she completed breastfeeding 3 months postdelivery. CONCLUSION The elevation in T levels might indicate that pregnancy and delivery can result in some temporary reversible changes in hearing sensation manifested by map levels of CI users.
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Pawlak-Osinska K, Burduk PK, Kopczynski A. Episodes of repeated sudden deafness following pregnancies. Am J Obstet Gynecol 2009; 200:e7-9. [PMID: 19027097 DOI: 10.1016/j.ajog.2008.09.880] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2008] [Revised: 09/29/2008] [Accepted: 09/29/2008] [Indexed: 10/21/2022]
Abstract
Sex hormones influence and provoke changes in hearing levels. Sudden deafness is rarely observed in pregnant women. The effective treatment of sudden deafness in pregnant women is a challenging problem. We present a case of repeatable, completely regressed sudden deafness in a woman during her first and second pregnancies.
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