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Purpose Long-term outcomes of sudden sensorineural hearing loss (SSNHL) are poorly studied. The recurrence rate is heterogeneous, and the prognosis of relapses is uncertain. The aim of this retrospective study was to evaluate the recurrence rate of SSNHL and to analyze the correlation with clinical and audiometric characteristics. Method Seventy-three patients with idiopatic SSNHL were evaluated. Clinical and audiometric features were recorded. Seventy patients (95.8%) had at least a 2-year follow-up, whereas 50 (68.4%) had a 5-year follow-up. Results Two- and 5-year recurrence rates were 5.60% and 10.34%, respectively. Mean time lapse between 1st episode and recurrence was 29.33 ± 26.60 months. About 70% of patients had a partial recovery at recurrence. The same ear was affected in 42.8% of patients, the contralateral ear was affected in 42.8% of patients, and recurrence was bilateral in 14.4% of cases. Recurrence correlated only with the presence of tinnitus during follow-up. However, the small number of participants with recurrence represented a limiting factor of our study. Conclusions Recurrences of SSNHL are rare events that can involve ipsilateral or contralateral ear. Further studies are necessary to identify predictors of recurrence.

Objectives: The recurrence rate of sudden sensorineural hearing loss (SSNHL) varies from 0.8% to 40%. However, to the best of our knowledge, no data on long-term hearing variations are present in the literature. The aim of this observational study was to analyze long-term variations of the hearing threshold in unilateral SSNHL without recurrence., Materials and Methods: A total of 50 patients affected by unilateral SSNHL were evaluated. Patients underwent a treatment consisting of intravenous corticosteroids. Clinical and audiometric features were recorded. Patients underwent pure tone audiometry at a mean follow-up of 5.26±2.28 years. Differences between the affected and unaffected ear were analyzed., Results: Comparing the post-treatment and follow-up audiograms, there was a worsening of hearing in the unaffected ear. On the contrary, no significant difference over time was found for the affected ear. 54% of patients showed no changes over time, 26% showed worsening, and 20% showed an improvement in hearing. The variation correlated with alcohol consumption and the presence of vasculopathies. An average improvement of hearing over time was observed at low frequencies., Conclusion: The time evolution in SSNHL is not predictable on the basis of the clinical and audiometric data. The majority the patients shows no changes in hearing loss in the affected ear. Patients who consume alcohol or have vasculopathies also have a higher risk of worsening of hearing. Further prospective studies are mandatory to better assess variations over time and their relationship with the effect of aging on hearing.

Aims: Few studies have analysed the presence of hearing abnormalities in diabetes. We assessed the presence of subclinical auditory alterations and their possible association with early vascular and neurological dysfunction in young adults with Type 1 diabetes of long duration., Methods: Thirty-one patients with Type 1 diabetes (mean age 33 ± 2.3 years, disease duration 25.7 ± 4.2 years) and 10 healthy controls underwent pure tone audiometry (PTA), distortion product otoacoustic emission (DPOAE) and auditory brainstem response (ABR) analyses. Associations with metabolic variables and chronic complications were explored., Results: Compared with healthy controls, patients with diabetes had significantly higher mean hearing thresholds, although still within the normoacusic range. DPOAE intensities at medium frequencies (2.8-4 kHz) were significantly lower in patients with diabetes. In ABR, in addition to waves I, III and V, we observed the appearance of a visible wave IV in patients with diabetes compared with controls (prevalence 61% vs. 10%, P < 0.05), and its appearance was related to a prolonged I-V interval (4.40 ± 0.62 ms vs. 4.19 ± 0.58 ms, P < 0.05). Diastolic blood pressure was higher in people with abnormal DPOAE (P < 0.05), whereas systolic blood pressure correlated with wave V and interpeak I-V interval latencies. A trend towards an association between evidence of wave IV and the presence of somatic neuropathy or abnormal cardiovascular autonomic tests was observed., Conclusions: Young adults with long-term Type 1 diabetes have subclinical abnormalities in qualitative auditory perception, despite normal hearing thresholds, which might reflect neuropathic and/or vascular alterations., (© 2015 Diabetes UK.)

Objectives/hypothesis: To determine whether speech recognition scores (SRS) differ between adults with long-term auditory deprivation in the implanted ear and adults who received cochlear implant (CI) in the nonsound-deprived ear, either for hearing aid-assisted or due to rapidly deteriorating hearing loss., Study Design: Retrospective study., Methods: Speech recognition scores at evaluations (3 and 14 months postimplantation) conducted with CI alone at 60-dB sound pressure level intensity were compared in 15 patients (4 with bilateral severe hearing loss; 11 with asymmetric hearing loss, 7 of which had contralateral hearing aid), all with long-term auditory deprivation (mean duration 16.9 years) (group A), and in 15 other patients with postlingual hearing loss (10 symmetric, 5 asymmetric with bimodal stimulation) (controls, group B)., Results: Comparison of mean percentage of correctly recognized words on speech audiometry at 3 and 14 months showed improvement within each group (P < 0.05). Between-group comparison showed no significant difference at 3 (P = 0.17) or 14 months (P = 0.46). Comparison of SRSs in group A (bimodal stimulation [n = 7] and binaural sound deprivation [n = 4]) versus group B showed no significant differences at 3 (bimodal stimulation P = 0.16; binaural sound deprivation P = 0.19) or 14 months (bimodal stimulation P = 0.14; binaural sound deprivation P = 0.82)., Conclusions: Speech recognition scores in monaural and binaural sound-deprived ears did not significantly differ from ears with unilateral cochlear implantation in nonsound-deprived ears when tested with CI alone. Improvement in the implanted worse ear indicates that it could be a potential candidate ear for cochlear implantation even when sound deprived., Level of Evidence: 4. Laryngoscope, 126:1905-1910, 2016., (© 2015 The American Laryngological, Rhinological and Otological Society, Inc.)

Following injury to the adult mammalian cochlea, hair cells cannot be spontaneously replaced. Nonetheless, the postnatal cochlea contains progenitor cells, distinguished by the expression of nestin, which are able to proliferate and form neurospheres in vitro. Such resident progenitors might be endowed with reparative potential. However, to date little is known about their behaviour in situ following hair cell injury. Using adult mice and ex vivo cochlear cultures, we sought to determine whether: (i) resident cochlear progenitors respond to kanamycin ototoxicity and compensate for it; and (ii) the reparative potential of cochlear progenitors can be stimulated by the addition of growth factors. Morphological changes of cochlear tissue, expression of nestin mRNA and protein and cell proliferation were investigated in these models. Our observations show that ototoxic injury has modest effects on nestin expression and cell proliferation. On the other hand, the addition of growth factors to the injured cochlear explants induced the appearance of nestin-positive cells in the supporting cell area of the organ of Corti. The vast majority of nestin-expressing cells, however, were not proliferating. Growth factors also had a robust stimulatory effect on axonal sprouting and the proliferative response, which was more pronounced in injured cochleae. On the whole, our findings indicate that nestin expression after kanamycin ototoxicity is related to tissue reactivity rather than activation of resident progenitors attempting to replace the lost receptors. In addition, administration of growth factors significantly enhances tissue remodelling, suggesting that cochlear repair may be promoted by the exogenous application of regeneration-promoting substances., (© 2014 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.)

Objective: To assess differences in hearing threshold estimation of four different ABR tone-bursts at 1kHz., Methods: Twenty-one (21) ears from 11 subjects were tested with pure-tone audiometry (PTA): 5 ears (24%) were normal hearing, 5 (24%) affected by mild hearing loss, 7 (33%) showed moderate hearing loss and 4 (19%) severe hearing loss. After PTA each subject underwent tone-burst ABR test at 1kHz using a linear gated (L&#95;ABR) or Blackman windowed (B&#95;ABR) stimuli with (nn&#95;ABR) and without ipsilateral notched noise. Stimulation rate and filters settings were unchanged., Results: Overall correlation between PTA and all ABRs thresholds was high, ranging from 0.84 to 0.94. In normal hearing ears none of the differences was significant, except for those measured with B&#95;nn&#95;ABR, which showed a mean 16dB overestimation of the pure-tone threshold (p<0.05). In mild hearing loss group none of the differences between thresholds were significant. In moderate and severe hearing loss groups significant differences were measured with L&#95;nn&#95;ABR (p<0.05) with a mean 7.5dB underestimation of PTA., Conclusions: Although very similar, some significant differences were found when considering specific group of patients with different degrees of hearing loss., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

The aims of this study were to evaluate the influence of age and exposure to noise in determining the evolution of hearing loss after noise-induced hearing loss has been already established and to define the further evolution of presbycusis. This is a cross-sectional study based on the evaluation of pure-tone audiometry threshold on 568 subjects affected by noise-induced hearing loss and exposed to noise for at least 10 years; noise exposure at testing was 85-90 dB Leqd(A). The further evolution of hearing loss was found to be more related to age than to noise exposure and was significantly less than expected for presbycusis. In conclusion our data support the hypothesis that once NIHL has manifested, it tends to worsen slightly with continued noise exposure and that progressive hearing loss is chiefly due to aging. However, in individuals with NIHL, age-related hearing loss is significantly less at frequencies damaged by noise than in non-noise-exposed individuals.

The authors present the results obtained during an audiometric screening of 153 children aged 5-18 years, affected by beta-thalassemia and treated with regular blood transfusions and iron overload chelation by means of desferrioxamine. Thirty-eight percent of the patients showed a significant sensorineural hearing loss at high frequencies with recruitment. Younger patients had a greater hearing loss, indicating that cochlear damage was not due to the disease itself. Furthermore, hearing loss appeared to be correlated with the mean and peak desferrioxamine doses administered and was higher in subjects with lower iron load. Thus, the ototoxic effect seems to have been higher when a good iron chelation had been obtained. Among our patients, conductive hearing loss was not more frequent than in patients without beta thalassemia.