Audiology by Alexandros G. Sfakianakis: 03/10/16

Πέμπτη 10 Μαρτίου 2016

Economic Evaluation of Treatments for Pediatric Bilateral Severe to Profound Sensorineural Hearing Loss: An Australian Perspective.

Objectives: In Australia, surgical treatment options for children with bilateral severe to profound sensorineural hearing loss exist in a continuum ranging from unilateral cochlear implantation (CI), sequential bilateral CI through to simultaneous bilateral CI, depending on the condition. When treatment options are mutually exclusive, the mean costs and benefits of each treatment group are summed together to obtain the total mean costs and benefits. This enables an incremental analysis of treatment options in the context of the treated populations. The objective was to evaluate the cost-utility of current Australian CI treatment practices in children using domestic costs and consequences when compared with bilateral hearing aids (HAs). Research Design: Economic evaluation including a Markov model based on secondary sources. Setting: The base case modeled a government health payer perspective over a child's lifetime. Primary and secondary school education costs were also assessed. Intervention: Bilateral HAs compared with CI, including unilateral, sequential bilateral, or simultaneous bilateral CI weighted according to treatment. Main Outcome Measures: Incremental costs per quality adjusted life year. Results: Approximately 42% of children in Australia with unilateral CI did not transition to sequential bilateral nor undergo simultaneous bilateral implantation. This differs from previous economic evaluations that assumed 100% of children transitioned to sequential bilateral CI treatment or were treated with simultaneous bilateral CI. The incremental cost utility of unilateral cochlear implantation compared with HAs was AUD 21,947/QALY. The weighted average incremental cost utility of the combined cochlear implantation treatment groups was AUD 31,238/QALY when compared with HAs. Conclusion: Previous economic evaluations of cochlear implantation assumed 100% of unilaterally treated patients would transition to sequential bilateral or be treated with simultaneous bilateral implantation. This approach does not take into account the total treated population, where a proportion of patients are treated with unilateral CI. CI was cost effective when compared with HAs, and included children treated with unilateral, sequential bilateral, and simultaneous bilateral CI. The model was sensitive to the number of assessment and habilitation visits. Alternative health service models with cost efficiencies are needed to reduce after care costs. This is an open access article distributed under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://ift.tt/1eRPUFd Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Cost-Utility Analysis of Cochlear Implantation in Australian Adults.

Objectives: Sequential and simultaneous bilateral cochlear implants are emerging as appropriate treatment options for Australian adults with sensory deficits in both cochleae. Current funding of Australian public hospitals does not provide for simultaneous bilateral cochlear implantation (CI) as a separate surgical procedure. Previous cost-effectiveness studies of sequential and simultaneous bilateral CI assumed 100% of unilaterally treated patients' transition to a sequential bilateral CI. This assumption does not place cochlear implantation in the context of the generally treated population. When mutually exclusive treatment options exist, such as unilateral CI, sequential bilateral CI, and simultaneous bilateral CI, the mean costs of the treated populations are weighted in the calculation of incremental cost-utility ratios. The objective was to evaluate the cost-utility of bilateral hearing aids (HAs) compared with unilateral, sequential, and simultaneous bilateral CI in Australian adults with bilateral severe to profound sensorineural hearing loss. Research Design: Cost-utility analysis of secondary sources input to a Markov model. Setting: Australian health care perspective, lifetime horizon with costs and outcomes discounted 5% annually. Intervention: Bilateral HAs as treatment for bilateral severe to profound sensorineural hearing loss compared with unilateral, sequential, and simultaneous bilateral CI. Main Outcome Measures: Incremental costs per quality adjusted life year (AUD/QALY). Results: When compared with bilateral hearing aids the incremental cost-utility ratio for the CI treatment population was AUD11,160/QALY. The incremental cost-utility ratio was weighted according to the number of patients treated unilaterally, sequentially, and simultaneously, as these were mutually exclusive treatment options. Conclusion: No peer-reviewed articles have reported the incremental analysis of cochlear implantation in a continuum of care for surgically treated populations with bilateral severe to profound sensorineural hearing loss. Unilateral, sequential, and simultaneous bilateral CI were cost-effective when compared with bilateral hearing aids. Technologies that reduce the total number of visits for a patient could introduce additional cost efficiencies into clinical practice. This is an open access article distributed under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://ift.tt/1eRPUFd Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Emergence of Binaural Summation After Surgical Correction of Unilateral Congenital Aural Atresia.

Objective: To investigate the emergence of binaural summation in patients with unilateral congenital aural atresia undergoing surgical correction. Study Design: Preoperative and postoperative audiometric testing in a prospective cohort of 10 patients with unilateral congenital aural atresia. Setting: University-based tertiary care center. Patients: Ten patients (ages 6-53) with an average 69 dB (+/-9 dB sd) unilateral conductive hearing loss, normal hearing in the nonatretic ear, and normal bone conduction in the atretic ear. Interventions: Pre- and postoperative hearing in noise test in quiet and in noise. Main Outcome Measures: Levels of sentences presented from a single central speaker were adaptively varied to determine a speech reception threshold (SRT), first in quiet and then with simultaneous multitalker babble at 65 dB SPL from the same speaker. Results: Preoperative SRT was worse than normal controls in both quiet (p = 0.001) and in noise (p = 0.05), as expected. Postoperative SRT in quiet improved 3.5 dB (marginally significant with one-tailed p value of 0.05); thresholds in noise improved an insignificant 0.8 dB (one-tailed p = 0.2). Converting results to dB-worse-than normal, atresia patients did better in noise (relative to normal) than in quiet (p = 0.008). Conclusion: The expected summation effect (3 dB) occurs after atresia surgery in quiet but not in noise. Relative to normal, these patients performed better in noise than quiet, perhaps because these patients develop skills attending to threshold-level speech in noise during their years without binaural benefit. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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High Frequency Ex Vivo Ultrasound Imaging of the Middle Ear to Show Simulated Ossicular Pathology.

Hypothesis: To illustrate the ability of high frequency ultrasound (HFUS) using a transducer array to demonstrate a variety of simulated clinical scenarios involving the ossicular chain. Background: HFUS (>20 MHz) is a relatively new area of ultrasonic imaging that provides an order of magnitude better image resolution than the conventional low-frequency systems. HFUS may be a real-time imaging system that could be used in the clinic and would complement computed tomography (CT) and magnetic resonance imaging (MRI) to enhance the decision-making process for patients with middle ear pathology. Methods: Using a commercially available HFUS scanner, we imaged a variety of simulated clinical scenarios to demonstrate the ability of HFUS to image middle ear pathology. Results: We were able to clearly demonstrate real-time visualization of ossicular pathology in human temporal bones, whereas there are some limitations in the current technique to be addressed before it is used in vivo. Conclusion: HFUS allows excellent visualization of middle ear anatomy and pathology through an intact tympanic membrane (TM), and these experiments go some way towards giving the otologist access to high resolution, real-time imaging of the middle ear in the clinic. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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D-methionine (D-met) significantly reduces kanamycin-induced ototoxicity in pigmented guinea pigs

10.3109/14992027.2016.1143980 Kathleen C. M. Campbell

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Psychometric properties of a Mandarin version of the tinnitus questionnaire

10.3109/14992027.2016.1146414 Zhaoli Meng

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Comorbidities and recurrence of benign paroxysmal positional vertigo: personal experience

10.3109/14992027.2016.1143981 P. M. Picciotti

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Evidence-based guidelines for recommending cochlear implantation for postlingually deafened adults

10.3109/14992027.2016.1146415 Jaime R. Leigh

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D-methionine (D-met) significantly reduces kanamycin-induced ototoxicity in pigmented guinea pigs

10.3109/14992027.2016.1143980 Kathleen C. M. Campbell

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Psychometric properties of a Mandarin version of the tinnitus questionnaire

10.3109/14992027.2016.1146414 Zhaoli Meng

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Comorbidities and recurrence of benign paroxysmal positional vertigo: personal experience

10.3109/14992027.2016.1143981 P. M. Picciotti

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Evidence-based guidelines for recommending cochlear implantation for postlingually deafened adults

10.3109/14992027.2016.1146415 Jaime R. Leigh

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D-methionine (D-met) significantly reduces kanamycin-induced ototoxicity in pigmented guinea pigs

10.3109/14992027.2016.1143980 Kathleen C. M. Campbell

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Psychometric properties of a Mandarin version of the tinnitus questionnaire

10.3109/14992027.2016.1146414 Zhaoli Meng

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Comorbidities and recurrence of benign paroxysmal positional vertigo: personal experience

10.3109/14992027.2016.1143981 P. M. Picciotti

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Evidence-based guidelines for recommending cochlear implantation for postlingually deafened adults

10.3109/14992027.2016.1146415 Jaime R. Leigh

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D-methionine (D-met) significantly reduces kanamycin-induced ototoxicity in pigmented guinea pigs

10.3109/14992027.2016.1143980 Kathleen C. M. Campbell

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Psychometric properties of a Mandarin version of the tinnitus questionnaire

10.3109/14992027.2016.1146414 Zhaoli Meng

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Comorbidities and recurrence of benign paroxysmal positional vertigo: personal experience

10.3109/14992027.2016.1143981 P. M. Picciotti

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Evidence-based guidelines for recommending cochlear implantation for postlingually deafened adults

10.3109/14992027.2016.1146415 Jaime R. Leigh

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D-methionine (D-met) significantly reduces kanamycin-induced ototoxicity in pigmented guinea pigs

10.3109/14992027.2016.1143980 Kathleen C. M. Campbell

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Psychometric properties of a Mandarin version of the tinnitus questionnaire

10.3109/14992027.2016.1146414 Zhaoli Meng

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Comorbidities and recurrence of benign paroxysmal positional vertigo: personal experience

10.3109/14992027.2016.1143981 P. M. Picciotti

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Evidence-based guidelines for recommending cochlear implantation for postlingually deafened adults

10.3109/14992027.2016.1146415 Jaime R. Leigh

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Uncertainties of reverberation time estimation via adaptively identified room impulse responses

This paper investigates the reverberation time estimation methods which employ backward integration of adaptively identified room impulse responses (RIRs). Two kinds of conditions are considered; the first is the “ideal condition” where the anechoic and reverberant signals are both known a priori so that the RIRs can be identified using system identification methods. The second is that only the reverberant speech signal is available, and blind identification of the RIRs via dereverberation is employed for reverberation time estimation. Results show that under the “ideal condition,” the average relative errors in 7 octave bands are less than 2% for white noise and 15% for speech, respectively, when both the anechoic and reverberant signals are available. In contrast, under the second condition, the average relative errors of the blindly identified RIR-based reverberation time estimation are around 20%−30% except the 63 Hz octave band. The fluctuation of reverberation times estimated under the second condition is more severe than that under the ideal condition and the relative error for low frequency octave bands is larger than that for high octave bands under both conditions.

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Effects of pulsatile electrical stimulation of the round window on central hyperactivity after cochlear trauma in guinea pig

Publication date: Available online 10 March 2016
Source:Hearing Research
Author(s): W.H.A.M. Mulders, T.C. Spencer, D. Robertson
Partial hearing loss induced by acoustic trauma has been shown in animal models to result in an increased spontaneous firing rate in central auditory structures. This so-called hyperactivity has been suggested to be involved in the generation of tinnitus, a phantom auditory sensation. Although there is no universal cure for tinnitus, electrical stimulation of the cochlea, as achieved by a cochlear implant, can result in significant reduction of the tinnitus percept. However, the mechanism by which this tinnitus suppression occurs is as yet unknown and furthermore cochlear implantation may not be an optimal treatment option for tinnitus sufferers who are not profoundly deaf. A better understanding of the mechanism of tinnitus suppression by electrical stimulation of the cochlea, may lead to the development of more specialised devices for those for whom a cochlear implant is not appropriate. This study aimed to investigate the effects of electrical stimulation in the form of brief biphasic shocks delivered to the round window of the cochlea on the spontaneous firing rates of hyperactive inferior colliculus neurons following acoustic trauma in guinea pigs. Effects during the stimulation itself included both inhibition and excitation but spontaneous firing was suppressed for up to hundreds of ms after the cessation of the shock train in all sampled hyperactive neurons. Pharmacological block of olivocochlear efferent action on outer hair cells did not eliminate the prolonged suppression observed in inferior colliculus neurons, and it is therefore likely that activation of the afferent pathways is responsible for the central effects observed.

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Effects of high intensity noise on the vestibular system in rats

Publication date: Available online 10 March 2016
Source:Hearing Research
Author(s): Courtney Stewart, Yue Yu, Jun Huang, Adel Maklad, Xuehui Tang, Jerome Allison, William Mustain, Wu Zhou, Hong Zhu
Some individuals with noise-induced hearing loss (NIHL) also report balance problems. These accompanying vestibular complaints are not well understood. The present study used a rat model to examine the effects of noise exposure on the vestibular system. Rats were exposed to continuous broadband white noise (0-24kHz) at an intensity of 116dB sound pressure level (SPL) via insert ear phones in one ear for three hours under isoflurane anesthesia. Seven days after the exposure, a significant increase in ABR threshold (43.3+1.9dB) was observed in the noise-exposed ears, indicating hearing loss. Effects of noise exposure on vestibular function were assessed by three approaches. First, fluorescein-conjugated phalloidin staining was used to assess vestibular stereocilia following noise exposure. This analysis revealed substantial sensory stereocilia bundle loss in the saccular and utricular maculae as well as in the anterior and horizontal semicircular canal cristae, but not in the posterior semicircular canal cristae. Second, single unit recording of vestibular afferent activity was performed under pentobarbital anesthesia. A total of 548 afferents were recorded from 10 noise-treated rats and 12 control rats. Noise exposure produced a moderate reduction in baseline firing rates of regular otolith afferents and anterior semicircular canal afferents. Also a moderate change was noted in the gain and phase of the horizontal and anterior semicircular canal afferent’s response to sinusoidal head rotation (1 and 2Hz, 45 degrees/s peak velocity). Third, noise exposure did not result in significant changes in gain or phase of the horizontal rotational and translational vestibular-ocular reflex (VOR). These results suggest that noise exposure not only causes hearing loss, but also causes substantial damage in the peripheral vestibular system in the absence of immediate clinically measurable vestibular signs. These peripheral deficits, however, may lead to vestibular disorders over time.

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Effects of pulsatile electrical stimulation of the round window on central hyperactivity after cochlear trauma in guinea pig

Effects of high intensity noise on the vestibular system in rats

Effects of pulsatile electrical stimulation of the round window on central hyperactivity after cochlear trauma in guinea pig

Publication date: Available online 10 March 2016
Source:Hearing Research
Author(s): W.H.A.M. Mulders, T.C. Spencer, D. Robertson
Partial hearing loss induced by acoustic trauma has been shown in animal models to result in an increased spontaneous firing rate in central auditory structures. This so-called hyperactivity has been suggested to be involved in the generation of tinnitus, a phantom auditory sensation. Although there is no universal cure for tinnitus, electrical stimulation of the cochlea, as achieved by a cochlear implant, can result in significant reduction of the tinnitus percept. However, the mechanism by which this tinnitus suppression occurs is as yet unknown and furthermore cochlear implantation may not be an optimal treatment option for tinnitus sufferers who are not profoundly deaf. A better understanding of the mechanism of tinnitus suppression by electrical stimulation of the cochlea, may lead to the development of more specialised devices for those for whom a cochlear implant is not appropriate. This study aimed to investigate the effects of electrical stimulation in the form of brief biphasic shocks delivered to the round window of the cochlea on the spontaneous firing rates of hyperactive inferior colliculus neurons following acoustic trauma in guinea pigs. Effects during the stimulation itself included both inhibition and excitation but spontaneous firing was suppressed for up to hundreds of ms after the cessation of the shock train in all sampled hyperactive neurons. Pharmacological block of olivocochlear efferent action on outer hair cells did not eliminate the prolonged suppression observed in inferior colliculus neurons, and it is therefore likely that activation of the afferent pathways is responsible for the central effects observed.

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Effects of high intensity noise on the vestibular system in rats

Publication date: Available online 10 March 2016
Source:Hearing Research
Author(s): Courtney Stewart, Yue Yu, Jun Huang, Adel Maklad, Xuehui Tang, Jerome Allison, William Mustain, Wu Zhou, Hong Zhu
Some individuals with noise-induced hearing loss (NIHL) also report balance problems. These accompanying vestibular complaints are not well understood. The present study used a rat model to examine the effects of noise exposure on the vestibular system. Rats were exposed to continuous broadband white noise (0-24kHz) at an intensity of 116dB sound pressure level (SPL) via insert ear phones in one ear for three hours under isoflurane anesthesia. Seven days after the exposure, a significant increase in ABR threshold (43.3+1.9dB) was observed in the noise-exposed ears, indicating hearing loss. Effects of noise exposure on vestibular function were assessed by three approaches. First, fluorescein-conjugated phalloidin staining was used to assess vestibular stereocilia following noise exposure. This analysis revealed substantial sensory stereocilia bundle loss in the saccular and utricular maculae as well as in the anterior and horizontal semicircular canal cristae, but not in the posterior semicircular canal cristae. Second, single unit recording of vestibular afferent activity was performed under pentobarbital anesthesia. A total of 548 afferents were recorded from 10 noise-treated rats and 12 control rats. Noise exposure produced a moderate reduction in baseline firing rates of regular otolith afferents and anterior semicircular canal afferents. Also a moderate change was noted in the gain and phase of the horizontal and anterior semicircular canal afferent’s response to sinusoidal head rotation (1 and 2Hz, 45 degrees/s peak velocity). Third, noise exposure did not result in significant changes in gain or phase of the horizontal rotational and translational vestibular-ocular reflex (VOR). These results suggest that noise exposure not only causes hearing loss, but also causes substantial damage in the peripheral vestibular system in the absence of immediate clinically measurable vestibular signs. These peripheral deficits, however, may lead to vestibular disorders over time.

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Effects of pulsatile electrical stimulation of the round window on central hyperactivity after cochlear trauma in guinea pig

Effects of high intensity noise on the vestibular system in rats

Effects of pulsatile electrical stimulation of the round window on central hyperactivity after cochlear trauma in guinea pig

Effects of high intensity noise on the vestibular system in rats

Clinical Practice Recommendations For The Management And Prevention Of Cisplatin-Induced Hearing Loss Using Pharmacogenetic Markers.

Clinical Practice Recommendations For The Management And Prevention Of Cisplatin-Induced Hearing Loss Using Pharmacogenetic Markers.

Ther Drug Monit. 2016 Mar 5;

Authors: Lee JW, Pussegoda K, Rassekh RS, Monzon JG, Liu G, Hwang S, Bhavsar AP, Pritchard S, Ross CJ, Amstutz U, Carleton BC, CPNDS clinical recommendations group

Abstract
Currently no pharmacogenomics-based criteria exist to guide clinicians in identifying individuals who are at risk of hearing loss from cisplatin-based chemotherapy. This review summarizes findings from pharmacogenomic studies that report genetic polymorphisms associated with cisplatin-induced hearing loss and aims to (1) provide up-to-date information on new developments in the field; (2) provide recommendations for the use of pharmacogenetic testing in the prevention, assessment and management of cisplatin-induced hearing loss in children and adults; and (3) identify knowledge gaps to direct and prioritize future research. These practice recommendations for pharmacogenetic testing in the context of cisplatin-induced hearing loss reflect a review and evaluation of recent literature and are designed to assist clinicians in providing optimal clinical care for patients receiving cisplatin based chemotherapy.

PMID: 26960170 [PubMed - as supplied by publisher]

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A case report: the first successful cochlear implant in Uganda.

A case report: the first successful cochlear implant in Uganda.

Afr Health Sci. 2015 Dec;15(4):1342-8

Authors: Byaruhanga R, Roland JT, Buname G, Kakande E, Awubwa M, Ndorelire C, Namwagala J

Abstract
Hearing impairment is a significant disability. According to the World Health Organization (WHO), more than 80% of the world's approximately 120 million people with hearing impairment live in developing countries. Cochlear implant is the only therapeutic intervention for those with severe-profound sensorineural hearing loss. We are reporting an interesting case of the very first cochlear implant operation carried out in Uganda. The patient was a 23 year old male whose presenting complaint was inability to hear in the left ear for three and a half years and in the right ear for one year. He had been treated for TB(Tuberculosis) mastoiditis. After the 8 months of treatment, the otorrhea persisted and he underwent a tympanomastoidectomy on the same ear. He reported no familial history of hearing loss. On examination, ENT examination revealed a small pars flaccida retration pocket of the right tympanic membrane with cholesteatoma. The left ear had an intact tympanic membrane. Pure tone audiometry revealed profound sensorineural hearing loss in both ears (see attached PTA results), CT scan of the temporal bone showed normal inner ear anatomy bilaterally and mild sclerotic changes in both mastoid bones. He then had surgery on his right ear which included cochlear implantation. The cochlear implant (CI) was activated on the first postoperative day remotely via internet with the help of the cochlear implant team at New York University Cochlear Implant Center and the patient was immediately able to appreciate some sounds. He received a pneumococcal vaccine on the first postoperative day and was discharged the following day.

PMID: 26958040 [PubMed - in process]

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Pediatric Auditory Brainstem Implant Surgery: A New Option for Auditory Habilitation in Congenital Deafness?

Pediatric Auditory Brainstem Implant Surgery: A New Option for Auditory Habilitation in Congenital Deafness?

J Am Board Fam Med. 2016 Mar-Apr;29(2):286-8

Authors: Shah PV, Kozin ED, Kaplan AB, Lee DJ

Abstract
INTRODUCTION: The auditory brainstem implant (ABI) is a neuroprosthetic device that provides sound sensations to individuals with profound hearing loss who are not candidates for a cochlear implant (CI) because of anatomic constraints. Herein we describe the ABI for family physicians.
METHODS: PubMed was searched to identify articles relevant to the ABI, as well as articles that contain outcomes data for pediatric patients (age <18 years) who have undergone ABI surgery.
RESULTS: The ABI was originally developed for patients with neurofibromatosis type 2 (NF2) who become deaf from bilateral vestibular schwannomas. Over the past decade, indications for an ABI have expanded to adult patients without tumors (without NF2) who cannot receive a CI and children with no cochlea or cochlear nerve. Outcomes among NF2 ABI users are modest compared to cochlear implant patients, but recent studies from Europe suggest that some non-tumor adult and pediatric ABI users achieve speech perception.
CONCLUSION: The ABI is a reasonable surgical option for children with profound hearing loss due to severe cochlear or cochlear nerve deformities. Continued prospective data collection from several clinical trials in the U.S. will provide greater understanding on long term outcomes that focus on speech intelligibility.

PMID: 26957388 [PubMed - in process]

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Endothelial dysfunction in patients with sudden sensorineural hearing loss.

Endothelial dysfunction in patients with sudden sensorineural hearing loss.

Adv Biomed Res. 2016;5:5

Authors: Berjis N, Moeinimehr M, Hashemi SM, Hashemi SM, Bakhtiari EK, Nasiri S

Abstract
BACKGROUND: Endothelial dysfunction probably has a role in the etiology of sudden sensorineural hearing loss (SSNHL). The aim of this study was determining of the relationship between endothelial dysfunction and SSNHL.
MATERIALS AND METHODS: In a case-control study, 30 patients with SSNHL and 30 otherwise healthy age and sex-matched controls were studied. Demographic data gathered included age, gender, family history of SSNHL, and history of smoking, cardiovascular disease, hypertension, diabetes, and dyslipidemia. Laboratory data included measurement of hemoglobin, fasting blood sugar (FBS) and lipid profile. Endothelial function was assessed by measuring flow-mediated dilation (FMD).
RESULTS: The two groups were the same in age (47.9 ± 9.3 and 48.1 ± 9.6 years, P = 0.946) with female/male ratio of 1:1 in both groups. Diabetes and dyslipidemia were more frequent in patients than controls (20% vs. 0%, P = 0.024). Brachial artery diameter was greater in patients than controls before (4.24 ± 0.39 vs. 3.84 ± 0.23 mm, P < 0.001) and after ischemia (4.51 ± 0.43 vs. 4.28 ± 0.27 mm, P = 0.020), but FMD was lower in patients than controls (6.21 ± 3.0 vs. 11.52 ± 2.30%, P < 0.001). Binary logistic regression analysis showed that FMD was associated with SSNHL independent from FBS and lipid profile (odds ratio [95% confidence interval] =0.439 [0.260-0.740], P = 0.002).
CONCLUSION: Endothelial dysfunction, among other cardiovascular risk factors, is associated with SSNHL. This association is independent from other cardiovascular risk factors including diabetes and dyslipidemia.

PMID: 26955626 [PubMed]

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