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Blood tests as biomarkers for the diagnosis and prognosis of sudden sensorineural hearing loss in adults: a systematic review

Published online by Cambridge University Press:  16 February 2023

A Al-Azzawi  and
E Stapleton Open the ORCID record for E Stapleton [Opens in a new window]
A Al-Azzawi
Affiliation:
Medical School, University of Manchester, Manchester, UK
E Stapleton*
Affiliation:
Department of Otolaryngology, Manchester Royal Infirmary, Manchester, UK
*
Corresponding author: Dr E Stapleton; Email: emmastapleton@doctors.org.uk
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Abstract

Objective

Sudden sensorineural hearing loss is considered idiopathic in up to 90 per cent of cases. This study explored the role of blood tests as biomarkers for the diagnosis and prognosis of sudden sensorineural hearing loss.

Method

Two researchers filtered 34 papers into the final review. This review was pre-registered on the Prospero database and conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines.

Results

Raised inflammatory markers are almost universal in sudden sensorineural hearing loss, suggesting an inflammatory or autoimmune process. The most useful biomarkers are neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and fibrinogen level. Focused investigations should be deployed on a case-by-case basis to identify underlying metabolic, infective and autoimmune conditions.

Conclusion

A full blood count and coagulation screen (fibrinogen) is recommended in all cases of sudden sensorineural hearing loss. These are inexpensive, accessible and offer as much diagnostic and prognostic information as any other biomarker. There is emerging evidence regarding specific biomarkers for sudden sensorineural hearing loss prognosis, with heat shock protein-70, anti-endothelial cell antibody and prestin demonstrating potential; investigation of their validity through prospective, controlled research is recommended.

Keywords

Hearing disordershearingloss' suddenhearingloss' sensorineuralbiomarkersearly diagnosisprognosisblood cell count
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 9 , September 2023 , pp. 977 - 984
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr E Stapleton takes responsibility for the integrity of the content of the paper

References

NICE. Hearing loss. Hearing loss in adults: assessment and management, 2018. In: https://www.nice.org.uk/guidance/ng98 [27 June 2023]Google Scholar
Hughes, GB, Freedman, MA, Haberkamp, TJ, Guay, M. Sudden SNHL. Otolaryngol Clin North Am 1996;29:393–405CrossRefGoogle Scholar
Mijovic, T, Zeitouni, A, Colmegna, I. Autoimmune sensorineural hearing loss: the otology-rheumatology interface. Rheumatol 2013;52:780–9CrossRefGoogle ScholarPubMed
Linthicum, FH, Doherty, J, Berliner, KI. Idiopathic sudden sensorineural hearing loss. Otolaryngol Head Neck Surg 2013;149:914–7CrossRefGoogle ScholarPubMed
Cadoni, G, Agostino, S, Scipione, S, Galli, J. Low serum folate levels: a risk factor for sudden sensorineural hearing loss? Acta Otolaryngol 2004;124:608–11CrossRefGoogle Scholar
Tayer-Shifman, OE, Ilan, O, Tovi, H, Tal, Y. Cogan's syndrome - clinical guidelines and novel therapeutic approaches. Clin Rev Allergy Immunol 2014;47:65–72CrossRefGoogle ScholarPubMed
Heman-Ackah, SE, Jabbour, N, Huang, TC. Asymmetric sudden sensorineural hearing loss: is all this testing necessary? Otolaryngol Head Neck Surg 2010;39:486–90Google ScholarPubMed
Rossini, B, Penido, N, Munhoz, M, Bogaz, E, Curi, R. Sudden sensorioneural hearing loss and autoimmune systemic diseases. Int Arch Otorhinolaryngol 2017;21:213–23Google ScholarPubMed
Wiles, NM, Hunt, BJ, Callanan, V, Chevretton, EB. Sudden sensorineural hearing loss and antiphospholipid syndrome. Haematologica 2006;91(suppl 12):ECR46Google ScholarPubMed
Boulassel, MR, Deg, N. Inner ear autoantibodies and their targets in patients with autoimmune inner ear diseases. Acta Otolaryngol 2001;121:28–34Google ScholarPubMed
Čvorović, L, Đeric, D, Probst, R, Hegemann, S. Prognostic model for predicting hearing recovery in idiopathic sudden sensorineural hearing loss. Otol Neurotol 2008;29:464–9CrossRefGoogle ScholarPubMed
Dayal, VS, Ellman, M, Sweiss, N. Autoimmune inner ear disease: clinical and laboratory findings and treatment outcome. Otolaryngol Head Neck Surg 2008;37:591–6Google ScholarPubMed
Chandrasekhar, SS, Tsai Do, BS, Schwartz, SR, Bontempo, LJ, Faucett, EA, Finestone, SA et al. clinical practice guideline: sudden hearing loss. Otolaryngol Head Neck Surg 2019;161:S1–S45Google ScholarPubMed
Ågrup, C, Luxon, LM. Immune-mediated inner-ear disorders in neuro-otology. Curr Opin Neurol 2006;19:26–32CrossRefGoogle ScholarPubMed
Magro, CM, Poe, JC, Lubow, M, Susac, JO. Susac syndrome. Am J Clin Pathol 2011;136:903–12CrossRefGoogle ScholarPubMed
Cooper, GS, Bynum, MLK, Somers, EC. Recent insights in the epidemiology of autoimmune diseases: improved prevalence estimates and understanding of clustering of diseases. J Autoimmun 2009;33:197–207CrossRefGoogle ScholarPubMed
Toubi, E, Halas, K, Ben-David, J, Sabo, E, Kessel, A, Luntz, M. Immune-mediated disorders associated with idiopathic sudden sensorineural hearing loss. Ann Otology Rhinol Laryngol 2004;113:445–9CrossRefGoogle ScholarPubMed
Sun, Y, Xia, L, Wang, H, Chen, Z, Wu, Y, Chen, B et al. Is nucleate cell count and neutrophil to lymphocyte ratio related to patients with audiographically distinct sudden sensorineural hearing loss? Medicine 2018;97:e10586CrossRefGoogle ScholarPubMed
Salvago, P, Rizzo, S, Bianco, A, Martines, F. Sudden sensorineural hearing loss: is there a relationship between routine haematological parameters and audiogram shapes? Int J Audiol 2017;56:148–53CrossRefGoogle Scholar
Durmuş, K, Terzi, H, Karataş, TD, Doğan, M, Uysal, IÖ, Şencan, M et al. Assessment of hematological factors involved in development and prognosis of idiopathic sudden sensorineural hearing loss. J Craniofac Surg 2016;27:e85–91CrossRefGoogle ScholarPubMed
Seo, YJ, Jeong, J hui, Choi, JY, Moon, IS. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio: novel markers for diagnosis and prognosis in patients with idiopathic sudden sensorineural hearing loss. Dis Markers 2014;2014:1–6CrossRefGoogle ScholarPubMed
Seo, YJ, Park, YA, Bong, JP, Park, DJ, Park, SY. Predictive value of neutrophil to lymphocyte ratio in first-time and recurrent idiopathic sudden sensorineural hearing loss. Auris Nasus Larynx 2015;42:438–42CrossRefGoogle ScholarPubMed
Cao, Z, Li, Z, Xiang, H, Huang, S, Gao, J, Zhan, X et al. Prognostic role of haematological indices in sudden sensorineural hearing loss: review and meta-analysis. Clinica Chimica Acta 2018;483:104–11CrossRefGoogle ScholarPubMed
Zhang, X, Weng, Y, Xu, Y, Xiong, H, Liang, M, Zheng, Y et al. Selected blood inflammatory and metabolic parameters predicted successive bilateral sudden sensorineural hearing loss. Dis Markers 2019;2019:1–9Google ScholarPubMed
Bozan, N, Alpaycı, M, Aslan, M, Cankaya, H, Kıroglu, AF, Turan, M et al. Mean platelet volume, red cell distribution width, platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios in patients with ankylosing spondylitis and their relationships with high-frequency hearing thresholds. Eur Arch Otorhinolaryngol 2016;273:3663–72CrossRefGoogle ScholarPubMed
Sancaktar, ME, Ağrı, İ, Çeçen, AB, Akgül, G, Çelebi, M. The prognostic value of circulating inflammatory cell counts in sudden sensorineural hearing loss and the effect of cardiovascular risk factors. Ear Nose Throat J 2020;99:464–9CrossRefGoogle ScholarPubMed
Ulu, Ş, Kınar, A, Bucak, A, Özdemir, M. Systemic immune inflammatory index of patients with idiopathic sudden sensorineural hearing loss: comparison of neutrophil-lymphocyte ratio and PRL values. Ear Nose Throat J 2021;100:726–30CrossRefGoogle Scholar
Sun, C, Xuan, X, Zhou, Z, Yuan, Y, Xue, F. A Preliminary report on the investigation of prestin as a biomarker for idiopathic sudden sensorineural hearing loss. Ear Nose Throat J 2020;99:528–31CrossRefGoogle ScholarPubMed
Parker, A, Parham, K, Skoe, E. Reliability of serological prestin levels in humans and its relation to otoacoustic emissions, a functional measure of outer hair cells. Ear Hear 2021;42:1151–62CrossRefGoogle ScholarPubMed
Sciancalepore, PI, de Robertis, V, Sardone, R, Quaranta, N. Sudden sensorineural hearing loss: what factors influence the response to therapy? Audiol Res 2020;10:234CrossRefGoogle ScholarPubMed
Xie, S, Ning, H, She, Y, Jing, Q, Jiang, Q, Zhang, Y et al. Effect of systemic lupus erythematosus and rheumatoid arthritis on sudden sensorineural hearing loss. Laryngoscope 2020;130:2475–80CrossRefGoogle ScholarPubMed
Kanzaki, S, Sakagami, M, Hosoi, H, Murakami, S, Ogawa, K. High fibrinogen in peripheral blood correlates with poorer hearing recovery in idiopathic sudden sensorineural hearing loss. PLoS One 2014;9:e104680CrossRefGoogle ScholarPubMed
Hira, I, Yasar, M, Kaya, A, Bayram, A, Ozcan, I. Prognostic value of fibrinogen/hdl ratio in idiopathic sudden sensorineural hearing loss. J Int Adv Otol 2021;17:91–5CrossRefGoogle ScholarPubMed
Cayir, S, Kayabasi, S, Hizli, O. Predictor parameters for poor prognosis in patients with sudden sensorineural hearing loss: fibrinogen to albumin ratio vs C-reactive protein to albumin ratio. Braz J Otorhinolaryngol 2021;87:457–61CrossRefGoogle ScholarPubMed
Cadoni, G, Fetoni, AR, Agostino, S, Santis, A de, Manna, R, Ottaviani, F et al. Autoimmunity in sudden sensorineural hearing loss: possible role of anti-endothelial cell autoantibodies. Acta Otolaryngol 2002;122:30–3CrossRefGoogle Scholar
Cadoni, G, Agostino, S, Manna, R, de Santis, A, Fetoni, AR, Vulpiani, P et al. Clinical associations of serum antiendothelial cell antibodies in patients with sudden sensorineural hearing loss. Laryngoscope 2003;113:797–801CrossRefGoogle ScholarPubMed
Bertoli, LF, Pappas, DG, Barton, JC, Barton, JC. Serum immunoglobulins in 28 adults with autoimmune sensorineural hearing loss: increased prevalence of subnormal immunoglobulin G1 and immunoglobulin G3. BMC Immunol 2014;15:43CrossRefGoogle ScholarPubMed
Gündoğan, F, Bayram, A, Kalkan, M, Özcan, İ. Plasma levels of endothelial cell-specific molecule-1 and pentraxin-3 in idiopathic sudden sensorineural hearing loss. J Laryngol Otol 2018;132:995–9CrossRefGoogle ScholarPubMed
Lee, JM, Kim, JY, Bok, J, Kim, KS, Choi, JY, Kim, SH. Identification of evidence for autoimmune pathology of bilateral sudden sensorineural hearing loss using proteomic analysis. Clinical Immunology 2017;183:24–35CrossRefGoogle ScholarPubMed
Ianuale, C, Cadoni, G, de Feo, E, Liberati, L, Simo, RK, Paludetti, G et al. A systematic review and meta-analysis of the diagnostic accuracy of anti-heat shock protein 70 antibodies for the detection of autoimmune hearing loss. Otol Neurotol 2013;34:214–9CrossRefGoogle ScholarPubMed
Cao, Z, Gao, J, Huang, S, Xiang, H, Zhang, C, Zheng, B et al. Genetic polymorphisms and susceptibility to sudden sensorineural hearing loss: a systematic review. Audiol Neurotol 2019;24:8–19CrossRefGoogle ScholarPubMed
Masuda, M, Kanzaki, S, Minami, S, Kikuchi, J, Kanzaki, J, Sato, H et al. Correlations of inflammatory biomarkers with the onset and prognosis of idiopathic sudden sensorineural hearing loss. Otol Neurotol 2012;33:1142–50CrossRefGoogle ScholarPubMed
Chen, L, Zhang, G, Zhang, Z, Wang, Y, Hu, L, Wu, J. Neutrophil-to-lymphocyte ratio predicts diagnosis and prognosis of idiopathic sudden sensorineural hearing loss. Medicine 2018;97:e12492CrossRefGoogle ScholarPubMed
Guo, Y, Liu, J. The roles played by blood inflammatory parameters in sudden sensorineural hearing loss. Ear Nose Throat J 2021;2021 014556132096035 Epub 2021 Oct 18CrossRefGoogle ScholarPubMed
Kang, JW, Kim, MG, Kim, SS, Im, HI, Dong, SH, Kim, SH et al. Neutrophil-lymphocyte ratio as a valuable prognostic marker in idiopathic sudden sensorineural hearing loss. Acta Otolaryngol 2020;140:307–13CrossRefGoogle ScholarPubMed
Özler, GS. Increased neutrophil-lymphocyte ratio in patients with idiopathic sudden sensorineural hearing loss. J Craniofac Surg 2014;25:e260–3CrossRefGoogle ScholarPubMed
Özcan, İ, Hira, İ, Kaya, A, Yaşar, M, Doğan, M, Mutlu, C. The prognostic and predictive value of platelet parameters in diabetic and nondiabetic patients with sudden sensorineural hearing loss. Open Life Sci 2020;15:884–9CrossRefGoogle ScholarPubMed
Koçak, HE, Elbistanlı, MS, Acıpayam, H, Alakras, WME, Kıral, MN, Kayhan, FT. Are neutrophil/lymphocyte and platelet/lymphocyte ratios related with formation of sudden hearing loss and its prognosis? Eur Ann Otorhinolaryngol Head Neck Dis 2017;134:383–6CrossRefGoogle ScholarPubMed
Qiao, XF, Li, X, Wang, GP, Bai, YH, Zheng, W, Li, TL. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with sudden sensorineural hearing loss. Med Princ Pract 2019;28:23–7CrossRefGoogle ScholarPubMed
Sun, Y, Guo, Y, Wang, H, Chen, Z, Wu, Y, Shi, H et al. Differences in platelet-related parameters among patients with audiographically distinct sudden sensorineural hearing loss. Medicine 2017;96:e7877CrossRefGoogle ScholarPubMed
Yildiz, S, Zer Toros, S. Vascular occlusion role in the etiopathohegenesis of idiopathic sudden sensorineural hearing loss: risk analysis with hematological parameters. J Coll Physicians Surg Pak 2020;30:606–10Google ScholarPubMed
Mirvakili, A, Dadgarnia, MH, Baradaranfar, MH, Atighechi, S, Zand, V, Ansari, A. Role of platelet parameters on sudden sensorineural hearing loss: a case-control study in Iran. PLoS One 2016;11:e0148149CrossRefGoogle ScholarPubMed
Ni, W, Song, SP, Jiang, YD. Association between routine hematological parameters and sudden sensorineural hearing loss: a meta-analysis. J Otol 2021;16:47–54CrossRefGoogle ScholarPubMed
Oya, R, Takenaka, Y, Imai, T, Sato, T, Osaki, Y, Ohta, Y et al. Serum fibrinogen as a prognostic factor in sudden sensorineural hearing loss: a meta-analysis. Otol Neurotol 2018;39:e929–35CrossRefGoogle ScholarPubMed
Xie, W, Dai, Q, Liu, J, Liu, Y, Hellström, S, Duan, M. Analysis of clinical and laboratory findings of idiopathic sudden sensorineural hearing loss. Sci Rep 2020;10:6057CrossRefGoogle ScholarPubMed
Berger, T, Kaiser, T, Scholz, M, Bachmann, A, Ceglarek, U, Hesse, G et al. Fibrinogen is not a prognostic factor for response to HELP-apheresis in sudden sensorineural hearing loss (SSHL). Eur Arch Otorhinolaryngol 2015;272:3693–703CrossRefGoogle Scholar
Li, H, Zhang, M, Wang, M, Zhang, S, Ma, S, Wang, X. Clinical feature and prognosis of sudden sensorineural hearing loss with rheumatoid arthritis. Otol Neurotol 2021;42:e267–71CrossRefGoogle ScholarPubMed
Li, C, Zhou, H, Feng, Y, Zhao, Y, Wang, J, Chen, Z et al. Coagulation states in patients with sudden sensorineural hearing loss evaluated by thromboelastography. Otolaryngol Head Neck Surg 2021;164:1280–6CrossRefGoogle ScholarPubMed
Zheng, Z, Liu, C, Shen, Y, Xia, L, Xiao, L, Sun, Y et al. Serum albumin levels as a potential marker for the predictive and prognostic factor in sudden sensorineural hearing loss: a prospective cohort study. Front Neurol 2021;12:747561CrossRefGoogle ScholarPubMed
Mohammed, AAM. Lipid profile among patients with sudden sensorineural hearing loss. Indian J Otolaryngol Head Neck Surg 2014;66:425–8CrossRefGoogle ScholarPubMed
Lam, M, Bao, Y, Hua, GB, Sommer, DD. Sudden sensorineural hearing loss and metabolic syndrome: systematic review and meta-analysis. Otol Neurotol 2021;42:1308–13CrossRefGoogle ScholarPubMed
Chang, IJ, Kang, CJ, Yueh, CY, Fang, KH, Yeh, RM, Tsai, YT. The relationship between serum lipids and sudden sensorineural hearing loss: a systematic review and meta-analysis. PLoS One 2015;10:e0121025CrossRefGoogle ScholarPubMed
Jeong, J, Lim, H, Lee, K, Hong, CE, Choi, HS. High risk of sudden sensorineural hearing loss in several autoimmune diseases according to a population-based national sample cohort study. Audiol Neurotol 2019;24:224–30CrossRefGoogle ScholarPubMed
Zhai, SQ. Review of experimental and clinical studies on autoimmune sensorineural hearing loss. Minerva Med 2015;106:177–80Google ScholarPubMed
Hirose, K, Wener, MH, Duckert, LG. Utility of laboratory testing in autoimmune inner ear disease. Laryngoscope 1999;109:1749–54CrossRefGoogle ScholarPubMed
Psillas, G, Binos, P, Dimas, GG, Daniilidis, M, Constantinidis, J. Human leukocyte antigen (HLA) influence on prognosis of autoimmune hearing loss. Audiol Res 2021;11:31–7CrossRefGoogle ScholarPubMed
Zhou, B, Kermany, MH, Cai, Q, Cai, C, Zhou, Y, Nair, U et al. Experimental autoimmune hearing loss is exacerbated in IL-10-deficient mice and reversed by IL-10 gene transfer. Gene Ther 2012;19:228–35CrossRefGoogle ScholarPubMed
Chien, CY, Tai, SY, Li, KH, Yang, HL, Chan, LP, Hsi, E et al. The association of genetic polymorphisms in interleukin-1 receptors type 1 and type 2 with sudden sensorineural hearing loss in a Taiwanese population: a case control study. Otolaryngol Head Neck Surg 2021;50:69CrossRefGoogle Scholar
Nelson, L, Johns, JD, Gu, S, Hoa, M. Utilizing single cell RNA-sequencing to implicate cell types and therapeutic targets for sudden sensorineural hearing loss in the adult cochlea. Otol Neurotol 2021;42:e1410–21CrossRefGoogle ScholarPubMed