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Doppler Ultrasonography of the Vertebrobasilar Circulation in Patients with Sudden Sensorineural Hearing Loss

The etiology of sudden sensorineural hearing loss (SSNHL) is still unclear and is most probably diverse. Our objective was to determine the relationship between vertebrobasilar circulation and hearing in patients with SSNHL treated with pentoxifylline. Our case-control study consisted of 32 consecutive patients with SSNHL. Transcranial Doppler (TCD) ultrasonography of vertebrobasilar circulation and hearing levels were examined at onset of SSNHL (before treatment), after 10 days of therapy, and after 3 months. Patients with SSNHL had more frequent pathologic TCD ultrasonographic finding compared with a normal population. Thirteen patients with SSNHL had normal TCD ultrasonographic findings, eight had borderline findings, and six had pathologic findings, and in five patients, initially, pathologic TCD ultrasonohraphic findings improved during therapy. Patients with normal TCD ultrasonographic findings had an avreage hearing improvement of 17 dB, whereas patients with borderline and pathologic TCD ultrasonographic finding had 3 and 0 dB of avreage hearing improvement, respectively. Athough the number of patients is small, our results led to the conclusion that SSNHL has vascular etiology, at least in some patients. Consequently, the therapy for SSNHL should depend on etiology ; that is, vasoactive medications should be reserved for patients with supposed vascular etiology. TCD ultrasonography could have a role in the decision regarding the optimal treatement of SSNHL.

Doppler ultrasonography; sudden sensorineural hearing loss; vertebrobasilar circulation

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