Effect of steroid therapy on saccule and semicircular canals function in patients with unilateral sudden sensorineural hearing loss

Abstract

Background and Aim: In unilateral sudden sensorineural hearing loss (SSNHL), the ves­tibular system may be involved in addition to the auditory system. Several hearing assess­ments have shown that the disease course and the patient's improvement, at least two step of vestibular assessments can help in better control of the patient's balance function. The aim of this study was to evaluate the results of cervical ves­tibular evoked myogenic potentials (cVEMP) and video head impulse test (vHIT) used for assessment of saccule and semicircular canals before and after steroid therapy.

Methods: Twenty three patients with SSNHL were evaluated for auditory and vestibular func­tion before and after steroid therapy. The results of cVEMP and vHIT were compared between intact and impaired ears and between pretest/
posttest stages before and after treatment.

Results: For 26.08% of patients, the cVEMP response was absent in the affected ear, but after treatment it was reported for all patients. There was a significant difference in vestibulo-ocular reflex (VOR) gain for both posterior and ante­rior semicircular canals of affected ear before and after treatment, but it was not significantly different after treatment as VOR gain increased.

Conclusion: Dysfunction of nervous and vesti­bular systems in SSNHL is possible. Steroid therapy can improve the vestibular function and hearing of these patients. Therefore, vestibular evaluation can be used to determine the extent of lesions in SSNHL.

Keywords: Unilateral sudden sensorineural hearing loss; vestibular evoked myogenic potentials; saccule; semicircular canals; video head impulse test