Sudden hearing loss in people over 60 may indicate blood vessel problems in the brain. Dutch researchers concluded this in a study published on May 1 in the scientific journal Scientific reports popped up. In younger people with acute hearing problems, they see no connection with vascular disease.
With sudden deafness, hearing deteriorates sharply within a few seconds to minutes, usually on one side. The perceived sound may suddenly sound duller or distorted, or may even no longer be perceived at all. It occurs in people of all ages. Acute hearing loss affects approximately 1 in 12,500 people in the Netherlands every year, approximately 1,500 people per year.
The causes of acute hearing loss are diverse: it can be caused by a head injury or a tumor, by an infection, an autoimmune disease, or by certain medications. However, often the cause is not clear. The current treatment consists of anti-inflammatory corticosteroids, based on the suspicion that a viral infection is the culprit. But that treatment is only effective in 30 to 50 percent of patients.
Stroke
For several years now, scientists have also suggested vascular damage as a possible cause of acute hearing loss, but until now studies have been based on data from insurers. These are often medically incomplete and less reliable.
In the new study, researchers from Gelre hospitals in Apeldoorn, the Radboudumc in Nijmegen and the LUMC in Leiden searched the electronic patient files from 2011 to 2021 of 84 general practices. They found 480 adults with acute hearing loss. They compared their data and fate with those of 1,911 patients who did not have it – for every patient with hearing loss, there were four controls matched for gender, age and general practice. They mapped out which of the patients suffered a cerebral infarction or hemorrhage within five years, or a TIA (transient ischemic attack) – a temporary blockage of a blood vessel in the brain.
When all adults were taken together, the researchers saw no clear difference in the risk of stroke or TIA between the people who had developed acute hearing problems and the other patients. But that risk increased sharply in people aged 60 and over. Above that age, the risk of stroke for people with sudden hearing loss was suddenly 4.84 times higher than in the control group.
Sudden deafness can therefore possibly be seen as an indication of vascular damage, the researchers conclude. “This deafness may be caused by a TIA,” says Tjard Schermer, one of the authors of the study and epidemiologist at Radboud university medical center. “You also see this in a form of temporary, acute blindness in one eye, amaurosis fugax.”
High cholesterol
It is still too early to adjust the treatment and give blood thinners to every person over 60 with acute hearing loss. “We now see that there is a connection. In follow-up research, we will examine whether vascular damage can be seen again in patients with acute hearing loss and during check-ups in several hospitals or on MRI images,” says Schermer. “But based on the findings, it is recommended to look carefully at the risk profile for cardiovascular disease if an older patient presents with acute hearing loss. For example, if the patient also smokes, or has high cholesterol or high blood pressure, it may be useful to give blood thinners.”
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