Vertigo as a Prognostic Indicator of Outcome in Sudden Sensorineural Hearing Loss

In this issue of JAMA Otolaryngology–Head & Neck Surgery, Yu et al report results of their meta-analysis of sudden sensorineural hearing loss (SSHL) literature, addressing the association of vertigo with the hearing outcome. They screened 685 articles, of which 10 met inclusion criteria, including 4814 patients with SSHL, of whom 1709 (35.5%) had vertigo and 3105 (64.5%) did not. Overall, the rate of hearing recovery was 42.13% in the vertigo group and 60.29% in the nonvertigo group, suggesting that vertigo is negatively associated with the hearing outcome in SSHL. Subgroup analysis by treatment modality (systemic corticosteroid alone vs systemic corticosteroid and/or intratympanic corticosteroid) found that the difference in hearing outcome as a function of vertigo was present only in the systemic corticosteroid treatment subgroup; no difference in rates of hearing recovery were found between vertigo and nonvertigo groups in patients treated with intratympanic corticosteroids. The authors do not report the recovery rates of each subgroup. They conclude that use of intratympanic treatment might be preferable in patients with SSHL who present with vertigo, but methodologic limitations of the study preclude drawing a strong conclusion.

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