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Am J Otolaryngol
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A R T I C LE I N FO A B S T R A C T
Keywords: Background: Due to high prevalence of vitamin D deficiency and the possible association with Sudden Sensory-
Sudden Sensory-Neural Hearing Loss (SSNHL) Neural Hearing Loss (SSNHL) finding the main causes and appropriate treatments are highly essential. This study
Response to treatment aimed to investigate vitamin D levels in patients suffering SSNHL and its effect on response to treatment.
Vitamin D Materials and methods: This cross-sectional study was performed on two groups of case (34 SSNHL patients) and
control (34 healthy subjects without risk of hearing loss). All patient information such as age, sex, audiogram
illustration of hearing frequency and the level of vitamin D were recorded at baseline. Patients with SSNHL
received routine treatments such as 10 days of 1 mg/kg/day steroid and the response or lack of complete re-
sponse to treatment was recorded and analyzed according to the audiometry.
Results: Vitamin D level in SSNHL group with a mean of 19.28 ± 9.56 ng/ml was significantly less than the
control group (25.71 ± 11.21 ng/ml; P value < 0.001). After treatment, 76.5% were completely recovered and
23.5% did not recover completely. Factors such as age, sex and level of initial hearing loss did not have a
significant effect on the response to treatment, but the level of vitamin D in these patients had a significant
relationship with the response to treatment (P value = 0.004); so that all patients with sufficient vitamin D level
had completely recovered, versus 87.5% of patients with vitamin D deficiency and 12.5% of insufficient vitamin
D had no response to treatment.
Conclusion: According to the results of the present study, the prevalence of vitamin D deficiency in patients with
SSNHL was more than healthy people. SSNHL patients with deficient vitamin D had the highest percentage of no
response to treatment.
1. Introduction unknown cause, the best and most effective cure is corticosteroids.
Other treatments are intravenous and oral steroids, intratympanic
Sudden Sensory-Neural Hearing Loss (SSNHL) refers to hearing loss steroid treatment, hyperbaric oxygen therapy, meglumine, antiviral
above 30 dB (or higher) in three consecutive frequencies occurring drugs, anticoagulants, vasodilators such as papaverine, nicotinic acid
within a 72-h period [1]. The estimated annual incidence of SSNHL is and anti-inflammatory drugs [7,8].
5–30 cases in every 100,000 with annual report of 15,000 new cases all On the other hand, it is estimated that around one billion people
over the world and about 4000 new cases in the USA [2]. worldwide suffer from vitamin D deficiency. The prevalence of vitamin
On the other hand, though the causes of SSNHL are unknown and D deficiency has been observed in Middle Eastern and Asian countries
the case is classified as idiopathic, the identified causes of the disease (including Iran), which 50.8% of adults with high levels of vitamin D
can be trauma, infection, neoplasm, blood vessel diseases, autoimmune deficiency [9–11]. Today, vitamin D deficiency in adults is associated
diseases and central nervous system disorders [3]. with cases such as autoimmune diseases, increased triglycerides, type 1
This disease is one of the most controversial issues in otorhinolar- and type 2 diabetes and neoplasms, and in children with severe asthma,
yngology. It is the responsibility of physicians to seek out specific bronchiolitis, and decreased or lack of response to corticosteroids
causes, and to identify and investigate effective factors in its prognosis [12,13]. In addition, given the presence of vitamin D receptor in the
and to find the appropriate treatment for this agitating and annoying inner ear, it seems reasonable that deficiency of this vitamin can cause
disease [4–6]. problems in this area [14,15]. Moreover, vitamin D deficiencies or its
The treatment of SSNHL is based on its cause. In case of SSNHL with metabolic derivatives 25-OHD and 1.25(OH)2D may directly lead to
⁎
Corresponding author.
E-mail addresses: Mj.6483@gmail.com, www.mj_6483@yahoo.com (M. Jamshidi-koohsari).
https://doi.org/10.1016/j.amjoto.2019.102327
Received 2 October 2019
0196-0709/ © 2019 Elsevier Inc. All rights reserved.
Please cite this article as: Hossein Ghazavi, Amir-Abbas Kargoshai and Mohammad Jamshidi-koohsari, Am J Otolaryngol,
https://doi.org/10.1016/j.amjoto.2019.102327
H. Ghazavi, et al. Am J Otolaryngol xxx (xxxx) xxxx
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H. Ghazavi, et al. Am J Otolaryngol xxx (xxxx) xxxx
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H. Ghazavi, et al. Am J Otolaryngol xxx (xxxx) xxxx
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