Association Between Vertigo and Hearing Prognosis in Patients with Sudden Sensorineural Hearing Loss: a Systematic Review and Meta-analysis

ABSTRACT Objective. Our aim was to explore the relationship between vertigo symptoms and the prognosis of hearing indicators in patients with sudden sensorineural hearing loss. Data Source. Eligible studies were identified from the “PubMed”, “EMBASE”, and “Web of Science” databases from January 2000 to September 2023. Study Selection. Studies were selected from all original and retrospective or prospective studies that focused on the relationship between vertigo and hearing prognosis in patients with sudden sensorineural hearing loss. Data Extraction and Synthesis. Observational metrics for data extraction included type of study, number of subjects with or without vertigo, treatment regimen, definition of pure tone hearing thresholds, criteria for hearing improvement, treatment duration, follow-up time, and age distribution of subjects. Meta-analysis was performed using Stata 15 software. Main Outcome and Measure. Association of vertigo symptoms and the prognosis of hearing indicators in patients with sudden sensorineural hearing loss. Results. A total of 4290 patients with sudden sensorineural hearing loss were identified in 23 studies. The hearing recovery rate was 40.8% in the group with vertigo and 53.76% in the group without vertigo. Vertigo was significantly associated with poorer hearing recovery (OR = 2.13; 95% CI, 1.63-2.79; I = 68.3%). Subgroup analyses revealed similar results for medication (OR=2.65; 95% CI, 1.84-3.83; I = 50.8%). However, an attenuated association between vertigo and the prognosis of sudden sensorineural hearing loss was observed in the subgroups treated with drugs combined with hyperbaric chambers (OR= 1.76; 95% CI, 0.75-4.15; I = 84.9%) and drugs combined with intratympanic injections (OR= 1.62; 95% CI, 1.02-2.58; I = 65.6%). Conclusions and Relevance. Our study suggested that vertigo may be a negative factor in sudden sensorineural hearing loss.Based on the results of the subgroup analysis,the combined treatment regimen has better efficacy in patients with sudden sensorineural hearing loss with vertigo.