(139) Diagnostic Markers Evaluating Autoimmune-mediated Sudden Sensorineural Hearing loss:A Systematic Review

Introduction: Incidence of sudden sensorineural hearing loss (SSNHL) is estimated at 5-to-20 per 100,000 persons per year. Autoimmune disease has been cited as a possible etiology and evidence-based guidelines for diagnostic workup are lacking. The current study aims to review the literature regarding diagnostic investigations used to evaluate autoimmune causes of SSNHL.

Methods: A systematic review of literature following Preferred Reporting Items for Systematic Review and Meta Analyses (PRISMA) guidelines was conducted using multiple databases (Medline, EMBASE, CDSR, CENTRAL, CINAHL). English studies up to December 2022 were included which evaluated diagnostic markers for autoimmune conditions in SSNHL patients.

Results: Fourteen studies with 833 patients with SSNHL were included. Most commonly tested autoimmune markers were ANA in 9/14 studies (64%), ESR in 7/14 studies (50%) and western blot in 7/14 studies (50%). Other markers investigated included complement factors, CRP, anticardiolipin, anti-double stranded DNA, antiendothelial cell antibody (AECA), antithyroid antibodies and p-ANCA. Of the 421 patients (51%) that had reported ANA values, 79 of them (19%) had a high positive titer. The most correlated autoimmune test was AECA, with 49% having a positive result.

Conclusions: This is the first systematic review to assess the correlation of autoimmune markers with SSNHL. There is potential for autoimmune diagnostic testing to help delineate etiology of SSNHL. However, causality remains to be better established in literature and further studies are needed. Future research with a goal of developing a robust diagnostic panel may aide in management of those cases of SSNHL that are autoimmune in nature.