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Cited by 9Vestibular and auditory disordersHearing, Cochlea, Tinnitus, GeneticsAcute Ischemic Stroke Management

Recurrent sudden sensorineural hearing loss—A literature review

Open access
Zhang, Bang‐Yan, Wang, Yu‐Chien, Chan, Kai‐Chieh·2022·Laryngoscope Investigative Otolaryngology
DOI 10.1002/lio2.828PMC PMC9194968
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Abstract

Objective: Sudden sensorineural hearing loss (SSNHL) is one of the few emergent otologic conditions. Although more than half of all patients would benefit from timely treatment, recurrence occasionally develops unexpectedly. The aim of our study is to evaluate the recurrence rate after SSNHL, and present the prognosis after first‐episode and recurrent SSNHL. Methods: A literature search was conducted of the PubMed and Embase electronic databases. Results: Seven studies with a total of 3781 patients were included, and 96 patients experienced recurrence. The recurrence rate ranged between 1.4% and 17%. The average time to recurrence was about 2 years in most studies. The majority of the studies reported using systemic steroids for treating first‐episode SSNHL, and one study used a plasma expander in patients with recurrent SSNHL. The recovery rate for first‐episode patients was 58%–79%, while that for recurrent SSNHL ranged widely, from 21% to 86%. There were no common risk factors for SSNHL recurrence among the studies, although low‐frequency hearing loss, the presence of tinnitus during follow‐up, and an increased neutrophil‐to‐lymphocyte ratio and platelet‐to‐lymphocyte ratio have been proposed. Conclusion: Understanding the recurrence rate, risk factors, and prognosis after recurrence of SSHNL is crucial for comprehensive medical care; in this respect, further prospective studies with long‐term follow‐up may be instructive. Level of Evidence: 4

AI snapshot

Written from the paper’s full text.

TL;DR

This literature review found that recurrent sudden sensorineural hearing loss (SSNHL) is uncommon but variable, with recurrence rates from 1.4% to 17% across seven retrospective studies. Recovery after recurrent SSNHL ranged widely (21%–86%), and no consistent risk factors were identified.

Key findings

  • Seven studies with 3,781 SSNHL patients were included; 96 patients experienced recurrence, with recurrence rates ranging from 1.4% to 17%.
  • Average time to recurrence was about 2 years in most studies; one study reported 2- and 5-year cumulative recurrence rates of 5% and 10%, respectively.
  • Recovery rates were 58%–79% for first-episode SSNHL and 21%–86% for recurrent SSNHL; most studies used systemic corticosteroids, and one used a plasma expander for recurrent SSNHL.
  • Proposed risk factors included low-frequency hearing loss, tinnitus during follow-up, and increased neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios, but there were no common risk factors across studies.

Methods

  • Literature search of PubMed and Embase on October 14, 2021, using keywords for sudden deafness, sudden sensorineural hearing loss, sudden hearing loss, recurrent, recurrence, and recurrences; 562 articles were found and screened per PRISMA.
  • Inclusion required retrospective or prospective studies on SSNHL recurrence, SSNHL diagnosed by clinical practice guidelines (sudden loss of 30 dB over three consecutive frequencies within 72 h), assessment of demographic factors and potential risk factors, and English publication.
  • Seven studies met inclusion criteria; all were retrospective. Data extracted included patient numbers, recurrence, inclusion/exclusion criteria, mean age, gender, treatment, recovery rate, time to recurrence, risk factors, progression to Ménière’s disease, and side of recurrence. Newcastle–Ottawa Scale was used for quality assessment.

Limitations

  • The authors state that only PubMed and Embase were searched and only English-language studies were included, so relevant research in other languages and databases may have been missed.
  • The authors state that all included studies were retrospective and may have been affected by selection bias and confounding factors.
  • The authors state that inclusion/exclusion criteria were inconsistent across studies, and side of recurrence, treatment choice, definition of hearing improvement, and mean hearing gain were sometimes unreported, preventing calculation of mean recurrence and improvement rates; the text also makes evident that different definitions of improvement precluded meta-analysis.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1002/lio2.828

Cites

29 of 29 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

4 of 36 cited sources checked · 4 supported · 0 flagged

  • Premisecitation
    § 3.2.3 | Risk factors for SSHNL recurrence · p. 3

    Psillas et al. compared low- with high-tone SSNHL and concluded that the recurrence rate was higher in the low-tone group.

    “Psillas et al. compared low- with high-tone SSNHL and concluded that the recurrence rate was higher in the low-tone group. 10”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [10] 10. Psillas G, Rizou A, Rachovitsas D, Tsiropoulos G, Constantinidis J. Hearing outcome of low-tone compared to high-tone sudden sensorineural hearing loss. International Archives of Otorhinolaryngology . 2019; 23:65-69. source
  • Premisecitation
    § 4.5 | Possible mechanism for recurrent SSNHL · p. 8

    Only a small proportion of patients progressed to Ménière's disease.

    “Only a small proportion of patients progressed to Ménière's disease. 6,10”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites [6] 6. Härkönen K, Kivekäs I, Rautiainen M, Kotti V, Vasama JP. Quality of life and hearing eight years after sudden sensorineural hearing loss. Laryngoscope . 2017;127:927-931. source
    • cites [10] 10. Psillas G, Rizou A, Rachovitsas D, Tsiropoulos G, Constantinidis J. Hearing outcome of low-tone compared to high-tone sudden sensorineural hearing loss. International Archives of Otorhinolaryngology . 2019; 23:65-69. source
  • Findingown data
    § 3.2 | Findings · p. 2

    Among four included studies reporting gender of recurrent SSNHL patients, 38 (52.1%) of 73 recurrent patients were male.

    “Four 9,11 -13 of the studies reported the gender of the recurrent SSNHL patients; 38 (52.1%) of the 73 recurrent patients were male.”
    Quote in the paperNot a substantial claim
  • Findingown data
    § Abstract · p. 1

    The recovery rate for recurrent SSNHL ranged widely from 21% to 86%.

    “while that for recurrent SSNHL ranged widely, from 21% to 86%.”
    Quote in the paperSubstantial claim
  • Findingcitation
    § 3.2.2 | Follow-up time and time to recurrence · p. 3

    One included study reported 2- and 5-year cumulative recurrence rates of 5% and 10%, respectively.

    “One study 8 reported 2- and 5-year cumulative recurrence rates of 5% and 10%, respectively.”
    Quote in the paperNot a substantial claim
  • May combine two claims. 20
  • Classified as probably not a substantial claim. 21

  • May combine two claims.

    Premisecitation
    § 4.5 | Possible mechanism for recurrent SSNHL · p. 8

    Although some hypotheses have been proposed regarding the causes of SSNHL, such as vascular insufficiency, virus infection, and immune dysfunction, none of these can explain SSNHL in all patients.

    “Although some hypotheses have been proposed regarding the causes of SSNHL, such as vascular insufficiency, 22 virus infection, 28 and immune dysfunction, 29 none of these can explain SSNHL in all patients.”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites [22] 22. Yamasoba T, Kikuchi S, Higo R, O'Uchi T, Tokumaru A. Sudden sensorineural hearing loss associated with slow blood flow of the vertebrobasilar system. Ann Otol Rhinol Laryngol . 1993;102:873-877. source
    • cites [28] 28. Chen X, Fu YY, Zhang TY. Role of viral infection in sudden hearing loss. J Int Med Res . 2019;47:2865-2872. source
    • cites [29] 29. Li G, You D, Ma J, Li W, Li H, Sun S. The role of autoimmunity in the pathogenesis of sudden sensorineural hearing loss. Neural Plast . 2018;2018:7691473-7691479. How to cite this article: Zhang B-Y, Wang Y-C, Chan K-C. Recurrent sudden sensorineural hearing loss -A literature review. Laryngoscope Investigative Otolaryngology . 2022;7(3): 854 -862. doi:10.1002/lio2.828 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data
    § Abstract · p. 1

    The majority of included studies reported using systemic steroids for treating first-episode SSNHL.

    “The majority of the studies reported using systemic steroids for treating first-episode SSNHL”
    • Also stated in: § 3.2.5 | Treatment and recovery rates after the first and second SSHNL episodes · p. 3 · plain
      “Most studies used systemic corticosteroids with/without intratympanic corticosteroids for treating SSNHL.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation
    § Identification of studies via databases and registers · p. 3

    One included study reported 3 (4.1%) cases of a third episode of SSNHL, and none of them was diagnosed with Ménière's disease.

    “One study 8 reported 3 (4.1%) cases of a third episode of SSNHL and none of them was diagnosed of Ménière's disease.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Abstract · p. 1

    Seven studies with a total of 3781 patients with SSNHL were included in the review, and 96 of these patients experienced recurrence.

    “Seven studies with a total of 3781 patients were included, and 96 patients experienced recurrence.”
    • Also stated in: § 3.2 | Findings · p. 2 · plain
      “A total of 3781 patients with SSNHL were included in the seven eligible studies, 96 of whom had recurrence (Table 3).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation
    § Abstract · p. 1

    Low-frequency hearing loss, presence of tinnitus during follow-up, and increased neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio have been proposed as risk factors for SSNHL recurrence.

    “although lowfrequency hearing loss, the presence of tinnitus during follow-up, and an increased neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio have been proposed.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation
    § 3.2.2 | Follow-up time and time to recurrence · p. 3

    Härkönen et al. had the longest follow-up and reported a recurrence rate of 3.5%.

    “Härkönen et al. 6 had the longest follow-up and reported a recurrence rate of 3.5%.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation
    § 3.2.4 | Progression to Ménière's disease after first SSNHL episode · p. 3

    Another included study reported that no patients experienced progression to Ménière's disease.

    “while another 8 reported that no patients experienced progression.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given
    § Identification of studies via databases and registers · p. 3

    Some included studies excluded patients with recurrent hearing loss in whom other diseases were also diagnosed, such as vestibular schwannoma or Ménière's disease.

    “and some excluded patients with recurrent hearing loss in whom other diseases were also diagnosed, such as vestibular schwannoma or Ménière's disease.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given
    § 3.2.1 | SSHNL recurrence rate · p. 2

    Despite different inclusion criteria, all included studies used the most common definition of SSNHL.

    “Despite applying different inclusion criteria, all studies used the most common definition of SSNHL.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data
    § Abstract · p. 1

    One included study used a plasma expander in patients with recurrent SSNHL.

    “and one study used a plasma expander in patients with recurrent SSNHL.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given
    § 4.6 | Treatment and recovery rate for recurrent SSNHL · p. 8

    Most of the studies in this review applied systemic steroids, except for one study using a plasma expander.

    “Most of the studies in this review applied systemic steroids, except for one study using a plasma expander.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation
    § 3.2.6 | Ipsilateral versus bilateral recurrence · p. 6

    More than half of the recurrences occurred on the contralateral side in three of four studies reporting side, while one study reported a rate of ipsilateral recurrence of 91%.

    “Interestingly, more than half of the recurrences occurred on the contralateral side in three of those studies, 8,12,13 while the other one 11 reported a rate of ipsilateral recurrence of 91%.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [8] 8. Pecorari G, Riva G, Bruno G, et al. Recurrences in sudden sensorineural hearing loss: a long-term observational study. Am J Audiol . 2020; 29:18-22.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [12] 12. Wu PH, Lee CY, Chen HC, et al. Clinical characteristics and correlation between hearing outcomes after different episodes of recurrent idiopathic sudden sensorineural hearing loss. Auris Nasus Larynx . 2021;48:870-877.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [13] 13. Kuo YL, Young YH. Hearing outcome of recurrent sudden deafness: ipsilateral versus contralateral types. Acta Otolaryngol . 2012;132: 247-254. source

  • May combine two claims.

    Findingreasoning
    § 3.2.6 | Ipsilateral versus bilateral recurrence · p. 6

    The side of recurrence was reported in 64 patients, in 31 of whom the recurrence was ipsilateral; 32 patients had recurrence on the contralateral side, and one patient had bilateral recurrence.

    “In summary, the side of recurrence was reported in 64 patients, in 31 of whom the recurrence was ipsilateral; 32 patients had recurrence on the contralateral side, and one patient had bilateral recurrence.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation
    § 3.2.5 | Treatment and recovery rates after the first and second SSHNL episodes · p. 6

    Two studies only calculated the improvement rate of recurrent SSNHL patients with their first attack, and it ranged from 73% to 91%.

    “Two studies 11,12 only calculated the improvement rate of recurrent SSNHL patients with their first attack, and it ranged from 73% to 91%.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [11] 11. Park IS, Kim YB, Choi SH, Hong SM. Clinical analysis of recurrent sudden sensorineural hearing loss. ORL J Otorhinolaryngol Relat Spec . 2013;75:245-249. source
    • cites [12] 12. Wu PH, Lee CY, Chen HC, et al. Clinical characteristics and correlation between hearing outcomes after different episodes of recurrent idiopathic sudden sensorineural hearing loss. Auris Nasus Larynx . 2021;48:870-877.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Findingcitation
    § 4.2 | Fluctuating hearing loss · p. 6

    One of the seven included studies reported three cases of a third episode of SSNHL, and all three patients experienced partial recovery.

    “In fact, one 8 of the seven included studies reported three cases of a third episode of SSNHL, and all three patients experienced partial recovery.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8] 8. Pecorari G, Riva G, Bruno G, et al. Recurrences in sudden sensorineural hearing loss: a long-term observational study. Am J Audiol . 2020; 29:18-22.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given
    § 4.6 | Treatment and recovery rate for recurrent SSNHL · p. 8

    Other studies did not analyze prognostic factors for recurrent SSNHL.

    “Other studies did not analyze prognostic factors for recurrent SSNHL.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation
    § 3.2.6 | Ipsilateral versus bilateral recurrence · p. 6

    Pecorari et al. reported one case with bilateral recurrence, but details of the condition of this patient were lacking.

    “Pecorari et al. 8 reported one case with bilateral recurrence, but details of the condition of this patient were lacking (i.e., whether the autoimmune profile was checked, among other potential etiologies).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8] 8. Pecorari G, Riva G, Bruno G, et al. Recurrences in sudden sensorineural hearing loss: a long-term observational study. Am J Audiol . 2020; 29:18-22.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationreasoning
    § 3.2.3 | Risk factors for SSHNL recurrence · p. 3

    Because more than half of the patients in Pecorari et al. had tinnitus during follow-up, tinnitus was not a particularly useful predictor of recurrence.

    “however, more than half of the patients had tinnitus during follow-up so it was not a particularly useful predictor.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § 3.2.3 | Risk factors for SSHNL recurrence · p. 3

    Pecorari et al. concluded that the presence of tinnitus during follow-up was associated with a higher rate of recurrence.

    “Pecorari et al. concluded that the presence of tinnitus during follow-up was associated with a higher rate of recurrence 8”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8] 8. Pecorari G, Riva G, Bruno G, et al. Recurrences in sudden sensorineural hearing loss: a long-term observational study. Am J Audiol . 2020; 29:18-22.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given
    § 2.1 | Literature search · p. 2

    The Newcastle-Ottawa Scale was used to assess the quality of the included cohort and case-control studies.

    “The Newcastle -Ottawa Scale was used to assess the quality of the included cohort and case -control studies.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation
    § 4.6 | Treatment and recovery rate for recurrent SSNHL · p. 8

    Kuo et al. reported a higher rate of recovery from the second episode in patients with normal cervical vestibular evoked myogenic potential, but the number of cases was small.

    “Kuo et al. reported a higher rate of recovery from the second episode in patients with normal cervical vestibular evoked myogenic potential, but the number of cases was small. 13”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] 13. Kuo YL, Young YH. Hearing outcome of recurrent sudden deafness: ipsilateral versus contralateral types. Acta Otolaryngol . 2012;132: 247-254. source

  • Classified as probably not a substantial claim.

    Premisecitation
    § 4.3 | Acute low-tone hearing loss versus SSNHL · p. 8

    Acute low-tone sensorineural hearing loss (ALHL) is regarded as a variant of SSNHL.

    “First described by Abe 18 in 1982, acute low-tone sensorineural hearing loss (ALHL) is regarded as a variant of SSNHL.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [18] 18. Abe T. Acute sensorineural hearing loss in low frequencies. Otolaryngol Tokyo . 1982;54:385-392.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning
    § 4.5 | Possible mechanism for recurrent SSNHL · p. 8

    Recurrent SSNHL should be regarded as a different disease.

    “Therefore, recurrent SSNHL should be regarded as a different disease.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The cause of recurrence is unknown.

  • May combine two claims.

    Study design and conductreasoning
    § 5 | LIMITATION · p. 9

    The side of recurrence, treatment choice, definition of hearing improvement, and mean hearing gain were not reported in some studies, so the mean recurrence and improvement rates could not be calculated.

    “In addition, the side of recurrence, treatment choice, definition of hearing improvement, and mean hearing gain were not reported in some studies. Therefore, the mean recurrence and improvement rates could not be calculated.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § KEYWORDS · p. 2

    Wu et al. suggested that insufficient cochlear perfusion is an important risk factor for recurrence of sudden deafness.

    “suggesting that insufficient cochlear perfusion is an important risk factor for the recurrence of sudden deafness”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7] 7. Wu CM, Lee KJ, Chang SL, Weng SF, Lin YS. Recurrence of idiopathic sudden sensorineural hearing loss: a retrospective cohort study. Otol Neurotol . 2014;35:1736-1741.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § 4.5 | Possible mechanism for recurrent SSNHL · p. 8

    Kuo et al. directly compared 16 patients (7 with ipsilateral recurrence and 9 with contralateral recurrence) and found no significant difference in the side of recurrence according to age, inter-episode interval, gender, presence of vertigo, or abnormal caloric results.

    “Kuo et al. directly compared 16 patients (7 with ipsilateral recurrence and 9 with contralateral recurrence) and found no significant difference in the side of recurrence according to age, inter-episode interval, gender, presence of vertigo, or abnormal caloric results. 13”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] 13. Kuo YL, Young YH. Hearing outcome of recurrent sudden deafness: ipsilateral versus contralateral types. Acta Otolaryngol . 2012;132: 247-254. source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § 4.3 | Acute low-tone hearing loss versus SSNHL · p. 8

    Shimono et al. reported a 92% prevalence rate of cochlear endolymphatic hydrops in patients with ALHL based on 3-Tesla MRI.

    “Shimono et al. 21 reported a 92% prevalence rate of cochlear endolymphatic hydrops in patients with ALHL based on 3-Tesla magnetic resonance imaging (MRI).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] 21. Shimono M, Teranishi M, Yoshida T, et al. Endolymphatic hydrops revealed by magnetic resonance imaging in patients with acute low-tone sensorineural hearing loss. Otol Neurotol . 2013;34:1241-1246. source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § 4.4 | Differential diagnosis of recurrent SSNHL · p. 8

    Recurrent hearing loss in patients with an underlying autoimmune disease is sometimes considered as autoimmune hearing loss.

    “Recurrent hearing loss in patients with an underlying autoimmune disease is sometimes considered as autoimmune hearing loss. 23,24”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [23] 23. Psillas G, Binos P, Dimas GG, Daniilidis M, Constantinidis J. Human leukocyte antigen (Hla) influence on prognosis of autoimmune hearing loss. Audiol Res . 2021;11:1-7.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [24] 24. Psillas G, Dimas GG, Daniilidis M, Binos P, Tegos T, Constantinidis J. Audiological patterns in patients with autoimmune hearing loss. Audiol Neurotol . 2021;1-10. source

  • Classified as probably not a substantial claim.

    Study design and conductnone given
    § 3.1 | Study selection · p. 2

    Articles were selected according to the PRISMA guidelines.

    “Articles were selected according to the PRISMA guidelines (Figure 1).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § KEYWORDS · p. 2

    In Wu et al.'s study, coronary artery disease, hypertension, chronic renal disease, diabetes mellitus, and hypercholesterolemia were not associated with a higher incidence of ISSNHL.

    “however, coronary artery disease, hypertension, chronic renal disease, diabetes mellitus, and hypercholesterolemia were not associated with a higher incidence of ISSNHL.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7] 7. Wu CM, Lee KJ, Chang SL, Weng SF, Lin YS. Recurrence of idiopathic sudden sensorineural hearing loss: a retrospective cohort study. Otol Neurotol . 2014;35:1736-1741.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § 4.3 | Acute low-tone hearing loss versus SSNHL · p. 8

    Junicho reported higher recurrence and progression rates for Ménière's disease in patients with ALHL who had spontaneous nystagmus.

    “Junicho 15 reported higher recurrence and progression rates for Ménière's disease in patients with ALHL who had spontaneous nystagmus, as recorded by electronystagmography.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] 15. Ohashi T, Nishino H, Arai Y, Nishimoto Y, Kakutani T, Koizuka I. Electrocochleographic findings in recurrent idiopathic sudden sensorineural hearing loss. Acta Otolaryngol . 2012;132:1022-1027. source

  • May combine two claims.

    Study design and conductnone given
    § 5 | LIMITATION · p. 9

    Although all included studies used the same diagnostic criteria, the inclusion and exclusion criteria were not consistent among the studies.

    “Third, although all of the included studies used the same diagnostic criteria, the inclusion and exclusion criteria were not consistent among the studies.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning
    § 4.3 | Acute low-tone hearing loss versus SSNHL · p. 8

    Patients with ALHL may not conform to the diagnosis of SSNHL, which may lead to selection bias and heterogeneity.

    “Furthermore, patients with ALHL may not conform to the diagnosis of SSNHL, which may lead to selection bias and heterogeneity.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The relationship between ALHL and SSNHL is subject to debate, and no consensus has yet been reached.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given
    § 2.1 | Literature search · p. 2

    The title and abstract of each article were screened by the first author and reviewed by the second author, with discrepancies eliminated through discussion.

    “The title and abstract of each article were screened by the first author and reviewed by the second author. Discrepancies between the authors were eliminated through discussion.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § 4.3 | Acute low-tone hearing loss versus SSNHL · p. 8

    Fushiki found no difference in recurrence rate between patients with ALHL and those with another form of sudden low-tone hearing loss.

    “On the other hand, Fushiki found no difference in recurrence rate between patients with ALHL and those with another form of sudden low-tone hearing loss. 20”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] 20. Fushiki H, Junicho M, Kanazawa Y, Aso S, Watanabe Y. Prognosis of sudden low-tone loss other than acute low-tone sensorineural hearing loss. Acta Otolaryngol . 2010;130:559-564. source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § KEYWORDS · p. 1

    Systemic steroids, intratympanic or otherwise, are the mainstay of treatment for SSNHL.

    “Systemic steroids, intratympanic or otherwise, are the mainstay of treatment although their mechanism of action has not yet been clarified. 4”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] 4. Wei BP, Stathopoulos D, O'Leary S. Steroids for idiopathic sudden sensorineural hearing loss. Cochrane Database Syst Rev . 2013;2013: Cd003998. source

  • May combine two claims.

    Study design and conductreasoning
    § 5 | LIMITATION · p. 8

    The review searched PubMed and Embase only, and restricted to studies published in English, so relevant research in other languages and databases may have been missed.

    “First, we searched PubMed and Embase only, and restricted our review to studies published in English. Thus, relevant research published in other languages and databases may have been missed.”
    Quote in the paperNot a substantial claim
37 of 37

  • The paper relies on this without support.

    The recurrence rate of SSNHL is low compared with other audiovestibular disorders such as Ménière's disease.

    “Compared to other audiovestibular disorders, such as Ménière's disease, the recurrence rate of SSNHL is low and thus often overlooked.”

  • The paper relies on this without support.

    SSNHL recurrence is often overlooked.

    “Compared to other audiovestibular disorders, such as Ménière's disease, the recurrence rate of SSNHL is low and thus often overlooked.”

  • The paper relies on this without support.

    A literature review of recurrent hearing loss after SSNHL is needed.

    “A literature review of recurrent hearing loss after SSNHL is needed.”

  • The paper relies on this without support.

    More than half of all patients with SSNHL would benefit from timely treatment.

    “Although more than half of all patients would benefit from timely treatment, recurrence occasionally develops unexpectedly.”

  • The paper relies on this without support.

    A definition of recurrent SSNHL is lacking.

    “Although there is a commonly accepted definition of SSNHL, a definition of recurrent SSNHL is lacking.”

  • The paper relies on this without support.

    There is no definition of fluctuating hearing loss, making differentiation of these two conditions difficult.

    “Similarly, there is no definition of fluctuating hearing loss, making differentiation of these two conditions difficult.”

  • The paper relies on this without support.

    The relationship between ALHL and SSNHL is subject to debate, and no consensus has yet been reached.

    “The relationship between ALHL and SSNHL is subject to debate, and no consensus has yet been reached.”

  • The paper relies on this without support.

    The cause of recurrence is unknown.

    “The cause of recurrence is also unknown.”

  • The paper relies on this without support.

    Systemic steroids remain the main therapy for SSNHL.

    “Systemic steroids remain the main therapy for SSNHL, but little is known about the mechanism of action.”

  • The paper relies on this without support.

    Little is known about the mechanism of action of systemic steroids.

    “Systemic steroids remain the main therapy for SSNHL, but little is known about the mechanism of action.”

  • The paper relies on this without support.

    Different conditions may cause recurrent hearing loss after SSNHL.

    “Different conditions may cause recurrent hearing loss after SSNHL.”

  • The paper relies on this without support.

    A fluctuating hearing level with vertigo may lead to the diagnosis of Ménière's disease or perilymph fistula.

    “A fluctuating hearing level with vertigo may lead to the diagnosis of Ménière's disease or perilymph fistula.”

  • The paper relies on this without support.

    Progressive hearing loss implies an autoimmune inner ear disorder or central lesion.

    “Progressive hearing loss implies an autoimmune inner ear disorder or central lesion.”

  • The paper relies on this without support.

    Multiple recurrence is regarded as fluctuating hearing loss in most situations.

    “Multiple recurrence may be extremely rare, and it is regarded as fluctuating hearing loss in most situations.”
14 of 14

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Abe T, 1982, Acute sensorineural hearing loss in low frequencies, Otolaryngol Tokyo, 54

Cited by

Still being checked.

Related

Authors
Zhang, B., Wang, Y., & Chan, K.
Affiliations
Chang Gung University (TW)
Corresponding author
Chan, Kai‐Chieh
ORCID
Venue
Laryngoscope Investigative Otolaryngology
Publisher
Wiley
Published
2022-05-26
Volume
7
Issue
3
Pages
854-862
ISSN
2378-8038 (ISSN-L)
DOI
10.1002/lio2.828
PMC
PMC9194968
OpenAlex
W4281553713
Semantic Scholar
9a2ccce6272ff3323015bdc512112fa6948d58a8
Cited by
9
References
29
Citations by year
2026: 4 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 1
FWCI
0.36
Type
journal article
Language
en
Open access
Licence
Locations
  • Laryngoscope Investigative Otolaryngology (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • PubMed Central (submittedVersion, cc-by-nc-nd)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics
  • Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
  • Life Sciences › Neuroscience › Sensory Systems › Hearing, Cochlea, Tinnitus, Genetics
  • Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
Keywords
sudden sensorineural hearing loss, recurrence rate, prognosis, systemic corticosteroids, plasma expanders, hearing recovery, risk factors, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, tinnitus, low-frequency hearing loss

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

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Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-22.

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