Vascular involvement in the pathophysiology of acute audiovestibular loss

Abstract

The objective of this thesis is to investigate associations between cardiovascular disease

and acute hearing loss, acute vestibulopathy or both and thereby provide an indication of the plausibility of vascular involvement in the pathophysiology of sudden deafness, vestibular neuritis or

labyrinthitis.

We summarize the existing literature on associations between cardio-vascular disease and SSNHL by performing a systematic review and meta-analyses of studies that either explored the cardiovascular risk factors, the degree of cerebral small vessel disease or the subsequent risk of stroke in patients with SSNHL. Furthermore, we retrospectively investigated the presence of cerebral small vessel disease in elderly patients with vestibular neuritis, menieres disease and sudden sensorineural hearing loss. By using primary care data we assessed the the subsequent risk of stroke patients experienced within 5 years after diagnosis with SSNHL. Additionally, we assessed the persistent limitations in terms of balance problems and activity-avoidance in patients with concurrent hearling loss and vestibulopathy. To conclude this thesis we reported the study protocol for the ungoing Rosalie studie evaluating the cardiovascular risk factors and cerebral small vessel disease in patients with sudden deafness in a prospective multi-centre cohort study