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Oussoren et al performed a systematic review and meta-analyses of current literature on the above topic: specifically, cardiovascular risk factors for developing idiopathic sudden sensorineural hearing loss (iSSNHL), the presence of white matter hyperintensities in patients with iSSNHL and the subsequent risk of stroke after experiencing iSSNHL. PRISMA (Preferred Reporting Item for Systematic Reviews and Meta-analyses) guidelines were utilised for the study. Cardiovascular risk factor review identified 33 articles. Abnormal BMI, diabetes, hypertension, total cholesterol, low-density lipoprotein cholesterol and a medical history of myocardial infarction were associated with iSSNHL. Interestingly, smoking was non-significantly higher in patients with iSSNHL. In regard to cerebral small vessel disease, five articles were identified. They found no association between white matter hyperintensities identified on imaging and iSSNHL. Their stroke research question identified seven articles, and patients with iSSNHL showed a higher risk of stroke compared to controls, hazard ratio ranging from 1.22 to 4.08. The authors highlight study limitations, most notably small study populations (11 studies with less than 60 cases of iSSNHL). They have identified significant risk of bias associated with this and large heterogeneity in study data and outcomes. The authors recommend a prospective cohort study to establish accuracy of investigated associations prior to recommending cardiovascular risk management in cases of sudden hearing loss as appropriate. Overall, I think this is a well-structured review and meta-analyses. It perhaps allows us in clinical practice to signpost some patients to vascular prevention if appropriate and established (such as hypertension/BMI/cholesterol levels) in line with current cardio/cerebrovascular guidelines.

Cardiovascular Risk Factors, Cerebral Small Vessel Disease, and Subsequent Risk of Stroke in Patients with Idiopathic Sudden Sensironeural Hearing Loss: Systematic Review and Meta-Analyses of the Current Literature.
Oussoren FK, Schermer TR, van Leeuwen RB, Bruintjes TD.
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Aaron SJ Ferguson

Victoria Hospital, Kirkcaldy, NHS Fife, UK.

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