Inner Ear Disorders in the Elderly with Carotid Artery Disease Requiring Revascularization: Prevalence, Characteristics, and Association

Razan Alfakir (Department of Otolaryngology and Division of Audiology, Mayo Clinic, Jacksonville, Florida, United States;Department of Communication Disorders, Auburn University, Alabama, United States)

Abstract


Background: Aging is almost assocaited with inner ear disorders (InEarDs) by means of age-related hearing impairment (ARHI) or vertigo-and-dizziness as well as the carotid artery disease requiring revascularization (CAD-R).

Objective: The present study aimed to study the prevalence and characteristics of InEarDs in older adults diagnosed with CAD-R. The other aim was to determine if InEarDs in CAD-R patients is age-related or might be explained by a concomitant CAD-R.

Method: A retrospective, case-control study was conducted at the Mayo Clinic, Florida. The study cohort includes 919 patients who had CAD-R. The control group consisted of 244 age- and gender-matched patients presenting with cardiac or peripheral artery disease. The InEarDs were assessed based on the diagnosis upon presentation to the Audiology Clinic and follow-up.

Results: Of the 919, 348 had ARHI that includes significant peripheral signs and central symptoms (24.9%), vertigo-and-dizziness events that are recurrent and persistent with normal objective vestibular testing (12.9%), or a combination of both (11.0%). These percentages were significantly higher in the study group relative to the control group. After adjustment for the vascular risk factors, the study group had significantly higher odds of ARHI (OR= 1.94; 95% CI: 1.09-3.44; P<0.05),

Conclusion: CAD-R patients had significantly higher InEarDs than the control group. CAD-R is more likely to be associated with ARHI rather than the vertigo-and-dizziness even after adjusting for the vascular risk factors.


Keywords


Carotid Atherosclerosis;Age-related hearing impairment;Vertigo-and-dizziness

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References


Herrington, W., et al. Epidemiology of Atherosclerosis and the Potential to Reduce the Global Burden of Atherothrombotic Disease. Circ Res, 2016, 118(4): 535-46.

von Eckardstein, A. Risk factors for atherosclerotic vascular disease. Handb Exp Pharmacol, 2005(170): 71-105.

Polak, J.F., et al. The value of carotid artery plaque and intima-media thickness for incident cardiovascular disease: the multi-ethnic study of atherosclerosis. Journal of the American Heart Association, 2013, 2(2): e000087-e000087.

Bhat, V., et al. Clinical & radiological evaluation of atherosclerotic changes in carotid & coronary arteries in asymptomatic & clinically symptomatic individuals as a tool for pre-symptomatic diagnosis of cardiovascular disease. Indian J Med Res, 2016, 143(2): 197-204.

Tota-Maharaj, R., et al. Coronary artery calcium for the prediction of mortality in young adults 75 years old. Eur Heart J, 2012, 33(23): 2955-62.

McClelland, R.L., et al. Arterial age as a function of coronary artery calcium (from the Multi-Ethnic Study of Atherosclerosis [MESA]). Am J Cardiol, 2009, 103(1): 59-63.

Blaha, M.J. The future of CV risk prediction: multisite imaging to predict multiple outcomes. JACC Cardiovasc Imaging, 2014, 7(10): 1054-6.

Lanzino, G., A.A. Rabinstein, and R.D. Brown, Jr.,Treatment of carotid artery stenosis: medical therapy, surgery, or stenting? Mayo Clinic proceedings, 2009, 84(4): 362-368.

Benavente, O., D. Moher, B. Pham. Carotid endarterectomy for asymptomatic carotid stenosis: a meta-analysis. Bmj, 1998, 317(7171): 1477-80.

Raman, G., et al. Management strategies for asymptomatic carotid stenosis: a systematic review and meta-analysis. Ann Intern Med, 2013, 158(9): 676-685.

Dutra, A.P. Cognitive function and carotid stenosis: Review of the literature. Dementia & neuropsychologia, 2012, 6(3): 127-130.

de la Torre, J.C. Cardiovascular risk factors promote brain hypoperfusion leading to cognitive decline and dementia. Cardiovascular psychiatry and neurology, 2012, 2012: 367516-367516.

Wanleenuwat, P., P. Iwanowski, W. Kozubski, Alzheimer’s dementia: pathogenesis and impact of cardiovascular risk factors on cognitive decline. Postgrad Med, 2019, 131(7): 415-422.

Hultcrantz, E. Clinical treatment of vascular inner ear diseases. Am J Otolaryngol, 1988, 9(6): 317-22.

Tange, R.A. Vascular inner ear partition: a concept for some forms of sensorineural hearing loss and vertigo. ORL J Otorhinolaryngol Relat Spec, 1998, 60(2): 78-84.

Trune, D.R., A. Nguyen-Huynh, Vascular Pathophysiology in Hearing Disorders. Seminars in hearing, 2012, 33(3): 242-250.

Hilger, J.A. The common ground of allergy, autonomic dysfunction and endocrine imbalance. Trans Am Acad Ophthalmol Otolaryngol, 1953, 57(3): 443- 6.

Laughlin, G.A., et al. Fetuin-A, a new vascular biomarker of cognitive decline in older adults. Clin Endocrinol (Oxf), 2014, 81(1): 134-40.

Dorobisz, K., et al. The evaluation of the sense of hearing in patients with carotid artery stenosis within the extracranial segments. Acta Neurologica Belgica, 2019, 119(3): 385-392.

Böhme, G. [Speech audiometry in the diagnosis of cerebrovascular disorders]. Laryngol Rhinol Otol (Stuttg), 1981, 60(3): 125-9.

Böhme, G., H. Böhme. [Possibilities of assessing cerebrovascular disease by audiometry: Comparison with Doppler ultrasound in the assessment of extracranial vascular occlusion (author’s transl)]. Dtsch Med Wochenschr, 1979, 104(41): 1443-7.

Christensen, V.T., N. Datta Gupta. Hearing loss and disability exit: Measurement issues and coping strategies. Econ Hum Biol, 2017, 24: 80-91.

Fischer, M.E., et al. Subclinical atherosclerosis and increased risk of hearing impairment. Atherosclerosis, 2015, 238(2): 344-349.

Bamiou DE, Werring D, Cox K, Stevens J, Musiek FE, Brown MM, et al. Patient-reported auditory functions after stroke of the central auditory pathway. Stroke. 2012, 43: 1285-9. DOI: 10.1161/STROKEAHA.111.644039

Koohi N, Vickers DA, Lakshmanan R, Chandrashekar H, Werring DJ, Warren JD, et al. Hearing characteristics of stroke patients: prevalence and characteristics of hearing impairment and auditory processing disorders in stroke patients. J Am Acad Audiol. 2017, 28: 491-505. DOI: 10.3766/jaaa.15139

Koohi, N., D.E. Bamiou. Hearing Screening Protocol for Stroke Patients. The Hearing Journal, 2020, 73(1).

Eckert, M.A., et al. White matter hyperintensities predict low frequency hearing in older adults. Journal of the Association for Research in Otolaryngology: JARO, 2013. 14(3): 425-433.

Schuknecht HF, Gacek MR. Cochlear pathology in presbycusis. Ann Otol Rhinol Laryngol, 1993, 102:1.

Wada M, Takeshima T, Nakamura Y, Nagasaka S, Kamesaki T, Kajii E. Carotid plaque is a new risk factor for peripheral vestibular disorder: a retrospective cohort study. Medicine (Baltimore). 2016, 95(31): e4510. DOI: 10.1097/MD.0000000000004510

Dieterich M, Staab JP. Functional dizziness: from phobic postural vertigo and chronic subjective dizziness to persistent postural-perceptual dizziness. Curr Opin Neurol. 2017, 30(1): 107-113. DOI:10.1097/WCO.0000000000000417

Dispenza F, Mazzucco W, Mazzola S, Martines F. Observational study on risk factors determining residual dizziness after successful benign paroxysmal positional vertigo treatment: the role of subclinical BPPV. Acta Otorhinolaryngol Ital. 2019, 39(5): 347- 352. DOI: 10.14639/0392-100X-2247. PMID: 31708581; PMCID: PMC6843589.

Balatsouras DG, Koukoutsis G, Fassolis A, Moukos A, Apris A. Benign paroxysmal positional vertigo in the elderly: current insights. Clin Interv Aging. 2018, 5(13): 2251-2266. DOI: 10.2147/CIA.S144134. PMID: 30464434; PMCID: PMC6223343.

Bamiou D-E. Hearing disorders in stroke. Handb Clin Neurol. 2015, 129: 633-47. DOI: 10.1016/B978-0-444-62630-1.00035-4



DOI: https://doi.org/10.30564/jgm.v2i3.2385

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