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Recently proven and disproven associations between hearing loss and other conditions and procedures, as well as new information about hearing evaluations in adults and treatments in children, resulted in this week's top trending clinical topic.
Results of new research published online in the Journal of the American Geriatrics Society establish a link between osteoporosis and hearing loss, as measured by self-reporting every 2 years over as long as 34 years (see Infographic below). Those who sustained a vertebral fracture were also found to have higher risk. Researchers adjusted for key factors, including age, race/ethnicity, and oral hormone use. Although a separate study had found a potential link between bisphosphonate use and prevention of noise-induced hearing loss in mice, the use of bisphosphonate therapy was not found to reduce the risk in women.
In terms of the mechanisms responsible for the association, the authors note that in addition to compromising more prominent skeletal sites, bone loss could potentially extend to structures in the ear. "Bone mass at peripheral sites is correlated with bone mass at central sites, such as hip and spine, with correlation coefficients between 0.6 and 0.7," they explain. "Plausibly, systemic bone demineralization could involve the temporal bone, the otic capsule, and the middle ear ossicles." Hearing loss previously has been linked to other pathologic bone disorders, including otosclerosis and Paget disease.
Although the connection between hearing loss and osteoporosis has now been supported, a significant association with sudden sensorineural hearing loss and COVID vaccination has not. Analysis of Centers for Disease Control and Prevention (CDC) data has not identified any link between mRNA vaccines and impaired hearing. A review of information from the Vaccine Adverse Event Reporting System (VAERS) of the 86.5 million vaccine doses administered from December 14, 2020 to March 2, 2021, found 40 total cases of sensorineural hearing loss. A sensitivity analysis determined that the maximum potential incidence was 4.1 per 100,000 per year, which is still lower than the known incidence of sudden sensorineural hearing loss in the general population.
A recent survey examined whether primary care providers routinely check on patient hearing loss. According to the poll, most adults have not been asked by their doctor if they have impairment. Only 20% of patients aged 50-80 years report that their doctor asked about their hearing over the past 2 years. Among those who rated their hearing as fair or poor, only 26% said they had been asked. Men were more likely than women to have been asked (24% vs 17%), and adults aged 65-80 years were more likely than younger adults to have been asked (25% vs 16%).
In regard to hearing loss among infants, a new study found that infants with isolated sensorineural hearing loss as a result of congenital cytomegalovirus infection may benefit from treatment with valganciclovir. A separate, large multicenter study examined cisplatin-induced hearing loss in children. The highest prevalence was among patients younger than 5 years. After accounting for cumulative cisplatin dose, the study found that higher fractionated doses were significantly associated with hearing loss risk.
Pediatric and adult concerns about hearing loss causes and care, along with significant new research, resulted in this week's top trending clinical topic.
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Cite this: Ryan Syrek. Trending Clinical Topic: Hearing Loss - Medscape - Jun 18, 2021.