Vestibular Functional Patterns in Sudden Sensorineural Hearing Loss: A Systematic Review and Pooled Analysis

OBJECTIVES: To identify the most prevalent vestibular dysfunction patterns in idiopathic sudden sensorineural hearing loss (SSNHL) and their potential clinical significance. DESIGN: A systematic search was conducted in PubMed, SCOPUS, and Google Scholar (October 2024), following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies assessing vestibular function in SSNHL using the video head impulse test, cervical vestibular evoked myogenic potentials, and ocular vestibular evoked myogenic potentials were included. Exclusion criteria encompassed studies without differentiation of vestibular patterns by patient group, case reports, and those involving bilateral or secondary SSNHL. Data on vestibular test results, sample characteristics, and diagnostic criteria were extracted. A Chi-square test was used to assess the significance of observed vestibular dysfunction patterns ( p < 0.05). RESULTS: Out of 2868 identified studies, eight met the inclusion criteria, comprising 464 SSNHL cases. Vestibular dysfunction was present in 72.4% of cases, with the posterior semicircular canal (PSC), saccule (S), and utricle (U) being the most frequently affected structures. The most prevalent patterns were cochlear (C)-only (27.6%), C + PSC (8.2%), C + S (7.8%), C + U (8%), and C + S + U + PSC (5.8%) with statistical significance. Dysfunction involving all vestibular organs was observed in 5.4% of cases. CONCLUSIONS: SSNHL is frequently accompanied by vestibular dysfunction. Certain vestibulopathy patterns may be linked to the vascular supply of the vestibulocochlear artery and/or the common cochlear artery, supporting the concept of a possible vascular etiology. Further studies are warranted to confirm these associations and their implications for treatment strategies.