Evaluation of serum prestin level in patients with sudden sensorineural hearing loss

Introduction: Sudden sensorineural hearing loss (SSNHL) is an acute event that causes sudden hearing loss when not treated, disrupts the patient's social life and quality of life. Many factors have been blamed for etiopathogenesis but have not yet been fully elucidated. Therefore, there is still no definitive treatment. Combined treatment procedures involving many drugs are taken into consideration, considering possible etiologies. Early diagnosis is one of the most important prognostic factors. External hair cells in the cochlea are damaged in patients with sudden sensorineural hearing loss. The relationship of the prestin molecule, which is the motor protein responsible for the movement of these outer hair cells, with hearing loss is important. The aim of this study was to determine the value of serum prestin in determining prognosis in patients with sudden sensorineural hearing loss. Materials and Methods: This study was performed in 40 cases group and 40 healthy control groups in with the diagnosis of sudden idiopathic sensorineural hearing loss in the Otorhinolaryngology Clinic of University Medical Faculty. There was no inherited, acquired or chronic disease in the patient group, and both groups were similar in age. Fasting blood samples were taken into biochemistry tubes. The blood samples were centrifuged and their serum were separated. The prestin level of these serum was measured using the ELISA method commercial kit. In the Audiology Unit of YYU Dursun Odabaş Medical Center, pure tone audiometry test was applied to the case group twice at the first month after the treatment. A pure tone audiometry test was applied to the control group at the time of admission. Results: No statistically significant difference was found between the case group and the control group in terms of age. In the pre-treatment group, the Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) were significantly higher than the post-treatment and control groups. (For NLR, respectively P = 0.011 and P = 0.002, for PLR, P = 0.017 and 0.012). The serum prestin levels of the patients who applied at the second week were found to be significantly higher than the patients admitted at the 1st week (P = 0.012). Although the serum prestin level of the patients admitted in the second week was higher than the late group and the control group, this height was not statistically significant (P = 0.093 and P = 0.326, respectively). Although the serum prestin level of the patients admitted in the first week was lower than the control and late patients, there was no statistical significance (P = 0.132 and P = 0.458, respectively). When Prestin levels were evaluated after treatment, the lowest level of prestin was found in the non-healing group, but this value was not statistically significant when compared with the partial recovery and the complete recovery group (P = 0.546 and P = 0.474, respectively). The highest serum prestin level was detected in the complete recovery group, but there was no statistically significant difference between the non-healing and partially recovered groups (P = 0.474 and P = 0.782 respectively). At the time of presentation, the level of recovery was found to be higher in patients with low serum prestin levels. However, this difference was not statistically significant. Serum prestin level was lower in patients who recovered completely, but was not statistically significant compared to the partial recovery and non-healing group. (P = 0.625 and P = 0.183, respectively). Conclusion: In our study, the presence of inflammatory process in SSNHL etiology and prognostic significance of NLR and PLR levels were determined statistically. There was a correlation between the prestin levels measured after treatment and their response to treatment. In addition, there was a correlation between the low serum prestin level at admission and improvement. Therefore, we believe that Prestin may be a prognostic marker for SSNHL. Key words: Sudden Sensorineural Hearing Loss, Inflammation, Prestin, Prognosis