Jones, Nicholas Spencer; (1997) Hyperlipidaemia and hearing loss. Doctoral thesis (M.D), UCL (University College London).

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Abstract

Hyperlipidaemia has been said to be an aetiological factor in sensorineural hearing loss. The literature contains many references which refer to a relationship between hyperlipidaemia and hearing loss, but the majority of reports are retrospective, lack adequate controls, or are based on a series of cases which may represent incidental findings and not a true causal relationship. The prevalence of hyperlipidaemia in the normal population means that hyperlipidaemia is regularly found, possibly incidentally, in patients who have a hearing loss of unknown aetiology. Animal work has been sparse, of inadequate numbers, and of questionable methodology. This work set out to test the Null hypothesis that there is no relationship (causative or associated) between hyperlipidaemia and sensorineural hearing loss. This hypothesis was examined using four case-controlled studies. The first was a retrospective case-controlled study of 1,490 consecutive new patients who presented to a Neuro-otology Clinic. This group is exceptional in that all patients had had fasting lipid profiles done regardless of their presenting problem. The second was a prospective case-controlled study of 197 men between 50 and 60 years old, with risk factors for ischaemic heart disease or hyperlipidaemia. The third was a prospective case-controlled study of 50 consecutive hyperlipidaemic patients attending a lipid clinic with a fasting cholesterol level outside the upper limit of two standard deviations from the population mean. The fourth was a prospective case-controlled study of 87 patients presenting consecutively with a sensorineural hearing loss of unknown aetiology. The selection of control groups is crucial in case-controlled studies. Control subjects were recruited from patients undergoing nasal surgery for either internal or external structural abnormalities. All study and control groups were also compared with the National Study of Hearing data (Davis 1995). No consistent association between hyperlipidaemia and hearing loss was found which would lead to the rejection of the null hypothesis that there is no relationship between hyperlipidaemia and hearing loss.

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