D . B.V.N. Mu alidha Reddy e al. S udy o Incidence o Senso ineu al Hea ing Loss in Alle gic Rhini is. In . J Med.
Pha m. Res., 6 (6): 574‐578, 2025
574
In e na ional Jou nal o Medical
and Pha maceu ical Resea ch
Online ISSN-2958-3683 | P in ISSN-2958-3675
F equency: Bi-Mon hly
A ailable online on: h ps://ijmp .in/
O iginal A icle
S udy o Incidence o Senso ineu al Hea ing Loss in Alle gic Rhini is
D . B.V.N. Mu alidha Reddy1, D . Geo ge Pallapa i2, D . B. Zaiba kousa 3
1 Associa e p o esso , Depa men o ENT, Go e nmen Medical College, Nandyal, Andh a P adesh
2,3 Assis an p o esso , Depa men o ENT, Go e nmen Medical College, Nandyal, Andh a P adesh
A B S T R A C T
Co esponding Au ho :
D . Geo ge Pallapa i
Assis an p o esso , Depa men
o ENT, Go e nmen Medical
College, Nandyal, Andh a P adesh.
Recei ed: 17-09-2025
Accep ed: 05-10-2025
A ailable online: 20-10-2025
Backg ound: Alle gic hini is (AR) is a common in lamma o y diso de o he
nasal mucosa ha may ha e sys emic e ec s ex ending o he audi o y sys em.
Recen s udies sugges ha alle gic in lamma ion may con ibu e o senso ineu al
hea ing loss (SNHL), bu i s incidence among AR pa ien s emains unde -
ecognized. The p esen s udy was conduc ed o de e mine he incidence o
senso ineu al hea ing loss in pa ien s wi h alle gic hini is and o assess i s
associa ion wi h demog aphic and clinical a iables.
Ma e ials and Me hods: A c oss-sec ional s udy was conduc ed on 210 pa ien s
wi h clinically and alle gologically con i med alle gic hini is a ending he ENT
ou pa ien depa men . De ailed o ological examina ion and pu e one audiome y
we e pe o med o assess hea ing h esholds. Pa ien s wi h middle ea disease, noise
exposu e, o sys emic diso de s a ec ing hea ing we e excluded. S a is ical
analysis was done using chi-squa e and - es s, wi h p < 0.05 conside ed signi ican .
Resul s: Among he 210 pa ien s, 19.5% had SNHL, mos ly mild (13.3%), wi h no
cases o se e e loss. SNHL was sligh ly mo e equen in pe ennial AR (21.1%)
han in seasonal AR (17.1%), al hough he di e ence was no s a is ically
signi ican (p > 0.05). No signi ican gende di e ence was obse ed (p = 0.47).
The mean age o he s udy popula ion was 29.1 ± 8.1 yea s, and a g adual inc ease
in SNHL p e alence wi h age was no ed. These indings indica e ha subclinical
SNHL can occu e en in young adul s wi h AR, possibly due o p olonged alle gic
in lamma ion a ec ing cochlea unc ion
Conclusion: Nea ly one- i h o pa ien s wi h alle gic hini is exhibi subclinical o
mild senso ineu al hea ing loss, indica ing possible cochlea in ol emen due o
alle gic in lamma ion. Rou ine audiological e alua ion should be conside ed in he
managemen o alle gic hini is o ensu e ea ly de ec ion and in e en ion.
Copy igh © In e na ional Jou nal o
Medical and Pha maceu ical Resea ch
Keywo ds: Alle gic hini is, Senso ineu al hea ing loss, Audiome y, Pe ennial
hini is, Cochlea dys unc ion.
INTRODUCTION
Alle gic hini is (AR) is a common IgE-media ed in lamma o y diso de o he nasal mucosa cha ac e ized by symp oms
such as nasal conges ion, hino hea, sneezing, and i ching. Globally, AR a ec s 10–30% o adul s and up o 40% o
child en, and i s p e alence has been ising o e he pas ew decades due o en i onmen al and li es yle changes [1,2]. In
India, he p e alence is es ima ed o be a ound 20–25%, wi h u ban popula ions showing highe incidence due o inc eased
alle gen exposu e [3].
AR can be classi ied in o seasonal (in e mi en ) and pe ennial (pe sis en ) ypes based on he pa e n and du a ion o
alle gen exposu e. While he main ocus in AR managemen is elie o nasal and ocula symp oms, ch onic in lamma ion
associa ed wi h AR can lead o complica ions in ol ing he ea , nose, and h oa , such as Eus achian ube dys unc ion, o i is
media wi h e usion, and a ely, senso ineu al hea ing loss (SNHL) [4–6].
D . B.V.N. Mu alidha Reddy e al. S udy o Incidence o Senso ineu al Hea ing Loss in Alle gic Rhini is. In . J Med.
Pha m. Res., 6 (6): 574‐578, 2025
575
Senso ineu al hea ing loss in AR is no well documen ed, unlike conduc i e hea ing loss which is commonly associa ed
wi h middle ea e usions. The pa hophysiology o SNHL in AR is belie ed o in ol e immune-media ed cochlea damage,
ch onic in lamma o y cy okine ac i i y, and p olonged Eus achian ube dys unc ion, which may comp omise inne ea
homeos asis [7,8]. Se e al s udies ha e sugges ed ha mild o subclinical SNHL can occu e en in young adul s wi h AR,
o en emaining unde ec ed unless audiological assessmen s a e pe o med [9,10].
Ea ly iden i ica ion o SNHL in AR pa ien s is impo an because un ea ed hea ing loss can lead o communica ion
di icul ies, dec eased quali y o li e, and delayed cogni i e de elopmen in younge popula ions. Despi e his, ou ine
audiome ic sc eening is a ely inco po a ed in o s anda d AR managemen p o ocols. Iden i ying he incidence o SNHL
among AR pa ien s will help in aising awa eness and may guide clinicians o include audiological e alua ion as pa o
ou ine ca e.
Objec i e o he s udy: This s udy aims o de e mine he incidence o senso ineu al hea ing loss in pa ien s wi h alle gic
hini is, and o assess i s ela ionship wi h ype o AR, age, and gende . Unde s anding hese associa ions can con ibu e o
ea ly diagnosis and imely in e en ion o p e en long- e m audi o y impai men .
MATERIALS AND METHODS
This was a c oss-sec ional obse a ional s udy conduc ed a he Depa men o ENT a a e ia y ca e hospi al o a pe iod
o 6 mon hs om Janua y 2025 o June 2025. The s udy aimed o de e mine he incidence o senso ineu al hea ing loss
(SNHL) in pa ien s wi h alle gic hini is (AR) and analyze i s co ela ion wi h ype o AR, age, and gende .
S udy Popula ion: A o al o 210 pa ien s diagnosed wi h alle gic hini is we e included in he s udy.
Inclusion C i e ia
1. Pa ien s aged 18–50 yea s.
2. Clinically diagnosed alle gic hini is based on ARIA (Alle gic Rhini is and i s Impac on As hma) guidelines.
3. Pa ien s willing o unde go audiome ic e alua ion and p o ide in o med consen .
Exclusion C i e ia
1. His o y o ch onic o i is media, ympanic memb ane pe o a ion, o ea su ge y.
2. Known congeni al o acqui ed hea ing loss un ela ed o AR.
3. Use o o o oxic d ugs (e.g., aminoglycosides, loop diu e ics).
4. Sys emic illnesses a ec ing hea ing (e.g., diabe es melli us, hype ension, ch onic kidney disease).
5. Inabili y o coope a e wi h audiome ic es ing.
Clinical Assessmen
1. De ailed his o y- aking, including du a ion and ype o AR symp oms, pas medical his o y, amily his o y o alle gies,
and occupa ional/en i onmen al exposu es.
2. Physical examina ion, including an e io hinoscopy and o oscopic e alua ion o ule ou middle ea pa hology.
3. Classi ica ion o AR:
o Seasonal AR: Symp oms occu ing du ing speci ic seasons.
o Pe ennial AR: Symp oms pe sis ing h oughou he yea .
Audiological E alua ion
1. Pu e- one audiome y (PTA): Conduc ed in a sound- ea ed oom using a calib a ed audiome e . Th esholds we e
measu ed a equencies 250 Hz o 8 kHz o bo h ea s.
2. Tympanome y: Pe o med o assess middle ea unc ion and exclude conduc i e hea ing loss. Only pa ien s wi h
no mal ympanog ams (Type A) we e included in SNHL assessmen .
3. De ini ion o SNHL: Hea ing loss o >25 dB HL a any equency, wi h ai -bone gap ≤10 dB, classi ied as:
o Mild: 26–40 dB HL
o Mode a e: 41–55 dB HL
o Se e e: >55 dB HL
Da a Collec ion and S a is ical Analysis: Da a we e eco ded in a s uc u ed p o o ma. Con inuous a iables we e
exp essed as mean ± s anda d de ia ion. Ca ego ical a iables we e exp essed as pe cen ages. Chi-squa e es was used o
analyze associa ions be ween SNHL and gende , ype o AR, and age g oups. p- alue < 0.05 was conside ed s a is ically
signi ican . S a is ical analysis was pe o med using SPSS e sion 20.
RESULTS
A o al o 210 pa ien s diagnosed wi h alle gic hini is (AR) we e included in he s udy. The s udy popula ion comp ised
sligh ly mo e males (54.3%) han emales (45.7%), wi h a mean age o 29.1 yea s. Pe ennial AR was mo e common han
seasonal AR, e lec ing con inuous alle gen exposu e in he s udy egion (Table 1).
D . B.V.N. Mu alidha Reddy e al. S udy o Incidence o Senso ineu al Hea ing Loss in Alle gic Rhini is. In . J Med.
Pha m. Res., 6 (6): 574‐578, 2025
576
Table 1. Demog aphic and Clinical P o ile o S udy Popula ion
Va iable
Numbe (%) / Mean ± SD
To al pa ien s
210 (100%)
Gende (M:F)
114:96
Mean age (yea s)
29.1 ± 8.1
Pe ennial AR
128 (61.0%)
Seasonal AR
82 (39.0%)
O e all, 19.5% o pa ien s wi h AR had SNHL, p edominan ly mild in deg ee. Mode a e SNHL was less common, and
no se e e cases we e de ec ed. This sugges s ha mild, subclinical SNHL may be an unde - ecognized complica ion among
alle gic hini is pa ien s (Table 2).
Table 2. Incidence and Se e i y o Senso ineu al Hea ing Loss (SNHL)
Se e i y o SNHL
Numbe o Pa ien s
Pe cen age (%)
Mild (26–40 dB HL)
28
13.3
Mode a e (41–55 dB HL)
13
6.2
Se e e (>55 dB HL)
0
0
To al wi h SNHL
41
19.5
No mal hea ing
169
80.5
SNHL was sligh ly mo e p e alen in pe ennial AR (21.1%) compa ed o seasonal AR (17.1%), possibly due o yea -
ound alle gen exposu e and p olonged in lamma o y e ec s on he Eus achian ube and cochlea pa hways. Al hough his
di e ence was no s a is ically signi ican (p > 0.05), i indica es ha disease ch onici y may in luence audi o y unc ion
(Table 3).
Table 3. Dis ibu ion o SNHL by Type o Alle gic Rhini is
Type o AR
To al Pa ien s
SNHL P esen
Pe cen age (%)
Pe ennial AR
128
27
21.1
Seasonal AR
82
14
17.1
The e was no signi ican gende di e ence in he incidence o SNHL (p = 0.47), indica ing ha bo h males and emales
wi h AR a e equally suscep ible o senso ineu al hea ing loss (Table 4).
Table 4. Gende -wise Dis ibu ion o SNHL
Gende
To al Pa ien s
SNHL P esen
Pe cen age (%)
Male
114
20
17.5
Female
96
21
21.9
The incidence o SNHL showed a g adual inc ease wi h age, bu di e ences we e no s a is ically signi ican . E en
younge adul s (18–25 yea s) exhibi ed mild SNHL (14.7%), emphasizing he impo ance o ea ly audiological sc eening
in all AR pa ien s (Table 5).
Table 5. Age-wise Dis ibu ion o SNHL
Age G oup (yea s)
To al Pa ien s
SNHL P esen
Pe cen age (%)
18–25
68
10
14.7
26–35
94
19
20.2
36–45
48
12
25.0
DISCUSSION
The p esen c oss-sec ional s udy was conduc ed o de e mine he incidence o senso ineu al hea ing loss (SNHL) among
pa ien s wi h alle gic hini is (AR) and o e alua e i s associa ion wi h he ype o AR, age, and gende . Ou o 210 pa ien s
D . B.V.N. Mu alidha Reddy e al. S udy o Incidence o Senso ineu al Hea ing Loss in Alle gic Rhini is. In . J Med.
Pha m. Res., 6 (6): 574‐578, 2025
577
e alua ed, 41 (19.5%) we e ound o ha e SNHL, p edominan ly mild in deg ee. This inding ein o ces ha alle gic
hini is, beyond being a nasal diso de , can in luence inne ea unc ion h ough in lamma o y and immunologic
mechanisms.
Compa ison wi h P e ious S udies
The obse ed incidence o SNHL (19.5%) in he p esen s udy closely pa allels p e ious epo s in li e a u e. Kim e al.
(2019) ound SNHL in 18% o AR pa ien s, sugges ing ha inne ea in ol emen is no uncommon in alle gic condi ions
[11]. Simila ly, Chen e al. (2018) epo ed 20% subclinical SNHL among AR pa ien s, pa icula ly hose wi h pe ennial
symp oms [12]. Jeong e al. (2017) demons a ed cochlea dys unc ion using o oacous ic emissions in 16% o AR pa ien s,
e en when audiome ic h esholds we e no mal [13].
These indings collec i ely indica e ha alle gic in lamma ion can sub ly a ec cochlea s uc u es, o en wi hou o e
symp oms, highligh ing he need o audiological sc eening in AR.
Possible Pa hophysiological Mechanisms
Se e al mechanisms ha e been p oposed o explain he associa ion be ween AR and SNHL. Ch onic nasal and
nasopha yngeal in lamma ion may cause Eus achian ube dys unc ion, esul ing in al e ed middle ea p essu e and
impai ed cochlea homeos asis [14]. Fu he mo e, immune-media ed cochlea inju y may occu due o sys emic alle gic
esponses and cy okine elease.
Inc eased le els o in lamma o y media o s such as in e leukin-4, in e leukin-5, umo nec osis ac o -α, and his amine
may ex end beyond he nasal mucosa, leading o mic oci cula o y dis u bances and damage o ou e hai cells wi hin he
cochlea [15,16]. Expe imen al models ha e shown eosinophilic in il a ion in he cochlea egion in alle gic condi ions,
suppo ing he concep o alle gy-induced cochlea in lamma ion [17].
The indings o his s udy, wi h nea ly one- i h o pa ien s demons a ing SNHL, lend u he clinical suppo o hese
pa hophysiological mechanisms.
Associa ion wi h Type o Alle gic Rhini is
In he cu en s udy, SNHL was sligh ly mo e p e alen in pe ennial AR (21.1%) compa ed o seasonal AR (17.1%),
al hough he di e ence was no s a is ically signi ican (p > 0.05). This end mi o s indings by DiBe a dino e al. (2006),
who epo ed highe a es o hea ing impai men among pa ien s wi h pe sis en alle gic hini is due o con inuous
alle gen exposu e and sus ained mucosal in lamma ion [18]. The ch onici y o in lamma ion in pe ennial AR may lead o
p olonged cy okine ac i a ion and immune cell in il a ion, p edisposing hese pa ien s o sub le cochlea damage. Thus,
du a ion and pe sis ence o symp oms may be impo an isk ac o s o hea ing changes in alle gic indi iduals.
Age and Gende Co ela ion
No signi ican gende di e ence was obse ed in he incidence o SNHL, consis en wi h Kim SH e al. (2012), who
epo ed a simila absence o sex p edilec ion in audi o y h eshold changes among AR pa ien s [19]. The age- ela ed
inc ease in SNHL obse ed in his s udy, al hough no s a is ically signi ican , aligns wi h p e ious e idence sugges ing
ha ch onic alle gic in lamma ion may exace ba e cochlea aging o me abolic s ess o e ime [20].
In e es ingly, mild SNHL was also no ed among younge adul s (18–25 yea s), ein o cing ha hea ing loss in AR is no
es ic ed o olde age g oups and can de elop ea ly i alle gic in lamma ion is uncon olled.
Clinical Implica ions
The indings o his s udy ha e impo an clinical implica ions. Alle gic hini is is o en managed wi h a ocus on nasal and
ocula symp oms, while audi o y mani es a ions a e equen ly o e looked. The de ec ion o mild SNHL in nea ly one- i h
o AR pa ien s unde sco es he need o ou ine audiome ic e alua ion, e en in hose wi hou ea complain s.
Ea ly diagnosis allows imely in e en ion h ough alle gen a oidance, an ihis amines, and in anasal co icos e oids,
which may help educe inne ea in lamma ion and p e en p og ession o hea ing loss [21]. In eg a ing audiological
sc eening in o ARIA (Alle gic Rhini is and i s Impac on As hma) guidelines could enhance comp ehensi e managemen
o alle gic hini is [22].
CONCLUSION
This s udy ound ha 19.5% o pa ien s wi h alle gic hini is had senso ineu al hea ing loss, mos ly mild in deg ee.
The indings sugges ha alle gic in lamma ion may ex end o he inne ea , e en in pa ien s wi hou ea symp oms. Regula
audiological e alua ion should be included in he managemen o alle gic hini is o enable ea ly de ec ion and ea men .
La ge p ospec i e s udies a e needed o con i m hese obse a ions and cla i y unde lying mechanisms.
D . B.V.N. Mu alidha Reddy e al. S udy o Incidence o Senso ineu al Hea ing Loss in Alle gic Rhini is. In . J Med.
Pha m. Res., 6 (6): 574‐578, 2025
578
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