{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:01:58Z","timestamp":1790694118779,"version":"4.1.0"},"reference-count":17,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000002","name":"national institutes of health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Otol Rhinol Laryngol"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The aim of this scoping review is to identify and categorize uncommon disorders of hearing instability, enabling a better understanding of their clinical presentations and treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The framework for the review was developed using the PRISMA-ScR. Literature was pulled from Medline, Web of Science, Embase, and Cochrane Central and screened independently by 3 reviewers with an extended inclusion and exclusion criteria. Once included, data extraction included etiological category of the disease, hearing loss type (sudden, fluctuating, or both), associated symptoms, comorbidities, treatments administered, and hearing recovery outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 334 studies were included after screening, and data from 2247 patients was extracted. The most common etiologies per study were infectious (30.2%, n\u2009=\u2009101 studies), neoplastic (29.6%, n\u2009=\u200999 studies), and vascular (28.1%, n\u2009=\u200994 studies). Average age across cases was 45.9\u2009years (range: 0-90). Among patients, 89.8% exhibited sudden hearing loss, while 8.18% experienced fluctuating hearing loss. Neoplastic-related hearing instability had the highest number of total patients (n\u2009=\u20091101 patients), predominantly involving vestibular schwannomas (n\u2009=\u2009582 patients) while infectious diseases had the second highest number of patients (n\u2009=\u2009493 patients), with COVID-19 as the most reported infection (n\u2009=\u2009146 patients). Causes identified without a known association with hearing loss in other literature include acute or chronic myeloid leukemia (n\u2009=\u200924), metastatic tumor disease (n\u2009=\u200910), or infective endocarditis (n\u2009=\u20093).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Hearing instability can arise from a variety of uncommon causes. Increased awareness of these conditions may help clinicians initiate appropriate treatment sooner, potentially improving patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00034894261470539","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T08:49:08Z","timestamp":1784537348000},"page":"880-886","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Uncommon Hearing Instability Disorders: A Scoping Review"],"prefix":"10.1177","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2392-916X","authenticated-orcid":false,"given":"Jeremiah","family":"Olabosipo","sequence":"first","affiliation":[{"name":"Georgetown University School of Medicine, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7473-2066","authenticated-orcid":false,"given":"Christina","family":"Zhu","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Telischi","sequence":"additional","affiliation":[{"name":"Auditory Development and Restoration Program, Section on Inner Ear Therapeutics, Neurotology Branch, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean Andrew","family":"Aston","sequence":"additional","affiliation":[{"name":"Data Science Core, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Cheng","sequence":"additional","affiliation":[{"name":"Data Science Core, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hoa","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine, Washington, DC, USA"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1084713811408349"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1159\/000500658"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200161080-00005"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-019-05681-5"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2022.111072"},{"issue":"3","key":"e_1_3_2_7_2","first-page":"238","article-title":"Advances in the study of fluctuating sensorineural hearing loss","volume":"37","author":"Zhu Q","year":"2023","unstructured":"Zhu Q, Zhang K, Zou S, et al. Advances in the study of fluctuating sensorineural hearing loss. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023;37(3):238-242.","journal-title":"Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10162-018-0669-5"},{"key":"e_1_3_2_9_2","unstructured":"Casale J Kandle PF Murray IV et al. Physiology cochlear function. Updated April 1 2023. In: StatPearls [Internet]. StatPearls Publishing; January 2025. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK531483\/"},{"key":"e_1_3_2_10_2","unstructured":"Bordoni B Mankowski NL Daly DT. Neuroanatomy Cranial Nerve 8 (Vestibulocochlear). Updated May 22 2023. In: StatPearls [Internet]. StatPearls Publishing; January 2025. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK537359\/"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-62630-1.00001-9"},{"key":"e_1_3_2_12_2","unstructured":"Cheslock M De Jesus O. Presbycusis. Updated August 23 2023. 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