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Purpose <p>Cochlear nerve (CN) atrophy has been reported as a secondary change in acquired sensorineural hearing loss (ASNHL). However, the findings remained inconsistent across studies. A systematic review and meta-analysis was conducted to compare CN size between affected ears and normal-hearing controls.</p> Methods <p>Embase, PubMed, Web of Science and Scopus databases were searched before August, 2025. A random-effect meta-analysis was used to estimate the standardized mean difference (SMD) and 95% confidence interval to quantify the difference of CN size between groups. Cross-sectional area (CSA) was set as the outcome for CN measurement. Modified Newcastle–Ottawa scale was used for methodological quality.</p> Results <p>Ten articles comprising 665 subjects (728 ears) in study group and 504 subjects (663 ears) in control group were included. A significant reduction in the CSA of CN in ASNHL ears compared to normal-hearing controls (SMD=-0.67, 95%CI: -1.03~-0.31; <i>P</i> &lt; 0.001) was found, albeit with substantial heterogeneity (I²=83.7%). Subgroup analysis stratified by hearing loss duration and measured location demonstrated a significantly smaller CSA of CN at mid-point of the internal auditory canal (IAC) in patients with long-term ASNHL (SMD=-0.63, 95%CI: -0.95~-0.32; <i>P</i> &lt; 0.001), with low heterogeneity (I²=0%), but not in sudden ASNHL or in measurements at the IAC fundus. The robustness of these primary findings was tested by sensitivity analysis.</p> Conclusion <p>CN atrophy was pronounced in long-term ASNHL ears when measured at mid-point of IAC, highlighting possible degenerative neural changes from hearing deprivation. The recommended measurement and target population for CN atrophy were proposed in ASNHL for future studies.</p>

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Cochlear nerve atrophy in acquired sensorineural hearing loss: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2026年4月24日

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  • Siwei Yang,
  • Yan Huang,
  • Furen Guo,
  • Jingying Guo,
  • Yuhe Liu,
  • Zhenchang Wang,
  • Pengfei Zhao

摘要

Purpose

Cochlear nerve (CN) atrophy has been reported as a secondary change in acquired sensorineural hearing loss (ASNHL). However, the findings remained inconsistent across studies. A systematic review and meta-analysis was conducted to compare CN size between affected ears and normal-hearing controls.

Methods

Embase, PubMed, Web of Science and Scopus databases were searched before August, 2025. A random-effect meta-analysis was used to estimate the standardized mean difference (SMD) and 95% confidence interval to quantify the difference of CN size between groups. Cross-sectional area (CSA) was set as the outcome for CN measurement. Modified Newcastle–Ottawa scale was used for methodological quality.

Results

Ten articles comprising 665 subjects (728 ears) in study group and 504 subjects (663 ears) in control group were included. A significant reduction in the CSA of CN in ASNHL ears compared to normal-hearing controls (SMD=-0.67, 95%CI: -1.03~-0.31; P < 0.001) was found, albeit with substantial heterogeneity (I²=83.7%). Subgroup analysis stratified by hearing loss duration and measured location demonstrated a significantly smaller CSA of CN at mid-point of the internal auditory canal (IAC) in patients with long-term ASNHL (SMD=-0.63, 95%CI: -0.95~-0.32; P < 0.001), with low heterogeneity (I²=0%), but not in sudden ASNHL or in measurements at the IAC fundus. The robustness of these primary findings was tested by sensitivity analysis.

Conclusion

CN atrophy was pronounced in long-term ASNHL ears when measured at mid-point of IAC, highlighting possible degenerative neural changes from hearing deprivation. The recommended measurement and target population for CN atrophy were proposed in ASNHL for future studies.