La surdité brusque résultats thérapeutique et facteurs pronostiques / Sudden sensorineural hearing loss: therapeutic outcome and prognostic factors

Objectifs: évaluer les résultats thérapeutiques et étudier les facteurs pronostiques de la surdité brusque.Patients et méthodes: Il s'agit d'une étude rétrospective à propos de 61 patients (39 hommes et 22 femmes) pris en charge pour surdité brusque dans le service d'Otorhinolaryngologie et de Chirurgie Cervico-Faciale de l'hôpital Bourguiba de Monastir durant une période de 16 ans (2001-2016). Une analyse statistique a été réalisée afin d'identifier les facteurs influençant le pronostic de la surdité brusque. Le seuil de significativité retenu était de 5%. Résultats:L'âge moyen était de 43 ans [16-80 ans]. Le taux global de récupération auditive était de 45%. Les facteurs pronostiques selon l'analyse uni variée étaient: un antécédent d'hypoacousie controlatérale, la présence d'un vertige associé, la sévérité de la perte auditive initiale, une courbe audiométrique de type E, l'absence du réflexe stapédien et le recours à l'oxygénothérapie hyperbare (OHB). En analyse multivariée, les seuls facteurs retenus étaient une perte auditive initiale supérieure ou égale à 70 dB, la présence d'un vertige et l'absence d'un épisode infectieux précédant la survenue de la surdité. Conclusion: Notre étude a permis de retenir comme facteurs de mauvais pronostic indépendants la perte auditive initiale supérieure ou égale à 70 dB, la présence d'un vertige et l'absence d'un épisode infectieux précédant la survenue de la surdité. Ceci nous incite à une réflexion quant au protocole thérapeutique adopté dans notre service et à indiquer l'OHB, qui est normalement prescrite en cas de non réponse, en première intention, afin d'optimiser la récupération auditive.

Self-reported hearing-related complaints among dental professionals: a questionnaire-based survey

Background: As a result of workplace noise, dental personnel are potentially predisposed to auditory and non-auditory effects of noise which may expose hidden or imminent hearing impairment. There is the need to capture these self-reported hearing and hearing-related complaints using well designed questionnaires as a prelude to formal audiometric tests. Materials And Methods: This was a cross-sectional self-administered questionnaire study conducted between the periods April to August 2015. Participants were given questionnaires to fill and return which captured socio-demographic data and exposure to noise at workplace and symptoms experienced. Upon return of the questionnaire, each questionnaire was examined to ensure they were properly filled with signed consent. All data and findings were evaluated anonymously. Results: One hundred and thirty eight questionnaires were returned giving 86% response rate, 35(25.4%) reported hearing impairment. Eighteen (13.0%) respondents have experienced tinnitus, while 20 (14.5%) of the respondents experienced Hyperacusis, another 53(38.4%) of the respondents also have difficulty hearing in places with competing noise. Stress and sleep disturbance were also common complains. Conclusion: The presence of especially tinnitus, hyperacusis, impaired hearing in areas with competing sounds are all symptoms indicative of imminent hearing impairment that could be used to predict undetected hearing losses among dental personnel

Evaluation of universal newborn hearing screening in South African primary care

Background: Universal Newborn Hearing Screening (UNHC) is the gold standard toward early hearing detection and intervention; hence the importance of its deliberation within the South African context. Aim: To determine the feasibility of screening in low-risk neonates, using Otoacoustic Emissions (OAEs), within the Midwife Obstetric Unit (MOU) three-day assessment clinic at a Community Health Centre (CHC); at various test times following birth.Method: Within a quantitative, prospective design, 272 neonates were included. Case history interviews, otoscopic examinations and Distortion Product OAEs (DPOAEs) screening were conducted at two sessions (within six hours and approximately three days after birth). Data were analysed via descriptive statistics. Results: Based on current staffing profile and practice, efficient and comprehensive screening is not successful within hours of birth, but is more so at the MOU three-day assessment clinic. Significantly higher numbers of infants were screened at session 2; with significantly less false-positive results. At session 1, only 38.1% of the neonates were screened; as opposed to more than 100% at session 2. Session 1 yielded an 82.1% rate of false positive findings, a rate that not only has important implications for the emotional well-being of the parents; but also for resource-stricken environments where expenditure has to be accounted for carefully. Conclusion: Current findings highlight the importance of studying methodologies to ensure effective reach for hearing screening within the South African context. These findings argue for UNHS initiatives to include the MOU three-day assessment to ensure that a higher number of neonates are reached and confounding variables such as vernix have been eliminated

Prevalence des troubles de l'audition en milieu scolaire de Kinshasa

Les troubles de l'audition constituent un probleme de sante publique. Ces troubles affectent; non seulement le developpement psychosocial et affectif de l'enfant; mais aussi et surtout sa scolarite. Cependant; l'ampleur de cette affection en milieu scolaire des pays en developpement reste en grande partie inconnue. Le but de cette etude etait de determiner la prevalence et l'etiologie de ces troubles chez les enfants en milieu scolaire. Cette etude transversale a ete realisee grace a un echantillon aleatoire des eleves frequentant les ecoles de l'enseignement maternel; primaire et secondaire du reseau catholique de Kinshasa; en Republique Democratique du Congo. Tous les eleves des ecoles selectionnees ont ete examines. Au total; 2298 eleves ont ete examines a l'otoscopie et testes a l'audiometrie tonale liminaire dans une classe calme. Le seuil moyen ? 30 dB HL a 1; 2 et 4 kHz a ete definie comme perte auditive significative. Dans l'ensemble; 22 eleves (0;96; IC 95: 2;0 - 2;8) ont ete identifies comme ayant un seuil auditif de plus de 30 dB a une oreille au moins et dont 18 (82) suite a une otite moyenne chronique suppuree ; 87 eleves (3;8) avaient une perforation tympanique et 444 (19;3); avaient des bouchons de cerumen. La deficience auditive; evaluee a environ 1des eleves en bonne sante apparente en milieu scolaire de Kinshasa; a pour cause principale (82des cas); l'otite moyenne chronique suppuree (OMC). Une sensibilisation des parents et des enseignants; grace a des programmes d'education sanitaire et un depistage regulier; pourraient aider a cibler les mesures preventives; susceptibles d'ameliorer le potentiel de l'enfant ayant une deficience auditive; en termes d'interaction sociale et de reussite scolaire

Hearing Disorders in HIV Positive Adult Patients

Background: This study was aimed at determining the prevalence and type of hearing disorders in HIV positive patients and any correlationship with the CD4 counts/stage of HIV/AIDS in patients attending the omprehensive care clinic (CCC). Methods: Case control study of 194 HIV positive patients attending CCC recruited into the study after informed consent. A thorough clinical examination and otoscopy done followed by tuning fork tests; Pure Tone Audiometry and tympanometric tests. This was compared with 124 HIV negative subjects matched for age and sex who were recruited from the voluntary counseling and testing centre. The world health organization staging of the HIV/AIDS disease and the CD4 positive lymphocyte cell count were carried out and correlated with any hearing disorder. Results were analyzed using statistical package for social sciences version 10.0. Results: Hearing loss (HL) was present in 33.5of HIV positive compared to 8.1in negative subjects. No gender bias in HL but HL worsened with advancement of age. SNHL was the most common and the higher frequencies were the most affected. Low CD4 cell count and advanced HIV disease were associated with increased chance of having a hearing loss. Conclusion: Hearing loss is more prevalent in HIV positive individuals than negative normal subjects and tends to worsen with the advancement of the HIV disease. This may negatively impact on the overall care and standard of living of HIV positive patients; hence otological care should be part of the comprehensive care

Screening audiometry in Nigerian school children

Audiometric screening tests done on 292 six-year old primary school children in Benin; shows that 9.2of the children had significant hearing impairment with elevation of hearing thresholds (HTL) above recommended screening levels at all or most of the frequencies tested; a total of 31of all subjects had some threshold elevation although in the majority of cases only one or two frequencies were affected. Otoscopic abnormalities were evident in a higher proportion of children who had hearing impairment than in those with normal hearing. The need for routine audiometric screening of school children is emphasized