Ossicular chain status in ear pathology cases

Introduction: The tympanic cavity contains three ossicles in humans, the malleus, incus and stapes. These ossicles form a chain across the tympanic cavity from the tympanic membrane to fenestra vestibuli respectively. They develop from mesenchymal condensation of tubotympanic recess at the 6th week of intrauterine life. Later due to programmed cell death a part of tissue remains as ossicles. It attains adult size in the fetal life itself. However, studies have shown gain in size and weight even 2 years after birth. The ossicles help in sound conducting mechanism in hearing. These ossicles are vulnerable to damage in the various diseases of the middle ear cleft resulting into either partial or total loss. Incus is the most, followed by stapes and least by malleus. 20% mucosal diseases show ossicular damage, while squamous epithelial disease involve in 80% [1,2]. The integrity of the ossicular chain is most important for the transmission mechanism of external sounds to the inner ear fluids. Objectives: 1. To study the percentage of ossicular damage in the diseases of the middle ear cleft among the patients being operated for chronic suppurative otitis media in our tertiary care hospital. 2.To assess the extent and frequency of individual ossicular chain involvement in simple mucosal disease and squamous epithelial diseases. Methods: A prospective clinical study was conducted in our tertiary care hospital over a period of five and a half years in our tertiary care hospital among 100 cases of chronic suppurative otitis media after ethical committee clearance. Detailed clinical and radiological examinations of the patients were done and ossicular chain status was noted on table. Patients were also called up for regular follow up. Results: Ossicular chain erosion was mostly seen in squamosal disease, with incus and incudo-stapedial joint being the most common sites for ossicular erosion. Conclusion: it was concluded that long process of incus was the most commonly eroded structure, with the incus being the most commonly involved ossicle Few factors that were found to be associated with ossicular erosion were atticoantral disease, pediatric age group and bigger tympanic membrane perforations.

A study of pure tone audiometry in adults with hypothyroidism

Background: Thyroid hormones are important for overall growth and maturation. Hypothyroidism is associated with many symptom complexes, one of them being hearing loss. Aim and Objectives: Evaluating the hearing loss in hypothyroid patients of the age group of 18� years and comparing them with those in healthy people. Materials and Methods: A case-control study was conducted in subjects aged between 18 and 45 years, in which 80 hypothyroid cases were selected after proper exclusion and informed consent and 80 age-and sex-matched healthy controls were studied. Hearing loss was assessed by pure tone audiometry. Statistical Package for the Social Sciences version 18 was used for statistical analysis. Results: SNHL was the common type of hearing loss seen. The prevalence of hearing loss was found to be 66.3% in cases. Hearing loss was mild, bilateral, and commonly affected the high frequency. Conclusions: Hypothyroid patients were more prone to sensorineural hearing loss. In patients with thyroid disorders, hearing evaluation helps in the detection of hearing loss earlier and thus treatment could be started.

Effects of Obesity on the Auditory Function of Children and Adolescents

Abstract Introduction Childhood and adolescent obesity is associated with insulin resistance, abnormal glucose metabolism, hypertension, dyslipidemia, inflammation, liver disease, and compromised vascular function. Objective We aimed to evaluate the effects of obesity on the auditory function and speech audiometry of children and adolescents. Methods Subjects with a body mass index (BMI) higher than +2 standard deviation (SD) were classified as obese, and subjects with normal BMI SD were classified as the control group. Blood samples were taken for glucose, insulin, and lipid profiles following an 8-hour fasting period, and a hepatobiliary ultrasound was performed. The homeostatic model assessment for insulin resistance (HOMA-IR) was calculated. The audiological evaluation included pure-tone audiometry (PTA), speech reception threshold (SRT), and speech discrimination score (SDS). Results The study included 100 children (50 girls) with obesity, with a mean age of 11.4 ± 2.9 years and 30 children with normal body weight, with a mean age of 11.9 ± 3.3 years. Of the children with obesity, 55% (n = 55) were found to have hyperlipidemia, 68% (n = 68) insulin resistance, and 21% (n = 21) hepatosteatosis. There were no statistically significant differences between children with obesity and the control group in terms of SDS or PTA, while SRT was found to be higher in children with obesity. There was no difference between obese children with or without hyperlipidemia, between obese children with or without insulin resistance, and between obese children with or without hepatosteatosis, according to hearing tests. Conclusion The result of the present study indicates that children with obesity are more prone to having auditory problems than the normal population. We recommend more frequent audiological evaluations, including speech audiometry, in children and adolescents with obesity problems

Comparative study of pure tone audiometry in diabetics and non-diabetics

Background: Diabetes mellitus (DM) is a non-communicable disorder which is metabolically disrupted associated with several complications, which include retinopathy, nephropathy, angiopathy, and neuropathy. Angiopathy and neuropathy caused by DM have been considered important factor for vestibulocochlear disorder found in these patients. Aims and Objectives: The study was done to compare sensory-neural hearing losses (SNHL) in Type 2 diabetics with healthy individuals. To find out effect of age of individual on hearing, how glycemic control of diabetes affects hearing acuity which frequencies of hearing affected by diabetic patients. Materials and Methods: The present study was conducted on 30 Type 2 diabetics and 30 healthy individuals are takes as controls in the age group of 30–60 years. Selection of individuals is done based on inclusion and exclusion criteria. All patients are asked for detailed history and their detailed clinical examination is done. After this, all patients are investigated for HbA1C. All subjects underwent pure tone audiometry and findings were recorded and analyzed. Results: The diabetics with SNHL are 90% when compared to the control are 60% which is highly significant (P = 0.017). Diabetes patients had hearing losses which are insidious in nature which is gradually progressive and affects hearing in both the sides. The audiogram of diabetics was suggestive of mild to moderately severe SNHL which was more toward higher frequencies. SNHL is aggravated with increasing age. In non-diabetic, SNHL is mainly due to age, but in diabetic, SNHL is mainly due to poorer control of diabetes not only due to age. Conclusion: The Type 2 diabetic patients had hearing losses at higher threshold more significantly which is bilateral, mild to moderately severe SNHL as compared to healthy individual of similar age. The glycemic control-HbA1C has significant correlation with severity of hearing loss. SNHL is more significant in patients whom had poor glycemic control.

Development of High-performance Hearing Test System / 中国医疗器械杂志

This paper analyzes the shortcomings of the existing pure tone audiometers, and proposes a system to realize pure tone audiometry and speech audiometry with a new DSP processor. The pure tone test signal produced by the system has accurate frequency, high signal-to-noise ratio, and small harmonic distortion. The noise generator that comes with DSP adds a band-pass filter to realize the generation of narrow-band noise. At the same time, due to the modular structure of software design, the system has good ease of use and scalability. The test results show that the hearing test system has excellent performance and can be better used in hearing medical diagnosis.

Vertigo Patients Characteristic in Neurotology Outpatient Clinic, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia

@#Introduction: Vertigo is estimated to occur in 3% of adults every year. In contrast to dizziness, vertigo is associated with symptoms of peripheral or central balance disorders, while dizziness is associated with cardiovascular, neuropathic, neuromuscular, or psychosomatic diseases. Methods: Data for 123 patients at Hospital were taken retrospectively. The variables studied were demographic data, vestibular examination, audiometry, and vertigo diagnosis. Results: There were 123 vertigo patients consisting of 42 men and 81 women. The average age of the patients was 48.46 years. Most patients were diagnosed with other peripheral vertigo 37.40%, then unspecified disorder of vestibular function 15.45%, BPPV 14.63%, Meniere’s disease 8.94%, dizziness 8.94%, central vertigo 8.13%, and vestibular neuritis 6.50%. The types of hearing loss were Conductive Hearing loss (CHL) 6.10%, Sensorineural Hearing Loss (SNHL) 21.54%, and Mixed Hearing Loss (MHL) 11.38%. Location of hearing loss was unilateral 23.58% and bilateral 26.83%. Mean Pure Tone Average (PTA) of vertigo with hearing loss was 52.54 dB in right ear and 55.96 dB in left ear. Conclusion: Most patients were diagnosed with other peripheral vertigo is female. They had normal hearing. The most common type of hearing loss was SNHL with a mean PTA of 52.54 dB in right ear and 55.96 dB in left ear. Mean PTA in vertigo patients with normal hearing was 18.29 ± 4.24 dB in right ear and 17.55 ± 4.13 dB in left ear, while mean PTA in vertigo with hearing loss was 52.54 ± 29.93 dB in right ear and 55.96 ± 28.01 in left ear.

Comparison of ASSR, ABR and 40 Hz AERP Response Thresholds at Different Frequencies and Their Forensic Applications / 法医学杂志

OBJECTIVES@#To explore the relationship between the frequency characteristics and response threshold of auditory steady-state response (ASSR), auditory brainstem response (ABR) and 40 Hz auditory event related potential (40 Hz AERP), and their application values in forensic medicine.@*METHODS@#Thirty volunteers with normal hearing (60 ears) were selected to perform pure tone audiometry (PTA) threshold and ASSR, ABR and 40 Hz AERP response threshold tests in the standard sound insulation shielding room, and the results were statistically analyzed by SPSS 22.0 software.@*RESULTS@#At 0.5 kHz and 1.0 kHz frequencies, the correlation between 40 Hz AERP response threshold and PTA threshold was good, which was better than that of ASSR and ABR response threshold. At 2.0 kHz and 4.0 kHz frequencies, the correlation between ASSR and ABR response thresholds and PTA threshold was good, which was better than that of 40 Hz AERP response threshold.@*CONCLUSIONS@#To evaluate the hearing at 0.5 kHz and 1.0 kHz frequencies, it is recommended to use 40 Hz AERP and ASSR to comprehensively assess the PTA threshold of the subjects. To evaluate the hearing at 2.0 kHz and 4.0 kHz frequencies, ABR and ASSR are recommended to assess the PTA threshold of subjects comprehensively. The combination of ASSR, ABR and 40 Hz AERP can improve the accuracy of hearing function evaluation.

Comparison of radiation and chemoradiation-induced sensorineural hearing loss in head and neck cancer patients

Aim: The purpose of this study was to assess and compare the incidence and severity of sensorineural hearing loss (SNHL) in head-and-neck patients undergoing radiotherapy (RT) and concurrent cisplatin-based chemoradiotherapy (CRT). Materials and Methods: Pure tone audiometry (PTA) was performed at 0.25–12 kHz on 35 RT and 25 CRT patients after 12-month followed up. The hearing loss was evaluated according to the Common Terminology Criteria for Adverse Events (CTCAE) criteria. Results: SNHL increased to 84% in patients who had received CRT, compared with 26% increasing in patients who had treated with RT. There was an increased risk of SNHL at all frequencies for ears received a cochlear mean dose >50 Gy in RT group, compared to those receiving cochlear mean dose >30 Gy in CRT group. SNHL was more severe at higher frequencies in both patient groups. Conclusion: Characteristic of radiation-induced SNHL is different from CRT-induced SNHL, especially in threshold radiation dose and PTA frequency.

Osteoporosis and hearing loss: findings from the Korea National Health and Nutrition Examination Survey 2009-2011 / Osteoporose e perda auditiva: resultados da Pesquisa Nacional do Exame de Saúde e Nutrição da Coreia de 2009 a 2011

Abstract Introduction: Age-related hearing impairment is the most common sensory dysfunction in older adults. In osteoporosis, the mass of the ossicles will be decreased, affecting the bone density of the cochlea, and interfering with the sound transmission to the cochlea. Age related hearing loss might be closely related to osteoporosis. Objective: To determine the relationship between age-related hearing impairment and osteoporosis by investigating the relationship between hearing loss and cortical bone density evaluated from femur neck bone mineral density. Methods: We used data from the Korea National Health and Nutrition Examination Survey to examine the associations between osteoporosis and age-related hearing impairment from 2009 to 2011. Total number of participants was 4861 including 2273 men and 2588 women aged 50 years or older. Osteoporosis was defined as a bone mineral density 2.5 standard deviations below according to the World Health Organization diagnostic classification. Age-related hearing impairment was defined as the pure-tone averages of test frequencies 0.5, 1, 2, and 4 kHz at a threshold of 40 dB or higher on the more impaired hearing side. Results: Total femur T-score (p < 0.001), lumbar-spine T-score (p < 0.001) and, femur neck T-score (p < 0.001) were significantly lower in the osteoporosis group compared to the normal group. Thresholds of pure-tone averages were significantly different in normal compared to osteopenia, and osteoporosis groups. In addition, there were significantly higher pure-tone averages thresholds in the osteoporosis group compared to other groups (p < 0.001). After adjusting for all covariates, the odds ratio for hearing loss was significantly increased by 1.7 fold with reduced femur neck bone mineral density (p < 0.01). However, lumbar spine bone mineral density was not statistically associated with hearing loss (p = 0.22). Conclusion: Our results suggest that osteoporosis is significantly associated with a risk of hearing loss. In addition, femur neck bone mineral density was significantly correlated with hearing loss, but lumbar spine bone mineral density was not.

Resumo Introdução: A perda auditiva associada ao envelhecimento é a disfunção sensorial mais comum em idosos. Na osteoporose, a massa dos ossículos diminui e afeta a densidade óssea da cóclea, o que irá interferir na transmissão do som para a mesma. A perda auditiva associada à idade pode estar intimamente relacionada à osteoporose. Objetivo: Determinar a relação entre deficiência auditiva relacionada à idade e osteoporose, investigar a relação entre perda auditiva e densidade óssea cortical avaliada a partir da densidade mineral óssea do colo do fêmur. Método: Utilizamos dados da Korea National Health and Nutrition Examination Survey para examinar as associações entre osteoporose e perda auditiva associada ao envelhecimento de 2009 a 2011. O número total de participantes foi de 4.861, incluiu 2.273 homens e 2.588 mulheres com 50 anos ou mais. A osteoporose foi definida como densidade mineral óssea com 2,5 desvios-padrão abaixo da média, de acordo com a classificação diagnóstica da Organização Mundial da Saúde. A perda auditiva associada ao envelhecimento foi definida como as médias de tom puro das frequências de teste de 0,5, 1, 2 e 4 kHz a um limiar de 40 dB ou superior no lado da audição mais afetado. Resultados: O T-score total do fêmur (p < 0,001), o T-score da coluna lombar (p < 0,001) e o T-score do colo do fêmur (p < 0,001) foram significantemente menores no grupo com osteoporose em comparação ao grupo normal. Os limiares de médias de tom puro foram significantemente diferentes nos grupos normais em comparação com aqueles com osteopenia e osteoporose. Além disso, houve limiares significantemente maiores de médias de tom puro no grupo com osteoporose em comparação com os outros grupos (p < 0,001). Após o ajuste para todas as covariáveis, a odds ratio da perda auditiva mostrou estar significantemente aumentada em 1,7 vez com densidade mineral óssea reduzida no colo do fêmur (p < 0,01). No entanto, a densidade mineral óssea da coluna L não se associou estatisticamente à perda auditiva (p = 0,22). Conclusão: Nossos resultados sugerem que a osteoporose está significantemente associada ao risco de perda auditiva. Além disso, a densidade mineral óssea da coluna lombar não se correlacionou com a perda auditiva, apenas a densidade mineral óssea do colo do fêmur foi significantemente correlacionada.

Comparative Study of Hearing Assessment in Diabetic Patients and Non-Diabetic Patients using Otoacoustic Emission and Pure Tone Audiometry at Sree Gokulam Medical College, Trivandrum, Kerala, South India

Introduction: The association between diabetes and hearing loss has been a topic of discussion since many years. Type 2diabetes mellitus (DM) which is the most predominant form of diabetes worldwide, accounts for 90% of cases globally. DMis a chronic metabolic disorder characterized by high blood glucose level, associated with insulin resistance and relativeinsulin deficiency. DM is associated with a lot of complications; a lesser known complication is auditory organ dysfunction.The International Diabetes Federation estimated in 2014 that 387 million people have diabetes worldwide and that by 2035this number will rise to 592 million. Among these, 179 million are undiagnosed. In the United States, the Centers for DiseaseControl and Prevention estimated in 2014 that 29.1 million people had diabetes and that 8.1 million of them (27.8%) wereundiagnosed. These data reflect the late detection of hearing loss due to undiagnosed diabetes. Studies have indicated thatvascular changes which include thickening of capillary walls in the stria vascularis, neural changes in the cochlea, and loss ofouter hair cells are the causes of hearing changes in DM.Objective: The objectives are as follows: (1) Primary objective: To assess the prevalence of hearing loss in patients with Type 2DM when compared to non-diabetic patients and (2) secondary objective: To analyze the effect of age, glycemic control (HbA1c),and duration of diabetes on auditory acuity and to assess whether otoacoustic emission (OAE) can be used as a screeningtest for hearing assessment in diabetics.Materials and Methods of Study: The design of this study was hospital based observational prospective study carried outfrom February 2017 to July 2018. A total of 100 patients who presented to the ENT OP Department Sree Gokulam MedicalCollege and Research Foundation were studied by dividing into two groups; Group A consisted of 50 type 2 diabetic patientsand Group B consisted of 50 age- and gender-matched non-diabetic patients. The age group of the patients was between 30and 50 years. All the patients were subjected to Pure Tone Audiometry for the quantitative and qualitative assessment of hearingloss. Transient OAE (transient evoked OAEs [TEOAE]) was also done to know whether it can be used as a screening test forthe early detection of hearing loss. HbA1c was done in diabetic patients to detect any association with the hearing loss. Ageand duration of diabetes and its correlation with hearing loss were also assessed.Results: Our study confirmed the existence of sensorineural hearing loss (SNHL) in type II diabetic patients, mostly bilateralmoderate SNHL. Age and duration of diabetics had an association with SNHL. As the age increases, there is increase in theauditory thresholds and amount of hearing loss (AHL). Type 2 diabetic patients with long duration of diabetes also had higherauditory thresholds at all frequencies from 250 to 8000 Hertz (Hz), when compared to non-diabetic patients and the AHL wasalso higher as the duration of diabetes increased. HbA1clevel had no significant correlation with hearing loss. Theresult of TEOAE was refer, i.e. abnormal in all the patientswith hearing loss.Conclusion: The present study reports SNHL in 68% of type IIdiabetic subjects and 2% of healthy non-diabetic subjects.The majority of the patients had bilateral moderate SNHL.The diabetic patients had increased hearing threshold at all frequencies with gradual increase in hearing loss from 250 Hz to 8000 Hz. Age and duration of diabetes had a positive correlationwith hearing loss. As the age increased AHL also increased. Similarly, as duration of diabetes increased, AHL also increased.HbA1c had no relation with auditory threshold and AHL. TEOAE can be used as a screening test for the early detection ofhearing loss in Type 2 diabetic patients, as the result was abnormal in all the patients with hearing loss. Since hearing loss canbe considered to be a consequence of diabetes, a metabolic assessment may be useful for patients presenting with hearingloss so as to reduce the high rate of undiagnosed diabetes mellitus in the community. The use of audio logical tests to monitorhearing in diabetic patients should be considered as a routine procedure so that quality of life can be improved for long standingdiabetics with needed therapeutic interventions for hearing improvement.

Effect of electro-nape-acupuncture on hearing in patients with refractory flat descending idiopathic sudden sensorineural hearing loss / 中国针灸

OBJECTIVE@#To compare the therapeutic effect of electro-nape-acupuncture (ENA) combined with hyperbaric oxygen therapy (HBOT) and single HBOT on refractory flat descending idiopathic sudden sensorineural hearing loss (ISSNHL).@*METHODS@#A total of 78 patients were randomized into an ENA combined with HBOT (ENA+HBOT) group and a HBOT group, 39 cases in each one. Patients in both groups were treated with oral extract of ginkgo biloba leaves and mecobalamin tablets. On the basis of the conventional medication treatment, HBOT was adopt in the HBOT group. On the basis of the treatment in the HBOT group, electro-nape-acupuncture was applied at Fengchi (GB 20), Gongxue (Extra), Zhongzhu (TE 3), Waiguan (TE 5) and Yifeng (TE 17), Tinggong (SI 19), Tinghui (GB 2) and the vertigo-auditory area of affected side in the ENA+HBOT group. Pulse acupuncture instrument was connected at Fengchi (GB 20) and Gongxue (Extra) for 30 min (with continuous wave, 2 Hz in frequency), the needles were retained for another 30 min after electroaupuncture. The treatment was given once a day, 6 times a week for 4 weeks in both groups. Before the treatment and 2,4 weeks into the treatment, the average auditory threshold, the scores of tinnitus handicap inventory (THI) and dizziness handicap inventory (DHI) were observed, and the therapeutic effect was evaluated in both groups.@*RESULTS@#Compared before treatment, the average auditory threshold, the scores of THI and DHI of 2,4 weeks into the treatment were decreased in both groups (0.05).@*CONCLUSION@#Electro-nape- acupuncture can improve the mean auditory threshold and the symptoms of tinnitus and dizziness in patients with refractory flat descending idiopathic sudden sensorineural hearing loss.

Application value of 40Hz auditory event related potential in hearing assessment in noise-exposed workers / 中国职业医学

OBJECTIVE: To evaluate the application value of 40 Hz auditory event related potential(40 Hz AERP) in hearing assessment in workers exposed to noise by observing the consistency between pure tone audiometry(PTA) and 40 Hz AERP. METHODS: A total of 240 ears of 120 workers who exposed to noise with PTA high-frequency hearing threshold > 25 dB were selected as the research subjects using the convenient sampling method. The thresholds of PTA and 40 Hz AERP at different frequencies were investigated. According to the average hearing threshold of PTA language frequency, the workers were divided into normal hearing group and mild-, medium-, medium-severe-, severe-hearing loss groups, and the difference and correlation between the thresholds of 40 Hz auditory potential and PTA were analyzed. RESULTS: The response thresholds of 40 Hz AERP of 0.5, 1.0, 2.0 kHz in ears of normal hearing group, and mild-and moderate-hearing loss groups were higher than the PTA hearing threshold(P<0.01), while the 40 Hz AERP response thresholds of 0.5 kHz in the ears of medium-severe-and severe-hearing loss groups were lower than the hearing thresholds of PTA(P<0.05). The different value of the response threshold of 40 Hz AERP and PTA of 1.0 and 2.0 kHz in ears of normal hearing group was higher than 0.5 kHz(median: 25.0 vs 15.0 dBHL, 30.0 vs 15.0 dBHL, P<0.01). Except for 0.5 and 1.0 kHz of mild-hearing loss group, the different value of the response threshold of 40 Hz AERP and PTA in ears of the other hearing loss groups were lower than that of the normal hearing group(P<0.01). The 40 Hz AERP response threshold was frequency-specific and correlated well with PTA at the same frequency. The correlation coefficients of 0.5, 1.0 and 2.0 kHz were 0.744, 0.732 and 0.665 respectively(P<0.01). CONCLUSION: It is feasible to evaluate PTA in noise-exposed workers using 40 Hz AERP response threshold, but the 40 Hz AERP cannot completely replace PTA. The measurement frequency and the degree of hearing loss should be considered simultaneously.

Audição em altas frequências em trabalhadores rurais expostos a agrotóxicos / High frequency hearing among rural workers exposed to pesticides

Resumo Os agrotóxicos podem causar inúmeros problemas de saúde e são considerados agentes otoagressores. O objetivo deste estudo foi analisar as características auditivas nas altas frequências em trabalhadores com e sem exposição aos agrotóxicos, que apresentaram resultados normais na audiometria convencional. Estudo transversal com 87 trabalhadores, de ambos os gêneros, entre 19 e 59 anos, com vínculo de trabalho formal, informal e/ou que atuavam na agricultura familiar e realizaram Audiometria de Altas Frequências. O uso de glifosato foi relatado por 73% dos trabalhadores e as misturas de agrotóxicos diversos ocorreram em 78% deles. Não foi identificado uso adequado dos equipamentos de proteção individual recomendados para a atividade agrícola. Os trabalhadores expostos a agrotóxicos apresentaram piores resultados na Audiometria de Altas Frequências quando comparados aos que não tiveram contato com agrotóxicos (p < 0,0001). A Audiometria de Altas Frequências pode ser considerada um instrumento sensível para detectar, precocemente, alterações auditivas em trabalhadores expostos a agrotóxicos, e, seu uso em serviços de saúde poderá contribuir para as ações de vigilância em saúde do trabalhador.

Abstract Pesticides may cause a number of health problems and are considered oto-agressive agents. The objective of this study was to investigate the high frequency hearing characteristics of workers both with and without exposure to pesticides, that presented normal conventional audiometry. It involved a cross-sectional study with 87 workers, of both genders, between 19 and 59 years, with formal or informal jobs and some of whom worked with family agriculture, either using pesticides or not, who had taken High-Frequency Audiometry tests. The use of glyphosate was reported by 73% of workers and several pesticide mixtures occurred in 78% of them. There were no cases of proper use of personal protective equipment recommended for the activity. The workers exposed to pesticides had worse results in High-Frequency Audiometry tests in comparison with those who had no contact with pesticides (p < 0.0001). High-Frequency Audiometry has proved to be a useful and effective tool in the early detection of hearing loss caused by pesticides.

Clinical Evidence of Hearing Loss in Patients Treated with Cisplatin for Head-and-Neck Squamous Cell Carcinomas

Background: Cisplatin is a chemotherapeutic agent that is widely used to treat a variety of malignant tumors. Serious doselimiting side effects such as ototoxicity, nephrotoxicity, and neurotoxicity are likely to occur with its use.Aim of the study: The aim of the study was to do audiological evaluation of patients on cisplatin before and after chemotherapyfor squamous cell carcinomas of head and neck and analyze for hearing loss (HL).Materials and Methods: A total of 46 patients undergoing cisplatin administration were included in the study. History taking,preliminary ENT examination, and audiological evaluation with pure-tone audiometry were done. A pure-tone average (PTA) wascalculated using the speech frequencies (500, 1000, and 1500 kHz). High-frequency pure-tone audiometry was also done in allpatients to know the basal auditory threshold before starting cisplatin therapy. Baseline audiometry was done Prior to Chemotherapyor at least 24 h after administration of Cisplatin. Monitoring audiometry was done before each cycle of Cisplatin therapy. Follow-upaudiometry was done 1, 3, and 6 months after chemotherapy. Dosage of cisplatin ranged from 50 mg to 115 mg with cumulativedose ranging from 250 mg to 850 mg in all the patients. All the data were analyzed using standard statistical methods.Observations and Results: Among 46 patients, there were 33 males and 13 females (28.26%) with a male-to-female ratioof 2.53:1. Patients were aged between 45 years and 70 years and the mean age was 55.35 ± 2.70 years. 22/46 (47.82%)patients were in the range of 55–65 years age group followed by 15/46 (32.60%) patients who were in the 45–55 yearsage group. 9/46 (19.56%) patients were in the 65–75 years age group. Patients of all age groups showed high-frequency(3000 kHz–12,000 kHz) HL in the study group. The thresholds were found to be increasing from 35 dB to 59 dB with increasingfrequencies from 3000 kHz to 12,000 kHz.Conclusions: In this study, all the patients showed significant evidence of severe mixed type of HL. The HL was significant inall the age groups and in both the genders. Six months follow-up showed no recovery of HL presumable resulting in permanentHL. Very few patients showed vestibular involvement. Audiometric monitoring may help to provide early evidence of decreasedhearing ability, leading to the possible limitation of the severity of ototoxicity.

Clinical Profile of MDR-TB patients with special reference to kanamycin induced ototoxicity in a tertiary care hospital of eastern India

Introduction: MDR-TB is defined as resistance to isoniazid and rifampicin, with or without resistance to other anti-TB drugs. Multidrug-resistant TB (MDR-TB) remains a public health crisis and a health security threat. Kanamycin, is an aminoglycoside antibiotic used to treat multi-drug resistant TB in the intensive phase. Objective: To analyze the patients of MDR-TB with respect to age, sex and presence of comorbidities like diabetes mellitus. Also to study the incidence of hearing impairments among patients of MDR-TB receiving injectable Kanamycin. Methods: 40 patients of MDR-TB diagnosed by sputum culture and drug susceptibility testing (DST) have been classified on the basis of age, sex and presence of diabetes mellitus. All have received injectable Kanamycin for 6months in their intensive phase (IP). Patients giving history of auditory impairments underwent pure tone audiometry (PTA) for detection of sensory neural hearing loss, if any. Result: Out of 40 patients of MDR-TB, 30 were males and the rest 10 were females. Age ranges from 12 to 70 years among which maximum patients fell in the age group of 21-30 years (12 patients). 16 patients were diabetic. After getting Kanamycin, 8 patients gave the history of auditory disturbances and only 1 patient found to have severe sensory neural hearing loss confirmed by pure tone audiometry. Conclusion: Prevalence of MDR-TB has been found more among males and in younger age group. Diabetes Mellitus play a major role here. Kanamycin induced hearing loss is not a very serious concern in our study.

Effect of Listening to Music Over Ear Phones/Head Phones on Hearing

Music has always been an effective way to pass time. With the advent of cell phones, most of the people have an easy means to access music as almost all the phones are capable of playing music. Low quality ear phones are available at an affordable price. Adolescent and young adults are potentially at risk of hearing loss by listening to music with ear phones / head phones. Aim: The present study is an effort to know the effect of listening to music for longer duration through ear phones in young adults. Methods: The present study is conducted at Government Medical College, Anantapuramu on 100 subjects. 50 subjects who listened to music through ear phones for more than 2 hours/day and for 2 years or more were included in group A. 50 subjects who very occasionally used ear phones were included in group B. All subjects were made to undergo Pure Tone Audiometry in the audiometry room in both ears using pure tones of 250 Hz – 12000 Hz frequencies. Results: None of the subjects in Group B reported any hearing problem. Self-reported hearing problems in group A participants recorded. In Group A, 66% of subjects had no hearing problems and 34% of subjects had different hearing problems. There is significant increase in hearing threshold of Group A subjects at high frequencies compared to Group B. Conclusion: The output levels from cell phone are high enough to cause music induced hearing loss when phones are used at high volume for long periods. It is necessary to educate oneself about the dangers and use methods to prevent its harmful effects. Regular audiometric screening of all mobile phone users is recommended.

Asymptomatic Hearing Impairment Frequently Occurs in Early-Onset Parkinson's Disease

OBJECTIVE: Recent reports of hearing impairment in Parkinson's disease (PD) have suggested that auditory dysfunction could be a non-motor manifestation of PD. These reports were based on observations of elderly patients for whom presbycusis may, to some extent, have contributed to hearing dysfunction. Therefore, we aimed to explore the auditory functions in younger patients with PD. METHODS: We conducted a case-control study in a relatively younger (< 55 years of age at study time) population of PD patients and healthy volunteers to test whether auditory dysfunction is a significant non-motor dysfunction in PD. Pure tone audiometry (PTA) and brainstem evoked response audiometry (BERA) were performed in all participants. RESULTS: None of the patients or controls reported hearing deficits. Fifty-one patients with PD and 50 healthy volunteers who were age- and gender-matched to the patients participated. PTA-detected hearing impairment was found in 64.7% of patients and 28% of controls (p < 0.001) for both low-mid and/or high frequencies. Hearing impairment was more frequent in the younger subgroups of patients than age-matched controls, while the frequency of hearing impairment was similar in older groups of subjects. BERA was not different between patients and controls. CONCLUSION: Asymptomatic auditory dysfunction is a common non-motor manifestation of early-onset PD and more frequent in younger patients, indicating that it may be independent of aging. The mechanism underlying this dysfunction appears to be peripheral, although a central dysfunction cannot be ruled out based on the findings of this study.

Change of the Pure Tone Threshold as a Function of Frequency and Clinical Characteristics in Definite Meniere's Disease / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: One of the characteristics of Meniere’s disease is pure tone threshold shift at low frequencies in the lesion; although, in some patients, more pure tone threshold shifts were also shown at mid or high frequencies. Authors speculated that the most varied pure tone frequency may be related with diversity of clinical symptoms and other characteristics. SUBJECTS AND METHOD: We reviewed medical records of 85 patients who met the criteria of definite Meniere’s disease (1995 American Academy of Otolaryngology-Head and Neck Surgery). Patients were classified into 3 groups (high frequency, mid frequency, low frequency) depending on the frequency at which pure tone threshold changes encountered the most. The vestibular function tests and clinical characteristics were compared between the groups. RESULTS: Thirty-six patients (42.0%) showed pure tone threshold changes at 0.25 or 0.5 kHz (low frequency group). Twenty-five patients (30.0%) showed greatest pure tone threshold change at 1 or 2 kHz (mid frequency group). Twenty-four patients (28.0%) belonged to the high frequency group with most changes taking place not lower than 4 kHz. Frequency of vertigo attack, and duration of vertigo attack did not differ between the groups. Low frequency group showed more chance of tinnitus with statistical significance. Vestibular evoked myogenic potentials (VEMP) abnormality was more frequently encountered in the low frequency group. CONCLUSION: This study shows that changes in the pure tone threshold is not confined to low frequencies in definite Meniere’s disease. Patients with pure tone threshold changes at low frequencies have more chance of tinnitus and abnormal cVEMP.

Characteristics of auditory brainstom response and auditory steady state evoked responses in noise-induced hearing loss population / 中华劳动卫生职业病杂志

Objective@#To explore the characteristics of auditory steady state evoked responses (ASSR) and auditory brainstem response (ABR) in noise-induced hearing loss population and the relationship between the response threshold of corresponding frequency and pure tone audiometry (PTA) .@*Methods@#Noise-induced hearing loss patients who completed subjective and objective audiometry in our hospital from October 2014 to October 2018 were collected. The results of PTA, ABR, ASSR and the correlation between subjective and objective audiometry were discussed.@*Results@#A total of 381 ears of 193 patients were enrolled. The difference of 0.5, 1.0, 2.0 and 4.0 kHz between ASSR threshold and PTA was 5.9, 6.9, 11.8 and 1.8 dB, respectively. The correlation coefficients were 0.638, 0.680, 0.657 and 0.608. The difference of 1.0, 2.0, 3.0 and 4.0 kHz between ABR threshold and PTA was 44.2, 35.0, 19.0 and 2.0 dB. With the increase of frequency, the threshold difference between ABRt V wave and PTA decreased gradually.@*Conclusion@#ASSR and ABR response thresholds are valuable in subjective assessment on noise-induced hearing loss. The thresholds of ASSR and ABR at 4 kHz are close to those of PTA.

A Study Of Hearing Improvement After Tympanoplasty By Means Of Pure Tone Audiometry During Period Of One Year In Teritiary Care Hospital.

Objectives 1. Selection of patients of CSOM with conductive deafness to undergo various types of Tympanoplasty surgeries. 2. To document hearing improvement after various types of Tympanoplasty surgeries in cases of CSOM by means of PTA. Methods Atotal of 50 cases of CSOM presented with hearing loss were compiled after applying the inclusion and exclusion criterias. All the cases underwent detailed otoscopic and audiometric examination. All the patients were treated surgically and were followed up after 3 months. Descriptive and inferential statistical analysis has been carried out in this study. Results Comparing the preop and 3 months postop PTA, significant AB gap closure was seen in 30(60%) patients, remained same in 18(36%) patients and worsened in 2(4%) patients. Maximum improvement (75%) was seen in pre op 21-30 dB group. The mean preop AB gap calculated was 37.2±6.875 dB and mean postop AB gap calculated was 27.08±9.9 dB.