Auditory brainstem response in type 2 diabetes mellitus patients

Background: Diabetes is a chronic metabolic disorder and its complications pose a significant healthcare burden. Basic pathophysiology of diabetic complications is angiopathy leading to neuropathy. Angiopathy of small vessels of cochlea and neuropathy of cochlear nerve may lead to hearing impairment. Aim and Objectives: The present study was taken up with an objective to evaluate the changes in the auditory brainstem evoked potentials in type 2 diabetic patients leading to hearing loss compared to healthy controls. Materials and Methods: A total of 40 subjects in the age group of 40–60 were enrolled into the study and were categorized into 2 groups of 20 each. In the Group 1, age- and sex-matched healthy controls were included and in the Group 2 subjects with type 2 diabetes of more than 5 years duration were included in the study. Any hearing impairment caused by a known disease, drug or injury either traumatic, iatrogenic or noise induced were excluded from the study. They were subjected to auditory brainstem response test Brainstem evoked response audiometry. Absolute latency of wave I-V and interpeak latencies (IPL) I-III, III-V, and I-V was recorded. The data obtained were evaluated using VassarStats. Results: There was no significant difference in the wave latency of wave I and II between the groups; however, the latencies of waves III, IV, and V was higher in the diabetic group compared to controls on both right and left ear stimulation and it was statistically significant. With respect to the IPL comparison, it was observed that IPL I-III, III-V, and I-V were significantly increased in diabetics with both right and left ear stimulation were statistically significant on comparison with the controls. Conclusion: The delayed transmission of the auditory pathway at the level of brainstem and midbrain observed in the study advocates the presence of central neuropathy in patients with type 2 diabetes mellitus.

A Comparative Study on Brain Stem Evoked Response Audiometry among Pre-school Children with Normal and Delayed Development of Speech Attending Bankura Sammilani Medical College

Introduction: The main consequence of hearing loss,especially in children, is the impact caused by sensorydeprivation in the development of auditory and languageskills and learning. Any degree of hearing loss can resultin significant damage, as it interferes with perception andunderstanding of speech sounds.This proposed descriptivecross sectional study tries to compare BERA parametersbetween normal and delayed speech/language impairmentchildren. Study also examines possible abnormalities inBERA in children with speech and language impairment.Material and Methods: One descriptive study withcross-sectional design was conducted in neurophysiologylaboratory in the Department of Physiology, BankuraSammilani Medical College and Hospital for one year.About106 pre-school children (1 to below 6years) of eithersex were selected from those referred from Paediatric andENT Department with complaint of delayed speech who hadbeen advised BERA test. About 105 children without havingdelayed speech development were chosen randomly.Results: Descriptive analysis was done of BERA parametersamong all subjects. Mean and standard deviation of both maleand female were calculated separately. Independent ‘t’ testwas done between the BERA parameters of normal childrenand children diagnosed with speech impairment. The testshowed significant changes (p value <0.05) in waves I, IIIlatency, I-III, I-V, III-V inter peak in study subject.Conclusion: The brainstem speech evoked auditory responsescan serve as an efficient tool in identifying underlying auditoryprocessing difficulties in children with learning disability andcan help in early intervention.

Neonatal hearing screening- time to make a noise- experience from a private medical college in South Rajasthan

Background: Neonatal Hearing Loss has a prevalence that is twice than that of disorders like congenital hypothyroidism, phenyl ketonuria etc. Early detection of hearing impairment is vital since early intervention in form of hearing aids and speech therapy would help lead a child a normal life. The aim of the study was to set up a neonatal hearing screening program and to study the various risk factors which could be associated with hearing loss.Methods: The prospective descriptive study was carried over a period of two years. All neonates before being discharged were subjected to OAE. OAE was done on Oto Read Machine (Intra acoustic) and BERA was done on BERA eclipse machine (Intra acoustic). Babies who failed the first OAE were called back for a repeat OAE at six weeks of age. Babies who failed the second OAE were referred to a trained audiologist for BERA which was performed on BERA Eclipse machine.Results: Out of 1114 neonates screened, 285 neonates failed the first OAE and were called back at six weeks for repeat OAE. Out of the 285 babies who were called for repeat OAE, 258 turned up 27(9.47%) were lost to follow up. Out of the 258 babies who turned up, 245 passed the test while 13 failed the test. 13 Babies who had failed the second OAE screening were called back 1 month later for BERA testing. Out of the 13 babies who turned up for BERA testing, 12 passed the test and 1 failed giving us a prevalence of 0.89 per 1000 population. Of the various risk factors studied only low birth weight was found to be having significant association with hearing loss.Conclusion: Neonatal hearing screening is the need of the hour. Larger multi centric studies are required to establish the prevalence of hearing impairment among newborns.

Finding out incidence of deafness among neonates at a tertiary care centre of western Rajasthan, India using otoacoustic emission

Background: Newborn hearing screening is conducted to identify suspected hearing loss and not to confirm the presence/absence of hearing loss or define features of the loss. Speech and hearing are interrelated, i.e., a problem with one could mean a problem with the other as speech and language is acquired normally through auditory system.Methods: A descriptive study conducted in the Department of Paediatrics, Dr. S. N. Medical College, Jodhpur, from June 2016 to December 2017. 5000 neonates were screened using otoacoustic emissions (OAE) in 2 stages at birth during 3rd to 7th day and 15-30 days respectively, followed by BERA at 3 months of age.Results: 1.4 infants per thousand infants had hearing loss. Presence of high-risk factors was seen to be associated be associated with hearing loss more than normal infants on screening with distortion product otoacoustic emissions (DPOAE) tests. However, on testing with BERA no such association was seen.Conclusions: 1.4 per 1000 infants had hearing loss. This study has shown that two stage distortion product otoacoustic emissions (DPOAE) hearing screening followed by british educational research association '(BERA) to confirm the hearing deficit, can be successfully implemented as new born hearing screening method in a hospital set-up, for early detection of hearing impaired, on a large scale, to achieve the high-quality standard of screening programs in a resource limited and developing nation like India.

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.