Is there "hidden hearing loss" in patients with chronic rhinosinusitis?

Objective: This study was to investigate whether there is impairment of auditory function in chronic rhinosinusitis (CRS).Study sample: A total of 85 patients were allocated into either the CRS group (n = 65) or a simple deviated nasal septum group (n = 20). Both groups without other risk factors for sensorineural hearing loss exhibited normal thresholds at standard audiometric frequencies. Another group (n = 30) of healthy subjects without CRS or a deviated nasal septum were gender and age matched.Design: Analyse the results of audiology test including pure tone audiometry, an acoustic impedance test, distortion product otoacoustic emissions (DPOAE) and the auditory brainstem response (ABR) for each subject analyse the test results of for each object.Results: The group differences were statistically significant for each high-frequency pure tone (p < 0.05). The ABR showed a difference between groups in amplitude. The DPOAE pass rate of the CRS group was lower than that of the control group.Conclusions: This study showed a significant correlation between CRS and auditory impairment. CRS might impair cochlear functions by damaging inner ear hair cells and/or, outer hair cells (OHCs), consequently altering the activity of the entire auditory pathway originating in the ventral cochlear nucleus (VCN) to the inferior colliculus.

Is Sensorineural Hearing Loss Related to Chronic Rhinosinusitis Caused by Outer Hair Cell Injury?

BACKGROUND Sensorineural hearing loss is caused by defects in the inner ear. In the present study, associations between chronic rhinosinusitis, outer hair cell injury, and sensorineural hearing loss were investigated. MATERIAL AND METHODS A total of 103 patients who met the inclusion criteria were recruited and allocated into a chronic rhinosinusitis group (n=82) and a simple deviated nasal septum group (n=21). Degree and type of hearing loss, including distortion product otoacoustic emissions, were used to assess the status of cochlear outer hair cells. RESULTS The rate of hearing loss in the simple deviated nasal septum group was significantly lower than in the chronic rhinosinusitis group (4.76%, 1/21 vs. 24.39%, 20/82, P<0.05), among which 15 chronic rhinosinusitis patients (75%, 15/20) had hearing loss in the high frequency range. Acoustic stapedial reflexes were elicited in all patients of the 2 groups, while positive Metz was found in 3 chronic rhinosinusitis patients (15%, 3/20). The pass rate of distortion product otoacoustic emissions (DPOAEs) for chronic rhinosinusitis patients was significantly lower than in simple deviated nasal septum patients (88.10% vs. 70.73%, P<0.05). Moreover, the signal-to-noise ratio of DPOAE test results at 704 Hz, 3991 Hz, and 5649 Hz in the chronic rhinosinusitis group were significantly lower than in the simple deviated nasal septum group (P<0.05). Logistic regression analysis revealed a correlation between severity of chronic rhinosinusitis and sensorineural hearing loss (OR=1.39, P<0.05). CONCLUSIONS Outer hair cell injury and sensorineural hearing loss may have a common cause in chronic rhinosinusitis patients.

[Imaging and audiology analysis of the congenital inner ear malformations].

OBJECTIVE: To investigate imaging and audiology features of temporal bone and analyze the classification and prevalence of inner ear abnormalities in children with sensorineural hearing loss. METHOD: Children who were diagnosed with sensorineural hearing loss were examined by high resolution CT and the inner ear fluid of MRI. And each chart was retrospectively reviewed to determine the imaging and audiology features. RESULT: There were 125 patients(232 ears) found with inner ear malformation in 590 children with SNHL. About 21.71% of the inner ear malformation occurred in severe and profound hearing loss ears, and 12.85% occurred in r moderate hearing loss ears. The inner ear malformation rate in normal hearing ears were 13.59%. CONCLUSION: CT and MRI examinations of temporal bone are important diagnostic tools to indentify inner ear malformations. Inner ear malformations are almost bilateral and hearing loss are profoud. Cochleo-vestibular malformations and large vestibular aqueduct are the 2 most frequent deformities. Among the children with SNHL, deformity rate in the severe and profound hearing loss ears is higher than that in moderate hearing loss ear. Inner ear malformations can exist in people with normal hearing.

[The relevance of high stimulus rate ABR and recurrent vertigo and its clinical significance].

OBJECTIVE: To study the relevance of the high stimulus rate auditory brainstem response(auditory brainstem response, ABR) test in recurrent vertigo, investigate the cause of recurrent vertigo, and provide important help for the clinical treatment. METHOD: One hundred and one cases with recurrent vertigo were retrospectively analyzed, and high stimulus rate ABR were tested and compared in attack episodes and intermittent episodes. RESULT: The abnormal difference between ABR I and V latency was selected as parameters. The abnormal rate of high stimulation ABR was 56.4% in patients with recurrent episodes of vertigo many times (2 and above), of which the highest rate was 71.9% in MV patients, and the second one was BPPV. The abnormal rate of high stimulation ABR was 14.9% in patients during medication or intermittent episodes. The abnormal rate in all groups decreased obviously as compared to attack episodes. CONCLUSION: Abnormal rate of high stimulus rate ABR correlates well with recurrent vertigo significantly. The inner ear microcirculation may result in the attack of recurrent vertigo.

[Test-retest reliability of Mandarin monosyllable lists: a multi-center study in Chinese dialectal regions].

OBJECTIVE: To develop 22 Chinese Mandarin monosyllable lists with good psychometrical equivalence. This study was to evaluate the test-retest reliability of these lists when it was used in speech recognition test in normal hearing dialectal speakers. METHODS: Seven cities including Dalian, Shanghai, Hangzhou, Wuhan, Guangzhou, Fuzhou and Xiamen were selected as testing centers which contain 6 typical Chinese dialectal regions including north of China, East of China, north of Fujian, south of Fujian, Guangdong and mid-south of China. At each center, 22 local normal hearing people were selected to join this study. Every participant was tested by each recognition test of all 22 lists twice in two sessions and same test order respectively. The second run of testing was carried out within 10 days-1 month since first run of testing. RESULTS: There was a significant correlations between scores obtained at the two sessions (r = 0.682, P < 0.01). Paired student-t test had shown that a gross score of all dialectal participants was significantly higher than that of initial test to retest (P < 0.01). The mean increment of score was (2.7 +/- 10.1)%. A significant difference of test-retest score in 7 sites was 19.8% and it was equal to 5 test items. A one way ANOVA analysis had indicated that there were statistically significant difference between the score improvement of 7 test sites (P < 0.01). Another analysis had shown that there was no significant correlation between test-retest score improvement and intra-session intervals (P = 0.947). CONCLUSIONS: Mandarin monosyllabic recognition test seems to be more stable, and the present study has indicated a systematic differences in Chinese Mandarin monosyllable recognition scores between test and retest. Monosyllable recognition test is not susceptible to memory effect. Pearson's correction analysis is not suitable to evaluation for test-retest reliability.

[Performance-intensity function of mandarin monosyllable and sentence materials for normal-hearing subjects].

OBJECTIVE: To analyze the monosyllabic and sentence lists of Mandarin speech test materials (MSTMs) which have been evaluated the equivalence of difficulty, and to establish the performance-intensity function (P-I function) for people with normal hearing. METHOD: Forty subjects (the age-ranged from 18 to 25 years old) who speak Mandarin well in their daily lives with normal hearing participated in this study. Eight of them joined the pilot study, which aimed to identify an appropriate presentation level for the formal test. Thirty-two subjects participated in the formal speech perception test. The results were analyzed by Statistical Package for the Social Sciences (SPSS) software version 11.0. Seven monosyllabic lists (50 words per list) and 15 sentence lists (50 key words per list) were used. RESULT: The results showed P-I function of 3.1% per dB for monosyllabic Mandarin materials and 7.4% per dB for sentence Mandarin materials. The sound pressure level of speech corresponding to a 50% recognition score for monosyllabic lists was 30.1 dBSPL or 10.1 dBHL, and 23.1 dBSPL or 3.1 dBHL for sentence lists. CONCLUSION: The study established the P-I function of the Mandarin monosyllabic and sentence materials with equal difficulty, which provides the normative data for identifying the normal hearing in a clinical setting.

[Pathogenesis of benign paroxysmal positional vertigo].

OBJECTIVE: To explore the etiological factors of benign paroxysmal positional vertigo (BP-PV). METHODS: The clinical data of 145 patients with BPPV were retrospectively reviewed. The impacts of gender and age on BPPV were analyzed. The relationship between the onset of BPPV and the internal ear ischemia was also explored. RESULTS: The abnormality rate of auditory brainstem response (ABR) under high stimulus rate was 59.3% (86/145) in all the patients with, including 22.1% (32/145) in male and 37.2% (54/ 145) in female (P > 0.05). The abnormality rate of ABR under high stimulus rate were 37.9% (55/145) and 21.4% (31/145) in middle-aged (30-55 years) and old ( > 55 years) patients, respectively (P > 0.05). CONCLUSION: The onset of BPPV may relate to ischemic internal ear but is not relevant with gender and age.