Cochlear Function In Patients Research Articles

Changes in vestibular and cochlear function following platinum-based chemotherapy: A preliminary report.

This study investigated the changes in vestibular and cochlear function in patients receiving platinum-based chemotherapy. A longitudinal study of 32 participants (10-70years) receiving chemotherapy participated in the study. Baseline and exit vestibular and hearing assessments that included video head impulse (VHIT) testing, cervical and ocular vestibular evoked myogenic potentials (VEMP), dynamic visual acuity (DVA) and pure-tone audiometry were performed at the patient's treatment venue. Half (50%) of the participants showed cochleotoxicity from baseline to exit testing, with left ears significantly more affected than right ears. There was no consistent relationship between hearing loss and vestibular dysfunction. DVA yielded normal results at baseline and exit testing in all participants. VEMP responses were absent in 28.1% of participants at baseline, reflecting the challenges of using VEMP for monitoring. VEMP and VHIT results showed a statistically significant (p < 0.05) decline in results from baseline to exit testing; however, participants did not report symptoms related to vestibular dysfunction. VHIT also showed left ears significantly (p < 0.05) more affected than right ears. VHIT proved to be a valuable measure of changes in vestibular function secondary to ototoxicity. Future investigations should determine vestibulotoxicity criteria and optimal protocols for vestibulotoxicity monitoring at the patient's treatment venue.

Effect of N-acetylcysteine on cochlear function in patients with chronic kidney disease undergoing hemodialysis

Objective: This study aimed to investigate the effect of N-acetylcysteine (NAC) on cochlear function in patients with chronic kidney disease (CKD). Methodology: The statistical population of this controlled clinical trial included all CKD patients. In total, 64 samples, selected from patients visiting the Dialysis Center of Al-Zahra Hospital from February 2017 to May 2017, were equally randomized into the intervention and control groups. At the baseline, the pure-tone audiometry (PTA) and Distortion Product Oto Acoustic Emissions (DP-OAE) tests were conducted. Then, NAC was administered in the intervention group for 8 weeks. Aforementioned hearing tests were repeated at the end of the interventions and results were compared. Finally, data analysis was carried out in SPSS. Results: Based on the mean scores of hearing threshold, there was no significant between-group difference in the speech discrimination score (SDS) speech reception threshold (SRT) of the left and right sides following NAC administration (P > 0.05). Comparison of the mean OAE following NAC administration showed a significant between-group difference, based on the mean signal/noise ratios (S/N 1000, 2000, and 4000) of the both right and left ears (P 0.05). Conclusion: This study showed the effectiveness of NAC in improving cochlear function in 1, 2, and 4 KHz; whereas, it did not significantly affect the hearing threshold.

Cochlear Function in Adults with Epilepsy and Treated with Carbamazepine

Background: Epilepsy is a chronic medical disease and is associated with comorbid adverse somatic conditions due to epilepsy itself or its long-term treatment. Objectives: This study evaluated cochlear function in patients with idiopathic epilepsy and treated with carbamazepine (CBZ). Patients and Methods: Included were 47 patients (mean age = 34.56 ± 7.11 years and duration of illness = 17.84 ± 7.21 years) and 40 healthy subjects. They underwent pure-tone audiometry and transient evoked otoacoustic emission (TEOAE) analyses. Results: Hearing loss (mainly bilateral mild) was reported in one third of patients. Compared to controls, patients had lower TEOAE amplitudes at 1.0–4.0 kHz particularly at high frequencies (3 and 4 kHz). Significant correlations were identified between TEOAE amplitudes with CBZ dose (at 3 kHz: r = –0.554, p = 0.008; at 4 kHz: r = –0.347, p = 0.01), its serum level (at 4 kHz: r = –0.280, p = 0.045) and duration of treatment (at 3 kHz: r = –0.392, p = 0.008; at 4 kHz: r = –0.542, p = 0.001). Conclusions: Long-term CBZ treatment may result in cochlear dysfunction and auditory deficits.

Comparison of otoacoustic emissions in patients with tinnitus having normal hearing versus mild hearing loss.

Tinnitus is an auditory sensation whose source comes from external stimulus to the body. All studies that can help people with this disorder are very imperative. This study investigates the cochlear function in patients with tinnitus, using Distortion Products Otoacoustic Emissions (DPOAE). Ears where the subjects referred to feel the tinnitus were considered for the study group while other ears without this sensation of tinnitus acted as a control group. Fifty subjects suffering from unilateral or bilateral tinnitus with normal hearing sensitivity or mild hearing loss were recruited. Where comparing the control and study group, the highest percentage of cases of DPOAE detected was in the control group, although these differences were not statistically significant. When the analyzed frequency is the same as the tinnitus frequency, the prevalence of detected DPOAE is in tinnitus ears (50.0 %). In ears where tinnitus was not perceived (73.5 %) a p value of 0.024 (< 0.05) was found, which means that the undetected DPOAE could be influenced by tinnitus. Based on the results, tinnitus might not be caused by changes in the outer hair cells but seems to be affected by that.

Cochlear function in patients with chronic kidney disease

To evaluate cochlear functioning in patients (18-45 years old) with varying stages of chronic kidney disease (CKD). Using purposive sampling, 50 participants, 10 in each of the 5 stages of CKD, were selected and underwent pure tone audiometric testing and distortion product otoacoustic emissions (DPOAEs). Significant differences (p < 0.05) were found between pure tone audiometry and DPOAEs in detecting early cochlear dysfunction in the high-frequency range in stages 3 (6,000/5,000 Hz; p = 0.00), 4 (6,000/5,000 Hz; p < 0.03) and 5 (4,000/3,333 Hz; p < 0.01, 8,000/6,667 Hz: p < 0.05) with DPOAEs being more sensitive in identifying early cochlear dysfunction. Patients in stages 1 and 2 presented with normal puretone thresholds and DPOAEs, suggesting that cochlear functioning in these patients was normal. Early cochlear dysfunction, thereby indicating a subclinical hearing loss, was identified in stages 3, 4 and 5 by DPOAE testing. In addition, blood test results, drug intake and concomitant conditions were recorded and analysed which suggested a relationship between reduced cochlear functioning and increased electrolyte levels, treatment regimens and concomitant conditions. Participants in the later stages of CKD presented with early cochlear dysfunction, presenting with subclinical hearing loss. It was postulated that this subclinical hearing loss resulted from a combination of electrolytic, urea and creatinine imbalances, together with concomitant medical conditions and ototoxic drug intake. It was concluded that audiological monitoring be included in the management of patients with CKD and that DPOAEs be introduced as part of the test battery to monitor cochlear function in patients with varying degrees of CKD.

Cochlear function in patients with chronic kidney disease

To evaluate cochlear functioning in patients (18-45 years old) with varying stages of chronic kidney disease (CKD). Using purposive sampling, 50 participants, 10 in each of the 5 stages of CKD, were selected and underwent pure tone audiometric testing and distortion product otoacoustic emissions (DPOAEs).Significant differences (p < 0.05) were found between pure tone audiometry and DPOAEs in detecting early cochlear dysfunction in the high-frequency range in stages 3 (6,000/5,000 Hz; p = 0.00), 4 (6,000/5,000 Hz; p < 0.03) and 5 (4,000/3,333 Hz; p < 0.01, 8,000/6,667 Hz: p < 0.05) with DPOAEs being more sensitive in identifying early cochlear dysfunction. Patients in stages 1 and 2 presented with normal puretone thresholds and DPOAEs, suggesting that cochlear functioning in these patients was normal. Early cochlear dysfunction, thereby indicating a subclinical hearing loss, was identified in stages 3, 4 and 5 by DPOAE testing. In addition, blood test results, drug intake and concomitant conditions were recorded and analysed which suggested a relationship between reduced cochlear functioning and increased electrolyte levels, treatment regimens and concomitant conditions.Participants in the later stages of CKD presented with early cochlear dysfunction, presenting with subclinical hearing loss. It was postulated that this subclinical hearing loss resulted from a combination of electrolytic, urea and creatinine imbalances, together with concomitant medical conditions and ototoxic drug intake. It was concluded that audiological monitoring be included in the management of patients with CKD and that DPOAEs be introduced as part of the test battery to monitor cochlear function in patients with varying degrees of CKD.

Study of the Cochlear Function in Patients with Myotonic Dystrophy Type 1

Objectives: Myotonic Dystrophy type 1 is a progressive autosomal dominant multisystem disorder, the second most common form of muscular dystrophy. The disease is associated with various vestibular, oculomotor, and auditory disorders. The aim of the present study was to undertake a detailed vestibular and audiological evaluation, and specifically to analyze the cochlear function using transiently evoked otoacoustic emissions. Methods: 24 patients with genetically diagnosed myotonic dystrophy type 1 were studied during the past 4 years in Eginition hospital of Athens. Twenty-one normal subjects were used as controls. Testing included pure-tone audiometry, tympanometry, auditory brainstem responses (Abr), transiently evoked otoacoustic emissions, and nystagmography. Results: Tympanograms were normal in most patients. 15 (62.5%) patients had a varying degree of sensorineural hearing loss, with no conductive element. In 9 of them (37.5%), ABR abnormalities were found, such as absence of wave I or increased latencies of waves III and V, compatible with sensorineural hearing loss (5 patients), as well as increased I-III and I-V interpeak latencies, compatible with retrocochlear involvment of the auditory pathways (4 patients). Subclinical cochlear damage was found in all patients, as evidenced by absent otoacoustic emissions or lower otoacoustic emission amplitude. Vestibular hypersthesia was found in 9 patients (37.5%), accompanied by spontaneous nystagmus in 4 of them (15.6%). Conclusions: Audiovestibular abnormalities are quite common in patients with myotonic dystrophy type 1. We have found that subclinical cochlear damage is a common finding of the disease, as concluded from the absence or decrease of otoacoustic emissions in these patients.

Distortion‐Product Otoacoustic Emission Tests Evaluate Cochlear Function and Differentiate Cochlear and Vestibular Schwannoma

(1) To investigate cochlear function in patients with acoustic neuroma by distortion-product otoacoustic emission tests and (2) to evaluate the utility of this method for identifying the nerve origin of acoustic neuroma. Diagnostic test assessment. Community hospital. The study included 196 patients with unilateral acoustic neuroma who were surgically treated in our hospital between April 2008 and March 2011. In all patients, pure-tone audiometry and distortion-product otoacoustic emission tests were conducted before surgery, and tumor size was measured on magnetic resonance imaging. Superior vestibular schwannoma (n = 112), inferior vestibular schwannoma (n = 80), and cochlear schwannoma (n = 4) were observed. Positive results of distortion-product otoacoustic emission tests were observed in 11 patients with superior vestibular schwannoma, 14 with inferior vestibular schwannoma, and 3 with cochlear schwannoma. They were predictive of cochlear schwannoma, with 75.0% sensitivity (95% confidence interval [CI], 30.6-95.4) and 87.0% specificity (95% CI, 86.1-87.4). Retrocochlear hearing loss was detected in 5 patients with inferior vestibular schwannoma and 1 with cochlear schwannoma. It was also predictive of cochlear schwannoma. This criterion showed 25.0% sensitivity (95% CI, 4.7-66.1) and 97.4% specificity (95% CI, 97.0-98.3). Percentages of patients with positive results on distortion-product otoacoustic emission tests and those with retrocochlear hearing loss differed by nerve origin. Distortion-product otoacoustic emission tests can be of some assistance in differentiating cochlear and vestibular schwannoma.

Evaluation of Hearing and Cochlear Function in Patients with Ankylosing Spondylitis

Objective: Ankylosing spondylitis (AS) is a chronic systemic inflammatory disorder that primarily affects spine and sacroiliac joints. Recent studies described audiovestibular impairment in AS patients. The aim of this study was to evaluate the hearing and function of cochlear system in patients with AS. Method: We prospectively evaluated 37 AS patients and 20 healthy controls. Otorhinolaryngologic examinations were performed in all patients together with pure tone audiometry, speech tests, tympanometry, and distortion product otoacoustic emission (DPOE). Disease duration, Basdai scores, and hematolgic findings (CRP, Sedimentation) were also collected. Results: Pure tone audiometry findings and of the patients and controls were significantly different in all frequencies ( P &gt; .05). No significant difference was found between DPOE responses of the patients and controls ( P &gt; 0.05). Conclusion: This study demonstrated that there is an association between AS and hearing loss. But the cochlea is not the main source of hearing loss.

Results for audiology and distortion product and transient evoked otoacoustic emissions in patients with systemic lupus erythematosus

The aim of the current study was to investigate hearing loss and cochlear function in patients with systemic lupus erythematosus, using audiology, distortion product otoacoustic emissions and transient evoked otoacoustic emissions. Prospective, case-control study. The study included 26 randomised patients with systemic lupus erythematosus (52 ears) and 30 healthy control subjects (60 ears). Pure tone audiometry was performed at 250 and 500 Hz and at 1, 2, 4, 6, 8, 10, 12, 14 and 16 kHz. Distortion product otoacoustic emissions and transient evoked otoacoustic emissions were measured using Biologic System equipment with Scout Acoustic Emissions System software. The distortion product otoacoustic emission signal responses were significantly different only at 750 Hz, while the distortion product otoacoustic emission signal-noise ratios were significantly different at 750 Hz and 6 kHz (p < 0.05), comparing patients and controls. The transient evoked otoacoustic emission signal-noise ratios were significantly different at 2 and 3 kHz, comparing patients and controls (p < 0.05). The transient evoked otoacoustic emission total signal-noise ratios were significantly different, comparing patients and controls (p < 0.05). In addition, the pure tone audiometry thresholds were significantly different at 250 and 500 Hz and at 1, 2, 10 and 12 kHz, comparing patients and controls (p < 0.05). Our findings do not completely agree with those of previous temporal bone histopathological studies. However, our results do support a general picture of low frequency hearing loss in systemic lupus erythematosus patients. We consider these results to be related to endolymphatic and cochlear hydrops, and we suggest that electrocochleography could be performed in further studies for clarification of this subject.

DPOAE in estimation of the function of the cochlea in tinnitus patients with normal hearing

Objective The most probable place generating tinnitus in the auditory pathway is the outer hair cells (OHCs) inside the cochlea. Otoacoustic emissions are used to assess their activity. The objective of the investigation was to measure the features of distortion product otoacoustic emissions (DPOAE) in a group of tinnitus patients without hearing loss, estimate the diagnostic value of the parameters for the analysis of cochlear function in the patients, emphasizing those most useful in localizing tinnitus generators, and determine the hypothetical influence of hyperacusis and misophony on DPOAE parameters in tinnitus patients. Patients and methods The material consisted of 44 patients with tinnitus and without hearing loss. In the control group were 33 patients without tinnitus with the same state of hearing. The tinnitus patients were divided into three subgroups: those with hyperacusis, those with misophonia, and those with neither. After collecting medical history and performing clinical examination of all the patients, tonal and impedance audiometry, ABR, and discomfort level were evaluated. Then DPOAE were measured using three procedures. First the amplitudes of two points per octave were assessed, second the “fine structure” method with 16–20 points per octave ( f2/ f1 = 1.22, L1 = L2 = 70 dB), and the third procedure included recording the growth function in three series for input tones of f2 = 2002, 4004, and 6006 Hz ( f2/ f1 = 1.22) and L1 = L2 levels increasing by increments of 5 dB in each series. Results and conclusions Hyperacusis was found in 63% and misophonia in 10% of the tinnitus patients with no hearing loss. DPOAE amplitudes in recordings with two points per octave and the fine structure method are very valuable parameters for estimating cochlear function in tinnitus patients with normal hearing. Function growth rate cannot be the only parameter in measuring DPOAE in tinnitus patients, including subjects with hyperacusis and misophonia. The markedly higher DPOAE amplitudes in the group of tinnitus patients without hearing loss suggest that tinnitus may be caused by increased motility of the OHCs induced by decreasing efferent fiber activity, and not by OHC failure. Hyperacusis significantly increases the amplitude of DPOAE in tinnitus patients with no hearing loss.

Efeito da acupuntura sobre as emissões otoacústicas de pacientes com zumbido

O tratamento do zumbido continua a ser um desafio da atualidade. Na medicina tradicional chinesa, a acupuntura é recomendada para o alívio do zumbido, apesar de faltarem provas cientificas nesta área. OBJETIVO: Verificar o efeito da acupuntura sobre a função coclear de indivíduos com zumbido através do uso das emissões otoacústicas. CASUÍSTICA E MÉTODO: Foi realizado um estudo clínico-prospectivo, no qual foram avaliados 38 pacientes do ambulatório de zumbido. Os pacientes foram avaliados por meio de emissões otoacústicas transitórias e pela medida da supressão das emissões otoacústicas transitórias. Essa avaliação foi realizada antes e após a aplicação de acupuntura em um ponto na região têmporo-parietal, correspondente à área cócleo-vestibular (no grupo intervenção 1 n=19) e em um ponto 3cm acima dessa região (para o grupo intervenção 2 n=19). RESULTADOS: Os resultados mostraram uma diferença estatisticamente significante na amplitude das emissões otoacústicas antes e após a aplicação da acupuntura para o grupo intervenção 1. Não foram observadas diferenças para o grupo intervenção 2. CONCLUSÃO: Os resultados sugerem que houve um efeito da acupuntura sobre as emissões otoacústicas dos pacientes com zumbido.

Impact of acupuncture on otoacoustic emissions in patients with tinnitus

SummaryThe treatment of tinnitus is still a challenge. Acupuncture is recommended for the relief of tinnitus in traditional Chinese Medicine, although scientific evidence is lacking. Aim: The aim of this study was to assess the effect of acupuncture on the cochlear function in patients with tinnitus by analyzing otoacoustic emissions. Methods: Thirty eight patients with tinnitus were included in the prospective clinical study. Measures of transitory otoacoustic emissions and suppression of otoacoustic emissions were obtained from all subjects before and after acupuncture. Patients were assigned to one of two groups: intervention group 1 (n=19), in which needle acupuncture was applied at the temporoparietal point corresponding to the vestibulocochlear area, and intervention group 2 (n=19), in which the needle was applied 3cm cranially to this area (which is not a recognized acupuncture point). Results: There was a significant difference between the amplitude of otoacoustic emissions assessed before and after acupuncture in intervention group 1. No difference was observed in intervention group 2. Conclusion: Acupuncture had a significant effect on otoacoustic emissions in patients with tinnitus.

Evaluation of Cochlear Function in Patients with Tinnitus Using Spontaneous and Transitory Evoked Otoacoustic Emissions

The aim of this paper has been to investigate the cochlear function and the basic properties of otoacoustic emissions (OAEs) in patients with tinnitus using Spontaneous Otoacoustic Emissions (SOAEs) and Transitory Evoked Otoacoustic Emissions (TEOAEs). We have analyzed the incidence, amplitude and spectral content of hearing thresholds, SOAEs and TEOAEs in a sample of 44 ears. We have measured incidence, intensity, frequency, number of peaks and amplitude of emission and their variability across frequency range from 500 to 5000 Hz. A correlation was determined between the OAEs results and the results obtained using hearing thresholds. We have not found statistically significant differences at 500, 1000, 2000, 4000 and 8000 Hz frequencies neither at mean hearing thresholds between the sample of ears with tinnitus and the sample of ears without tinnitus. SOAEs were only present in 1 of the 44 ears tested (2.27%) and it was a 17 dB SPL amplitude peak at 2770 Hz frequency. TEOAEs, however, were displayed in some frequency in all the ears. We have compared TEOAEs parameters between the sample of ears with tinnitus and the sample of ears without tinnitus in 500, 1000, 2000, 4000 and 5000 Hz frequencies, and we have only found statistically significant differences at 4000 Hz, p = 0.02. Comparison of TEOAEs parameters between ears with tinnitus and ears without tinnitus in the same patient have only found statistically significant differences at 4000 Hz frequency, p = 0.011. In both cases there were not statistically significant differences at 500, 1000, 2000 and 5000 Hz frequencies nor at mean TEOAEs amplitudes for every group. We have not found significant relations between tinnitus and OAEs registration.

Distortion product otoacoustic emissions in patients with King-Kopetzky syndrome

In the present study, mild impairment of cochlear function in patients with King-Kopetzky syndrome was investigated using DPOAEs. A significant decrease in DPOAE levels in both ears was found in patients with King-Kopetzky syndrome compared with the controls after considering the thresholds as a co-variable. It is noteworthy that the global mean levels of DPOAEs were still significantly greater in controls than in patients with matched thresholds. Further frequency analyses showed a significant decrease in DPOAE levels over the mid- and high-frequency range in patients with better hearing thresholds when compared with those in the control group. Moreover, significantly smaller DPOAEs were found in the ears of patients with King-Kopetzky syndrome and without SOAEs, than in such ears of control subjects after considering the thresholds as a co-variable. However, when SOAEs were present there was no difference. Decreases in DPOAE level appear to represent evidence of minor cochlear pathology, and provide a pathological basis for the difficulty of hearing speech in the presence of background noise, which characterizes King-Kopetzky syndrome.SumarioEn el presente estudio, se investigó una leve alteración en la función coclear en pacientes con el síndrome de King-Kopetzky usando DPOAE. Se encontró una disminución significativa en los niveles de intensidad de las DPOAE en ambos oídos en pacientes con este síndrome, al compararlos con los controles, luego de considerar el umbral como una co-variable. Es digno de resaltar que los niveles globales medios de las DPOAE fueron aún significativamente mayores en los controles que en los pacientes con umbrales correspondientes. Un análisis de frecuencia ulterior mostró una disminución significativa en los niveles de las DPOAE, en el rango de frecuencias medias y altas, en pacientes con los mejores umbrales auditivos, al compararlos con aquellos del grupo control. Más aún, se encontraron DPOAE significativamente menores en la audición de pacientes con el síndrome de King-Kopetzky y ausencia de SOAE, comparados con los oídos de sujetos control, luego de considerar el umbral como una co-variable. Sin embargo, cuando las SOAE estuvieron presentes, no hubo diferencia. La disminución en el nivel de intensidad de las DPOAE parece representar evidencia de patología coclear menor, y aporta una base patológica para explicar la dificultad para entender el lenguaje en presencia de ruido de fondo, que caracteriza al síndrome de King-Kopetzky.

Use of transient evoked otoacoustic emissions to detect and monitor cochlear damage caused by platinum-containing drugs.

Transient evoked otoacoustic emissions (TEOAE) have been evaluated as a means of monitoring cochlear function in patients receiving the chemotherapeutic agents cisplatin and carboplatin (-cis-diammine, 1,1-cyclobutane dicarboxylate (2) -0,0-platinum). Patients receiving these drugs were monitored prospectively with pure tone audiometry (PTA), tympanometry and TEOAE. Data was collected on 22 subjects receiving cisplatin and nine subjects receiving carboplatin. Significant deterioration in both PTA thresholds and TEOAE energy levels (with no change in tympanometry) were detected in the cisplatin group. No significant deterioration in audiological parameters occurred in the carboplatin group. It is indicated that cisplatin has a significant ototoxic effect in the majority of patients, whereas any ototoxic effect of carboplatin was undetectable. Our findings were different from previous studies in that the measurable changes in TEOAE occurred later than changes in the pure tone audiogram for the cisplatin group.