Contralateral Hearing Loss Research Articles

Langerhans' cell histiocytosis of the temporal bone: successful treatment of sensorineural hearing loss with low-dose radiotherapy

To present the successful treatment of sensorineural hearing loss secondary to Langerhans' cell histiocytosis with low-dose radiotherapy, and also the disparity between radiological resolution of Langerhans' cell histiocytosis lesions and lack of sensorineural hearing loss improvement, accompanied by a review of the literature on otolaryngological manifestations and management of Langerhans' cell histiocytosis. Langerhans' cell histiocytosis is a multisystem disease which frequently causes osseous lesions in the temporal bones. Hearing loss is usually conductive but may be sensorineural with lesions of the petrous temporal bone. We present a case of sensorineural hearing loss secondary to Langerhans' cell histiocytosis affecting the labyrinth and internal auditory meatus, which resolved following radiotherapy. Contralateral sensorineural hearing loss in the same patient, previously treated with chemotherapy, did not resolve despite radiological resolution of the temporal bone lesions. We suggest that timely radiotherapy for treatment of sensorineural hearing loss secondary to Langerhans' cell histiocytosis is an appropriate treatment option.

CONTRALATERAL HEARING LOSS AFTER VESTIBULAR SCHWANNOMA SURGERY

To describe a case of contralateral hearing loss (CHL) in vestibular schwannoma (VS) surgery and to discuss the factors potentially related with this complication. A 48-year-old man awakened with complete bilateral hearing loss after an uneventful retrosigmoid excision of a 20 mm left-sided VS. The patient had no complaints of vertigo or facial palsy on the contralateral side. The hearing loss proved to be endocochlear in origin and no improvement was observed after a 24-month follow-up period. CHL in VS surgery is not commonly reported but can occur frequently as a subclinical phenomenon if it is specially addressed. The cause is a compensatory endolymphatic hydrops generated by the loss of cerebrospinal fluid. In this circumstance, the hearing loss is usually reversible within 3 months, but irreversible cases have been described. Vascular damage to the cochlea can be another explanation in irreversible cases. The significance of other potential factors described in the literature as a cause of CHL in VS surgery is less clear. A case of CHL after VS surgery is presented. The hearing loss proved to be endochlear in origin and irreversible in nature. Irreversible damage to the cochlea resulting from loss of cerebrospinal fluid or vascular injury is probably related in this case reported.

Radiosurgery Treatment of Acoustic Neuromas. Our Experience

To evaluate the results and side effects obtained using radiosurgery to treat acoustic neuromas.Between 1999 and 2004 we treated 30 patients with unilateral acoustic neuromas with a mean age of 54 years old (31-76), a mean follow-up of 34 months (12-54), and tumour size between 4 and 38 millimetres (mean, 16.5). All of them were treated with radiosurgery (24 Gamma Knife and 6 LINAC) with doses of 1200-1300 cGy.Tumour growth control rate (smaller or same size) was 93 % (28/30). In 11 patients there was a post-treatment hearing loss (36.6 %). Trigeminal (3/30) and facial (2/30) neuropathy was transient.Although microsurgery is the treatment of choice for acoustic neuromas, we consider radiosurgical treatment a valid alternative for selected patients (the elderly, co-morbid conditions, small size, contralateral hearing loss...).

Hearing changes in the contralateral ear with juvenile unilateral profound hearing loss of unknown origin

Summary Objectives : Investigate contralateral hearing changes in patients with juvenile unilateral profound hearing loss (JUPHL) of unknown origin because patients with JUPHL have potentially bilateral hearing loss. Study design : A retrospective study. Setting : A tertiary referral center. Patients : Fifty patients with JUPHL of unknown origin included 42 unilaterally deaf patients and 8 patients with hearing loss over 70dB HL. The age of the patients was less than 15 years old at the first visit to our outpatient clinic. Patients with inner ear anomalies were excluded using CT images. Main outcome measures : The results of pure tone audiometry (PTA) were investigated. To obtain reliable PTA results, patients were over 6 years old. The following items were examined: level, fluctuation and worsening of hearing. Results : A hearing level over 30dB was observed at 20%, 4%, and 10% of patients in the low, middle and high frequencies, respectively. Hearing fluctuations were observed in 72%, 42% and 64% at the low, middle and high frequencies, respectively. Hearing worsening was observed in 8%, 4% and 4% at the low, middle and high frequencies, respectively. Conclusion : Seventy-two percent of patients with JUPHL had fluctuating hearing at low frequencies, and 8% of them had worsening hearing. These results imply that over 70% of patients with JUPHL may develop contralateral hearing loss and that we have to follow-up patients with unilateral juvenile profound hearing loss for a long time.

Autoimmune-Mediated Sympathetic Hearing Loss: A Case Report

Damage to one inner ear is occasionally followed by contralateral sensorineural hearing loss. This has been defined as sympathetic hearing loss. It is hypothesized that autoimmunity can play a role in the pathogenesis of sympathetic hearing loss. A male patient who developed right-sided sympathetic hearing loss at 20 years of age, 11 years after deafness of the left ear caused by a temporal bone fracture, is described. The patient's serum was analyzed for the presence of autoantibodies against inner ear tissues by immunocytochemistry and Western blotting using rat inner ear tissues. The patient's serum was tested specifically for antibodies against heat shock protein 70 by immunodot blot. The presence of autoantibodies known to play a role in systemic autoimmune disease was also examined. Immunocytochemistry on rat temporal bone sections demonstrated autoantibodies in the patient's serum specifically targeted against cochlear outer hair cells. No reactivity of the patient's serum was observed with control tissues including kidney, brain, and liver. Western blotting using homogenized rat cochlear tissues showed that the patient's serum reacted with a 25- and 27-kDa protein. No reactivity was observed with heat shock protein 70 in the immunodot blot analysis. The patient's serum did not contain autoantibodies against antinuclear antibodies, double-stranded DNA, antineutrophil cytoplasmic antibodies, basement membrane, reticulin, intestinal mucosa, muscle, collagen, or mitochondria. Observations indicate that this patient suffered sympathetic hearing loss caused by organospecific autoimmunity directed to cochlear outer hair cells.

Sympathetic cochleolabyrinthitis in revision stapedectomy surgery.

The purpose of this study was to determine whether revision stapedectomy could precipitate sensorineural hearing loss in the contralateral ear. We conducted a retrospective review of 148 patients undergoing primary or revision stapedectomy at an academic, tertiary care facility. Stapedectomy resulted in significant improvements in mean air conduction thresholds in the ipsilateral ear. Overall, there were no significant changes in either the air or bone conduction values of the contralateral ear. Two patients demonstrated a >20-dB decline in speech reception threshold and/or >20% decrease word recognition in the contralateral ear. Both of these patients demonstrated the decline only after revision surgery. Revision stapedectomy is on rare occasions associated with hearing loss in the contralateral ear. Contralateral hearing loss after revision stapedectomy may be due to sympathetic cochleolabyrinthitis.

Virtual endoscopy of the inner ear and the auditory canal.

To assess the role of virtual endoscopy (VE) in the examination of intracisternal structures and of the inner ear, we studied the anatomy of the labyrinth and internal auditory canal using the original CT slices and VE on the unaffected side in three female and three male patients, age range 3-46 years, with contralateral retrocochlear hearing loss. We also examined seven patients with different pathological findings. VE was performed using an advanced postprocessing program with high-resolution 3D data sets of CT (1-1.5 mm thickness, pitch 1.25) and MRI-CISS-3D (constructive interference in steady state) images of the basal cisterns (1.5 T, slice thickness 0.7-1 mm). VE provides an endoscopic-like view from a given point within the basal cisterns of vessels and nerves (on MRI) or of the structures of the inner ear (on CT). The complex anatomy and pathological changes in the inner ear can be faithfully shown. The main advantage is not basic diagnostic information but demonstration of topographically complex situations, such as the canalicular system of the inner ear, for discussion, preoperative planning and teaching.

Contralateral hearing loss in unilateral meniere's disease

Contralateral hearing loss in unilateral meniere's disease

Contralateral Hearing Loss in Unilateral Meniere's Disease

Contralateral Hearing Loss in Unilateral Meniere's Disease

Contralateral hearing loss after neurotologic surgery

Contralateral hearing loss after neurotologic surgery

聴神経腫よう術後，対側の急性感音難聴をきたした２症例

Two patients suffered from acute hearing loss of the contralateral side after acoustic tumor surgery were reported. The first patient was a 42-year-old-male. He had had a right progressive hearing loss over two years and CT scan revealed a mass of 20mm in diameter in the right cerebellopontine angle. The patient noticed the contralateral hearing loss on next morning after the total removal of tumor by translabyrinthine approach. However he had no complaint of vertigo or facial palsy. An audiogram of the contralateral side just after the onset showed flat type audiogram of sensorineural hearing loss with positive recruitment. With steroid therapy for two weeks, hearing and ABR findings improved and returned to nearly normal. The second case was a 47-year-old male. The patient had chronic renal failure treated by hemodialysis. His hearing loss in the right ear had gradually decreased over two years and an acoustic tumor of 2.5cm in diameter was demonstrated by CT scan. The tumor was removed by translabyrinthine approach. Nine day after the operation, he noted total deafness in contralateral ear and vertigo. He was given steroid hormone and his hearing improved up to 68 dB. Four cases have been reported in the literature. The mechanisms of acute sensorineural hearing loss observed in these cases were discussed. The cause remained unknown, however there were some hypothesis such as the compression to the opposite brainstem, peripheral nerve or feeding vessels by tumor or brain edema after operation, and local vasospasms might be also the cause of hearing impairment.(ABSTRACT TRUNCATED AT 250 WORDS)

Unilateral auditory cortex ablation in macaques results in a contralateral hearing loss.

1. The behavioral audiograms of four Japanese macaques (Macaca fuscata) were assessed before and after unilateral ablation of auditory cortex. The tones were presented via insertion earphones so that each ear could be tested separately. 2. Each animal had a hearing loss in the ear contralateral to the lesion, whereas the ipsilateral ear showed no change in sensitivity. The hearing loss initially appeared as a large shift in thresholds followed by rapid but incomplete recovery during the first 3-5 wk after surgery. The initial hearing loss ranged as high as 68 dB at some frequencies, although thresholds at other frequencies were occasionally unchanged. A threshold shift could be demonstrated with broadband noise as well as with tones. Although thresholds for some tones returned to normal within a few weeks, most were still elevated 16 wk after surgery when testing was discontinued. The largest long-term hearing losses occurred at frequencies from 4 to 25 kHz. 3. Analysis of the animals' psychophysical functions suggested that the hearing loss resembled a sensory deficit, as opposed to a nonsensory deficit in attention or vigilance. 4. Testing with binaural stimuli indicated that the hearing loss could best be described as a contralateral "ear" deficit, as opposed to a contralateral "auditory field" deficit. 5. It is suggested that a similar hearing loss occurs in humans after unilateral damage to auditory cortex.

Contralateral hearing and tympanoplasty

The relationship between the contralateral hearing threshold in the operated ear and the type of tympanoplasty and the hearing threshold in the operated ear was investigated in this report. The subjects of analysis were 863 ears that received tympanoplasty during the past nine years at the Nippon Medical School Main Hospital. Patients who had good hearing in the contralateral ear received type I tympanoplasty more frequently than did those who had poor hearing on the contralateral ear. On the other hand, patients who had poor hearing in the contralateral ear received a modified type III tympanoplasty more frequently. Patients who had good hearing in the contralateral ear tended to have better hearing in the operated ear compared to those who had poor hearing in the contralateral ear. The hearing threshold in patients who had normal contralateral hearing on the average had 20 dB better hearing than did those who had profound hearing loss in the contralateral ear. More than one third of the patients whose hearing thresholds were worse than 30 dB in the operated ear also had a contralateral hearing loss of 30 dB or more. The decision to perform tympanoplasty in cases of the better hearing ear or the only hearing ear must be made very carefully. The contralateral hearing in patients with chronic otitis media, however, is frequently not normal as was evidenced in this investigation. Also, patients who had poor hearing or were deaf in the contralateral ear received more benefit by tympanoplasty than did those who had good hearing in the contralateral ear.(ABSTRACT TRUNCATED AT 250 WORDS)

Bilateral Hearing Loss after Unilateral Removal of an Acoustic Neuroma by the Suboccipital Approach: Case Report

Contralateral hearing loss is a very rare complication of acoustic neuroma surgery. A case of immediate postoperative contralateral hearing loss is reported. Possible causes and the pertinent literature are reviewed.