Occurrence Of Sensorineural Hearing Loss Research Articles

Gram‐negative Bacteria are Associated With Sensorineural Hearing Loss in Chronic Otitis Media

ObjectChronic otitis media (COM) is an inflammatory disease that commonly presents with otorrhea and hearing loss. Bacteria‐induced inflammation can cause inner ear damage, leading to sensorineural hearing loss (SNHL). This study aimed to compare the prevalence and severity of SNHL in patients with gram‐negative versus gram‐positive cultures and examine associations between the concentrations of circulating monocytes and neutrophils with bacteria species and SNHL.MethodsThis was a retrospective study. Cholesteatoma or chronic suppurative otitis media patients with otorrhea were enrolled. Middle ear secretions were collected using sterile swabs under an otoscope, and sent for bacterial detection within 30 min. Pure tone audiometry and circulating leukocyte counts were recorded and analyzed in patients infected with different pathogens. Logistic regression analysis was used to identify the risk factors associated with SNHL.ResultsA total of 137 patients were enrolled, including 45 patients infected with gram‐negative bacteria, 41 with gram‐positive bacteria, 20 with polymicrobial infection, and 31 with no bacterial growth. Logistic regression analysis showed that bacterial culture positive infections (OR = 7.265, 95% CI 2.219–23.786, p = 0.001) were an independent risk factor for SNHL. Patients with gram‐negative bacteria had higher risks of SNHL (p < 0.0001) and more severe hearing loss (p = 0.005) than those with gram‐positive bacteria. COM patients infected with gram‐negative bacteria showed an increase in circulating monocytes, which correlated with the occurrence of SNHL (p = 0.0343).ConclusionGram‐negative bacteria are associated with elevated circulating monocyte counts and have a higher risk of severe SNHL.Level of Evidence4 Laryngoscope, 2024

Sensorineural Hearing Loss in Patients With Chronic Kidney Disease: A Comprehensive Review.

This article aims to ascertain the prevalence of loss of hearing in patients with chronic kidney disease (CKD) and also to examine potential causes of sensorineural hearing loss (SNHL) in patients suffering from CKD. It has been discovered in recent years that there is a relationship between the occurrence of SNHL and CKD. Nowadays many people are suffering from CKD. These patients deal with several otorhinolaryngological issues, such as SNHL, candidiasis, epistaxis, halitosis, dysgeusia, xerostomia, and lip and thyroid malignancies. One of the most frequent otorhinolaryngological complications is audiovestibular system impairment. There are various proposed mechanisms for the appearance of loss of hearing in people suffering from CKD. The kidney and the inner ear have multiple functional and structural similarities, which may be the cause of these problems in CKD patients. In addition, changes in the homeostasis of water and electrolytes can affect the endolymphatic fluid and result in endolymphatic hydrops. Finally, some medications, like aminoglycosides and loop diuretics, are well known for their ototoxicity and are utilized to treat patients with CKD. Only a small number of population-based research have so far been able to show a connection between CKD and audiovestibular system impairment. Some investigationhasshown that CKD patients are more likely than healthy people to experience vestibular impairment. The quality of life of a patient can be reduced by hearing loss. People with hearing loss experience communication issues in daily life, which negatively affects their cognitive and psychosocial functioning. Social isolation and a poor quality of life in terms of health can all result from hearing loss. In addition, decreased renal function has also been linked to poor quality of life, hospitalization, and cognitive dysfunction.

Mechanism of NLRX1 Mediating JNK Apoptosis Pathway to Participate in Functional Impairment of Cochlear Hair Cells in Mice with Senile Deafness.

To explore the mechanism of cochlear hair cell damage and study the prevention and treatment of sensorineural hearing loss, the effect of NLRX1 gene expression on the functional damage of cochlear hair cells in presbycusis was comprehensively analyzed. In the in vivo detection, C57BL/6 mice of different ages were used as experimental subjects. Cochlear tissues were taken after the hearing test of mice, and the number of cells and protein changes in NLRX1 immunofluorescence staining were detected. In the in vitro detection, the cochlear hair cell HEI-OE1 was used as the experimental object, and the cell proliferation activity was detected after overexpression or silencing of NLRX1.In the in vivo and in vitro experiments, the expression of JNK pathway-related proteins was simultaneously detected. The results of in vivo experiments showed that the hearing threshold of 270d -old mice was substantially greater than that of 15d-, 30d-, and 90d-old mice (P <0.05). I addition, with increasing age, the expression of p-JNK, Bcl-2, Bax, and Caspase-3 in the mouse cochlea gradually increased (P<0.05).In vitro experimental results showed that cell proliferation activity decreased after overexpression of NLRX1, and the expression of p-JNK, Bcl-2, Bax, and Caspase-3 was substantially decreased (P<0.05). Silencing NLRX1 can inhibit the above phenomenon, indicating that NLRX1 can inhibit the proliferation of hair cells in old mice through the activation of the JNK apoptosis pathway, thereby promoting the occurrence of sensorineural hearing loss.

Моделирование взаимосвязей между условиями труда и состоянием здоровья персонала нефтешахт с использованием нечеткой логики

Currently, occupational risk assessment at the workplace is a mandatory procedure. However, for qualitative and quantitative risk assessment, there is often not enough statistical data on negative health consequences. The issue of accounting the contribution of heterogeneous factors of the working conditions is also insufficiently studied. The article considers the workplace of a tunnelling machine operator for mining of high-viscosity oil, where the working conditions are rated class 3.2 (harmful of the second degree). The main contribution to the formation of harmful working conditions is made by the vibroacoustic factors, which is a consequence of the technological process in the oil sheds and maintenance of mining machines. Construction of a fuzzy model with two input vibroacoustic parameters (noise and general vibration), and an output parameter (sensorineural hearing loss as an occupational disease) is described. Modeling includes 4 stages: fuzzification; construction of the database of rules for fuzzy productions; composition using aggregation methods; defuzzification. Variant of fuzzification; of three selected parameters for assessing the risk to the personnel health is proposed: low, medium, high. In the interactive mode, the development and visualization of the fuzzy output system of the problem being solved using the graphical tools of the Fuzzy Logic Toolbox extension package of the MATLAB computer mathematics program was performed. As a result, the visual dependences of the output parameter on vibroacoustic factors are obtained: fuzzy output table, 3D-surface of the fuzzy output, functions of the dependence of the occurrence of sensorineural hearing loss from noise and general vibration. The proposed model can be supplemented with other input parameters that characterize the working conditions, thereby becoming more complicated at the fuzzification stage, refined at the stage of writing fuzzy production rules.

The clinical study of audiologic manifestations of type 2 diabetes mellitus in association with other diabetic microvascular complications: an observational study

Background: Sensorineural hearing loss (SNHL) is a major clinical and public health problem. Diabetes mellitus (DM) is characterized by various microvascular and macrovascular complications. DM is associated with thickening of basal membrane of the stria vascularis capillaries on the lateral wall of cochlea and neuropathic changes which leads to SNHL.Methods: This is an observational study involving 160 participants grouped into diabetics and non-diabetics. DM was diagnosed using standard American Diabetes Association (ADA) criteria. All the participants were subjected to pure tone audiometry to detect SNHL which was graded into mild, moderate, severe and profound based on degree of decibel loss. The occurrence of SNHL was compared with the occurrence of microvascular complications among diabetics.Results: In our study, 34 (42.5%) cases and 8 (10%) of controls had SNHL. The occurrence of SNHL was higher among diabetics than non-diabetics (p &lt;0.0001) with majority (88.23%) of cases having bilateral SNHL. Among diabetics, 26 (32.5%) had neuropathy, 23 (28.75%) had retinopathy, 21 (26.25%) had nephropathy. There was no statistically significant relationship between occurrence of SNHL and microvascular complications among diabetics (p=0.8614). The occurrence of SNHL correlated with the levels of HbA1c (p = 0.017). The occurrence of SNHL among diabetics was 42.5% as compared to only 10% among non-diabetics which was statistically significant. The occurrence of SNHL correlated with the levels of HbA1c among diabetics suggesting an association between DM and SNHL (p=0.017).Conclusions: There was increased occurrence of sensorineural hearing loss among the individuals with diabetes mellitus with significant relationship with the glycaemic index.

Determination of the occupational disease risk of hearing for coal mines employees

The article proposes a method of determining of the professional risk level for occurrence of hearing system deceases at miners while performing different technical operations. Based on the free literature sources analysis the major hazards peculiar to miners’ labour conditions with huge noise load as one of them were determined. It was suggested that Risk Score method according to DSTU-P OHSAS 18001 : 2006 «Health, Safety and Security Management Systems» is used for assessment of diminished hearing level as enough tested and adopted to use in EU countries. The calculations consist in multiplication of seriousness of consequences, hazard probability, and frequency of occurrence. As a result of processing of data from the maps of working conditions (noise load in different areas) it was stated that the value of risk level of professional decease occurrence of sensorineural hearing loss is moderate. Using the recommendations of ISO 1999 : 2013 standard it was determined that there exists the definite probability of hearing loss for some part of employees with the working life increase. Thus, in 5 years 50 % of persons not using hearing protective equipment will reach the level 12 dB hearing loss. The approach suggested may be used for calculations of hearing loss of miners in accordance with requirements of European Standard ISO 1999 : 2013. It was recommended to limit the time of presence of miners in the hazardous area to decrease the probability of sensorineural hearing loss. While choosing the hearing protective equipment it is important to consider the fact that their actual efficiency described by a producer is determined in laboratory conditions and overvalued, so it requires significant correction to be used as a protective means for miners.

Comparing Gelfoam vs fat as a sealing material in stapedotomy: A prospective double-blind randomised clinical trial.

One research aspect of stapes surgery is various materials that are used to seal the oval window. Several materials are used to seal the oval window, for example adipose tissue, perichondrium, vein graft, gelatin sponge (Gelfoam), blood clot and soft connective tissue. Up to now, there has been no randomised clinical trial that has evaluated the effects of different types of sealing material on hearing outcomes after stapedotomy. Hence, the present study aimed to find out which of these materials; fat or Gelfoam was associated with better hearing outcome, when used as a sealing material. This prospective, double-blind, randomised clinical trial was carried out on ears that had undergone stapedotomy. Dastgheib Hospital affiliated to Shiraz University of Medical Sciences, a referral otology centre in southern Iran. A total of 176 primary stapedotomies were analysed. Fat harvested from the ear lobule was used in 86 ears and Gelfoam in 90 ears. Preoperative and postoperative pure tone audiometric data and incidence of sensorineural hearing loss were evaluated. Total of 90.7% of all ears in the fat group and 87.8% of ears in Gelfoam group achieved postoperative air-bone gap (ABG) within 20dB, and this difference was not significant. There was no case of sensorineural hearing loss (defined as 10dB or more reduction in BC threshold) in both groups in mean frequencies of 0.5-3kHz. There were 9 cases of sensorineural hearing loss at 4kHz in the fat group vs 4 in the Gelfoam group. The occurrence of sensorineural hearing loss in different frequencies was not significant between the two groups (P>0.05). In addition, there was no case of dead ear in either group. We found similarity between hearing outcome in the Gelfoam and fat as sealing materials in stapedotomy. We believe that the first limitation of this study was the short-term follow-up in stapedotomy. The other issue is that one has to be cautious when using our result, which might not be applicable in larger fenestra stapedectomy.

Comparison of Audiological Findings in Patients with Vestibular Migraine and Migraine.

The aim of this study was to investigate and compare the auditory findings in vestibular migraine (VM) and migraine patients without a history of vertigo. This study was conducted on 44 patients diagnosed with definite VM and 31 patients diagnosed with migraine who were followed and treated between January 2011 and February 2015. Also, 52 healthy subjects were included in this study as a control group. All participants underwent a detailed otorhinolaryngological examination followed by audiological evaluation, including pure tone audiometry, speech reception threshold, speech recognition score, and acoustic immitancemetry. In the VM group, there were 16 patients (36.4%) with tinnitus, while in the other groups we did not observe any patients with tinnitus. The rate of tinnitus in the VM group was significantly higher in comparison to other groups (p<0.05). None of the groups had any patients with permanent or fluctuating sensorineural hearing loss. We conclude that patients with VM should be closely and longitudinally followed up for the early detection of other otological symptoms and possible occurrence of sensorineural hearing loss in the long term.

Screening of auditory acuity in patients with type 2 diabetes mellitus

Diabetes mellitus (DM) is a multifunctional metabolic disorder affecting almost all the systems of the body. There is a strong relation between DM and hearing. The three main theories of pathogenesis of hearing impairment in patients with diabetes are microangiopathy, neuropathy, and combination of both. Even though studies have proved the occurrence of sensorineural hearing loss in DM, disagreement still exists among some about their relation. Material and Methods: This study was a prospective design. Aim: The present study aimed (1) to focus on and evaluate the interrelation between Type 2 DM and hearing loss; (2) to screen the degree of auditory acuity in patients with Type 2 DM using pure tone audiometry; and (3) to analyze the effect of age, glycemic status (fasting blood sugar and postprandial blood sugar), glycemic control (glycosylated hemoglobin), and duration of Type 2 diabetes on auditory acuity. Results: In the present study, it was found that the patients with Type 2 diabetes had a higher hearing threshold than the healthy controls. The patients with diabetes showed significant high-frequency, bilateral, mild-to-moderate SNHL. Conclusion: The glycemic status had significant correlation with hearing loss may be explained by diabetic microangiopathy of the inner ear, and the hearing was affected in both sexes equally.

Maternal and Placental Factors Associated with Congenital Hearing Loss in Very Preterm Neonates

Sensorineural hearing loss (SNHL) is a multifactorial disease that more frequently affects preterm newborns. Although a number of maternal conditions have been reported to be associated with preterm birth, little information is available concerning maternal risk factors for the development of SNHL. We aimed to identify maternal and placental risk factors associated with a "refer" result on the newborn hearing screening (NHS) test and subsequently confirmed SNHL in very preterm neonates. This retrospective cohort study included 267 singleton neonates who were born alive after≤32weeks. Histopathologic examination of the placenta was performed, and clinical data were retrieved from a computerized perinatal database. Cases with two abnormal findings, "refer" on the NHS test, and presence of SNHL on the confirmation test were retrospectively reviewed based on electronic medical records. Forty-two neonates (15.7%) showed a "refer" result, and, on the confirmation test, permanent SNHL was identified in 1.87% (5/267) of all neonates. Multivariate regression analysis revealed that the presence of funisitis was independently associated with a "refer" on the NHS test, whereas use of antenatal corticosteroids was statistically significantly associated with a reduced incidence of "refer" on the screening test. Neither histologic chorioamnionitis nor prematurity (as defined by low gestational age and birth weight) was associated with a "refer" on the NHS test. By contrast, multivariate analysis with occurrence of SNHL as a dependent variable identified no significant associations with the parameters studied, probably owing to the small total number of neonates with permanent SNHL. Presence of funisitis was significantly and independently associated with increased risk of abnormal NHS results, while administration of antenatal corticosteroids was related to a normal NHS result. These findings support the hypothesis that a systemic fetal inflammatory response, manifested as funisitis, might play a role in the pathogenesis of SNHL in preterm neonates.

Auditory involvement in Behcet's disease: relationship with demographic, clinical, and therapeutic characteristics.

The study objective was to evaluate the occurrence of sensorineural hearing loss (SNHL) in patients with Behcet's disease (BD), looking at potential correlations with specific demographic, clinical, and therapeutic features. Forty-four consecutive patients (15 males, 29 females) fulfilling the International Study Group (ISG) and/or the International Criteria for Behçet's Disease (ICBD) were enrolled. The endpoints of the study consisted in identifying a deflection of at least 25dB on pure-tone audiometry and performing statistical analysis to evaluate demographic, clinical, or therapeutic differences between patients with and without SNHL. Our patients showed a mean age ± SD of 45.43±14.05years; a mean age at disease onset ± SD of 31.54±15.53years; a disease duration ± SD of 13.89±9.15years. SNHL was highlighted in 28 (63%) patients representing the fourth most frequent clinical manifestation in our group of patients. Otologic involvement was significantly more frequent among subjects fulfilling ISG criteria than in patients fulfilling ICBD criteria (p=0.04). Regarding correlations with BD manifestations, SNHL was significantly associated with cutaneous plus articular involvement (p=0.013). Conversely, detached analysis of articular and skin manifestations led to no significant differences (p=0.085 and p=0.067). No further significant correlations were found between SNHL and BD clinical features or previous or concomitant treatments. Hearing loss was the fourth most common clinical feature in our patients and probably represents an underrated aspect of BD. Hearing impairment was significantly associated with cutaneous plus articular involvement, suggesting the importance of an otologic evaluation in such patients.

Clinical Study to Evaluate the Association Between Sensorineural Hearing Loss and Diabetes Mellitus in Poorly Controlled Patients Whose HbA1c>8.

The relationship between sensorineural hearing loss (SNHL) and Diabetes mellitus has been known since more than 150years. The pathophysiology of diabetes related hearing loss is speculative. Hearing loss is usually, bilateral, gradual onset, affecting higher frequencies. This study aims at knowing the prevalence of SNHL in DM and its relation to age, sex, duration of DM and control of DM. A total of 50 type 2 diabetics of age group 30-65years were involved in the study. FBS, PPBS, HbA1c of all the subjects were done and later subjected to PTA. The type and severity of hearing loss was noted. Occurrence of SNHL was later compared with age, sex, duration, and control of DM. Sensorineural hearing loss was found in 66% of type II diabetic patients and 34% were found normal. Out of 50 diabetes mellitus patients, 33 patients had SNHL. All cases of SNHL detected were of gradual in onset and no one had hearing loss of sudden onset. Normal hearing was found in 34% of patients, whereas 54% of patients had mild hearing loss and 12% of patients had moderate hearing loss. Association of hearing loss of DM patients with sex of the patient is insignificant. However there is significant association between older age group, longer duration and uncontrolled DM with that of SNHL. In subjects with HbA1c more than 8 and duration of diabetes mellitus more than 10years prevalence of SNHL is more than 85%, which is statistically significant. Sensorineural hearing loss in diabetes mellitus is gradually progressive involving high frequency thresholds. Hearing threshold increases with increasing age duration of diabetes and also high level of HbA1c greater than 8%.

Radiotherapy-enhanced ototoxicity in elderly.

Introduction:Most head and neck cancers occur in elderly age and there is a natural occurrence of sensorineural hearing loss (SNHL) due to age also. Despite the ages and the physiological changes inherent to ageing, their auditory systems when exposed to aggressive agents caused the hearing loss to be greater as a consequence of the treatment received.Materials and Methods:Histopathologically proved 66 head and neck cancer patients were subjected to radiotherapy (RT) and 34 patients were subjected to concomitant chemoradiation (RT + CT) to study the occurrence of SNHL from 1st September 2010 to 31st August 2012.Result:It was found that the percentage of significant SNHL was more in patients >50 years after RT and RT + CT. It was also found that the results were significant.Conclusion:The occurrence of SNHL is more in elderly and the concern for the quality of life of patients undergoing cancer treatment is necessarily growing. Hence, the determination of hearing loss should be a part of investigations to enable better rehabilitation in elderly.

English

INTRODUCTION: Diabetes mellitus is a multifunctional metabolic disorder affecting almost all the systems of the body. There is a strong relation between diabetes mellitus and hearing. The three main theories of pathogenesis of hearing impairment in diabetics are micro angiopathy, .neuropathy and combination of both. Even though studies have proved the occurrence of sensorineural hearing loss (SNHL) in diabetes mellitus (DM), disagreement still exists among some about their relation. DESIGN: prospective design. AIM: Present study aimed 1) To find the prevalence of Sensorineural Hearing Loss in Type 2 Diabetes Mellitus 2) To study the association of hearing loss with the following factors among type 2 DM (a) Duration of Diabetes Mellitus (b) Severity of hyperglycemia. 3) To evaluate the result of our study and to compare our data with similarly published studies. METHOD: 75 individuals (150 ears) who have type 2 Diabetes Mellitus participated in the study. RESULTS: Prevalence of SNHL in type 2 DM was 80%. There was no association between SNHL and duration of DM but positive association was found between SNHL and severity of hyperglycemia. DISCUSSION: Globalization is rapidly transforming India from a developing to a developed country. People have become more health conscious and they expect to add more socially and economically productive years to their life span and hence this disorder which manifests mainly in middle age and older years of life require consideration. Hence this study is the need of the hour.

Magnetic Resonance Imaging in the Evaluation of Patients With Sensorineural Hearing Loss Caused by Meningitis

To determine the role of MRI in the evaluation of patients with sensorineural hearing loss (SNHL) caused by meningitis. Gadolinium-enhanced T1-weighted MRI (GdMRI) and 3D heavily weighted T2-weighted MRI (T2MRI) were associated with the occurrence of SNHL and the peroperative surgical findings during cochlear implantation, respectively. Retrospective cohort study. Tertiary referral otology and cochlear implant center. Seventeen patients who developed SNHL after bacterial meningitis were evaluated with MRI. Twenty-one cochlear implantations were performed in 11 patients with severe bilateral SNHL. Six patients developed unilateral SNHL and did not receive a CI. MRI scans were independently scored by 3 observers. Sensitivity, specificity, positive predictive value, negative predictive value, and interobserver reproducibility were calculated. Cochlea enhancement on GdMRI was present in 87% of the ears affected by SNHL. In patients with unilateral SNHL, a nonenhancing cochlea predicted the preservation of hearing on the ipsilateral side. In all cases with an incomplete electrode insertion (6/21), loss of cochlear patency was already seen on T2MRI. However, loss of fluid was also found in 29% of the cases in which full electrode insertion was achieved. MRI is crucial for decision making in patients with SNHL after meningitis. Diminished cochlear patency, as seen on T2MRI, is related to electrode insertion difficulty but does not always preclude full electrode insertion in cochlear implantation. Cochlear enhancement on GdMRI is associated with the occurrence of SNHL.

Sensorineural Hearing Loss in Patients with Chronic Suppurative Otitis Media

Even though there are other complications of chronic suppurative otitis media, the aspect of hearing loss is often studied. Nevertheless, the occurrence of sensorineural hearing loss in patients with this disease is still controversial. This study aim (1) to assess the association between sensorineural hearing loss and chronic suppurative otitis media, (2) to investigate some clinical factors that might affect the sensorineural component in patients with this disease. This was a retrospective analysis of the clinical records and pure tone audiograms of patients with chronic suppurative otitis media in a Nigerian Tertiary Health Institution from January 2003 to December 2008. Sixty-nine patients with a mean age of 28.93years; standard deviation of 18.593 were studied. They had an age range of 4-73years. The duration of otorrhea ranged from 2months to 20years; with a mean of 6.11years (standard deviation of 6.393). The mean bone conduction threshold in the diseased ear was 39.07dB (standard deviation of 12.028), and 10.26dB (standard deviation of 2.620) in the control ear (P<0.05). The mean bone conduction threshold differences between the diseased and control ears range from 21.69 to 34.52dB across the frequencies 0.5, 1.0, 2.0, and 4.0kHz. These differences tended to increase with increasing frequency and were all significant (P<0.05). In the diseased ears, there were no significant correlation between the age, duration of otorrhea, and the degree of SNHL (r=0.186, P>0.05; r=0.190, P>0.05 respectively). Patients with chronic suppurative otitis media had a significant degree of sensorineural hearing loss in this study. The higher frequencies were more affected; however, the patient's age and duration of otorrhea seem not to have any correlation with the degree of sensorineural hearing loss.

Hearing Loss in Children With Congenital Cytomegalovirus Infection in Relation to the Maternal Trimester in Which the Maternal Primary Infection Occurred

The purpose of this work was to study the relation between maternal trimester of primary infection with cytomegalovirus and the occurrence of sensorineural hearing loss in the congenitally infected offspring. Thirty-four consecutive live-born children diagnosed with a congenital cytomegalovirus infection after maternal primary cytomegalovirus infections were included in the study. Five were lost for follow-up, and 1 died. Of the remaining 28 congenitally infected children, an estimation of the maternal trimester in which cytomegalovirus primary infection occurred was performed. All of the children were investigated for potential sensorineural hearing loss. Five of the maternal infections occurred in the first trimester, 12 in the second trimester, and 11 in the third trimester of pregnancy. Sensorineural hearing loss was detected in 4 (80%) of the 5 congenitally infected children who were infected after a primary maternal infection in the first trimester of pregnancy and in 1 (8%) of the 12 children when the maternal infection occurred in the second trimester of pregnancy. No sensorineural hearing loss was detected after primary maternal infection occurring in the third trimester. Fluctuation and improvement of sensorineural hearing loss were seen regardless the trimester of pregnancy during which maternal primary infection occurred. Progression of sensorineural hearing loss occurred in 2 children born after a maternal primary infection of the first trimester. Hearing loss seemed more common in infants with congenital cytomegalovirus infection who were born to women who experienced a primary cytomegalovirus infection in the first trimester of pregnancy than when infection took place later in pregnancy.

Sensorineural hearing loss in patients with chronic otitis media

Chronic otitis media is generally associated with some degree of hearing loss, which is often the patient's chief complaint. This hearing loss is usually conductive, resulting from tympanic membrane rupture and/or changes in the ossicular chain due to fixation or erosion caused by the chronic inflammatory process. When cholesteatoma or granulation tissue is present in the middle ear cleft, the degree of ossicular destruction is even greater. An issue that has recently gained attention is additional sensorineural hearing loss due to chronic otitis media. While the conductive loss can be minimized through surgery, sensorineural hearing loss constitutes a permanent after effect, attenuated only through the use of a hearing aid. However, a few groups have reported a decrease in sensorineural function in these patients as well. This survey study performed at a referral center evaluates the occurrence of sensorineural hearing loss in ambulatory patients with this disease. We reviewed the files of patients with unilateral chronic otitis media. One hundred and fifty patients met the inclusion criteria: normal otoscopy and normal hearing in the contralateral ear. bone-conduction threshold averages were calculated for frequencies of 500, 1,000, 2,000, 3,000 and 4,000 Hz, with comparison between the normal ear and the ear with chronic otitis media. Thresholds were examined separately for each frequency. The bone-conduction threshold averages for the normal side were lower than those for the ear with chronic otitis media. The threshold shift was statistically significant for each frequency (P<0.0001, Student's t test). There were differences between the groups when analyzed for age (500 and 1,000 Hz) or the presence of cholesteatoma (1,000 Hz). This study shows that chronic otitis media is associated with a decrease in cochlear function.

Characteristics of hearing-impairment among patients in Ghana

The causes, and characteristics of hearing-impairment were determined prospectively among six thousand, four hundred and twenty-eight (6,428) patients who reported at the Komfo Anokye Teaching Hospital (KATH) with hearing problems. The purpose of the study was to determine the characteristics and some causes of hearing loss of patients who report for management at Komfo Anokye Teaching Hospital. The procedure adopted included a detailed case history, Otoscopy and Pure-tone Audiometry. Of the 6,428 patients, 5,734 (89.9 %) were diagnosed as having significant hearing loss. There were more hearing impaired women than men at all ages. Majority of the patients had mild hearing loss. The overall prevalence of Sensorineural Hearing Loss was more in worse ear than better ear. Again, the occurrence of Sensorineural Hearing Loss was more than other types of hearing loss. Noise, Fever, Presbycusis, Sickness, Meningitis and Meniere's diseases were the major causes of Sensorineural Hearing Loss. Conductive Hearing Loss was attributed in the main to Wax, Foreign Bodies, Otitis Media, and Traumas. These findings have important implications on the need of resources for rehabilitation.

Sensorineural hearing loss due to Toxoplasma gondii in children: a case–control study

Sensorineural hearing loss (SNHL) can follow congenital toxoplasmosis. Treatment in the first year of life is associated with diminished occurrence of this sequel. In various parts of Iran, the prevalence of antibodies to Toxoplasma gondii ranges from 24% to 57.7%. We evaluate the possible role of Toxoplasma gondii infection on the occurrence of SNHL in children. This case-control study was performed in a tertiary care center in Tehran between 2002 and 2003. This study was carried out based on diagnostic parameters of the American Academy of Otolaryngology criteria for SNHL and a healthy control group. We compared the specific Toxoplasma gondii antibodies (IgM & IgG) measured by ELISA in 95 blood samples of infants with SNHL and 63 healthy matched infants. Acute (IgM) and previous (IgG) immunity to Toxoplasma gondii was found in 12 and 21.2% of SNHL children, respectively. Most cases with previous infections (IgG positive) were children aged less than 1 year old (i.e. maternal immunity), but acute infection (IgM positive) was higher in 3-5 year old age group. Acute infection (IgM) was significantly more frequent in the SNHL group, and previous immunity was higher in the controls (CI 95%, P-value = 0.01; 0.01). With respect to seropositive children, as we were unable to differentiate congenital from acquired cases, we recommend prevention of congenital toxoplasmosis by treatment of Toxoplasma infection in pregnant women and treatment of acquired Toxoplasma gondii infection after birth to minimise the risk of SNHL in children.