Risk Of Sensorineural Hearing Loss Research Articles

Sensorineural Hearing Loss Associated with Neomycin Eardrops and Nonintact Tympanic Membranes

Use of neomycin eardrops in nonintact tympanic membranes (NITMs) due to tympanic membrane (TM) perforation or tympanostomy tubes (TTs) is controversial because of the potential for ototoxicity. We sought to compare the risk of sensorineural hearing loss (SNHL) in patients with NITMs who received neomycin with those who received fluoroquinolone eardrops. Retrospective cohort study. Administrative claims data analysis, including diagnoses and procedure detail for physician office and hospital visits and pharmacy dispensing events in children eligible for Medicaid fee-for-service benefits in 29 states between 1999 and 2006. Eligible patients (age <18 years) had to have received a study eardrop within 12 months after first diagnosis of NITM. The follow-up period started from the first eardrop dispensing. We compared the 12-month risk of SNHL using Cox proportional hazards regression models adjusted for SNHL risk factors. We found 982 SNHL cases in 134,598 children treated with neomycin or fluoroquinolone eardrops. The adjusted hazard ratio (HR) for 1, 2, and 3 or more prescriptions of neomycin was 0.90 (95% confidence interval [CI], 0.76-1.07), 1.45 (1.05-2.01), and 1.30 (0.71-2.36), respectively, when adjusted for SNHL risk factors, the interval between initial diagnosis of NITM and eardrop initiation, and total number of eardrop prescriptions. The results remained unchanged for several sensitivity analyses. Short-term use of neomycin eardrops in patients with NITMs is not associated with an increased risk of SNHL; however, repeated doses (ie, ≥ 2 prescriptions) showed a significant association with an increased risk of SNHL.

The Use of KTP Laser in Revision Stapedectomy

Revision stapes operations have lower success rates than primary surgeries. Success rates have increased since the introduction of the laser. Visible (KTP, argon) and infrared (CO2) spectrum lasers have been used in stapes surgery. A concern has been raised regarding the use of visible lasers in revision stapedectomy because of their properties of tissue penetrance. The objective of our study is to evaluate a series of patients who underwent revision stapedectomy with the use of KTP laser to determine whether there is an increased risk of sensorineural hearing loss associated with the use of this laser. Patients with otosclerosis requiring revision stapedectomy. Revision stapedectomy or stapedotomy were performed using the KTP laser. The primary outcome evaluated was the incidence of postoperative sensorineural hearing loss. Improvement in air-bone gap was evaluated as a secondary outcome. There were no cases of postoperative sensorineural hearing loss or deafness. Approximately 56.5% of patients achieved closure of the postoperative ABG to within 10 dB; 91.3% of patients achieved a postoperative ABG within 20 dB. The KTP laser was used most commonly to lyse fibrous adhesions. Although there is a theoretical risk of penetrance of the KTP laser through the oval window and underlying perilymph with resultant damage to the sense organ-containing endolymph, this theoretical risk did not translate into an increased rate of sensorineural hearing loss in our series. The KTP laser allowed for less traumatic clearing of middle ear adhesions and good hearing results.

Sensorineural Hearing Loss with Neomycin Ear Drops

Objective: Neomycin ear drops are contraindicated with non-intact TMs (NITM), either perforation (TMP) or tube (TT) because of the risk of ototoxicity. The aim of this study was to evaluate the comparative risk of sensorineural hearing loss (SNHL) with neomycin and quinolone ear drops and NITMs. Method: Pediatric Medicaid beneficiaries from 29 states, 1999-2006, were studied if they received a study drug within 12 months of TMP or TT, and were continuously enrolled ≥6 months before and 12 months after first dispensing. We compared the 12-month risk of SNHL using Cox regression adjusted for SNHL risk factors. Results: We found 1935 SNHL cases in 139,906 children treated with neomycin or quinolone eardrops (1-year incidence = 1.38). Within those with neomycin, 76.3% received 1 dose and 17.4% received 2. The adjusted hazard ratio (HR) for 1, 2, and ≥3 prescriptions of neomycin was 0.99 (95% CI 0.89-1.12), 1.32 (1.05-1.67), and 1.34 (0.89-2.01), respectively, when adjusted for SNHL risk factors and total number of otic antimicrobial prescriptions. Conclusion: Short-term use of neomycin ear drops in patients with NITMs does not appear to carry a significant risk of SNHL. Repeated doses of topical neomycin are associated with an increased SNHL risk.

Hubungan jenis bakteri aerob dengan risiko tuli sensorineural penderita otitis media supuratif kronis

Background: Sensorineural hearing loss (SNHL) as sequelae of chronic supurative otitis media(CSOM) is still debatable. Previous researches had shown the role of bacterial toxin upon the roundwindow membrane which could induce SNHL. Purpose: To find the relationship between the kind ofaerobic bacteria with the risk of SNHL in CSOM patients. Method: This study used cross sectional 2005 toDecember 31design and involved 45 CSOM patients with SNHL in Dr. Saiful Anwar hospital from January 1, 2010. The specimen for microbacterial cultures and sensitivity tests were taken from themastoid antrum during mastoidectomy. Statistical analysis employed Spearman correlation test, t-test,and Mann Whitney. Result: The mean values of bone conduction threshold (BCT) in all of CSOM cases,especially in dangerous type CSOM patients, with bacteria culture showed Staphylococcus aureus werehigher than others bacteria (p&lt;0.05). Conclusion: There was significant relationship between the kindof aerobic bacteria with the BCT averages in CSOM patients, especially dangerous type CSOM patients.s Keywords: CSOM, SNHL, aerobic bacteria, toxin, bone conduction threshold Abstrak : Latar belakang: Tuli sensorineural yang disebabkan oleh otitis media supuratif kronis (OMSK)mekanismenya belum diketahui secara pasti. Beberapa penelitian telah menunjukkan peran toksin bakterimerusak telinga dalam, sehingga menyebabkan tuli sensorineural. Tujuan: Mengetahui hubungan antarajenis bakteri aerob dengan risiko tuli sensorineural penderita OMSK. Metode: Penelitian ini menggunakandesain cross sectional dengan melibatkan 45 penderita OMSK yang disertai tuli sensorineural di RSUDDr. Saiful Anwar Malang, pada periode 1 Januari 2005-31 Desember 2010. Kultur bakteri diambil dariswab antrum mastoid saat operasi mastoidektomi. Analisis statistik yang digunakan adalah uji Spearman,uji t dan Mann Whitney. Hasil: Rerata ambang hantaran tulang cenderung lebih tinggipadapenderitadengan hasil kultur Staphylococcus aureus dibanding jenis bakteri lainnya. Hal ini berlaku pada penderitaOMSK keseluruhan dan OMSK tipe maligna saja (p&gt;0,05). Kesimpulan: Terdapat hubungan bermaknaantara jenis bakteri aerob dengan rerata ambang hantaran tulang penderita OMSK, khususnya OMSKtipe maligna. Kata kunci: OMSK, tuli sensorineural, bakteri aerob, toksin, ambang hantaran tulang

Is lenticulostriated vasculopathy a sign of central nervous system insult in infants with congenital CMV infection?

BackgroundIn previous studies, lenticulostriated vasculopathy (LSV) was detected in 0.4–5.8% of neonates who had undergone brain ultrasound studies during the neonatal period. Most infants were referred from neonatal intensive care...

Review of cytomegalovirus shedding in bodily fluids and relevance to congenital cytomegalovirus infection

Congenital cytomegalovirus (CMV) infections are a leading cause of sensorineural hearing loss (SNHL) and neurological impairment. Congenital transmission of CMV can occur with maternal primary infection, reactivation, or reinfection during pregnancy. We reviewed studies of CMV shedding in bodily fluids (defined as CMV detected by culture or CMV DNA detected by polymerase chain reaction). Following diagnosis at birth, children with congenital CMV infection exhibited the highest prevalences of CMV shedding (median = 80%, number of sample population prevalences [N] = 6) and duration of shedding, with a steep decline by age five. Healthy children attending day care shed more frequently (median = 23%, N = 24) than healthy children not attending day care (median = 12%, N = 11). Peak shedding prevalences in children occurred at 1-2 years of age, confirming that young children are the key transmission risk for pregnant women. CMV shedding among children was more prevalent in urine specimens than in oral secretions (median prevalence difference = 11.5%, N = 12). Adults with risk factors such as STD clinic attendance had higher shedding prevalences (median = 22%, N = 20) than adults without risk factors (median = 7%, N = 44). In adults with risk factors, CMV was shed more frequently in urine; in adults without risk factors genital shedding was most common. The prevalence of CMV shedding in nine sample populations of pregnant women increased with advancing gestation. In seven sample populations of children with congenital CMV infection, higher viral load at birth was consistently associated with an elevated risk of SNHL. Higher CMV viral load at birth also consistently correlated with the presence of symptoms of congenital CMV at birth. Published 2011. This article is a US Government work and is in the public domain in the USA.

C089 Neonatal cytomegalovirus blood load and risk of sensorineural hearing loss in asymptomatic congenitally infected newborns

C089 Neonatal cytomegalovirus blood load and risk of sensorineural hearing loss in asymptomatic congenitally infected newborns

Altered expression of middle and inner ear cytokines in mouse otitis media

The inner ear is at risk for sensorineural hearing loss in both acute and chronic otitis media (OM), but the mechanisms underlying sensorineural hearing loss are unknown. Previous gene expression array studies have shown that cytokine genes might be upregulated in the cochleas of mice with acute and chronic OM. This finding implies that the inner ear could manifest a direct inflammatory response to OM that may cause sensorineural damage. Therefore, to better understand inner ear cytokine gene expression during OM, quantitative real-time polymerase chain reaction and immunohistochemistry were used in mouse models to evaluate middle and inner ear inflammatory and remodeling cytokines. Basic science experiment. An acute OM model was created in Balb/c mice by a transtympanic injection of Streptococcus pneumoniae in one ear; the other ear was used as a control. C3H/HeJ mice were screened for unilateral chronic OM, with the noninfected ear serving as a control. Both acute and chronic OM caused both the middle ear and inner tissues in these two mouse models to overexpress numerous cytokine genes related to tissue remodeling (tumor necrosis factor-α, bone morphogenetic proteins, fibroblast growth factors) and angiogenesis (vascular endothelial growth factor), as well as inflammatory cell proliferation (interleukin [IL]-1α,β, IL-2, IL-6). Immunohistochemistry confirmed that both the middle ear and inner ear tissues expressed these cytokines. Cochlear tissues are capable of expressing cytokine mRNA that contributes to the inflammation and remodeling that occur in association with middle ear disease. This provides a potential molecular basis for the transient and permanent sensorineural hearing loss often reported with acute and chronic OM.

Perinatal profile of very low birthweight infants under a universal newborn hearing screening programme in a developing country: A case-control study

Objective: To determine the perinatal profile and developmental risks of very low birth weight (VLBW) infants (≤1500 g) under a universal hearing screening programme in a resource-poor country.Methods: A case-control study of VLBW survivors matched by date of birth and sex with normal birth weight (≥2500 g) infants delivered in an inner-city maternity hospital in Lagos, Nigeria. Hearing status was determined by two-stage screening with transient evoked otoacoustic emissions (TEOAE) followed by automated auditory brainstem response (AABR). Maternal and infant factors associated with VLBW were determined using unconditional and conditional multivariable logistic regression analyses.Results: All 45 VLBW singletons (mean weight 1.3 ± 0.1 kg) during the study period were matched with 225 controls (mean weight 3.4 ± 0.5 kg). VLBW was associated with maternal occupation, lack of antenatal care, low 5-minute Apgar score and hyperbilirubinemia based on unmatched and matched analyses. Additionally, VLBW infants were significantly associated with failed or incomplete hearing screening outcomes. Four (10.5%) of the 38 infants tested with AABR failed, but none returned for diagnostic evaluation and one child had previously passed TEOAE.Conclusions: VLBW infants in resource-poor settings are associated with the risk of sensorineural hearing loss and other perinatal outcomes that may potentially compromise their optimal development in early childhood.

Reliability of High-Resolution CT Scan in Diagnosis of Otosclerosis

To assess the reliability of high-resolution computed tomographic scan (HRCT scan) for the diagnosis of otosclerosis and to determine its usefulness to predict hearing deterioration and surgical difficulties. Prospective study. Tertiary reference center. Two hundred nine ears (200 patients) presenting progressive conductive hearing loss with normal tympanic membrane, abnormal stapedial reflex, and scheduled for stapes surgery. The mean age was 47.3 years. All patients underwent HRCT scan before surgery (slice thickness of 0.6 to 1 mm). Stapedotomy was performed in 99% of cases. High-resolution computed tomographic scan results were categorized as positive, doubtful, or negative. We classified a CT scan as positive for otosclerosis when a hypodense focus was seen around the otic capsule. Preoperative and postoperative air- and bone-conduction thresholds were collected. Of 209 HRCT scans, 84.2% were classified positive, 8.6% doubtful, and 7.2% negative. In all patients with positive CT scan, otosclerosis was confirmed in surgery. Among 15 negative cases, we found 4 minor malformations and 1 fracture of the stapes. Footplate incidents (mobilized, floating, or fractured footplate; 5.3%) occurred significantly more frequently when an HRCT scan was negative or doubtful (p = 0.05). Mean preoperative air-bone gap was 27.7 dB (standard deviation, 10). Mean postoperative air-bone gap was within 10 dB in 65% and within 20 dB in 92% of cases. Greater than 10 dB deterioration of bone-conduction thresholds occurred in 2% of cases. Mean preoperative and postoperative bone-conduction thresholds were significantly lower in cases of round window obliteration, pericochlear, or internal auditory canal hypodensities (p < 0.005 and p < 0.0001, respectively). In our series, the sensitivity of HRCT scan to otosclerosis was 95.1%. Hypodense otosclerotic foci were mostly localized at the anterior part of footplate. Negative or doubtful cases were associated with the highest incidence of stapes footplate complications. Foci involving otic capsule, internal auditory canal, or round window led to a significantly higher risk of sensorineural hearing loss.

Maternal and neonatal factors associated with mode of delivery under a universal newborn hearing screening programme in Lagos, Nigeria

BackgroundEmerging evidence from a recent pilot universal newborn hearing screening (UNHS) programme suggests that the burden of obstetric complications associated with mode of delivery is not limited to maternal and perinatal mortality but may also include outcomes that undermine optimal early childhood development of the surviving newborns. However, the potential pathways for this association have not been reported particularly in the context of a resource-poor setting. This study therefore set out to establish the pattern of delivery and the associated neonatal outcomes under a UNHS programme.MethodsA cross-sectional study in which all consenting mothers who delivered in an inner-city tertiary maternity hospital in Lagos, Nigeria from May 2005 to December 2007 were enrolled during the UNHS programme. Socio-demographic, obstetric and neonatal factors independently associated with vaginal, elective and emergency caesarean deliveries were determined using multinomial logistic regression analyses.ResultsOf the 4615 mothers enrolled, 2584 (56.0%) deliveries were vaginal, 1590 (34.4%) emergency caesarean and 441 (9.6%) elective caesarean section. Maternal age, parity, social class and all obstetric factors including lack of antenatal care, maternal HIV and multiple gestations were associated with increased risk of emergency caesarean delivery compared with vaginal delivery. Only parity, lack of antenatal care and prolonged/obstructed labour were associated with increased risk of emergency compared with elective caesarean delivery. Infants delivered by vaginal method or by emergency caesarean section were more likely to be associated with the risk of sensorineural hearing loss but less likely to be associated with hyperbilirubinaemia compared with infants delivered by elective caesarean section. Emergency caesarean delivery was also associated with male gender, low five-minute Apgar scores and admission into special care baby unit compared with vaginal or elective caesarean delivery.ConclusionsThe vast majority of caesarean delivery in this population occur as emergencies and are associated with socio-demographic factors as well as several obstetric complications. Mode of delivery is also associated with the risk of sensorineural hearing loss and other adverse birth outcomes that lie on the causal pathways for potential developmental deficits.

Adverse neonatal outcomes associated with trial of labor after previous cesarean delivery in an inner-city hospital in Lagos, Nigeria

Objective To identify delivery methods and associated adverse neonatal outcomes after previous cesarean delivery. Methods A retrospective cross-sectional study in an inner-city maternity hospital in Lagos, Nigeria, in which outcomes associated with delivery methods were determined by multinomial logistic regression. Results Of 435 eligible singleton deliveries, 171 (39.3%) occurred via elective cesarean, 249 (57.2%) via emergency cesarean, and 15 (3.4%) after successful trial of labor. Emergency cesarean delivery was associated with low 1-minute Apgar scores compared with successful trial of labor. It was also associated with low 5-minute Apgar scores compared with elective cesarean delivery, in addition to hyperbilirubinemia and admission to the special care baby unit. Successful trial of labor was less likely to be associated with low 1-minute Apgar scores than was elective cesarean delivery. The delivery methods were not associated with risk of sensorineural hearing loss. Conclusion Trial of labor is common in this tertiary hospital among women with previous cesarean delivery and is associated with high failure rates and adverse neonatal outcomes with potential developmental risks.

Infants with HIV‐infected mothers in a universal newborn hearing screening programme in Lagos, Nigeria

To establish the characteristics of infants with human immunodeficiency virus (HIV)-infected mothers enrolled under a two-stage universal newborn hearing screening programme in Lagos, Nigeria. A matched case-control study from May 2005 to December 2007 in which factors associated with maternal HIV status were determined by conditional multivariable logistic regression analysis. Some 266 newborns had HIV-infected mothers and were matched with 1330 controls by age and sex. Factors independently associated with increased risk of maternal HIV status were ethnicity, religion, housing sanitation facilities and prematurity while prior or current caesarean section, admission into special care unit and hyperbilirubinaemia were associated with lower risk of maternal HIV. Maternal HIV status was not significantly associated (p = 0.082) with the risk of sensorineural hearing loss although newborns with HIV-infected mothers had more than two-fold risk (p = 0.030) of not completing the hearing tests compared with controls. HIV-infected mothers are likely to live in poor housing conditions but their newborns are not at an increased risk of sensorineural hearing loss in this setting barring the potential effect of significantly increased drop-out rate in this group.

Diffusion tensor imaging of the inferior colliculus and brainstem auditory-evoked potentials in preterm infants

Preterm and low-birth-weight infants have an increased risk of sensorineural hearing loss. Brainstem auditory-evoked potentials (BAEP) are an effective method to detect subtle deficits in impulse conduction in the auditory pathway. Abnormalities on diffusion tensor imaging (DTI) have been shown to be associated with perinatal white-matter injury and reduced fractional anisotropy (FA) has been reported in patients with sensorineural hearing loss. To evaluate the possibility of a correlation between BAEP and DTI of the inferior colliculus in preterm infants. DTI at term age and BAEP measurements were performed on all very-low-birth-weight or very preterm study infants (n=56). FA and apparent diffusion coefficient (ADC) of the inferior colliculus were measured from the DTI. Shorter BAEP wave I, III, and V latencies and I-III and I-V intervals and higher wave V amplitude correlated with higher FA of the inferior colliculus. The association between the DTI findings of the inferior colliculus and BAEP responses suggests that DTI can be used to assess the integrity of the auditory pathway in preterm infants.

Follow‐up of 5‐ to 11‐year‐old children treated for persistent pulmonary hypertension of the newborn

Determine the prevalence of sensorineural hearing loss (SNHL) and relate this to cumulative exposure to hypoxia, hypocapnia and hypotension. Describe chronic health problems among 5- to 11-year-old children treated for persistent pulmonary hypertension of the newborn (PPHN). The index group consisted of 85 children and a reference group was matched for age, sex and municipality of current residence. Questionnaires were sent to the families. The families in the index group were asked to participate in an examination of their child's hearing. Seven children (11%) had SNHL. SNHL was not associated with hypoxia, hypocapnia or hypotension during treatment for PPHN. In the index group chronic health problems were reported in 42% compared with 17% in the reference group (chi-square test, p = 0.001). Twenty-one percent in the index group were treated with bronchodilator therapy compared with 8% in the reference group (chi-square test, p = 0.028). In the index group five children had cerebral palsy and two had developmental delay. Nineteen percent in the index group and 5% in the reference group had remedial education (chi-square test, p = 0.008). Children treated for PPHN are at high risk for SNHL. Exposure to hypoxia, hypocapnia or hypotension did not predict SNHL. The incidence of chronic health problems and use of remedial education was high.

Are risk factors for stillbirths in low-income countries associated with sensorineural hearing loss in survivors?

Objectives. To determine associated risk factors for stillbirths in Lagos, Nigeria and to examine possible relationships between these factors and the risk of sensorineural hearing loss (SNHL).Methods. Stillbirths in an inner-city maternity hospital from June 2005 to May 2007 were matched with live-birth controls at ratio 1:2. Risk factors and their associated adjusted odds ratio (OR) at 95% confidence interval (CI) were first determined by multiple logistic regression and then correlated with hearing screening failure among survivors who received a two-stage hearing screening with automated otoacoustic emissions and auditory brainstem response.Results. Of 201 cases examined and matched with 402 live births, 101 (50.2%) were fresh stillbirths and 100 (49.8%) macerated. Multiparity (OR: 1.92; CI: 1.16–3.20), lack of antenatal care (OR: 7.23; CI: 3.94–13.26), hypertensive conditions (OR: 6.48; CI: 2.94–14.29), antepartum haemorrhage (OR:18.84; CI: 6.96–51.00), premature rupture of membrane (OR:3.36; CI: 1.40–8.05), prolonged obstructed labour (OR: 22.25; CI: 10.07–49.16) and prematurity (OR: 2.30; CI: 1.2–4.01) were associated with increased risk of stillbirths whereas caesarean section (OR: 0.24; CI: 0.12–0.48) was associated with lower risk of stillbirths. Infants delivered by mothers with hypertensive conditions during pregnancy were at risk of SNHL (OR: 2.97; CI: 1.15–7.64).Conclusion. Hypertensive conditions during pregnancy increase the risk of stillbirths and place survivors at greater risk of SNHL.

Newborns at risk of sensorineural hearing loss in low-income countries

Objective:To identify factors placing newborns at risk of sensorineural hearing loss (SNHL) in hospital settings and evaluate their usefulness for targeted screening where resources for universal newborn hearing screening are...

Risk Factors Associated with Sensorineural Hearing Loss in Infants at the Neonatal Intensive Care Unit: 15-Year Experience at the National Institute of Perinatology (Mexico City)

Infants from neonatal intensive care units (NICU) are at high risk for sensorineural hearing loss (SNHL); however, risk factors may change from NICU to NICU and from country to country. Our objective was to describe the main causes associated with SNHL in infants from a tertiary level NICU in Mexico City and to show the associated audiometric profiles. We performed a comparison of follow-up of infants from NICU with SNHL and a control group with the same history but with normal hearing. Infants were examined at birth by brainstem auditory evoked potentials (BAEP) and followed by audiometric tests. Hearing loss was associated with clinical variables. SNHL group had 146 children and the control group had 272 children. Mean weight at birth in the SNHL group was 1530+/-581 g and in the control group, 1723+/-805 g (p<0.01). Days spent at the NICU and under mechanical ventilation were higher in the SNHL group (p<0.001). In addition, serum bilirubin levels were higher in the SNHL group than in the control group (p<0.001). Blood exchange, intraventricular hemorrhage, and neonatal meningitis comprised the main SNHL-associated variables. Use of prenatal steroids and pulmonary surfactant demonstrates protection against SNHL. Audiometric profiles disclosed mainly severe SNHL. Low birth weight, longer stay in NICU and under mechanical ventilation, higher serum bilirubin levels, prevalence of blood exchange, intraventricular hemorrhage, and meningitis in high-risk newborns were the main risk factors associated with SNHL and merit hearing screening and early intervention in high-risk infants.

Relative Contributions of Radiation and Cisplatin-Based Chemotherapy to Sensorineural Hearing Loss in Head-and-Neck Cancer Patients

To investigate the risk of sensorineural hearing loss (SNHL) in patients with head-and-neck cancer and treated with radiation therapy (RT) or concomitant cisplatin-based chemoradiation, the relationship among SNHL and radiation dose to the cochlea, the use of two common cisplatin dose regimens. A total of 62 head-and-neck cancer patients treated with curative intent were included in this prospective study. Of the patients, 21 received RT alone, 27 received 40 mg/m(2) weekly cisplatin, 13 received 100 mg/m(2) every 3 weeks during RT, and 1 received RT with weekly epidermal growth factor receptor inhibitor antibody. The effect of chemotherapy and RT dose on hearing was determined using a model that accounted for the age and variability between each ear for each patient. We constructed a model to predict dose-dependent hearing loss for RT or cisplatin-based chemotherapy either alone or in combination. For patients only receiving RT, no significant hearing loss was found at doses to the cochlea of less than 40 Gy. Patients receiving 100 mg/m(2) or 40 mg/m(2) of cisplatin chemotherapy had an estimated +21.5 dB and +9.5 dB hearing loss at 8,000 Hz with low radiation doses (10 Gy), which rose to +38.4 dB and +18.9 dB for high radiation doses (40 Gy). Use of RT alone with doses of less than 40 Gy did not result in clinically significant hearing loss. High-frequency SNHL was profoundly damaged in patients who received concomitant cisplatin when doses of 100 mg/m(2) were used. The threshold cochlear dose for hearing loss with cisplatin-based chemotherapy and RT was predicted to be 10 Gy. The inner ear radiation dose constraints and cisplatin dose intensity should be considered in the treatment of advanced head-and-neck cancer.

Hearing Loss and Diabetes: You Might Not Know What You're Missing

In this issue, Bainbridge and colleagues report that people with diabetes in the National Health and Nutrition Examination Survey had increased risk for hearing loss compared with nondiabetic perso...