A Prospective Study of the Effect of Tinnitus Sound Matching Degree on the Efficacy of Customized Sound Therapy in Patients with Chronic Tinnitus.

OBJECTIVES: The aim of this study was to explore and compare the customized sound therapy effect between tinnitus sound matching and nonmatching patients in tinnitus customized sound therapy and therapy-related influencing factors. METHODS: This prospective study investigated a total of 100 patients with unilateral chronic tinnitus who received customized sound therapy. The participants were dichotomously divided into matching (group A) and nonmatching (group B) groups after 4 stages of tinnitus matching via the tinnitus assistant app (provided by Sound Ocean Company, SuZhou, China). Each group consists of 50 participants. Before and 6 months after the treatment, Hospital Anxiety and Depression Scale (HADS), tinnitus handicap inventory (THI), and tinnitus loudness Visual Analog Scale (VAS) were used to evaluate the customized sound therapy effect and explore other related influencing factors. RESULTS: (1) The HADS-A, HADS-D, THI, and VAS scores of 2 groups were both significantly decreased after treatment. (2) The HADS-A and THI scores improved markedly in group A than that in group B, which could be related to the hearing loss of the tinnitus side ear before treatment; the lighter the degree of hearing loss, the better the improvement. No statistically significant differences were detected in HADS-D and VAS scores between the 2 groups, and also, these were not related to the degree of hearing loss. The differences in age, gender, and tinnitus duration did not show any statistically significant effect on the improvement of the 2 groups. CONCLUSIONS: Both tinnitus sound matching and nonmatching of the customized sound therapy brought a significant effect to tinnitus participants. Our study also suggests that THI and HADS-A scores of those with tinnitus matching participants improved markedly as compared to those of nonmatching participants, and the customized sound therapy effect is negatively correlated with the severity of hearing loss.

Effect of hypoglycemic anti-deafness capsules in diabetic patients with deafness and toxicological assessment in rats.

OBJECTIVE: Through experiment on animals and clinical trials to explore the safety and efficacy of hypoglycemic anti-deafness capsules on diabetic patients with deafness. METHODS: Total 296 patients with non-insulin dependent diabetes mellitus (NIDDM) were randomly divided into two groups. A treatment group of 164 patients (208 ears) was treated with hypoglycemic anti-deafness capsules based on TCM syndrome differentiation. A control group of 132 patients (184 ears) was treated with glibenclamide and conventional drug treatment for deafness. The following were observed: hearing, fasting plasma glucose (FPG), 2 h postprandial plasma glucose (2hPG), 24 h urine glucose (24hUG), improvement of main symptoms, platelet function, and changes in superoxide dismutase (SOD) and lipid peroxide (LPO) levels. In animal studies, Kunming mice, weighing 18-22 g were used. Half of the mice were males and half were females. Wistar rats, weighing 80-120 g were used. Half of the rats were males and half were females. Male Wistar rats, weighing 200-220 g, were also used. Their acute and chronic toxicity was studied. RESULTS: The hearing improvement was 56.7% in the treatment group and 26.6% in the control group. FPG, 2hPG, and 24hUG were improved significantly (P < 0.05, P < 0.01, P < 0.01, respectively) in the treatment group and 2hPG and 24hUG improved significantly in the control group (P < 0.05, P < 0.05). The improvement in 2hPG and 24hUG in the treatment group was significantly greater than that in the control group P < 0.01).There was no significant difference in FPG between the two groups (P < 0.05). Main symptoms in the treatment group were significantly more improved than those in the control group (P < 0.05, P < 0.01). In the treatment group, platelet adhesion and aggregation, SOD, and LPO were all significantly improved from before treatment (P < 0.05, P < 0.01). However, in the control group, except LOP (P < 0.05), there were no significant differences from before treatment to after (P < 0.05). In animal studies, no obvious acute or long-term toxicity was observed from capsule administration. CONCLUSION: Through experiment on animals and clinical trials, we can found that hypoglycemic anti-deafness capsules could decrease blood glucose and serum triglycerides of alloxan-induced diabetic rats. This herbal capsule is effective for safely treating diabetic patients with deafness.

Minimizing the dead ear in otosclerosis surgery.

OBJECTIVE: Assessment of a specific surgical technique regarding the postoperative hearing results and the incidence of "dead ear" comparing local and general anesthesia. METHODS: We present a retrospective review of all stapedectomies performed by the same surgeon under general and local anesthesia during a 9-year period (1997-2006) in non-revision cases. The analysis of our data (268 operations, 160 under general and 108 under local anesthesia) included hearing results based on the guidelines from the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery and complications recorded in the case notes. Excessive vertigo during stapedectomy under local anesthesia considered as a sign of possible profound sensorineural hearing loss. RESULTS: A postoperative air-bone gap up to 10dB (Grade A) was successfully obtained in 92.6% of operated ears. The mean postoperative air-bone gap in decibels was 6.8dB. There were no statistically significant differences between general and local anesthesia in hearing results. Excessive intraoperative dizziness occurred in five patients of local anesthesia group without postoperative sensorineural hearing loss. The incidence of dead ear was 1.8 % (three patients) under general and 0% under local anesthesia. CONCLUSION: Stapedectomy is a safe procedure in hands of an experienced otologist with minimum major complications especially when performed under local anesthesia. Local anesthesia offers the immediate evaluation of hearing restoration and the early recognition of possible dead ear. Training programs should consider stapedectomy under local anesthesia as a standard procedure for trainees in non-revision cases.

[Observation on acupuncture at "Neitinggong" for antagonisting ototoxicity caused by gentamicin].

OBJECTIVE: To explore the effect of acupuncture at "Neitinggong" drug-induced deafness. METHODS: Guinea pig deafness model was prepared by injection of gentamicin (GM). Acupuncture was respectively given at the points "Neitinggong" "Tinggong" (SI 19) and non-acupoints on the auricle in the experimental animals in different groups and the effects of different points on the auditory brainstem response and cochlear hair cells were observed. RESULTS: There was a significant difference between GM group and Neitinggong group, and between GM group and Tinggong group. There was no significant difference between GM group and the auricle group, and between Neitinggong group and Tinggong group. CONCLUSION: Acupuncture at "Neitinggong" can strength the function of the internal ear, and relieve the injury of cochlear hair cells caused by gentamicin, which is an effective acupoint for treatment of drug-induced deafness.

[Evoked otoacoustic emissions using clicks in detection of deafness in young children]. / Les oto-émissions acoustiques provoquées (OEAP) par des transitoires dans le dépistage de la surdité du jeune enfant.

Click-evoked otoacoustic emissions (EOAEs) are sounds emitted by the cochlea due to active outer hair cell contraction following stimulation of the stereocilia. The purpose of this study was to evaluate the use of testing for EOAEs as a valid auditory screening method in newborns, and 1074 healthy fullterm babies (2148 ears) with an Apgar score higher than 8 at birth were examined. EOAEs were elicited 4 days after birth and a correlation index higher than 70% represented normal response criteria. If there was no response, EOAEs and brainstem response potentials were tested at the age of one month. On the fourth day after birth. EOAEs specificity and efficiency were found to be 92.3% and 92.4% respectively, while sensitivity was 100%. Specificity and efficiency at one month were rated at 100%. The use of EOAEs offers numerous advantages over traditional auditory screening methods, thus suggesting that this technique is suitable for the mass-screening of infants.

[Effects of poria cocos on ototoxicity induced by kanamycin in guinea-pigs].

In order to prevent the ototoxicity of kanamycin (KM), the effects of Poria Cocos (PC) on the ototoxicity induced by KM in guinea-pigs was observed by infusing the PC decoction into the guinea-pigs with comparing the difference in the general intoxicating symptom, prayer's reflex (PR) threshold, brainstem auditory evoked potentials (BAEPs) and the absence rate of outer hair cells in the first turn of cochlea. The results suggested that the ototoxicity of KM was retarded by giving the PC decoction. On 7th day after given KM, PR threshold of 4,6,8 kHz in the medicated group and control group were 4.7 +/- 1.5 dB, 5.7 +/- 2.4 dB, 2.7 +/- 1.2 dB and 10.5 +/- 3.2 dB, 12.1 +/- 3.7 dB, 8.5 +/- 2.7 dB respectively. BAEPs threshold on 13th day given KM raised 22.7 +/- 9.7 dB in the medicated group and 51.3 +/- 14.4 dB in control group. The absence rate of outer hair cells in first turn of cochlea were 39.4% and 67.4% respectively. The results suggested that PC might be antagonistic to the ototoxicity of KM in guinea-pigs.

[The use of 6-flavor Rehmannia decoction with additives in the prevention of ototoxic deafness induced by gentamicin in guinea pigs].

The purpose of this study is to discuss the effects of the Chinese medicine six-flavor Rehmannia Decoction with additives on preventing deafness induced by gentamicin (GM) in guinea pig by means of testing the thresholds of Preyer's reflex (PR) cochlear microphonic potential (CM), action potential of the auditory nerve (N1) and scanning electron microscope of inner ear (SEM). The results showed that the medicine is effective in reducing the ototoxic effect of GM on inner ear.

Identification of impaired hearing in early childhood.

Although the incidence of congenital deafness is high, routine neonatal screening for this problem is not practised, and early identification of congenital or early acquired deafness is relatively rare. Delaying therapy until a child is 3 or more years old severely limits speech development, language acquisition and learning. The commonest causes of delay in diagnosis are the refusal of physicians to listen to the parents' observations, their failure to screen children for hearing and speech problems, and their reluctance to arrange prompt referral for audiologic assessment. Diagnostic delay occurs even though half the children who have impaired hearing are known to be at increased risk. A plea is made for the setting up of a register of infants known to be at risk for impaired hearing. First-contact physicians should be alert to the possibility of hearing problems, particularly in children at high risk. Screening methods for use by nonspecialist practitioners are outlined.

Early detection of deafness in young children.

It is generally accepted that early detection and intervention for children with hearing defects, either congenital or acquired, is both necessary and advantageous. Detection before the end of the first year of life seems to improve speech acquisition, lessen the likelihood of behaviour problems and decrease the cost of education. The methods for early detection are discussed and a procedure is recommended.