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3.
J Laryngol Otol ; 134(5): 419-423, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32425141

RESUMO

OBJECTIVE: To assess the Framingham risk score as a prognostic tool for idiopathic sudden sensorineural hearing loss patients. METHODS: Medical records were reviewed for unilateral idiopathic sudden sensorineural hearing loss patients between January 2010 and October 2017. The 10-year risk of developing cardiovascular disease was calculated. Patients were subdivided into groups: group 1 - Framingham risk score of less than 10 per cent (n = 28); group 2 - score of 10 to less than 20 per cent (n = 6); and group 3 - score of 20 per cent or higher (n = 5). RESULTS: Initial pure tone average and Framingham risk score were not significantly associated (p = 0.32). Thirteen patients in group 1 recovered completely (46.4 per cent), but none in groups 2 and 3 showed complete recovery. Initial pure tone average and Framingham risk score were significantly associated in multivariable linear regression analysis (R2 = 0.36). The regression coefficient was 0.33 (p = 0.003) for initial pure tone average and -0.67 (p = 0.005) for Framingham risk score. CONCLUSION: Framingham risk score may be useful in predicting outcomes for idiopathic sudden sensorineural hearing loss patients, as those with a higher score showed poorer hearing recovery.


Assuntos
Perda Auditiva Neurossensorial/diagnóstico , Doença Aguda , Audiometria de Tons Puros , Doenças Cardiovasculares/diagnóstico , Feminino , Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Neurossensorial/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Recuperação de Função Fisiológica/fisiologia , Medição de Risco/métodos
4.
Niger Postgrad Med J ; 27(2): 122-126, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32295943

RESUMO

Background: Studies have shown that hearing loss increases in patients with chronic kidney disease (CKD) with decreasing glomerular filtration rate. The hearing loss in CKD patients may worsen over time which in turn will negatively affect the patient's ability to effectively communicate with people, resulting in low self-esteem, social isolation, anger and depression. We aimed to assess the relationship between stage of CKD and hearing threshold in patients with CKD in Kaduna. Patients and Methods: A cross-sectional study of patients with CKD in Kaduna. Individuals were selected consecutively using convenience sampling. Ethical approval and informed consent were obtained. The patients were grouped based on the stage of the disease. The pure tone audiometry was carried out using a Diagnostic Audiometer (Graphic Digi-IS, USA). The hearing threshold of the patients was then compared based on stage of the disease. The data collected was analysed using Statistical Product and Service Solutions, version 20. Results: Sixty CKD patients (120 ears) were assessed. Their mean age was 43.2 ± 13.4 years and 70% were males. Of the 120 ears studied, 51 (42.5%) had normal hearing thresholds and 69 (57.5%) had hearing loss. Of the 69 ears with hearing loss, 11 (15.9%), 22 (31.9%) and 36 (52.2%) were in Stage III, IV and V, respectively, and the difference was statistically significant (P = 0.006). All those with Stage III CKD had mild hearing loss and the hearing loss worsen with advancing stage. Stage III CKD had significantly better hearing than those with stage IV and V (P < 0.001). Conclusion: Our study showed a statistically significant relationship between advancing stage of CKD and hearing loss. The hearing loss worsen with advancing stage of CKD.


Assuntos
Perda Auditiva/epidemiologia , Insuficiência Renal Crônica/complicações , Adulto , Idoso , Audiometria de Tons Puros , Comorbidade , Estudos Transversais , Feminino , Taxa de Filtração Glomerular , Perda Auditiva/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/epidemiologia , Índice de Gravidade de Doença , Inquéritos e Questionários
5.
PLoS One ; 15(4): e0231632, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32324766

RESUMO

INTRODUCTION: From an epidemiological point of view, the increase of pure-tone hearing thresholds as one aspect of biological ageing is moderated by societal factors. Since health policies refer to empirical findings, it is reasonable to replicate population-based hearing surveys and to compare estimates for different birth cohorts from the same regions or, conversely, for the same birth cohorts from different regions. METHODS: We pooled data from two independent cross-sectional German studies conducted between 2008 and 2012 and including 3105 adults. The increase of thresholds, the prevalence and risk of hearing impairment (HI) by age and gender were compared to results reported for European and US-American studies that were carried out at about the same time. Since these studies differed with regard to the age limits, the statistical approaches and, importantly, their definitions of HI, data adjustments were performed to enable the comparison. RESULTS: Overall, 15.5% of the participants in the German studies showed a pure-tone average at 0.5, 1, 2, and 4 kHz in the better ear (PTA) greater than 25 dB HL and 8.6% had a PTA of at least 35 dB HL. Based on one-to-one comparisons, the German estimates demonstrated a good agreement to a large Dutch study and with some reservations to a Swedish study, but considerable differences to US-American results. Comprehensive comparisons of the within-study gender differences showed that age-related HI was less and the gender gap was markedly smaller in Europe compared to the US due to the lower HI in males found in the European studies. CONCLUSION: Discrepancies in measurement procedures, conditions, and equipment that complicate the comparison of absolute HI estimates across studies play no or only a marginal role when comparing relative estimates. Hence, the gender gap differences reviewed in this analysis possibly stem from societal conditions that distinguish societies commonly labeled modern industrialized western countries.


Assuntos
Perda Auditiva/epidemiologia , Caracteres Sexuais , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Audiometria de Tons Puros , Limiar Auditivo , Feminino , Alemanha/epidemiologia , Auxiliares de Audição , Perda Auditiva/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Estados Unidos/epidemiologia , Adulto Jovem
6.
Ann Otol Rhinol Laryngol ; 129(8): 806-812, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32249593

RESUMO

OBJECTIVE: The aim of this study was to investigate the serum renin levels of patients with idiopathic sudden sensorineural hearing loss (ISSNHL). MATERIAL AND METHODS: Twenty-four patients with ISSNHL and 24 asymptomatic healthy volunteers were included in the study. Subjects underwent pure-tone audiometry and serum renin levels were measured. RESULTS: There were 14 women (mean age:42.35 ± 9.53) and 10 men (mean age:43.8 ± 6.87) in the patient group. There were 14 women (mean age:42.4 ± 4.7) and 10 men (mean age:41.4 ± 4.59) in the control group. ISSNHL was detected on the right side in 13 patients and on the left side in 11 patients. Serum renin levels of the patients and controls were 788.01 ± 327.8 and 282.37 ± 107.73 pg/mL, respectively. The serum renin levels were found to be significantly higher in the patient group compared to the control group (P ≤ .001). There was a statistically significant strong positive correlation between serum renin level and the severity of hearing loss (r = 0.77; P = .001). CONCLUSION: Serum renin levels of patients with ISSNHL were higher than controls. There was a statistically significant strong positive correlation between serum renin level and the severity of hearing loss.


Assuntos
Perda Auditiva Neurossensorial/sangue , Perda Auditiva Súbita/sangue , Audição/fisiologia , Renina/sangue , Adulto , Audiometria de Tons Puros/métodos , Biomarcadores/sangue , Ensaio de Imunoadsorção Enzimática , Feminino , Seguimentos , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/fisiopatologia , Perda Auditiva Súbita/diagnóstico , Perda Auditiva Súbita/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
7.
Am J Otolaryngol ; 41(3): 102483, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32307189

RESUMO

OBJECTIVE: The current study compared the amplitude of transient evoked otoacoustic emissions (TEOAEs) and thresholds of pure-tone audiometry between asymptomatic COVID-19 PCR-positive cases and normal non-infected subjects. METHODS: Twenty cases who were confirmed positive for COVID-19 and had none of the known symptoms for this viral infection formed the test group. Their age ranged between 20 and 50 years to avoid any age-related hearing affection. Patients who had definite symptoms of COVID-19 infection as well as those who had a history of hearing loss or a history of any known cause of hearing loss were excluded from the examined sample. TEOAEs amplitude was measured for all participants. RESULTS: The high frequency pure-tone thresholds as well as the TEOAE amplitudes were significantly worse in the test group. CONCLUSIONS: COVID-19 infection could have deleterious effects on cochlear hair cell functions despite being asymptomatic. The mechanism of these effects requires further research.


Assuntos
Doenças Assintomáticas , Audiometria de Tons Puros/métodos , Limiar Auditivo/fisiologia , Infecções por Coronavirus/fisiopatologia , Perda Auditiva Neurossensorial/diagnóstico , Pneumonia Viral/fisiopatologia , Testes de Impedância Acústica/métodos , Adulto , Betacoronavirus , Estudos de Casos e Controles , Infecções por Coronavirus/epidemiologia , Surtos de Doenças , Feminino , Seguimentos , Perda Auditiva Neurossensorial/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Valores de Referência , Estudos Retrospectivos , Medição de Risco , Adulto Jovem
8.
PLoS One ; 15(4): e0232112, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32324804

RESUMO

A definitive study on the prevalence of adult unilateral hearing loss and hearing aid rehabilitation is lacking in Korea. The purpose of our study was to investigate the prevalence of adult unilateral hearing loss and the factors associated with hearing aid use in patients with unilateral hearing loss in South Korea. We obtained data from 2009 to 2012 from the Korea National Health and Nutrition Examination Surveys (KNHANES), a cross-sectional, nationwide and population-based survey in the Republic of Korea. We analyzed the prevalence and associated factors of unilateral hearing loss and hearing aid adoption by univariable and multivariable analysis. Unilateral hearing loss was defined as pure tone average ≥ 41 dB in the worse hearing ear, and < 41 dB in the other ear assessed at 0.5, 1.0, 2.0, and 3.0 kHz. From 2009 to 2012, 33,252 individuals participated in the KNHANES. Among them, the number of patients with unilateral hearing loss was 1632 (5.55%) and the prevalence of hearing aid adoption in unilateral hearing loss was 1.56%. We also compared the factors between hearing aid users and non-users. Occupational status (OR 3.759, 95% CI 1.443-9.804), the hearing threshold in the better ear (OR 1.088, 95% CI 1.029-1.151), and hearing threshold in the worse ear (OR 1.031, 1.005-1.058) were found to affect the adoption of hearing aids. The prevalence of noise exposure at work in hearing aid users was significantly lower than the prevalence of noise exposure at work in those with no hearing aid. The prevalence of hearing aid use in patients with unilateral hearing loss in Korea is very low compared to other countries. Public health education is needed to increase public awareness of unilateral hearing loss, hearing aid adoption and its continued usage. Auditory rehabilitation should be actively recommended to patients with unilateral hearing loss.


Assuntos
Auxiliares de Audição/estatística & dados numéricos , Perda Auditiva Unilateral/epidemiologia , Perda Auditiva Unilateral/reabilitação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Audiometria de Tons Puros , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , República da Coreia/epidemiologia , Inquéritos e Questionários , Adulto Jovem
9.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 86-92, Jan.-Mar. 2020. tab
Artigo em Inglês | LILACS | ID: biblio-1090561

RESUMO

Abstract Introduction Spinocerebellar ataxia (SCA) is part of a genetic and clinical heteroge- neous group of neurodegenerative diseases characterized by progressive cerebellar ataxia. Objective To describe the results of audiological and electrophysiological hearing evaluations in patients with sporadic ataxia (SA). Methods A retrospective cross-sectional study was carried out with 11 patients submitted to the following procedures: anamnesis, otorhinolaryngological evaluation, tonal and vocal audiometry, acoustic immittance and brainstem auditory evoked potential (BAEP) tests. Results The patients presented with a prevalence of gait imbalance, of dysarthria, and of dysphagia; in the audiometric and BAEPs, four patients presented with alterations; in the acoustic immittance test, five patients presented with alterations, predominantly bilateral. Conclusion The most evident alterations in the audiological evaluation were the prevalence of the descending audiometric configuration between the frequencies of 2 and 4 kHz and the absence of the acoustic reflex between the frequencies of 3 and 4 kHz bilaterally. In the electrophysiological evaluation, the patients presented changes with a prevalence of increased I, III and V wave latencies and the interval in the interpeak I-III, I-V and III-V. In the present study, it was observed that auditory complaints did not have a significant prevalence in this type of ataxia, which does not occur in some types of autosomal recessive and dominant ataxia.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Audiometria de Tons Puros , Limiar Auditivo/fisiologia , Potenciais Evocados Auditivos do Tronco Encefálico , Ataxias Espinocerebelares/fisiopatologia , Testes de Impedância Acústica , Estudos Transversais , Estudos Retrospectivos , Ataxias Espinocerebelares/complicações , Transtornos da Audição/diagnóstico , Transtornos da Audição/etiologia
10.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 5-10, Jan.-Mar. 2020. tab
Artigo em Inglês | LILACS | ID: biblio-1090555

RESUMO

Abstract Introduction The cochlea and the vestibular receptors are closely related in terms of anatomy and phylogeny. Patients with moderate to profound sensorineural hearing loss (MPSHL) should have their vestibular organ functions tested. Objective To evaluate the incidence of vestibular abnormalities in patients with MPSHL and to study the correlation between the etiology of hearing loss (HL) and a possible damage to the labyrinth. Methods A case-control retrospective study was performed. In the case group, 20 adults with MPSHL of known etiology were included. The control group was composed of 15 adults with normal hearing. The case group was divided into 4 subgroups based on the etiology (bacterial meningitis, virus, vascular disease, congenital). Cervical vestibular-evoked myogenic potentials (cVEMPs) were used to rate the saccular function and lower vestibular nerve. Results The study was performed in 70 ears, and it highlighted the presence of early biphasic P1-N1 complex in 29 (71.5%) out of 40 ears in the study group, and in all of the 30 ears in the control group (p = 0.001). Regarding the presence or absence of cVEMPs among the four subgroups of patients with MPSHL, the data were statistically significant (p < 0.001). The comparison between the latencies and amplitude of P1-N1 in case and control groups from other studies and in the four subgroups of cases in the present study did not detect statistically significant differences. Conclusion The present study demonstrates that patients with MPSHL have a high incidence of damage to the labyrinthine organs, and it increases the current knowledge about the etiopathogenesis of sensorineural HL, which is often of unknown nature.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Potenciais Evocados Miogênicos Vestibulares , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Neurossensorial/fisiopatologia , Audiometria de Tons Puros , Doenças Vasculares/complicações , Viroses/complicações , Estudos de Casos e Controles , Doenças Vestibulares/diagnóstico , Doenças Vestibulares/epidemiologia , Incidência , Estudos Retrospectivos , Meningites Bacterianas/complicações , Perda Auditiva Neurossensorial/congênito , Doenças do Labirinto/diagnóstico , Doenças do Labirinto/fisiopatologia , Doenças do Labirinto/epidemiologia
11.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 93-98, Jan.-Mar. 2020. tab
Artigo em Inglês | LILACS | ID: biblio-1090556

RESUMO

Abstract Introduction Hearing is important for the proper development of every child, especially for those younger than 5 years of age, because it helps in the development of language and speech. Emotional and social problems, as well as issues with academic performance, can result from hearing loss even of mild degree. Early diagnosis and management can overcome those negative impacts. Objective To determine the prevalence of mild hearing loss in primary-school children and its association with their school performance. Methods A comparative cross-sectional study was conducted at a regular school. The study included the random selection of 120 apparently normal students (aged 6-9 years) who were considered as having normal hearing by their parents. A total of 20 students were excluded from the study due to the presence of wax in their ears. Finally, the study was conducted with 100 students. All participants were subjected to a basic audiological evaluation, and the Screening Instrument for Targeting Educational Risk (SIFTER) question- naire was given to their teachers to evaluate their school performance. Results From a total of 100 students, we confirmed that 23 (23%) had mild hearing loss, 17 (17%) had bilateral conductive hearing loss, and 6 (6%) had bilateral sensorineural hearing loss. The students who had low attention and communication performance were significantly associated with mild hearing loss. Conclusion The prevalence of mild hearing loss was of 23% (23 cases). This problem had an effect on the communication and attention in school; and it might affect academic performance later in life. A hearing assessment is highly recommended for every child, especially those who have a low rate of academic performance.


Assuntos
Humanos , Masculino , Feminino , Criança , Desempenho Acadêmico , Perda Auditiva/epidemiologia , Audiometria de Tons Puros , Testes de Impedância Acústica , Prevalência , Estudos Transversais , Inquéritos e Questionários , Ensino Fundamental e Médio , Otopatias/diagnóstico , Egito , Anamnese
12.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 68-72, Jan.-Mar. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1090546

RESUMO

Abstract Introduction The prevalence of tinnitus is higher in individuals with temporoman- dibular joint disorder (TMD) than in the general population. Magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) is the method of choice for investigation, and it has been hypothesized that specific MRI findings might be observed in TMD with comorbid tinnitus. Objective To comparatively describe MRI findings in patients with TMD with and without tinnitus, identifying the most common TMJ alterations and determining whether a correlation exists between severity of TMD and tinnitus. Methods A cross-sectional study of 53 adult patients with bilateral or unilateral TMD (30 with and 23 without tinnitus). The association between tinnitus and morphological aspects of TMD (changes in condylar morphology, articular eminence morphology, and disc morphology), disc displacement (with/without reduction), condylar translation, and intra-articular effusion was analyzed on MRI images. Results The mean patient age was 46.12 ± 16.1 years. Disc displacement was the most common finding in both groups (24 patients with tinnitus versus 15 without; p = 0.043). Only the frequency of disc displacement with reduction was significantly different between groups. Conclusion Additional imaging techniques should be explored to detect specific aspects of the relationship between tinnitus and TMD.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Articulação Temporomandibular/diagnóstico por imagem , Zumbido/diagnóstico por imagem , Imagem por Ressonância Magnética , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Audiometria de Resposta Evocada , Audiometria de Tons Puros , Articulação Temporomandibular/patologia , Zumbido/diagnóstico , Zumbido/etiologia , Índice de Gravidade de Doença , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/patologia , Estudos Transversais
13.
Otolaryngol Head Neck Surg ; 162(5): 731-736, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32180504

RESUMO

OBJECTIVE: To explore the immediate and 1-year outcomes of patients who underwent implantation with the slim modiolar electrode (SME). STUDY DESIGN: Consecutive case series with chart review. SETTING: Tertiary referral academic center. SUBJECT AND METHODS: Between May 2016 and August 2018, a total of 326 cochlear implantations (CIs) were performed. Intraoperative x-rays were performed in all cases to identify tip rollovers. Scalar location was identified for 76 CIs that had postoperative computed tomography reconstructions. Speech outcomes were measured at 3, 6, and 12 months with consonant-nucleus-consonant word and AzBio sentences in quiet and noise (+10-dB signal-to-noise ratio). Preservation of hearing was defined as maintaining a low-frequency pure tone average ≤80 dB at 250 and 500 Hz. RESULTS: Among 326 CIs, 23 (7%) had tip rollovers. Postoperative reconstructions revealed 5 of 76 (6.6%) scalar translocations. A subset of 177 cases met criteria for evaluation of speech perception scores. The marginal mean differences between presurgery and 12 months for speech tests were as follows: consonant-nucleus-consonant, 43.7 (95% CI, 39.8-47.6); AzBio in quiet, 49.7 (95% CI, 44.9-54.4); and AzBio in noise, 29.9 (95% CI, 25.2-34.7). Sixty-one patients were identified with preservable hearing (low-frequency pure tone average ≤80 dB), and 12 of 61 (20%) preserved hearing at 1 year. CONCLUSION: CI with SME provides reliable scala tympani insertion in a consistent perimodiolar position. An initially increased tip rollover rate improved with case volume and sheath design improvement. For long-term outcomes, speech performance was comparable to that of other cochlear implants. While hearing preservation for the SME may be better than prior perimodiolar electrodes, consistent outcomes are unlikely.


Assuntos
Implante Coclear/métodos , Implantes Cocleares , Eletrodos Implantados , Adulto , Idoso , Idoso de 80 Anos ou mais , Audiometria de Tons Puros , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Rampa do Tímpano/cirurgia , Percepção da Fala , Tomografia Computadorizada por Raios X
14.
Ann Otol Rhinol Laryngol ; 129(8): 821-828, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32126822

RESUMO

INTRODUCTION: Middle ear pathologies have been linked with HIV. The onset and development of these pathologies in individuals with HIV have not been categorized; and clarity has not been gained regarding whether their presentation is any different in this population when compared to HIV negative control group. PURPOSE: The aim of this study was to explore and document published evidence reflecting trends in middle ear pathologies in adults living with HIV. METHODS: A systematic review of literature from January 1982 to December 2018 was conducted using Medline, CINAHL, PubMed, and Psych Info. Studies that reported the occurrence rate of middle ear pathologies in adults with HIV and published in English were included. RESULTS: Twelve articles met the inclusion criteria. Evidence suggests that the reported occurrence rates of middle ear pathologies ranges from 2.5% to 58% in this population. The variability in assessment measures as well as the different cut-off criteria used in studies seem to have an influence in the findings, with pure tone audiometry identifying more middle ear pathologies in the current review than tympanometry with 226 Hz probe tone and clinical examination. Otitis media, conductive hearing loss, and type B tympanogram were common findings reported in this study. No evidence of an association between the use of antiretroviral therapy (ART) and the rates of middle ear pathologies was found. CONCLUSION: Although there are very few studies that have reported on middle ear pathologies in adults living with HIV, the available studies have sufficiently established a link between HIV and middle ear disease in this population, and have revealed that the rate of occurrence is influenced by a number of factors. Key amongst these is the type of assessment measure used. Careful analysis of middle ear pathologies in this population through well controlled research designs that include different assessment measures. The use of case-control and longitudinal designs to determine differences between groups and to establish the time of onset and development of middle ear pathologies is required.


Assuntos
Orelha Média/diagnóstico por imagem , Infecções por HIV/complicações , HIV , Perda Auditiva/epidemiologia , Testes de Impedância Acústica , Adulto , Audiometria de Tons Puros , Perda Auditiva/diagnóstico , Perda Auditiva/etiologia , Humanos
15.
Artigo em Chinês | MEDLINE | ID: mdl-32086912

RESUMO

Objective:The aim of this study was to explore the clinical features, hearing prognosis and differential diagnosis of recurrent low frequency sensorineural hearing loss (RLFD) . Method:The clinical characteristics, clinical manifestations, audiological examination and auxiliary examination of RLFD patients were retrospectively analyzed. We summarized clinical features, draw the pure tone audiometry curves, and analyze the diagnosis of RLFD. Result:Forty-seven patients (53 ears) with RLFD had a hearing review time of 1-124 months. The course of disease ranged from 3 to 320 months with an average course of 29 months. ①The incidence of tinnitus in the accompanying symptoms was 93.6%(44 cases), and the ear suffocation was 83.0%(39 cases), 38.3% (18 cases) of the patients developed vestibular symptoms during the course of the disease. ②During the observation period, 27 cases(57.4%) were diagnosed with related diseases: 7 cases(14.9%) Meniere's disease, 6 cases(12.8%) vestibular migraine, 2 cases(4.3%) with Meniere's disease and migraine, and 1 case(2.1%) with idiopathic intracranial hypotension 11 cases(23.4%) were possible cochlear migraine; ③Migraine-related RLFD had a younger onset age, more common in women; ④83.0%(44 ears)of the affected ears had stable or improved low-frequency hearing during the observation period, 17.0%(9 ears)of the affected ears experienced low-frequency hearing; ⑤18.9%(10 ears)of the affected ears had high-frequency hearing loss; ⑥RLFD had 6 types of audiological outcomes: low-frequency improvement combined with high-frequency stability; low-frequency stability combined with high-frequency stability; low frequency progress combined with high frequency stability type; low frequency improvement combined with high frequency progress type; low frequency stability combined with high frequency progress type; low frequency progress combined with high frequency progress type; ⑦Rising type hearing curve low frequency hearing prognosis is good, mountain type and descending low frequency hearing prognosis is poor. Conclusion:Tinnitus and ear stuffiness are the early symptoms and the most disturbing symptoms in patients with RLFD. The mechanism of Migraine may play an important role in the pathogenesis of RLFD. The rare causes such as intracranial hypotension syndrome should not be ignored. Most of the patients with RLFD had stable or improved hearing after long-term fluctuation, but some patients with low or high frequency hearing might decline. The type of initial hearing curve was a prognostic factor. Long-term hearing follow-up is helpful for prognosis evaluation.


Assuntos
Perda Auditiva Neurossensorial/diagnóstico , Audiometria de Tons Puros , Diagnóstico Diferencial , Feminino , Perda Auditiva Neurossensorial/complicações , Humanos , Masculino , Doença de Meniere/complicações , Transtornos de Enxaqueca/complicações , Prognóstico , Estudos Retrospectivos , Zumbido/complicações
16.
Artigo em Chinês | MEDLINE | ID: mdl-32086915

RESUMO

Objective:The aim of this study is to explore the best administration, timing and efficacy of dexamethasone and Mison in the treatment of different types of sudden deafness. Method:242 cases of sudden deafness first diagnosed in our department were selected. According to the guidelines(2015), the patients were divided into low frequency descending type (49 cases), high frequency descending type (66 cases), flat descending type (71 cases) and total deafness (56 cases). Different types of patients were randomly divided into tympanic injection group and systemic administration group on the basis of routine treatment. Tympanic injection group was further divided into initial injection group and delayed injection group. Tympanic injection was performed under ear endoscope, once every other day, three times for low frequency descending deafness, and five times for other types of deafness. Result:In comparison of total effective rate, there were significant differences among the three treatments in 49 cases of low frequency descending type, 71 cases of flat descending type and 56 cases of total deafness type (P<0.05). In 66 cases of high frequency descending type, there was no significant difference among the three treatments (P>0.05). In the comparison of cure rate, the difference of cure rate among the three treatment methods was also significant in low frequency descending type (P<0.05). In the other three types of deafness, there was no significant difference among the three treatment methods (P>0.05). There was no significant difference in the effective rate between men and women (P>0.05) in all patients treated by tympanic injection. There was significant difference in the effective rate of tympanic injection within 7 days of onset and 7 days after onset (P<0.05). Conclusion:Intratympanic injection of dexamethasone is safe, effective, and easy to use as an initial treatment for low frequency descent, flat, and full deafness, and the sooner the better.


Assuntos
Dexametasona/administração & dosagem , Injeção Intratimpânica , Audiometria de Tons Puros , Feminino , Perda Auditiva Súbita , Humanos , Masculino , Resultado do Tratamento
17.
PLoS One ; 15(2): e0228498, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32017804

RESUMO

OBJECTIVES: Tinnitus is a common symptom among patients with hearing loss, and many studies have reported successful tinnitus suppression with hearing devices. Active middle ear implantation of the Vibrant Soundbridge (VSB) is a good alternative to existing hearing devices. This study evaluated the effects of VSB implantation on tinnitus and sought to identify the main audiological factor that affects tinnitus suppression. METHODS: The study participants were 16 adults who had tinnitus with sensorineural hearing loss, and who underwent VSB implantations. Pure-tone audiometry; word recognition test; tinnitus handicap inventory (THI); and visual analog scale (VAS) assessment of loudness, awareness, and annoyance were performed before and 12 months after surgery. Changes in hearing threshold, word recognition scores (WRS), THI scores, and VAS scores were analyzed. RESULTS: VAS scores for loudness (mean difference: 1.9, 95% CI: 0.6, 3.1), awareness (mean difference: 1.6, 95% CI: 0.4, 2.8), and annoyance (mean difference: 1.7, 95% CI: 0.7, 2.8) showed significant improvements from baseline to 12 months after surgery. In addition, THI scores showed a significant decrease (mean difference: 13.8, 95% CI: 2.9, 24.9). The average hearing threshold level, WRS, and most comfortable level (MCL) also showed significant improvements at 12 months after surgery (mean difference: 17.3, 95% CI: 13.3, 21.3; mean difference: -7.6, 95% CI: -15.1, -0.1; mean difference: 26.3, 95% CI: 22.9, 29.6, respectively). Among the aforementioned factors, changes in MCL were best correlated with those in THI scores (mean difference: 2.55, 95% CI: 0.90, 4.21). CONCLUSION: A VSB implant is beneficial to subjects with tinnitus accompanied by sensorineural hearing loss. The changes in THI scores best correlated with those in MCL. This improvement may represent a masking effect that contributes to tinnitus suppression in patients with VSB implants.


Assuntos
Perda Auditiva Neurossensorial/complicações , Perda Auditiva Neurossensorial/cirurgia , Zumbido/diagnóstico , Idoso , Audiometria de Tons Puros , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prótese Ossicular , Índice de Gravidade de Doença , Zumbido/etiologia , Resultado do Tratamento , Escala Visual Analógica
18.
Otolaryngol Head Neck Surg ; 162(6): 914-921, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32097057

RESUMO

OBJECTIVES: Conventional reporting of posttympanoplasty hearing outcomes use a pure-tone averaged air-bone gap (ABG) largely representing a low-frequency sound conduction. Few studies report high-frequency conductive hearing outcomes. Herein, we evaluate high-frequency ABG in patients following temporalis fascia total drum replacement. STUDY DESIGN: Case series with chart review. SETTING: Tertiary care center. SUBJECTS AND METHODS: All patients who underwent type 1 tympanoplasty using a lateral graft total drum replacement technique between August 2016 and February 2019 were identified. Patients with pre- and postoperative audiograms were included. Low-frequency ABG was calculated as the mean ABG at 250, 500, and 1000 Hz. High-frequency ABG was calculated at 4 KHz. Pre- and postoperative ABGs were compared. RESULTS: Twenty-three patients were included, and the mean age at surgery was 44 years (range, 9-68 years). Perforation etiology was from trauma (n = 14) or chronic otitis media (n = 9). Preoperative mean low-frequency ABG was 27.8 ± 12.6 dB and mean high-frequency ABG was 21.5 ± 15.1 dB (P = .044). Postoperatively, the mean low-frequency ABG was significantly reduced by 15.5 ± 13.3 dB (P < .001) while the mean high-frequency ABG insignificantly changed (reduced by 2.6 ± 16.2 dB, P = .450). CONCLUSION: In a series of patients undergoing temporalis fascia total drum replacement, low-frequency ABG improved; however, high-frequency conductive hearing loss persists. Conventional methods of reporting ABG may not identify persistent high-frequency ABG. These results merit further study across a range of tympanoplasty graft materials and surgical techniques.


Assuntos
Condução Óssea/fisiologia , Orelha Média/cirurgia , Perfuração da Membrana Timpânica/cirurgia , Timpanoplastia/métodos , Adolescente , Adulto , Idoso , Audiometria de Tons Puros , Criança , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Retrospectivos , Resultado do Tratamento , Perfuração da Membrana Timpânica/fisiopatologia , Adulto Jovem
19.
Ann Otol Rhinol Laryngol ; 129(6): 578-584, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31965808

RESUMO

BACKGROUND: There is a lack of hearing health care globally, and tele-audiology and mobile technologies have been proposed as important strategies to reduce the shortfall. OBJECTIVES: To investigate the accuracy and reliability of smartphone self-test audiometry in adults, in community clinics in low-income settings. METHODS: A prospective, intra-individual, repeated measurements design was used. Sixty-three adult participants (mean age 52 years, range 20-88 years) were recruited from ENT and primary health care clinics in a low-income community in Tshwane, South Africa. Air conduction hearing thresholds for octave frequencies 0.5 to 8 kHz collected with the smartphone self-test in non-sound treated environments were compared to those obtained by reference audiometry. RESULTS: The overall mean difference between threshold seeking methods (ie, smartphone thresholds subtracted from reference) was -2.2 dB HL (n = 467 thresholds, P = 0.00). Agreement was within 10 dB HL for 80.1% (n = 467 thresholds) of all threshold comparisons. Sensitivity for detection hearing loss >40 dB HL in one ear was 90.6% (n = 84 ears), and specificity 94.2% (n = 84 ears). CONCLUSION: Smartphone self-test audiometry can provide accurate and reliable air conduction hearing thresholds for adults in community clinics in low-income settings.


Assuntos
Audiometria/métodos , Perda Auditiva/diagnóstico , Aplicativos Móveis , Smartphone , Adulto , Idoso , Idoso de 80 Anos ou mais , Audiometria de Tons Puros , Autoavaliação Diagnóstica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , África do Sul , Adulto Jovem
20.
Pediatrics ; 145(2)2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31915192

RESUMO

OBJECTIVE: To assess the association between gentamicin exposure in the neonatal period and hearing in school age. METHODS: This study included children exposed to a high-dose (6 mg/kg) gentamicin regimen as neonates (2004-2012), invited for follow-up at school age, and a healthy age-matched control group. We assessed hearing with pure tone audiometry including the extended high-frequency (EHF) range. Outcomes were average hearing thresholds in the midfrequencies (0.5-4 kHz) and the EHFs (9-16 kHz). The measures of gentamicin exposure were cumulative dose and highest trough plasma concentration. We used linear regression models to assess the impact of gentamicin exposure, and other peri- and postnatal morbidities, on hearing thresholds. RESULTS: A total of 219 gentamicin-exposed and 33 healthy-control children were included in the audiological analysis. In the gentamicin cohort, 39 (17%) had a birth weight <1500 g. Median cumulative doses and trough plasma concentrations were 30 (interquartile range 24-42) mg/kg and 1.0 (interquartile range 0.7-1.2) mg/L, respectively. Median hearing thresholds for the midfrequencies and the EHFs were 2.5 (0 to 6.3) dB hearing level and -1.7 (-5.0 to 5.0) dB hearing level, both of which were within the normal range. In an adjusted analysis, increasing hearing thresholds were associated with lower birth weight and postnatal middle-ear disease but not level of gentamicin exposure. After adjusting for birth weight, there was no difference in hearing threshold between the gentamicin-exposed cohort and healthy controls. CONCLUSIONS: Exposure to a high-dose gentamicin regimen in the neonatal period was not associated with an increase in hearing thresholds in schoolchildren being able to complete audiometry.


Assuntos
Antibacterianos/administração & dosagem , Limiar Auditivo/efeitos dos fármacos , Gentamicinas/administração & dosagem , Audição/efeitos dos fármacos , Adolescente , Antibacterianos/efeitos adversos , Antibacterianos/sangue , Audiometria de Tons Puros , Limiar Auditivo/fisiologia , Estudos de Casos e Controles , Criança , Potenciais Evocados Auditivos/fisiologia , Feminino , Gentamicinas/efeitos adversos , Gentamicinas/sangue , Audição/fisiologia , Humanos , Recém-Nascido de Baixo Peso/fisiologia , Recém-Nascido , Modelos Lineares , Masculino , Noruega , Tamanho da Amostra
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