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1.
Int J Mol Sci ; 22(10)2021 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-34070066

RESUMO

Megalin has been proposed as an endocytic receptor for aminoglycosides as well as estrogen and androgen. We aimed to investigate the otoprotective effects of antiandrogens (flutamide, FM) on kanamycin (KM)-induced hearing loss in rats. Rats were divided into four groups. The KM group was administered KM (20 mg/kg/day) for 5 days, while the FM group received FM (15 mg/kg/day) for 10 days. In the KM + FM group, KM and FM (15 mg/kg/day) were simultaneously injected for 5 days and then FM was injected for 5 days. Auditory brainstem responses were measured. Western blotting and/or quantitative reverse transcriptase-polymerase chain reaction were performed for megalin, cytochrome P450 1A1 (Cyp1a1), Cyp1b1, metallothionein 1A (MT1A), MT2A, tumor necrosis factor (TNF)-α, caspase 3, and cleaved caspase 3. The FM + KM group showed attenuated auditory thresholds when compared with the KM group at 4, 8, 16, and 32 kHz (all p < 0.05). The KM + FM group showed lower megalin and Cyp1b1 levels than the KM group (all p < 0.05). The KM + FM group revealed lower MT1A, TNFα, and caspase 3 protein levels, compared with those in the KM group (all p < 0.05). Androgen receptor inhibition protects against cochlear injuries in KM-induced hearing loss rats by attenuating megalin expression, revealing anti-inflammatory and anti-apoptotic effects.


Assuntos
Antagonistas de Receptores de Andrógenos/farmacologia , Perda Auditiva Neurossensorial/prevenção & controle , Animais , Antibacterianos/toxicidade , Limiar Auditivo/efeitos dos fármacos , Cóclea/efeitos dos fármacos , Cóclea/patologia , Cóclea/fisiopatologia , Citocromo P-450 CYP1A1/genética , Citocromo P-450 CYP1A1/metabolismo , Citocromo P-450 CYP1B1/genética , Citocromo P-450 CYP1B1/metabolismo , Potenciais Evocados Auditivos do Tronco Encefálico/efeitos dos fármacos , Flutamida/farmacologia , Expressão Gênica/efeitos dos fármacos , Perda Auditiva Neurossensorial/induzido quimicamente , Perda Auditiva Neurossensorial/fisiopatologia , Canamicina/toxicidade , Proteína-2 Relacionada a Receptor de Lipoproteína de Baixa Densidade/genética , Proteína-2 Relacionada a Receptor de Lipoproteína de Baixa Densidade/metabolismo , Masculino , Metalotioneína/genética , Metalotioneína/metabolismo , Substâncias Protetoras/farmacologia , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Ratos , Ratos Sprague-Dawley , Fator de Necrose Tumoral alfa/metabolismo
2.
Int J Mol Sci ; 22(6)2021 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-33799684

RESUMO

Age-related hearing loss (ARHL), a sensorineural hearing loss of multifactorial origin, increases its prevalence in aging societies. Besides hearing aids and cochlear implants, there is no FDA approved efficient pharmacotherapy to either cure or prevent ARHL. We hypothesized that selegiline, an antiparkinsonian drug, could be a promising candidate for the treatment due to its complex neuroprotective, antioxidant, antiapoptotic, and dopaminergic neurotransmission enhancing effects. We monitored by repeated Auditory Brainstem Response (ABR) measurements the effect of chronic per os selegiline administration on the hearing function in BALB/c and DBA/2J mice, which strains exhibit moderate and rapid progressive high frequency hearing loss, respectively. The treatments were started at 1 month of age and lasted until almost a year and 5 months of age, respectively. In BALB/c mice, 4 mg/kg selegiline significantly mitigated the progression of ARHL at higher frequencies. Used in a wide dose range (0.15-45 mg/kg), selegiline had no effect in DBA/2J mice. Our results suggest that selegiline can partially preserve the hearing in certain forms of ARHL by alleviating its development. It might also be otoprotective in other mammals or humans.


Assuntos
Envelhecimento/fisiologia , Modelos Animais de Doenças , Perda Auditiva Neurossensorial/tratamento farmacológico , Selegilina/farmacologia , Administração Oral , Animais , Antiparkinsonianos/administração & dosagem , Antiparkinsonianos/farmacologia , Limiar Auditivo/efeitos dos fármacos , Limiar Auditivo/fisiologia , Potenciais Evocados Auditivos do Tronco Encefálico/efeitos dos fármacos , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Perda Auditiva Neurossensorial/fisiopatologia , Humanos , Masculino , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos DBA , Substâncias Protetoras/administração & dosagem , Substâncias Protetoras/farmacologia , Selegilina/administração & dosagem , Transmissão Sináptica/efeitos dos fármacos , Transmissão Sináptica/fisiologia
3.
Int J Mol Sci ; 22(6)2021 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-33799503

RESUMO

Growth hormone (GH) plays an important role in auditory development during the embryonic stage. Exogenous agents such as sound, noise, drugs or trauma, can induce the release of this hormone to perform a protective function and stimulate other mediators that protect the auditory pathway. In addition, GH deficiency conditions hearing loss or central auditory processing disorders. There are promising animal studies that reflect a possible regenerative role when exogenous GH is used in hearing impairments, demonstrated in in vivo and in vitro studies, and also, even a few studies show beneficial effects in humans presented and substantiated in the main text, although they should not exaggerate the main conclusions.


Assuntos
Vias Auditivas/metabolismo , Hormônio do Crescimento/genética , Perda Auditiva Funcional/genética , Perda Auditiva Neurossensorial/genética , Hipocampo/metabolismo , Fator de Crescimento Insulin-Like I/genética , Animais , Córtex Auditivo/metabolismo , Córtex Auditivo/patologia , Vias Auditivas/patologia , Cóclea/metabolismo , Cóclea/patologia , Nervo Coclear/metabolismo , Nervo Coclear/patologia , Regulação da Expressão Gênica , Hormônio do Crescimento/metabolismo , Perda Auditiva Funcional/metabolismo , Perda Auditiva Funcional/fisiopatologia , Perda Auditiva Neurossensorial/metabolismo , Perda Auditiva Neurossensorial/fisiopatologia , Hipocampo/patologia , Humanos , Fator de Crescimento Insulin-Like I/metabolismo , Regeneração Nervosa/fisiologia , Ruído/prevenção & controle
4.
Med Sci Monit ; 27: e929300, 2021 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-33744908

RESUMO

BACKGROUND We aimed to explore the correlation between patients' sigmoid sinusoidal tinnitus (SST) and low-frequency sensorineural hearing loss (LFSHL) and illustrate the underlying mechanism. MATERIAL AND METHODS Seven healthy volunteers with normal hearing were subjected to 125-, 250-, and 500-Hz pure sound and different white noise-masking intensities. A retrospective analysis was made on the clinical data and postoperative follow-up data of 59 patients with SST in the First Affiliated Hospital of Chongqing Medical University. The patients' sex, age, chief complaints, affected site, concomitant symptoms, course of disease, pure-tone audiometry (PTA) results, tinnitus discomfort loudness scale results, imaging examination, and complications were collected. RESULTS The results of the simulation experiment showed that the threshold of each frequency segment was higher after noise masking than before masking; the intensity of noise masking was positively correlated with hearing loss, and the changes of the hearing threshold of the 3 frequencies before and after masking were statistically significant (P<0.05). Fifty-nine patients with SST were documented between January 2015 and January 2020. After the operation, their low-frequency hearing was recovered to normal; 11 cases had significantly alleviated tinnitus and 9 cases were cured. CONCLUSIONS SST often causes corresponding pseudo-low-frequency hearing loss due to the noise-masking effect. The center frequency of tinnitus appears not to be 250-Hz or 500-Hz octave frequency of PTA, barring the detection of the pseudo-hearing loss in the audiometry chart of most patients. Surgery positively affects patients with SST, and the pseudo-LFSHL can be completely recovered after the operation as a result of tinnitus elimination.


Assuntos
Limiar Auditivo/fisiologia , Perda Auditiva Neurossensorial/fisiopatologia , Zumbido/fisiopatologia , Adulto , Audiometria de Tons Puros/métodos , Percepção Auditiva/fisiologia , Feminino , Audição/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Ruído/efeitos adversos , Estudos Retrospectivos
5.
J Laryngol Otol ; 135(4): 304-309, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33745469

RESUMO

OBJECTIVES: This study aimed to evaluate hearing outcomes and device safety in a large, single-surgeon experience with the totally implantable active middle-ear implants. METHODS: This was a retrospective case series review of 116 patients with moderate-to-severe sensorineural hearing loss undergoing implantation of active middle-ear implants. RESULTS: Mean baseline unaided pure tone average improved from 57.6 dB before surgery to 34.1 dB post-operatively, signifying a mean gain in pure tone average of 23.5 dB (p = 0.0002). Phonetically balanced maximum word recognition score improved slightly from 70.5 per cent to 75.8 per cent (p = 0.416), and word recognition score at a hearing level of 50 dB values increased substantially from 14.4 per cent to 70.4 per cent (p < 0.0001). Both revision and explant rates were low and dropped with increasing surgeon experience over time. CONCLUSION: This study showed excellent post-operative hearing results with active middle-ear implants with regard to pure tone average and word recognition score at a hearing level of 50 db. Complication rates in this case series were significantly lower with increasing experience of the surgeon. Active middle-ear implants should be considered in appropriate patients with moderate-to-severe sensorineural hearing loss who have struggled with conventional amplification and are good surgical candidates.


Assuntos
Correção de Deficiência Auditiva/métodos , Orelha Média/cirurgia , Perda Auditiva Neurossensorial/reabilitação , Prótese Ossicular , Implantação de Prótese/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Audiometria de Tons Puros , Feminino , Audição , Perda Auditiva Neurossensorial/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
6.
JAMA Otolaryngol Head Neck Surg ; 147(3): 280-286, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33410869

RESUMO

Importance: Cochlear implantation is highly effective at improving hearing outcomes, but results have been limited to groupwise analysis. That is, limited data are available for individual patients that report comparisons of preoperative aided speech recognition and postimplantation speech recognition. Objective: To assess changes in preoperative aided vs postoperative speech recognition scores for individual patients receiving cochlear implants when considering the measurement error for each speech recognition test. Design, Setting, and Participants: This cross-sectional study used a prospectively maintained database of patients who received cochlear implants between January 1, 2012, and December 31, 2017, at a tertiary, university-based referral center. Adults with bilateral sensorineural hearing loss undergoing cochlear implantation with 6- or 12-month postoperative measures using 1 or more speech recognition tests were studied. Exposures: Cochlear implantation. Main Outcomes and Measures: Postoperative word recognition (consonant-nucleus-consonant word test), sentence recognition (AzBio sentences in quiet), and sentence recognition in noise (AzBio sentences in +10-dB signal-to-noise ratio) scores, and association of each speech recognition score change with aided preoperative score to each test's measurement error. Results: Analysis of data from a total of 470 implants from 323 patients included 253 male (53.8%) patients; the mean (SD) age was 61.2 (18.3) years. Most patients had statistically significant improvement in all speech recognition tests postoperatively beyond measurement error, including 262 (84.8%) for word recognition, 226 (87.6%) for sentence recognition, and 33 (78.6%) for sentence recognition in noise. A small number of patients had equivalent preoperative and postoperative scores, including 45 (14.5%) for word recognition, 28 (10.9%) for sentence recognition, and 9 (21.4%) for sentence recognition in noise. Four patients (1.6%) had significantly poorer scores in sentence recognition after implantation. The associations between age at implantation and change in speech recognition scores were -0.12 (95% CI, -0.23 to -0.01) for word recognition, -0.22 (95% CI, -0.34 to -0.10) for sentence recognition, and -0.10 (95% CI, -0.39 to 0.21) for sentence recognition in noise. Patients with no significant improvement were similarly distributed between all preoperative aided speech scores for word recognition (range, 0%-58%) and sentence recognition (range, 0%-56%) testing. Conclusions and Relevance: In this cross-sectional study, with respect to preoperative aided speech recognition, postoperative cochlear implant outcomes for individual patients were largely encouraging. However, improvements in scores for individual patients remained highly variable, which may not be adequately represented in groupwise analyses and reporting of mean scores. Presenting individual patient data from a large sample of individuals with cochlear implants provides a better understanding of individual differences in speech recognition outcomes and contributes to more complete interpretations of successful outcomes after cochlear implantation.


Assuntos
Implantes Cocleares , Perda Auditiva Neurossensorial/cirurgia , Audição/fisiologia , Percepção da Fala/fisiologia , Estudos Transversais , Feminino , Perda Auditiva Bilateral/fisiopatologia , Perda Auditiva Bilateral/cirurgia , Perda Auditiva Neurossensorial/fisiopatologia , Testes Auditivos , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Retrospectivos , Resultado do Tratamento
7.
JAMA Otolaryngol Head Neck Surg ; 147(3): 253-260, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33377936

RESUMO

Importance: Early detection and intervention of pediatric hearing loss is critical for language development and academic achievement. However, variations in the diagnostic workup and management of pediatric sensorineural hearing loss (SNHL) exist. Objective: To identify patient and clinician factors that are associated with variation in practice on a national level. Design, Setting, and Participants: This cross-sectional study used the Optum claims database to identify 53 711 unique children with SNHL between January 1, 2008, and December 31, 2018. Main Outcomes and Measures: National use rates and mean costs for diagnostic modalities (electrocardiogram, cytomegalovirus testing, magnetic resonance imaging, computed tomography, and genetic testing) and interventions (speech-language pathology, billed hearing aid services, and cochlear implant surgery) were reported. The associations of age, sex, SNHL laterality, clinician type, race/ethnicity, and household income with diagnostic workup and intervention use were measured in multivariable analyses. Results: Of 53 711 patients, 23 735 (44.2%) were girls, 2934 (5.5%) were Asian, 3797 (7.1%) were Black, 5626 (10.5%) were Hispanic, 33 441 (62.3%) were White, and the mean (SD) age was 7.3 (5.3) years. Of all patients, 32 200 (60.0%) were seen by general otolaryngologists, while 7573 (14.10%) were seen by pediatric otolaryngologists. Diagnostic workup was received by 14 647 patients (27.3%), while 13 482 (25.1%) received intervention. Use of genetic testing increased (odds ratio, 1.22 per year; 95% CI, 1.20-1.24), whereas use of computed tomography decreased (odds ratio, 0.93 per year; 95% CI, 0.92-0.94) during the study period. After adjusting for relevant covariables, children who were seen by pediatric otolaryngologists and geneticists had the highest odds of receiving workup and intervention. Additionally, racial/ethnic and economic disparities were observed in the use of most modalities of diagnostic workup and intervention for pediatric SNHL. Conclusions and Relevance: This cross-sectional study identified factors associated with disparities in the diagnostic workup and intervention of pediatric SNHL, thus highlighting the need for increased education and standardization in the management of this common sensory disorder.


Assuntos
Perda Auditiva Neurossensorial/diagnóstico , Testes Auditivos/métodos , Audição/fisiologia , Imageamento por Ressonância Magnética/métodos , Tomografia Computadorizada por Raios X/métodos , Criança , Estudos Transversais , Feminino , Perda Auditiva Neurossensorial/epidemiologia , Perda Auditiva Neurossensorial/fisiopatologia , Humanos , Incidência , Masculino , Estudos Retrospectivos , Estados Unidos/epidemiologia
9.
Am J Otolaryngol ; 42(1): 102830, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33176266

RESUMO

PURPOSE: Hearing is an important sensory skill for psychomotor development. As the cochlea and vestibule share the membranous labyrinth of the inner ear, children with sensorineural hearing loss (SNHL) may have vestibular dysfunction. This study aimed to evaluate static, dynamic, functional balance, and mobility as a whole in children with SNHL. MATERIAL AND METHODS: Eighty children, 40 with bilateral severe-to-profound SNHL (20 children between the ages of 6-10 were included in the Group 1, and 20 children between the ages of 11-15 were included in the Group 2) and 40 with normal-hearing (the Group 3 included 20 children between the ages of 6-10 and the Group 4 of 20 children between the ages of 11-15) were included in the study. The Single-Leg Stance (SLS) Test, Functional Reach Test (FRT), Time Up and Go (TUG) Test, and Pediatric Balance Scale (PBS) were used to evaluate the balance skills of children. RESULTS: The present study found out that children with SNHL in both age groups performed worse than those with normal-hearing in FRT, SLS, and PBS. In the TUG test, children with SNHL in the younger age group had lower performance compared to their peers with normal-hearing while the TUG performance of children with SNHL in the older age group was similar to their normal-hearing peers. CONCLUSION: It was concluded that the static, dynamic and functional balance skills of children with SNHL were impaired compared to their normal-hearing peers. Including balance assessment in the routine test battery in children with SNHL may be decisive for early diagnosis and rehabilitation of balance disorders. It may be beneficial to add static, dynamic and functional balance tests to the test battery in addition to mobility assessment, especially in children with SNHL in the older age groups.


Assuntos
Perda Auditiva Neurossensorial/fisiopatologia , Equilíbrio Postural/fisiologia , Vestíbulo do Labirinto/fisiopatologia , Adolescente , Fatores Etários , Criança , Diagnóstico Precoce , Feminino , Perda Auditiva Neurossensorial/complicações , Perda Auditiva Neurossensorial/diagnóstico , Humanos , Masculino , Transtornos das Sensações/diagnóstico , Transtornos das Sensações/etiologia , Transtornos das Sensações/reabilitação
10.
Am J Otolaryngol ; 42(1): 102773, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33161258

RESUMO

OBJECTIVE: To evaluate speech understanding outcomes in a large adult cohort who demonstrated poor hearing performance with well fit hearing aids in the unilateral and bilateral or bimodal listening conditions at preimplant, 3-, 6- and 12-months. SUBJECTS: Post-linguistically deafened adults (N = 100) with bilateral moderate-to-profound sensorineural hearing loss and limited functional benefit from well fit bilateral hearing aids. METHOD: A multicenter, prospective, repeated-measures, within-subject controlled study was conducted. All subjects were implanted with a Slim Modiolar cochlear implant and were required to use bimodal stimulation (cochlear implant and hearing aid in contralateral ear) for 6-months postimplant and optionally to 12-months. Evaluations included: speech recognition for monosyllabic consonant-nucleus-consonant (CNC) words in quiet; AzBio sentences in coincident noise (at +5 and +10 dB signal-to-noise ratio (SNR)), in implant ear and bimodal conditions. All speech tests were performed at preimplant and 6-months postimplant for primary endpoint outcomes, and a subset of speech tests at 3- and 12-months. RESULTS: In the implant ear only, at 3-, 6- and 12-months postimplant, 84%, 93% and 97% of subjects respectively, demonstrated significantly improved monosyllabic word scores in quiet compared to preimplant hearing aid scores (p < 0.05). At 12-months, a mean gain of 51% points, for monosyllabic words and 32% points for sentences in noise was observed (p < 0.001). In the bimodal condition, at 6-months postimplant, 87% of subjects demonstrated significantly improved monosyllabic word scores in quiet compared to preimplant bilateral hearing aid scores (p < 0.05). At 6-months, a mean gain of 40% points, for monosyllabic words was observed (p < 0.001). Speech scores for sentences in noise significantly improved for the bimodal condition at 6- and 12-months (p < 0.001). In addition to speech scores for the implanted ear, bimodal condition scores demonstrated further increments, especially for sentences in noise at 6- and 12-months (p < 0.001). CONCLUSION: Results support that bimodal hearing is superior to bilateral hearing aids in this cohort of bilateral moderate-to-profound adult hearing aid users. Our study cohort demonstrated significant improvements for speech scores for the cochlear implant (CI) ear only and bimodal conditions compared to the baseline preimplant unilateral and bilateral hearing aid conditions respectively. The greatest gain in performance was in the first three months of device use with incremental improvement through 12 months. These findings indicate that when hearing aids fit to National Acoustics Laboratory (NAL-1) targets do not provide the necessary audibility needed for speech recognition, referral for CI-candidacy evaluation is strongly recommended. TRIAL REGISTRATION: Clintrial.govNCT03007472. Registered 01/02/2017, https://clinicaltrials.gov/ct2/show/NCT03007472?term=clinical+evaluation+of+the+nucleus+CI532&draw=2&rank=2.


Assuntos
Implante Coclear/métodos , Perda Auditiva Neurossensorial/reabilitação , Perda Auditiva Neurossensorial/cirurgia , Audição , Percepção da Fala , Adulto , Idoso , Idoso de 80 Anos ou mais , Implantes Cocleares , Feminino , Auxiliares de Audição , Perda Auditiva Neurossensorial/fisiopatologia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
11.
Pan Afr Med J ; 35(Suppl 2): 139, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33193954

RESUMO

Thiamine-responsive megaloblastic anaemia (TRMA) is a syndrome associated with megaloblastic anaemia, diabetes mellitus and sensorineural deafness, due to mutations in the SLC19A2gene, which codes for a thiamine carrier protein. Oral thiamine supplementation is the main treatment. We report the case of a 19-year-old man known for TRMA, who presented in the emergency department with bicytopenia (haemoglobin 5,4 g/dL, thrombocytes 38×109/L) revealed by dyspnea and chest pain. Investigations excluded bleeding, hemolysis, coagulopathy and iron deficiencies. A recent infection and an acute coronary syndrome have also been eliminated. We later found out that thiamine treatment had been discontinued three months before, due to general confinement in Tunisia during the COVID-19 pandemic. Parenteral administration of 100 mg of thiamine daily resulted in the recovery of haematopoiesis within three weeks.


Assuntos
Anemia Megaloblástica/sangue , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Diabetes Mellitus/sangue , Perda Auditiva Neurossensorial/sangue , Pandemias , Pneumonia Viral/epidemiologia , Deficiência de Tiamina/congênito , Trombocitopenia/etiologia , Síndrome Coronariana Aguda/diagnóstico , Anemia Megaloblástica/tratamento farmacológico , Anemia Megaloblástica/fisiopatologia , Dor no Peito/etiologia , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/fisiopatologia , Diagnóstico Diferencial , Hemoglobina A Glicada/análise , Acesso aos Serviços de Saúde , Perda Auditiva Neurossensorial/tratamento farmacológico , Perda Auditiva Neurossensorial/fisiopatologia , Hemoglobinas/análise , Humanos , Masculino , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/etiologia , Recidiva , Tiamina/provisão & distribuição , Tiamina/uso terapêutico , Deficiência de Tiamina/sangue , Deficiência de Tiamina/tratamento farmacológico , Deficiência de Tiamina/fisiopatologia , Tunísia , Adulto Jovem
12.
PLoS One ; 15(9): e0239487, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32976532

RESUMO

BACKGROUND: For patients with single-sided deafness (SSD), restoration of binaural function via cochlear implant (CI) has been shown to improve speech understanding in noise. The objective of this study was to investigate changes in behavioral performance and cortical auditory responses following cochlear implantation. DESIGN: Prospective longitudinal study. SETTING: Tertiary referral center. METHODS: Six adults with SSD were tested before and 12 months post-activation of the CI. Six normal hearing (NH) participants served as experimental controls. Speech understanding in noise was evaluated for various spatial conditions. Cortical auditory evoked potentials were recorded with /ba/ stimuli in quiet and in noise. Global field power and responses at Cz were analyzed. RESULTS: Speech understanding in noise significantly improved with the CI when speech was presented to the CI ear and noise to the normal ear (p<0.05), but remained poorer than that of NH controls (p<0.05). N1 peak amplitude measure in noise significantly increased after CI activation (p<0.05), but remained lower than that of NH controls (p<0.05) at 12 months. After 12 months of CI experience, cortical responses in noise became more comparable between groups. CONCLUSION: Binaural restoration in SSD patients via cochlear implantation improved speech performance noise and cortical responses. While behavioral performance and cortical auditory responses improved, SSD-CI outcomes remained poorer than that of NH controls in most cases, suggesting only partial restoration of binaural hearing.


Assuntos
Córtex Auditivo/fisiologia , Surdez/fisiopatologia , Perda Auditiva Unilateral/fisiopatologia , Percepção da Fala/fisiologia , Fala/fisiologia , Idoso , Implante Coclear/métodos , Implantes Cocleares , Compreensão/fisiologia , Potenciais Evocados Auditivos/fisiologia , Feminino , Audição/fisiologia , Perda Auditiva Neurossensorial/fisiopatologia , Testes Auditivos/métodos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Ruído , Estudos Prospectivos , Localização de Som/fisiologia
13.
Med J Aust ; 213(8): 352-353.e1, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32946596

Assuntos
Doenças dos Nervos Cranianos/diagnóstico , Herpes Zoster/diagnóstico , Mononeuropatias/diagnóstico , Doenças do Nervo Abducente/diagnóstico , Doenças do Nervo Abducente/tratamento farmacológico , Doenças do Nervo Abducente/fisiopatologia , Doenças do Nervo Abducente/virologia , Idoso , Doenças dos Nervos Cranianos/tratamento farmacológico , Doenças dos Nervos Cranianos/fisiopatologia , Doenças dos Nervos Cranianos/virologia , Diagnóstico Diferencial , Diplopia/fisiopatologia , Dor de Orelha/fisiopatologia , Edema/fisiopatologia , Doenças do Nervo Facial/diagnóstico , Doenças do Nervo Facial/tratamento farmacológico , Doenças do Nervo Facial/fisiopatologia , Doenças do Nervo Facial/virologia , Paralisia Facial/fisiopatologia , Doenças do Nervo Glossofaríngeo/diagnóstico , Doenças do Nervo Glossofaríngeo/tratamento farmacológico , Doenças do Nervo Glossofaríngeo/fisiopatologia , Doenças do Nervo Glossofaríngeo/virologia , Glucocorticoides/uso terapêutico , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/tratamento farmacológico , Perda Auditiva Neurossensorial/fisiopatologia , Perda Auditiva Neurossensorial/virologia , Herpes Zoster/tratamento farmacológico , Herpes Zoster/fisiopatologia , Humanos , Masculino , Mononeuropatias/tratamento farmacológico , Mononeuropatias/virologia , Osteomielite/diagnóstico , Otite Externa/diagnóstico , Prednisolona/uso terapêutico , Base do Crânio , Doenças do Nervo Vago/diagnóstico , Doenças do Nervo Vago/tratamento farmacológico , Doenças do Nervo Vago/fisiopatologia , Doenças do Nervo Vago/virologia , Doenças do Nervo Vestibulococlear/diagnóstico , Doenças do Nervo Vestibulococlear/tratamento farmacológico , Doenças do Nervo Vestibulococlear/fisiopatologia , Doenças do Nervo Vestibulococlear/virologia , Ativação Viral
14.
PLoS One ; 15(8): e0238351, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32857825

RESUMO

The purpose of this study was to evaluate the association between the presence of Metabolic Syndrome (MetS) and idiopathic sudden sensorineural hearing loss (ISSHL) and the impact of MetS on recovery of patients with ISSHL. 39 Patients with ISSHL and 44 controls were enrolled in this study. Demographic, clinical characteristics and hearing recovery were evaluated. MetS was defined according to the diagnostic criteria of International Diabetes Federation (IDF) consensus definition. Patients affected by ISSHL presented a body mass index (BMI), waist circumference, waist hip ratio (WHR), fasting glucose and blood pressure significantly higher compared to controls. Considering patients with central obesity, 5 controls and 15 ISSHL patients met the criteria of MetS. According to Siegel criteria, a complete or partial recovery was observed in 60% of patients with MetS and in 91,66% of patients without MetS. MetS was associated with ISSHL and this association negatively influenced the hearing recovery of these patients.


Assuntos
Perda Auditiva Neurossensorial/epidemiologia , Perda Auditiva Súbita/epidemiologia , Síndrome Metabólica/epidemiologia , Feminino , Perda Auditiva Neurossensorial/fisiopatologia , Perda Auditiva Neurossensorial/terapia , Perda Auditiva Súbita/fisiopatologia , Perda Auditiva Súbita/terapia , Humanos , Masculino , Síndrome Metabólica/fisiopatologia , Síndrome Metabólica/terapia , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/fisiopatologia , Obesidade/terapia , Recuperação de Função Fisiológica
15.
Am J Otolaryngol ; 41(4): 102515, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32487334

RESUMO

OBJECTIVES: The purpose of this study was to compare different means of intratympanic steroid delivery in the treatment of idiopathic sudden sensorineural hearing loss. DESIGN: Prospective, multicentered, randomized controlled trial. SETTING AND PARTICIPANTS: Fifty-six patients who fulfilled the inclusion criteria for idiopathic sudden sensorineural hearing loss who failed or were contraindicated for oral steroids were included in this study. Patients were randomly divided into 2 groups according to delivery methods: group A received 4 sections of intratympanic dexamethasone injection and group B received grommet placement with dexamethasone delivery followed by 3 sections of dexamethasone ear drop application. Self-administered paper-based questionnaires were filled out to measure subjective pain scores, vertigo, anxiety, and overall satisfaction immediately after each procedure. Hearing threshold was measured with pure tone audiogram in the follow-up. RESULTS: There was no statistical significance detected in hearing threshold improvement between both groups (P = 0.30). Grommet placement followed by dexamethasone eardrop application demonstrated a significant difference in shorter waiting time (24 min in grommet group vs 52 min in injection group; P < 0.01); and better overall satisfaction (1.6 in grommet group vs 2.5 in injection group; P < 0.05). CONCLUSIONS: Grommet placement followed by dexamethasone eardrop application is a good alternative for a patient indicated for intratympanic steroid, with less administrative cost, shorter waiting time, and more satisfaction.


Assuntos
Dexametasona/administração & dosagem , Perda Auditiva Neurossensorial/tratamento farmacológico , Perda Auditiva Súbita/tratamento farmacológico , Audição , Ventilação da Orelha Média , Limiar Diferencial , Feminino , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/fisiopatologia , Perda Auditiva Súbita/diagnóstico , Perda Auditiva Súbita/fisiopatologia , Humanos , Injeção Intratimpânica , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Estudos Prospectivos , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento
16.
Am J Otolaryngol ; 41(4): 102503, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32402694

RESUMO

OBJECTIVES: Vertigo in sudden sensorineural hearing loss (SSNHL) is hypothesized as an extension of the disease caused by the anatomical proximity of the cochlea and vestibule. The present study aimed to demonstrate the association of vestibular function test (VFT) results with SSNHL disease severity and prognosis. MATERIALS AND METHODS: This study assessed clinical records of 263 SSNHL patients admitted to our hospital, between January 2010 and October 2017. Steroid treatment comprised high-dose intravenous dexamethasone (16 mg/d) or oral methylprednisolone (64 mg/d) for 4 days and tapered oral methylprednisolone for 8 days after discharge. Caloric tests were performed in all patients, and cervical vestibular-evoked myogenic potential (c-VEMP) and ocular VEMP (o-VEMP) tests were performed in 209 and 144 patients, respectively. RESULTS: Ninety six patients had vertigo, and caloric abnormalities were observed in 119 patients. Initial PTA in patients with vertigo were worse than in those without vertigo (63.0 dB vs 72.7 dB, P = .002). Initial PTA in patients with abnormal o-VEMP was worse than in those with normal o-VEMP (61.4 dB vs 73.0 dB, P = .004). PTA improvement after steroid treatment in patients with vertigo was lower than in those without vertigo (25.0 dB vs 20.9 dB, P = .028). PTA improvement after treatment in patients with abnormal caloric results was lower than in those with normal caloric results (26.0 dB vs 18.4 dB, P = .013). CONCLUSION: The functions of vestibular organs, particularly the utricle and lateral semicircular canal, are associated with disease severity and hearing outcome in SSNHL patients.


Assuntos
Perda Auditiva Neurossensorial/etiologia , Vertigem/etiologia , Vestíbulo do Labirinto/fisiopatologia , Administração Oftálmica , Adolescente , Adulto , Idoso , Testes Calóricos , Dexametasona/administração & dosagem , Potenciais Evocados , Feminino , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/tratamento farmacológico , Perda Auditiva Neurossensorial/fisiopatologia , Humanos , Infusões Intravenosas , Masculino , Metilprednisolona/administração & dosagem , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Vertigem/diagnóstico , Vertigem/tratamento farmacológico , Vertigem/fisiopatologia , Adulto Jovem
17.
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
18.
Am J Otolaryngol ; 41(4): 102512, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32471775

RESUMO

OBJECTIVE: The aim of this study was to report a case of cochlear implantation (CI) for a patient with an otic capsule-sparing traumatic brain injury (TBI) and to review the relevant literature. METHODS: A patient with history of TBI received a CI for bilateral profound hearing loss. A systematic review of the literature was performed to identify and compare similar cases. RESULTS: A 36-year-old male with a history of hearing loss from right acute labyrinthitis was referred for bilateral profound sensorineural hearing loss (SNHL) after a fall with associated injury to the central auditory nervous system (CANS) including the brainstem. On the right, behavioral acoustic threshold measurements were in the profound range with absent OAEs. On the left, testing revealed no measurable behavioral acoustic thresholds and variable physiologic measures. A right unilateral cochlear implant was performed with most recent follow-up demonstrating speech awareness thresholds of 25 dB HL with excellent detection of all 6 Ling sounds. However, the patient also continues to suffer from other neurologic sequelae related to his TBI, which challenge his ability to demonstrate objective and subjective benefit. A systematic review of the literature demonstrates variable outcomes for patients with TBI and SNHL. CONCLUSIONS: Patients with profound SNHL and TBI present a distinct rehabilitative challenge for clinicians. CI may provide meaningful benefit in this population, though care should be taken in patient selection and counseling.


Assuntos
Lesões Encefálicas Traumáticas/complicações , Implante Coclear , Perda Auditiva Bilateral/etiologia , Perda Auditiva Bilateral/reabilitação , Perda Auditiva Bilateral/cirurgia , Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Neurossensorial/cirurgia , Adulto , Córtex Auditivo/lesões , Tronco Encefálico/lesões , Limiar Diferencial , Audição , Perda Auditiva Bilateral/fisiopatologia , Perda Auditiva Neurossensorial/fisiopatologia , Perda Auditiva Neurossensorial/reabilitação , Humanos , Labirintite/complicações , Masculino , Percepção da Fala , Resultado do Tratamento
19.
Hum Genet ; 139(10): 1315-1323, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32382995

RESUMO

We present detailed comparative analyses to assess population-level differences in patterns of genetic deafness between European/American and Japanese cohorts with non-syndromic hearing loss. One thousand eighty-three audiometric test results (921 European/American and 162 Japanese) from members of 168 families (48 European/American and 120 Japanese) with non-syndromic hearing loss secondary to pathogenic variants in one of three genes (KCNQ4, TECTA, WFS1) were studied. Audioprofile characteristics, specific mutation types, and protein domains were considered in the comparative analyses. Our findings support differences in audioprofiles driven by both mutation type (non-truncating vs. truncating) and ethnic background. The former finding confirms data that ascribe a phenotypic consequence to different mutation types in KCNQ4; the latter finding suggests that there are ethnic-specific effects (genetic and/or environmental) that impact gene-specific audioprofiles for TECTA and WFS1. Identifying the drivers of ethnic differences will refine our understanding of phenotype-genotype relationships and the biology of hearing and deafness.


Assuntos
Proteínas da Matriz Extracelular/genética , Genótipo , Perda Auditiva Neurossensorial/genética , Canais de Potássio KCNQ/genética , Proteínas de Membrana/genética , Mutação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático , Audiometria , Estudos de Casos e Controles , Criança , Pré-Escolar , Grupo com Ancestrais do Continente Europeu , Feminino , Proteínas Ligadas por GPI/genética , Expressão Gênica , Estudos de Associação Genética , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/etnologia , Perda Auditiva Neurossensorial/fisiopatologia , Humanos , Lactente , Recém-Nascido , Japão , Masculino , Pessoa de Meia-Idade , Linhagem , Fenótipo , Estados Unidos
20.
Int J Pediatr Otorhinolaryngol ; 134: 110065, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32361253

RESUMO

Enlarged vestibular aqueduct (EVA) is the most frequent inner ear abnormality found on computed tomography in children with sensorineural hearing loss. The effects EVA abnormalities have on electrocochleography (ECochG) are unknown. Positive deflections in summation potential evoked by tone bursts were observed in 3/5 subjects, while a large negative deflection, similar to endolymphatic hydrops (EH), was observed for 2/5 subjects. The presence of an enlarged summation potential, with and without a compound action potential, was observed in response to a broadband click stimulus. Results suggest likely effects of a third window on ECochG responses and presence of EH in EVA.


Assuntos
Audiometria de Resposta Evocada , Implante Coclear , Perda Auditiva Neurossensorial/fisiopatologia , Aqueduto Vestibular/anormalidades , Aqueduto Vestibular/fisiopatologia , Adolescente , Criança , Feminino , Perda Auditiva Neurossensorial/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Aqueduto Vestibular/cirurgia
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