Assessing ototoxicity and patients’ satisfaction of topical local anaesthesia in myringotomy and ventilation tube insertion

2019 ◽  
Vol 133 (4) ◽  
pp. 285-288
Author(s):  
S Marzouk ◽  
A Al-lami ◽  
R Sykes ◽  
C Neumann ◽  
I J Nixon
Keyword(s):  
Local Anaesthesia ◽  
Pure Tone ◽  
Animal Studies ◽  
Bone Conduction ◽  
Sensorineural Hearing ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Pure Tone Average ◽  
Patients Satisfaction ◽  
Hearing Outcomes

AbstractObjectivesAnimal studies have suggested that exposure of the middle ear to topical local anaesthesia may be ototoxic. This study aimed to report sensorineural hearing outcomes and patients’ satisfaction in those who underwent myringotomy and ventilation tube insertion using topical local anaesthesia.MethodsTwenty-nine patients (32 ears) were operated on. Pre- and post-operative audiology findings were compared. A Likert-type questionnaire on treatment satisfaction was completed at the end of the procedure.ResultsMedian patient age was 55 years (range, 27–88 years). Pre- and post-operative bone conduction pure tone averages were 26.76 dB and 25.26 dB respectively (mean reduction of −1.22 dB, 95 per cent confidence interval of −5.91 to 8.13 dB; p = 0.7538). One ear (3 per cent) had a reduction in pure tone average of 10 dB.ConclusionThe results suggest that sensorineural hearing loss is not a complication of ear exposure to topical local anaesthesia during myringotomy and ventilation tube insertion. The procedure was well perceived.

Stapes fixation surgery: stapedectomy versus stapedotomy

2010 ◽  
Vol 4 (3) ◽  
pp. 429-434 ◽  
Author(s):  
Taweekiat Thamjarayakul ◽  
Pakpoom Supiyaphun ◽  
Kornkiat Snidvongs
Keyword(s):  
Success Rate ◽  
Pure Tone ◽  
Bone Conduction ◽  
Surgical Techniques ◽  
Speech Discrimination ◽  
Stapes Fixation ◽  
Pure Tone Average ◽  
Window Opening ◽  
Hearing Outcomes ◽  
Air Conduction

Abstract Background: Stapedectomy and stapedotomy are the standard techniques for stapes fixation surgery. Both techniques depend on the size of window opening (total, partial stapedectomy and small-hole stapedotomy) and the type of prosthesis used. Outcome of technique and prosthesis are controversy. Objective: Evaluate the outcomes of the two surgical techniques (stapedectomy/stapedotomy) and two sizes of prosthesis (Cawthorn 0.6mm/0.3mm) in terms of effectiveness and safety. Material and methods: Sixty-four medical records of patients undergoing stapedectomy or stapedotomy between the year 1995 and 2005 were reviewed. The subjects were classified into three groups including 0.6-mm stapedectomy, 0.6-mm and 0.3-mm stapedotomy group. The pre and post operative air-conduction threshold (AC) and air-bone gap (A-B gap) were compared for each group. The pre-and post-operative differences in pure tone average of AC, pure tone average of bone conduction threshold (BC), AB gap, AC at 4KHz, BC at 4KHz, AC at 8KHz, and speech discrimination score (SDS) were analyzed. The surgical complications were also compared. Results: Means of post-operative AC, and A-B gap were significantly better in all three groups. The mean of postoperative AC at 4KHz was significantly improved only in stapedotomy groups (0.6-mm and 0.3-mm stapedotomy). To compare the hearing outcomes among the three groups, there were no statistically significant differences between 0.6-mm stapedectomy vs. 0.6-mm stapedotomy, and between 0.6- mm vs. 0.3-mm stapedotomy. The complications were found in all three groups. The 0.3-mm stapedotomy had the lowest rate. Conclusion: Stapedectomy versus stapedotomy yields comparable hearing outcomes but stapedotomy results had a better success rate than the stapedectomy. For 0.6-mm stapedotomy vs. 0.3-mm stapedotomy, the overall results in both groups are not significantly different, in terms of both the hearing outcomes and the success rate. In terms of complication rate, 0.6-mm stapedectomy had the highest rate, while 0.3-mm stapedotomy had the lowest.

Sudden Sensorineural Hearing and Vestibular Loss in a Case of Relapsing Polychondritis

2021 ◽  
pp. 000348942110059
Author(s):  
Özge Akdoğan ◽  
Smirnov Exilus ◽  
Bryan K. Ward ◽  
Justin C. McArthur ◽  
Charles C. Della Santina ◽  
...  
Keyword(s):  
Cochlear Implantation ◽  
Pure Tone ◽  
Relapsing Polychondritis ◽  
Sensorineural Hearing ◽  
High Dose ◽  
Left Auricle ◽  
Vestibular Loss ◽  
Patient Reported ◽  
Loss Of Hearing ◽  
Hearing Outcomes

Objectives: To report a case of profound bilateral sensorineural hearing and vestibular loss from relapsing polychondritis and hearing outcomes after cochlear implantation. Methods: Case report and literature review. Results: A 43 year-old woman developed sudden loss of hearing and balance that progressed over several weeks to bilateral, profound hearing and vestibular loss. Steroid treatments were ineffective. She underwent vestibular physical therapy and left cochlear implantation. About 10 months after her initial presentation, she developed erythema, warmth, swelling, and pain of the left auricle sparing the lobule, flattening of the bridge of her nose, and right ankle swelling, warmth, and skin erythema. A biopsy of the left auricle revealed histopathologic findings consistent with relapsing polychondritis. She was treated with high dose prednisolone. The ear inflammation resolved, however, despite excellent auditory response to pure tone thresholds, the patient reported no improvement in speech perception after cochlear implantation. Conclusions: Relapsing polychondritis can present with rapidly progressive, profound loss of hearing and vestibular function. Hearing outcomes after cochlear implantation can include poor speech discrimination despite good pure tone detection thresholds.

Can audiometric results predict qualitative hearing improvements in bone-anchored hearing aid recipients?

2013 ◽  
Vol 128 (1) ◽  
pp. 35-42
Author(s):  
M L McNeil ◽  
M Gulliver ◽  
D P Morris ◽  
F M Makki ◽  
M Bance
Keyword(s):  
Pure Tone ◽  
Hearing Aid ◽  
Subjective Evaluation ◽  
Bone Conduction ◽  
Hearing Threshold ◽  
Sound Field ◽  
Hearing Aid Fitting ◽  
Pure Tone Average ◽  
Hearing Handicap ◽  
Bone Anchored Hearing Aid

AbstractIntroduction:Patients receiving a bone-anchored hearing aid have well-documented improvements in their quality of life and audiometric performance. However, the relationship between audiometric measurements and subjective improvement is not well understood.Methods:Adult patients enrolled in the Nova Scotia bone-anchored hearing aid programme were identified. The pure tone average for fitting the sound-field threshold, as well as the better and worse hearing ear bone conduction and air conduction levels, were collected pre-operatively. Recipients were asked to complete the Speech, Spatial and Qualities of Hearing questionnaire; their partners were asked to complete a pre- and post-bone anchored hearing aid fitting Hearing Handicap Inventory for Adults questionnaire.Results:Forty-eight patients who completed and returned the Speech, Spatial and Qualities of Hearing questionnaire had partners who completed the Hearing Handicap Inventory for Adults questionnaire. The results from the Speech, Spatial and Qualities of Hearing questionnaire correlated with the sound-field hearing threshold post-bone-anchored hearing aid fitting and the pure tone average of the better hearing ear bone conduction (total Speech, Spatial and Qualities of Hearing Scale to the pre-operative better hearing ear air curve (r = 0.3); worse hearing ear air curve (r = 0.27); post-operative, bone-anchored hearing aid-aided sound-field thresholds (r = 0.35)). An improvement in sound-field threshold correlated only with spatial abilities. In the Hearing Handicap Inventory for Adults questionnaire, there was no correlation between the subjective evaluation of each patient and their partner.Conclusion:The subjective impressions of hearing aid recipients with regards to speech reception and the spatial qualities of hearing correlate well with pre-operative audiometric results. However, the overall magnitude of sound-field improvement predicts an improvement of spatial perception, but not other aspects of hearing, resulting in hearing aid recipients having strongly disparate subjective impressions when compared to those of their partners.

Framingham risk score is associated with hearing outcomes in patients with idiopathic sudden sensorineural hearing loss

2020 ◽  
Vol 134 (5) ◽  
pp. 419-423
Author(s):  
Y-S Chang ◽  
S Park ◽  
M K Lee ◽  
Y C Rah ◽  
J Choi
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Risk Score ◽  
Pure Tone ◽  
Framingham Risk Score ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Pure Tone Average ◽  
Framingham Risk ◽  
Group 1

AbstractObjectiveTo assess the Framingham risk score as a prognostic tool for idiopathic sudden sensorineural hearing loss patients.MethodsMedical 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).ResultsInitial 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.ConclusionFramingham 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.

Sudden sensorineural hearing loss in a patient with primary antiphospholipid syndrome

2007 ◽  
Vol 122 (2) ◽  
pp. 204-206 ◽  
Author(s):  
K-T Kang ◽  
Y-H Young
Keyword(s):  
Hearing Loss ◽  
Acetylsalicylic Acid ◽  
Sensorineural Hearing Loss ◽  
Antiphospholipid Syndrome ◽  
Pure Tone ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Primary Antiphospholipid Syndrome ◽  
Pure Tone Average ◽  
The Right

AbstractObjective:Despite multiple systemic manifestations, sudden sensorineural hearing loss in a patient with antiphospholipid syndrome is rarely reported.Patient:A 46-year-old man with primary antiphospholipid syndrome had a sudden onset of hearing loss and tinnitus in the right ear in December 2005, because he discontinued use of warfarin and acetylsalicylic acid for a few days.Results:Audiometry revealed saucer-type sensorineural hearing loss with a pure tone average of 73 dB in the right ear, and flat-type hearing loss with a pure tone average of 25 dB in the left ear. Electronystagmography displayed multiple central signs and bilateral canal paresis, while a vestibular evoked myogenic potential test revealed bilateral delayed responses. After admission, the patient was re-treated with warfarin and acetylsalicylic acid. Follow-up audiometry showed recovery of right-sided hearing, with a pure tone average of 12 dB, three days after presentation.Conclusion:Consensus exists on the effectiveness of anticoagulant agents in aiding a favourable outcome of sudden sensorineural hearing loss in patients with antiphospholipid syndrome.

Tympanoscopy to increase the accuracy of diagnosis in conductive hearing loss

1998 ◽  
Vol 112 (2) ◽  
pp. 154-157 ◽  
Author(s):  
Tapio S. Karhuketo ◽  
Heikki J. Puhakka ◽  
Pekka J. Laippala
Keyword(s):  
Decision Making ◽  
Hearing Loss ◽  
Pure Tone ◽  
Conductive Hearing Loss ◽  
Bone Conduction ◽  
Speech Discrimination ◽  
Bone Conduction Threshold ◽  
Pure Tone Average ◽  
Stapedial Reflex ◽  
Conductive Hearing

AbstractThe diagnosis of conductive hearing loss is usually based on audiological methods and radiology. The aim of our study was to show that there is a useful additive method to clarify the findings of diseases with conductive hearing loss.Patients (151 ears) with conductive hearing loss were examined using several methods: otomicroscopy, air- and bone-conduction threshold, pure tone average, speech threshold, speech discrimination, tympanometry and stapedial reflex and tympanoscopy.The management of the patients changed in 17 per cent of cases due to tympanoscopy. In a group with normal tympanic membrane the movement of the stapes during endoscopy was compared to stapedial reflex. Stiff stapes were found more often than an abnormal stapedial reflex.Middle ear endoscopy can increase the accuracy of diagnosis of conductive hearing loss thus enhancing decision making in the case of the patient.

scholarly journals Comparison of Hearing Outcomes of Systemic Steroid Monotherapy and Intratympanic Steroid Combined Treatment in Idiopathic Sudden Sensorineural Hearing Loss

2021 ◽  
Vol 64 (3) ◽  
pp. 155-160
Author(s):  
Kyungil Jang ◽  
So Yun Lim ◽  
Eun-Ju Jeon ◽  
Hyun Jin Lee
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Pure Tone ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Systemic Steroid ◽  
Partial Recovery ◽  
Simultaneous Group ◽  
Hearing Outcomes

Background and Objectives Steroid treatment is used as a main treatment modality for sudden sensorineural hearing loss (SSNHL). Intratympanic injection of steroid (ITS) has been used and its therapeutic efficacy reported as being comparable to the systemic steroid administration (SS). This study compares the hearing outcomes of using ITS and SS simultaneously and SS alone.Subjects and Method Retrospective chart review was performed for 146 patients with SSNHL. The patients were divided into 2 groups according to the method of treatment (SS and ITS simultaneously vs. SS alone). The inclusion criteria were starting treatment within 7 days after onset, and follow up pure tone audiometry at least 4 weeks after treatment. Hearing gain for pure tone threshold of each frequency and average of 4 frequencies (500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz) were compared between both groups.Results The improvement in PTA at 1-month follow-up was 27.3±20.0 dB HL in the simultaneous group and 19.1±19.5 dB HL in the SS alone group; this was not statistically significant. Complete or partial recovery at 1-month follow-up was observed in 65.3% of the simultaneous group and 69.6% of the SS alone group; this was also not significant.Conclusion There was no significant difference in hearing outcomes between the simultaneous and SS alone group. The simultaneous therapy does not appear to be superior to the SS alone therapy. Further studies using more population and longer follow-up periods are necessary.

scholarly journals The practices and philosophies of cartilage tympanoplasty in difficult and challenging circumstances: audiological and morphological perspectives

2021 ◽  
Vol 7 (2) ◽  
pp. 358
Author(s):  
Apoorva Kumar Pandey ◽  
Ajaz U. Haq ◽  
Sharad Hernot ◽  
Madhuri Kaintura ◽  
Aparna Bhardwaj ◽  
...  
Keyword(s):  
Success Rate ◽  
Pure Tone ◽  
Randomized Study ◽  
Chronic Otitis Media ◽  
Functional Results ◽  
Pure Tone Average ◽  
Cartilage Tympanoplasty ◽  
The Difference ◽  
Graft Success ◽  
Hearing Outcomes

<p class="abstract"><strong>Background:</strong> The main objective of the study was to assess the anatomical and functional results of cartilage tympanoplasty using full thickness cartilage graft (with or without perichondrium) reinforced with fascia in high risk situations.</p><p class="abstract"><strong>Methods:</strong> This prospective non-controlled, non-randomized  study included 124 cases of chronic otitis media who underwent cartilage (reinforcement) tympanoplasty (underlay) and ossicular reconstruction with or without mastoidectomy in following seven groups:  revision cases, atelectatic cases, subtotal perforation (dry), larger anterior perforations (dry), tympanosclerosis, cholesteatomatous ear, and wet (discharging) ears .  Graft success was accepted labelled as an intact graft at the end of six month postoperatively. At the same time, hearing results were also assessed by comparing pre- and post-operative pure tone average air-bone gap (PTA-ABG) of each group using Student “t” test and p&lt;0.05 was considered statistically significant for the hearing outcomes.  </p><p class="abstract"><strong>Results:</strong> Anatomical success rate in this series was 94.36%. The overall mean pre- and post- operative pure tone average air-bone gap (PTA-ABG) were 31.33±10.41 dB and 19.55±12.04 dB, respectively and the difference was statistically significant (p&lt;0.05). Best take up rates were observed in atelectatic and tympanosclerotic group i.e., 100% and 96.55% respectively.</p><p class="abstract"><strong>Conclusions:</strong> This study discusses the results of cartilage tympanoplasty in specifically indicated seven situation and reveals good anatomic results in each group (minimum success rate was 86.66% in wet ears) and statistically significant differences in mean pre- and post op PTA-ABG in groups except cholesteatoma and wet ear group.</p>

scholarly journals Longitudinal analysis of the audiological phenotype in osteogenesis imperfecta: a follow-up study

2018 ◽  
Vol 132 (8) ◽  
pp. 703-710 ◽  
Author(s):  
S Martens ◽  
I J M Dhooge ◽  
F K R Swinnen
Keyword(s):  
Osteogenesis Imperfecta ◽  
Longitudinal Analysis ◽  
Otoacoustic Emissions ◽  
Pure Tone ◽  
Bone Conduction ◽  
Pure Tone Audiometry ◽  
Time Interval ◽  
Pure Tone Average ◽  
Acoustic Admittance

AbstractObjectiveThis prospective study involved a longitudinal analysis of the progression of hearing thresholds in patients with osteogenesis imperfecta.MethodsAudiometric results from 36 osteogenesis imperfecta patients (age range, 6–79 years) were compared between two test times with an average interval of 4 years. Audiometric evaluation included acoustic admittance measurements, acoustic stapedial reflex measurements, pure tone audiometry and otoacoustic emissions testing.ResultsAir conduction pure tone average, corrected for sex and age, and bone conduction pure tone average increased significantly in the study population (p < 0.05 and p < 0.001, respectively). In 14.3 per cent of the evaluated ears, an alteration in type and/or severity of hearing loss was observed.ConclusionAfter an average time interval of four years, significant changes in hearing status occurred in a population of osteogenesis imperfecta patients. These findings highlight the importance of regular audiological follow up in osteogenesis imperfecta patients, including audiometry, and measurements of acoustic admittance, acoustic stapedial reflexes and otoacoustic emissions.

Histone acetylation in refractory sudden sensorineural hearing loss patients after intratympanic methylprednisolone perfusion

2019 ◽  
Vol 133 (10) ◽  
pp. 895-902 ◽  
Author(s):  
L Xie ◽  
J Hou ◽  
H Qi ◽  
Y Dai ◽  
W She
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Histone Acetylation ◽  
Therapeutic Effect ◽  
Pure Tone ◽  
Histone H3 ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Average Gain ◽  
Pure Tone Average

AbstractObjectiveTo examine the relationship between the therapeutic effect of intratympanic methylprednisolone perfusion and histone acetylation in refractory sudden sensorineural hearing loss.MethodsThirty-four refractory sudden sensorineural hearing loss patients were enrolled and treated with intratympanic methylprednisolone perfusion. Pure tone average, acetylated histone H3, acetylated histone H4 and histone deacetylase 2 (HDAC2) were measured in peripheral blood mononuclear cells before and after intratympanic methylprednisolone perfusion. Sixteen healthy volunteers were recruited to obtain normal reference values.ResultsPure tone average in sudden sensorineural hearing loss patients improved from 84.14 ± 13.54 dB to 73.56 ± 18.45 dB after intratympanic methylprednisolone perfusion. Up-regulations in HDAC2 protein level, and down-regulations in histone H3 and H4 acetylation were observed in the intratympanic methylprednisolone perfusion sensitive group (pure tone average gain of 15 dB or more), while no significant changes were observed in the intratympanic methylprednisolone perfusion insensitive group (pure tone average gain of less than 15 dB).ConclusionIntratympanic methylprednisolone perfusion can improve hearing in a considerable number of refractory sudden sensorineural hearing loss patients. The therapeutic effect is closely related to reduced histone acetylation.

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