scholarly journals Relationship between distortion product otoacoustic emission signal-to-noise and hearing threshold change during methylprednisolone therapy for sudden deafness

2018 ◽  
Vol 1073 ◽  
pp. 042040
Author(s):  
J Bashiruddin ◽  
Risdawati ◽  
B Bramantyo ◽  
S Bardosono
2019 ◽  
Vol 49 (1) ◽  
pp. 1
Author(s):  
Brastho Bramantyo ◽  
Jenny Bashiruddin ◽  
Widayat Alviandi ◽  
Risdawati Risdawati

Latar belakang: Penatalaksanaan tuli mendadak menggunakan steroid sebagai terapi utama merupakan hasil konsensus terapi tuli mendadak tahun 2010 di Madrid-Spanyol dan Cochrane systematic review tahun 2009, yang saat ini diterapkan di Divisi Neurotologi Departemen Telinga Hidung Tenggorok-Kepala Leher Rumah Sakit Cipto Mangunkusumo. Evaluasi hasil pengobatan dilakukan dengan pemeriksaan audiometri dan Distortion Product Otoacoustic Emission (DPOAE). Pasien yang mengalami kesembuhan akan memperlihatkan peningkatan ambang dengar dan nilai Signal to Noise Ratio (SNR) emisi otoakustik. Tujuan: Mengevaluasi hasil terapi metilprednisolon dosis terbaru pada tuli mendadak dengan pemeriksaan DPOAE dan audiometri nada murni. Metode: Penelitian ini menggunakan desain pre dan post eksperimental. Diberikan terapi metilprednisolon 1 mg/kgBB dengan tapering off 20 mg setiap 5 hari. Dilakukan pemeriksaan DPOAE dan audiometri sebelum dan setelah terapi. Hasil: Total sampel yang diolah adalah 22 subjek. Penelitian ini mendapatkan perubahan yang bermakna nilai audiometri nada murni sebelum dan sesudah terapi pada semua frekuensi. Nilai SNR pada OAE sebelum dan setelah terapi rata-rata mengalami perubahan nilai pass, dengan perubahan nilai SNR pass terbanyak adalah pada frekuensi 8000 Hz (6 subjek). Tingkat perubahan ambang dengar sesudah terapi yang mengalami perbaikan paling banyak pada frekuensi 2000 Hz, 3000 Hz, 6000 Hz dengan masing-masing 16 subjek. Perbaikan emisi terjadi lebih awal dibandingkan perbaikan ambang dengar. Kesimpulan: Pada penelitian ini terdapat perubahan bermakna nilai audiometri, dan nilai DPOAE. Didapatkan hubungan bermakna perubahan SNR pada OAE dengan tingkat perubahan ambang dengar frekuensi 8000 Hz dan 10.000 Hz, setelah pengobatan metilprednisolon sesuai protokol penelitian ini. Background: Methylprednisolone as a drug of choice in sudden deafness was consented in Madrid, Spain 2010 and in Cochrane systematic review in 2009, and already applied in Neurotology Division, ENT Department Cipto Mangunkusumo Hospital. Sudden deafness treatment evaluation conducted by audiometry and Distortion Product Otoacoustic Emission (DPOAE) examinations. Hearing recovery could be assessed from the improvement of hearing threshold and Signal to Noise Ratio (SNR) of otoacoustic emission (OAE). Objective: To evaluate the current dose of methylprednisolone therapy for sudden deafness, by DPOAE and pure tone audiometry. Methods: This was a pre-post experimental study using methylprednisolone 1 mg/kg body weight tapered off 20 mg in every 5 days. DPOAE and audiometry examination were conducted pre and post therapy. Result: Total sample were 22 subjects. Significant improvement was seen in overall frequencies of audiometry examination. Pass result in SNR of OAE showed remarkable improvement in 8000 Hz (6 subjects). The level of pure tone threshold mainly increased in frequencies of 2000 Hz, 3000 Hz, and 6000 Hz, each 16 subjects. Improvement of the emision level occurred earlier than the hearing threshold. Conclusion: This study revealed significant improvement of audiometry threshold and OAE level. Significant correlation was found between SNR of OAE improvement with increased pure tone level in 8000 Hz and 10.000 Hz after methylprednisolone therapy according to the protocol of this study.


2009 ◽  
Vol 124 (2) ◽  
pp. 137-140 ◽  
Author(s):  
H Karabulut ◽  
M Dagli ◽  
A Ates ◽  
Y Karaaslan

AbstractThe aim of the current study was to investigate hearing loss and cochlear function in patients with systemic lupus erythematosus, using audiology, distortion product otoacoustic emissions and transient evoked otoacoustic emissions.Study design:Prospective, case–control study.Methods:The study included 26 randomised patients with systemic lupus erythematosus (52 ears) and 30 healthy control subjects (60 ears). Pure tone audiometry was performed at 250 and 500 Hz and at 1, 2, 4, 6, 8, 10, 12, 14 and 16 kHz. Distortion product otoacoustic emissions and transient evoked otoacoustic emissions were measured using Biologic System equipment with Scout Acoustic Emissions System software.Results:The distortion product otoacoustic emission signal responses were significantly different only at 750 Hz, while the distortion product otoacoustic emission signal–noise ratios were significantly different at 750 Hz and 6 kHz (p < 0.05), comparing patients and controls. The transient evoked otoacoustic emission signal–noise ratios were significantly different at 2 and 3 kHz, comparing patients and controls (p < 0.05). The transient evoked otoacoustic emission total signal–noise ratios were significantly different, comparing patients and controls (p < 0.05). In addition, the pure tone audiometry thresholds were significantly different at 250 and 500 Hz and at 1, 2, 10 and 12 kHz, comparing patients and controls (p < 0.05).Conclusion:Our findings do not completely agree with those of previous temporal bone histopathological studies. However, our results do support a general picture of low frequency hearing loss in systemic lupus erythematosus patients. We consider these results to be related to endolymphatic and cochlear hydrops, and we suggest that electrocochleography could be performed in further studies for clarification of this subject.


2016 ◽  
Vol 130 (5) ◽  
pp. 440-446 ◽  
Author(s):  
I Aladag ◽  
M Guven ◽  
M Songu

AbstractObjective:To investigate the use of systemic N-acetylcysteine and vitamin A in the prevention of gentamicin ototoxicity in rats.Methods:Forty-two Wistar rats were divided into four groups according to treatment: intratympanic saline, intratympanic gentamicin, intraperitoneal vitamin A after intratympanic gentamicin, and intraperitoneal N-acetylcysteine after intratympanic gentamicin. Signal-to-noise ratio and distortion product otoacoustic emissions were evaluated in all groups.Results:N-acetylcysteine had a significant protective effect at 1.5, 2, 3, 4, 6 and 8 kHz, whilst vitamin A had a significant protective effect at 2, 3, 4 and 6 kHz, as determined by the distortion product otoacoustic emission measurements. According to the signal-to-noise measurements, N-acetylcysteine had a significant protective effect at 1.5, 2, 3, 4, 6 and 8 kHz, whilst vitamin A had a significant protective effect at 3, 6 and 8 kHz.Conclusion:Gentamicin-induced hearing loss in rats may be prevented by the concomitant use of vitamin A and N-acetylcysteine. Specifically, N-acetylcysteine appeared to have a more protective effect than vitamin A for a greater range of noise frequencies.


2019 ◽  
Vol 133 (06) ◽  
pp. 466-476
Author(s):  
F C Akin Ocal ◽  
G G Kesici ◽  
S G Gurgen ◽  
R Ocal ◽  
S Erbek

AbstractObjectiveTo investigate whether oxytocin can prevent ototoxicity related to acoustic trauma.MethodsTwenty-eight rats were divided into four groups: noise (group 1), control (group 2), noise plus oxytocin (group 3), and oxytocin (group 4). Intratympanic oxytocin was administered on days 1, 2, 4, 6, 8 and 10 in groups 3 and 4. Groups 1 and 3 were exposed to acoustic trauma. Distortion product otoacoustic emission and auditory brainstem response testing were performed in all groups.ResultsIn group 1, auditory brainstem response thresholds increased significantly after acoustic trauma. In group 3, auditory brainstem response thresholds increased significantly on day 1 after acoustic trauma, but there were no significant differences between thresholds at baseline and on the 7th and 21st days. In group 1, significant differences were observed between distortion product otoacoustic emission signal-to-noise ratios measured before and on days 1, 7 and 21 after acoustic trauma. In group 3, no significant differences were observed between the distortion product otoacoustic emission signal-to-noise ratios measured before and on days 7 and 21 after acoustic trauma.ConclusionOxytocin had a therapeutic effect on rats exposed to acoustic trauma in this experiment.


2013 ◽  
Vol 40 (2) ◽  
Author(s):  
Asti Kristianti ◽  
Teti Madiadipoera ◽  
Bogi Soeseno

Background: Chemotherapy is worldwide used nowadays, and its toxicity still remain a problemespecially toxicity to the ear (ototoxicity). Cisplatin (cis-diamminedichloroplatinum) is one of themost commonly used chemotherapy and highly potent in treating epithelial malignancies. Ototoxicitycaused by cisplatin is irreversible, progressive, bilateral, sensorineural hearing loss especially on highfrequency (4-8 KHz) accompanied by tinnitus. Purpose: To observe the cochlear outer hair cells damagein malignancies patients treated with cisplatin. Methods: This study is an observational analytic studywith prospective design to determine the influence of high dose cisplatin on cochlear outer hair cellsfunction. The research was carried out at the ENT-HNS Department, Hasan Sadikin General HospitalBandung, from November 2007 until June 2008. Audiometry, tympanometry, and distortion productotoacoustic emission (DPOAE) examinations were conducted before chemotherapy and DPOAE, andtimpanometry was again measured three days after first and second cycles of cisplatin administration. McNemar test was performed to calculate the effects of high-dose cisplatin to the cochlear outer haircells function. To compare pre and post-cisplatin on alteration of cochlear hair cells function, Wilcoxontest was used. Results: In this study 60 ears from 30 subjects that meet the inclusion criteria, consistedof 25 man (83.3%) and 5 women (16.7%). The prevalence of damaged cochlear outer hair cells were63% at first cycle and 70% at second cycle of cisplatin administration. The decline of cochlear outerhair cells function was significant (p<0.001). Conclusion: High-dose cisplatin decreases cochlear outerhair cells function in patients with malignant neoplasm. Abstrak : Latar belakang: Kemoterapi sekarang rutin digunakan secara klinis di seluruh dunia. Sejalan denganhal tersebut toksisitas kemoterapi, khususnya terhadap telinga saat ini menjadi perhatian. Sisplatin(cis-diamminedichloroplatinum) adalah salah satu obat kemoterapi yang paling banyak digunakandan paling manjur untuk terapi keganasan epitelial. Efek ototoksik sisplatin yaitu terjadi gangguandengar sensorineural yang irreversible, progresif, bilateral pada frekuensi tinggi (4-8 kHz), dan disertaidengan tinitus. Tujuan: Untuk menilai penurunan fungsi sel rambut luar koklea pada penderita tumorganas sesudah pemberian sisplatin dosis tinggi dengan menggunakan DPOAE. Metode: Studi analitikobservasional dengan rancangan prospektif di Bagian IK. THT-KL RS. Hasan Sadikin Bandung mulaibulan November 2007 sampai dengan Juni 2008. Pada penelitian ini dilakukan pemeriksaan audiometrinada murni, timpanometri, dan distortion product otoacoustic emission (DPOAE) prakemoterapi, kemudianDPOAE dan timpanometri diulang tiga hari sesudah siklus pertama dan kedua kemoterapi sisplatin. Datayang diperoleh diuji dengan uji McNemar dan uji Wilcoxon. Hasil: Dari penelitian didapat 60 telingadari 30 subjek penelitian yang memenuhi kriteria inklusi yang terdiri dari 25 laki-laki (83,3%) dan 5perempuan (16,7%). Insidens penurunan fungsi sel rambut luar koklea sebesar 63% (38 kasus) sesudahsiklus pertama dan 70% (42 kasus) sesudah siklus kedua. Hubungan penurunan fungsi sel rambut luarkoklea memberikan nilai yang sangat bermakna sejak pemberian siklus pertama (p<0,001). Kesimpulan:Pemberian sisplatin dosis tinggi pada penderita tumor ganas menyebabkan penurunan fungsi sel rambutluar koklea.Kata kunci: kemoterapi, sisplatin dosis tinggi, sel rambut luar koklea.


2013 ◽  
Vol 127 (10) ◽  
pp. 952-956 ◽  
Author(s):  
A Goyal ◽  
P P Singh ◽  
A Vashishth

AbstractObjectives:This study aimed to: understand the effect that high intensity noise associated with drilling (during otological surgery) has on hearing in the contralateral ear; determine the nature of hearing loss, if any, by establishing whether it is temporary or persistent; and examine the association between hearing loss and various drill parameters.Methods:A prospective clinical study was carried out at a tertiary centre. Thirty patients with unilateral cholesteatoma and normal contralateral hearing were included. Patients were evaluated pre-operatively and for five days following surgery using high frequency pure tone audiometry, and low and high frequency transient evoked and distortion product otoacoustic emission testing.Results:The findings revealed statistically significant changes in distortion product otoacoustic emissions at high frequencies (p = 0.016), and in transient evoked otoacoustic emissions at both low and high frequencies (p = 0.035 and 0.021, respectively). There was a higher statistical association between otoacoustic emission changes and cutting burrs compared with diamond burrs.Conclusion:Drilling during mastoid surgery poses a threat to hearing in the contralateral ear due to noise and vibration conducted transcranially.


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