scholarly journals Prospective longitudinal assessment of sensorineural hearing loss with hyperfractionated radiation therapy alone in patients with average-risk medulloblastoma

2014 ◽  
Vol 1 (3) ◽  
pp. 86-93
Author(s):  
Tejpal Gupta ◽  
Sarthak Mohanty ◽  
Sadhana Kannan, ◽  
Rakesh Jalali
Keyword(s):  
Hearing Loss ◽  
Radiation Therapy ◽  
Sensorineural Hearing Loss ◽  
Pure Tone ◽  
Average Risk ◽  
Hearing Thresholds ◽  
Platinum Based Chemotherapy ◽  
Hyperfractionated Radiation Therapy ◽  
The Right

AbstractBackgroundTo report on sensorineural hearing loss (SNHL) in a cohort of patients treated with hyperfractionated radiation therapy (HFRT) without upfront platinum-based chemotherapy in average-risk medulloblastoma.MethodsHearing thresholds were assessed by ear-specific pure-tone audiograms at stimulus frequencies of 0.25, 0.5, 1, 2, 4, and 8 kilohertz. Audiometric assessments were done serially longitudinally at baseline, between 6–12 months after HFRT, and annually thereafter. Pure-tone audiograms were analyzed and graded according to Brock pediatric ototoxicity grading criteria.ResultsFive of 20 (25%) children had communicatively and developmentally significant SNHL (Brock grade 2 or worse) even before starting radiotherapy. On follow-up, new-onset Brock grade 2 or worse ototoxicity was documented in 6 previously normal ears. Eleven patients had preserved hearing in both ears on last audiometric follow-up. Compared with baseline testing, post-HFRT audiometry at 2–3 years showed modest decline in hearing threshold across all frequencies. Age at diagnosis and sex did not significantly impact hearing, while higher cochlear doses trended towards worse hearing outcomes. Tumors that extended more towards one side expectedly showed significant worsening in the ipsilateral ear. There was a differential impact of treatment on the right and left ears with the right ear (and not the left ear) showing significantly worse hearing thresholds in the low-to-intermediate speech frequency range over time.ConclusionThe use of HFRT for craniospinal irradiation and conformal tumor bed boost without upfront platinum-based chemotherapy in children with average-risk medulloblastoma results in preserved hearing in a large proportion of patients in the audible speech range.

scholarly journals Sensorineural Hearing Loss as a Sequelae of Radiotherapy and Chemotherapy in Head and Neck Cancer - An Observational Study from Maharashtra, India

2021 ◽  
Vol 10 (33) ◽  
pp. 2740-2744
Author(s):  
Sanket Chandrashekhar Prabhune ◽  
Abhay D. Havle ◽  
Swapna Ajay Shedge ◽  
Khaleel Basha Mannuru ◽  
Lakshmi Sravya Yarlagadda ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Head And Neck Cancer ◽  
Sensorineural Hearing Loss ◽  
Head And Neck ◽  
Neck Cancer ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Sensorineural Hearing ◽  
Group A

BACKGROUND Radiotherapy is a very well-known treatment modality for head and neck cancers besides surgery. The cochlea and its neuroepithelium are sensitive to ionizing radiation and resultant damage as it remains in the field of irradiation, the chemotherapy also has a similar effect leading to sensorineural hearing loss (SNHL). To minimize the adverse effects of hearing the advent of technology like intensitymodulated radiotherapy (IMRT) using smaller doses of radiation is now available with good control of the disease. The intended concomitant uses of chemotherapeutic agent cisplatin for increasing the sensitivity of radiation may induce ototoxicity. Both of these modalities result in a pronounced effect on highfrequency sensorineural hearing loss. We wanted to determine and compare sensorineural hearing loss amongst cases of head and neck cancer treated by radiotherapy, chemotherapy either alone or in a combination of both. METHODS All clinically diagnosed patients of head and neck cancer requiring treatment using radiotherapy or chemotherapy alone or in combination having a normal hearing on pure tone audiometry (PTA) were enrolled in the study. All enrolled cases were divided into three groups namely A, B and C based on treatment received like radiotherapy, chemotherapy and combination respectively and their effect on hearing was compared. Hearing acuity was assessed by doing PTA before and after completion of treatment and at 6 months follow up in every case. RESULTS In groups A, B and C SNHL was noted at higher frequencies of 4 kHz and 8 kHz during 1st as well as final follow up. Hearing loss was found maximum in group C receiving combination treatment compared to the other two groups receiving in isolation. Hearing loss was the least in Group - A cases that received radiotherapy using the IMRT technique. CONCLUSIONS The possibility of SNHL is increased in cases receiving a combination of radio and chemotherapy (94 %). Extra care of shielding the cochlea is essentially required during treatment with high doses (> 60Gy) using conformal radiotherapy to limit the resultant radiotherapy-induced SNHL. Radiation-induced SNHL in the IMRT technique was the least (28 %) in the group - A cases and hence should be employed in every case. Future searches for cases of head and neck malignancy the newer effective combination of chemotherapeutic drug and radiation obviating the ototoxicity needs to be continued. KEY WORDS Cisplatin, Radiotherapy, Intensity - Modulated, Audiometry, Pure - Tone, Ototoxicity, Hearing Loss, Sensorineural

scholarly journals Audiological findings of a patient with H syndrome: case report

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Diala Hussein ◽  
Büşra Altın ◽  
Münir Demir Bajin
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Auditory Brainstem Response ◽  
Pure Tone Audiometry ◽  
Auditory Brainstem ◽  
Sensorineural Hearing ◽  
Brainstem Response ◽  
The Right

Abstract Background H syndrome is an autosomal recessive disorder caused by mutations in SLC29A3. Hyperpigmentation, hypertrichosis, hyperglycemia, and hearing loss are some characteristics of this disorder, and it has a prevalence of < 1/1000. The aim of this report is to spread awareness among otologists, audiologists, and pediatricians about this syndrome and its audiological features. Case presentation An 8-year-old male with a diagnosed H syndrome registered to our clinic with a complaint of hearing loss. The patient was diagnosed with hearing loss in a different clinic using only the air-conducted click auditory brainstem response test which showed wave V at 60 dB nHL for the right ear and at 80 dB nHL for the left ear. The initially performed pure tone audiometry (PTA) test in our clinic revealed a bilateral asymmetric hearing loss with a moderate sensorineural hearing loss in the right ear and a profound mixed hearing loss in the left ear. The performed air conducted click auditory brainstem response (ABR) result showed wave V at 55 dB nHL for the right ear and at 70 dB nHL for the left ear. Then, the repeated PTA test revealed a mild-severe sensorineural sloping hearing loss in the right ear and a severe sensorineural hearing loss in the left ear. Conclusion Although hearing thresholds in H syndrome could be within normal limits in some patients, sensorineural hearing loss is an important characteristic feature for this syndrome. Sensorineural hearing loss could be progressive or of sudden onset and ranges from mild to profound. Thus, it must be taken into consideration to apply the audiological follow-up regularly and paying attention to the patient’s complaints; also, a regular follow-up for language development of children with H syndrome and for the hearing aids is advised.

AN OBSERVATIONAL STUDY OF HEARING THRESHOLDS IN PROFESSIONAL DRIVERS

2021 ◽  
pp. 49-51
Author(s):  
R. Shanthimalar ◽  
R. Bhuvaneswari ◽  
V. Sumathi
Keyword(s):  
Hearing Loss ◽  
Tamil Nadu ◽  
Pure Tone ◽  
Hearing Threshold ◽  
Pure Tone Audiometry ◽  
P Value ◽  
Professional Drivers ◽  
Threshold Levels ◽  
Hearing Thresholds ◽  
The Right

Introduction: Noise has become a very important stress factor in the environment. Drivers are the most commonly affected persons due to trafc noise. The majority of drivers remain unaware about noise induced hearing loss as this is an insidious process, leading to temporary or permanent hearing impairment, but preventable. Pure Tone audiometric test is used to determine the degree of hearing loss in noise exposed individuals. Aim & Objective: To nd the hearing threshold levels for high and mid frequency sounds for both ears in Professional drivers. To evaluate the preponderance of hearing loss between right and left ear using hearing thresholds. Materials & Methods: This study was conducted in 100 Professional male drivers aged between 30-40 years who are working in Tamil Nadu State Transport Corporation, Madurai. Pure tone audiometry was used to measure the high and mid frequency hearing threshold levels in both ears. Results: The mean (SD) hearing threshold for high and mid frequency sounds was signicantly higher in left ear comparative to right ear with P value < 0.05. The statistically signicant difference in hearing loss was observed between both ears. Conclusion : Our study showed statistically signicant higher hearing threshold for high and mid frequency sounds in left ear compared to right ear, that concludes left ear is more prone for hearing loss than the right ear

scholarly journals Isolated Sensorineural Hearing Loss as a Sequela after Lightning Strike

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Mahfuz Turan ◽  
Ferhat Kalkan ◽  
Nazım Bozan ◽  
İsa Özçalimli ◽  
Mehmet Zeki Erdem ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Tympanic Membrane Perforation ◽  
Sensorineural Hearing ◽  
Lightning Strike ◽  
External Ear ◽  
Good Care ◽  
Membrane Perforation ◽  
The Right

In most of the surviving patients after a lightning strike, audiovestibular abnormalities have been reported. The most frequently reported type of abnormalities is a tympanic membrane perforation with hearing loss and external ear canal burn. However a sensor neural hearing loss and mixed type hearing loss can also occur, but these occur rarely. A nineteen-year-old female patient had, after a lightning strike, serious burns on the left ear, behind the ear, and on the chest and neck. She also had in her left ear 108 dB hearing loss with irregular central perforation and in her right ear 52 dB sensorineural hearing loss. There was no hearing loss before the strike. A hearing aid was recommended for the right ear and good care and follow-up were recommended for the left ear. A lightning strike can cause serious audiological damage. Therefore, it is necessary to make a careful audiovestibular evaluation of the patients. Although there exist rarely healed cases from sensorineural hearing loss after lightning strike in literature, in our case hearing loss occurred bilaterally and then it healed unilaterally. This condition is quite rare in literature.

Validity of Hearing Thresholds Obtained from the Rising Portion of the Audiogram in Sensorineural Hearing Loss

1984 ◽  
Vol 27 (2) ◽  
pp. 206-211 ◽  
Author(s):  
Larry E. Humes ◽  
Anne Marie Tharpe ◽  
Gene W. Bratt
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Recent Work ◽  
High Frequency ◽  
Pure Tone ◽  
Low Frequency ◽  
Sensorineural Hearing ◽  
Test Frequency ◽  
Hearing Thresholds

Two experiments were performed for this study. The purpose of both experiments was to examine the validity of pure-tone hearing thresholds obtained near the rising portion of a sensorineural hearing loss. Recent work by other investigators has suggested that thresholds obtained near the rising portion of the audiogram may not correspond to the severity of damage at the cochlear place associated with the test frequency. In the first experiment this issue was addressed in 11 subjects having low frequency sensorineural hearing loss, whereas 12 subjects (19 ears) having notch-shaped high-frequency sensorineural hearing losses were examined in the second experiment. The results indicated that thresholds obtained from the rising portion of the audiometric configuration were, in most instances, determined by sensitivity at the test frequency. An exception to this generalization involved low-frequency sensorineural hearing loss with a slope for the rising portion of the audiogram exceeding -25 dB/octave. In these cases the severity of the loss may be underestimated for test frequencies immediately adjacent to the rising portion of the audiogram.

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.

scholarly journals CPAP Treatment Improves Pure Tone Audiometry Threshold in Sensorineural Hearing Loss Patients with Sleep-Disordered Breathing

2021 ◽  
Vol 18 (13) ◽  
pp. 6768
Author(s):  
Jessie Chao-Yun Chi ◽  
Shin-Da Lee ◽  
Ren-Jing Huang ◽  
Ching-Hsiang Lai ◽  
Stanley Yung Liu ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Pure Tone ◽  
Sleep Disordered Breathing ◽  
Pure Tone Audiometry ◽  
Sensorineural Hearing ◽  
Apnea Hypopnea Index ◽  
Cpap Treatment ◽  
Hearing Thresholds ◽  
Disordered Breathing

This article investigates the effects of continuous positive airway pressure (CPAP) on hearing impairment in sensorineural hearing loss (SNHL) patients with sleep-disordered breathing (SDB). This retrospective and observational study took place from September 2016 to February 2021, accumulating 77 subjects with SNHL and SDB (60.7 ± 11.1 years). Of which, 28 received CPAP treatment (63.0 ± 8.5 years). In our methodology, hearing thresholds at low, medium, high, and average frequencies are assessed by pure-tone audiometry at baseline (BL), three (3 m), six (6 m), and 12 (12 m) months. Our results show that the BL of at least three frequencies in all subjects is positively associated with old age, males, smoking, alcohol, coronary artery disease, hypertension, and apnea-hypopnea index [AHI] (all p < 0.05). Moreover, low, medium, and average frequencies are negatively correlated at CPAP-6 m (−5.60 ± 2.33, −5.82 ± 2.56, and −5.10 ± 2.26 dB; all p < 0.05) and CPAP-12 m (−7.97 ± 2.74, −8.15 ± 2.35, and −6.67 ± 2.37 dB; all p < 0.01) against corresponding measures of CPAP-BL. High, medium, and average frequencies positively correlated with age (p < 0.001 for high and average frequencies and <0.01 for medium frequencies). We conclude that in SNHL patients with SDB, hearing thresholds at low and medium frequencies improves under CPAP use after six months, which persists at least to the end of one year.

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 Clinical Features and Hearing Outcomes of Sudden Sensorineural Hearing Loss in Diabetic Patients

2021 ◽  
Vol 25 (1) ◽  
pp. 27-35
Author(s):  
Yeo Rim Ju ◽  
Hyoung-sik Park ◽  
Min Young Lee ◽  
Jae Yun Jung ◽  
Ji Eun Choi
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Clinical Features ◽  
Sudden Sensorineural Hearing Loss ◽  
Steroid Treatment ◽  
Diabetic Patients ◽  
Lymphocyte Ratio ◽  
Hearing Thresholds ◽  
Hearing Recovery

Background and Objectives: This study aimed to evaluate the clinical features and the clinical factors associated with prognosis of sudden sensorineural hearing loss (SSNHL) in diabetic patients.Subjects and Methods: Forty-nine diabetic with unilateral SSNHL were retrospectively included. All patients received systemic high dose steroid therapy within one month after onset and had more than one month of follow-up audiogram. The basic characteristics of the patients, initial and follow-up audiograms, laboratory data, and methods of steroid treatment were collected.Results: Compared to reference values in healthy subjects, 79%, 55%, and 45% of the patients had higher values of mean neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR), respectively. Older patients had significantly less degree of hearing loss, but they also had significantly worse hearing thresholds in the unaffected ear. After steroid treatment, less than half patients (47%) showed hearing recovery. Simultaneous intratympanic dexamethasone (ITD) injections with systemic steroid did not confer an additional hearing gain or an earlier recovery rate in diabetic patients with SSNHL. In the multivariate analysis, initial hearing thresholds of affected ear and timing of steroid treatment were significantly associated with hearing prognosis in diabetic patients with SSNHL.Conclusions: Diabetic patients with SSNHL tended to have increased NLR, LMR, and PLR, which are reported to be associated with microvascular angiopathy. Simultaneous ITD injections to improve hearing recovery in diabetic patients with SSNHL seems unnecessary.

scholarly journals A Controlled Comparison of Auditory Steady-State Responses and Pure-Tone Audiometry in Patients with Hearing Loss

2017 ◽  
Vol 96 (10-11) ◽  
pp. E47-E52
Author(s):  
Raman Wadhera ◽  
Sharad Hernot ◽  
Sat Paul Gulati ◽  
Vijay Kalra
Keyword(s):  
Hearing Loss ◽  
Steady State ◽  
Sensorineural Hearing Loss ◽  
Pure Tone ◽  
Conductive Hearing Loss ◽  
Pure Tone Audiometry ◽  
Normal Hearing ◽  
Sensorineural Hearing ◽  
Hearing Thresholds ◽  
Conductive Hearing

We performed a prospective interventional study to evaluate correlations between hearing thresholds determined by pure-tone audiometry (PTA) and auditory steady-state response (ASSR) testing in two types of patients with hearing loss and a control group of persons with normal hearing. The study was conducted on 240 ears—80 ears with conductive hearing loss, 80 ears with sensorineural hearing loss, and 80 normal-hearing ears. We found that mean threshold differences between PTA results and ASSR testing at different frequencies did not exceed 15 dB in any group. Using Pearson correlation coefficient calculations, we determined that the two responses correlated better in patients with sensorineural hearing loss than in those with conductive hearing loss. We conclude that measuring ASSRs can be an excellent complement to other diagnostic methods in determining hearing thresholds.

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