Sensorineural Hearing Loss in Chronic Ear Surgery

1977 ◽  
Vol 86 (1) ◽  
pp. 3-8 ◽  
Author(s):  
G. D. L. Smyth

The author's series of 3000 consecutive operations of tympanoplasty from 1960 to 1975 were reviewed in regard to the occurrence of sensorineural hearing loss as a consequence of the surgical procedure. Worsening of bone conduction thresholds by 10 dB through the frequencies 500 to 4000 cps, or a 10% reduction in speech discrimination scores were considered significant. Whereas in transcanal tympanoplasty the incidence of cochlear damage was greater in ears when initially the ossicular chain was incomplete, by contrast in combined approach tympanoplasty the risk was greater when the chain was intact initially. It was concluded that cochlear trauma was usually due to 1) the hydraulic effect of excessive stapes manipulation during the removal of disease, and 2) the development of a perilymph fistula. The unpredictable predisposing threat of cochlear fragility due to genetic and inflammatory factors was emphasized and the poor results of tympanoplasty in tympanosclerosis were underlined. The current methods of treating sensorineural hearing loss after tympanoplasty were enumerated and discussed. It was concluded that although those aimed at improving labyrinthine circulation had theoretical backing, there is as yet little experimental or clinical evidence to support the claims of their protagonists.

1997 ◽  
Vol 111 (12) ◽  
pp. 1137-1141 ◽  
Author(s):  
Gilead Berger ◽  
Yehuda Finkelstein ◽  
Shabtai Avraham ◽  
Mordehai Himmelfarb

AbstractA prospective study of hearing loss in 120 cases with non-explosive blast injury of the ear, gathered over a six-year period, is presented. Thirty-three (27.5 per cent) patients had normal hearing, 57 (47.5 per cent) conductive hearing loss, 29 (24.2 per cent) mixed loss and one (0.8 per cent) had pure sensorineural loss. The severity of conductive hearing loss correlated with the size of the eardrum perforation; only a marginal difference was found between water and air pressure injuries, with respect to this type of hearing loss. Of all locations, perforations involving the posterior-inferior quadrant of the eardrum were associated with the largest air-bone gap. Audiometric assessment revealed that none of the patients suffered ossicular chain damage. Three patterns of sensorineural hearing loss were identified: a dip at a single frequency, two separate dips, and abnormality of bone conduction in several adjacent high frequencies. Involvement of several frequencies was associated with a more severe hearing loss than a dip in a single frequency. Healing of the perforation was always accompanied by closure of the air-bone gap, while the recovery of the sensorineural hearing loss was less favourable.


2012 ◽  
Vol 3 (3) ◽  
pp. 127-132 ◽  
Author(s):  
Mustafa Paksoy ◽  
Arif Sanli ◽  
Umit Hardal ◽  
Sermin Kibar ◽  
Gokhan Altin ◽  
...  

ABSTRACT Objective In otology, a wide variety of devices are used that have significant noise output, both operated ear and the patient. We aimed to determine hearing damages due to drill-generated acoustic trauma in ear surgery. We want to find how degree drill-generated acoustic trauma is responsible from sensorineural hearing loss in ear surgery. Materials and methods We designed a retrospective study about 100 patients who underwent radical or modiphied radical mastoidectomy and tympanoplasty. The audiometric testing was done both pre and postoperatively to detect any significant hearing loss in the immediate postoperative period. The data were analyzed using the Wilcoxon sign and Mann-Whitney U tests. This study proposes that hearing loss is caused by drill noise conducted to the operated ear by vibrations of temporal bone. Results A sensorineural hearing loss soon after mastoid surgery is seen due to the noise generated by the drill. Mean pure-tone thresholds obtained was significantly more in mastoidectomy applied patients when compared to tympanoplasty . Mean bone conduction (BC) hearing levels impaired 6,6 dB in 1 kHz, 5.5 dB in 0.5 kHz, 5 dB in 4.kHz and 3.1 dB in 2 kHz in mastoidectomy groups but improved 5.5 dB in 0.5 kHz, 2.2 dB in 1 kHz, 2.7 dB in 2 kHz in tympanoplasty groups. Statistically significant differences were observed at the 0.5-1 and 4 kHz frequencies pre and postoperative in the hearing thresholds of BC changing in mastoidectomy group, however, the averages of ranks of all pre and postoperative measurement of hearing levels show differences between mastoidectomy and tympanoplasty groups was significant in statistically at independent groups (p < 0.05). Conclusion We conclude that drill-generated noise during mastoid surgery has been incriminated as a cause of sensorineural hearing loss. Drilling during mastoid surgery may result in temporary or permanent noise-induced hearing loss. Possible noise disturbance to the inner ear can only be avoided by minimizing the duration of harmful noise exposure and carefull using burr to near the cochlear structures. How to cite this article Paksoy M, Sanli A, Hardal U, Kibar S, Altin G, Erdogan BA, Bekmez ZE. How Drill-Generated Acoustic Trauma effects Hearing Functions in an Ear Surgery? Int J Head and Neck Surg 2012;3(3):127-132.


2017 ◽  
Vol 131 (10) ◽  
pp. 895-899 ◽  
Author(s):  
A Ahmadzadeh ◽  
M Daraei ◽  
M Jalessi ◽  
A A Peyvandi ◽  
E Amini ◽  
...  

AbstractObjective:Rheumatoid arthritis is thought to induce conductive hearing loss and/or sensorineural hearing loss. This study evaluated the function of the middle ear and cochlea, and the related factors.Methods:Pure tone audiometry, speech reception thresholds, speech discrimination scores, tympanometry, acoustic reflexes, and distortion product otoacoustic emissions were assessed in rheumatoid arthritis patients and healthy volunteers.Results:Pure tone audiometry results revealed a higher bone conduction threshold in the rheumatoid arthritis group, but there was no significant difference when evaluated according to the sensorineural hearing loss definition. Distortion product otoacoustic emissions related prevalence of conductive or mixed hearing loss, tympanometry values, acoustic reflexes, and speech discrimination scores were not significantly different between the two groups. Sensorineural hearing loss was significantly more prevalent in patients who used azathioprine, cyclosporine and etanercept.Conclusion:Higher bone conduction thresholds in some frequencies were detected in rheumatoid arthritis patients that were not clinically significant. Sensorineural hearing loss is significantly more prevalent in refractory rheumatoid arthritis patients.


2008 ◽  
Vol 136 (5-6) ◽  
pp. 221-225
Author(s):  
Slobodan Spremo ◽  
Zdenko Stupar

INTRODUCTION Cochlear damage secondary to exposure to acoustic trauma is the consequence of the acoustic energy effects on the hearing cells in Korti's organ. OBJECTIVE The objective was to assess the correlation between the degree of sensorineural hearing loss and the type of audiogram registered in acoustic trauma exposed patients. METHOD We analyzed 262 audiograms of patients exposed to acoustic trauma in correlation to 146 audiograms of patients with cochlear damage and hearing loss not related to acoustic trauma. "A" group consisted of acoustic trauma cases, while "B" group incorporated cases with hearing loss secondary to cochlear ischaemia or degeneration. All audiograms were subdivided with regard to the mean hearing loss into three groups: mild (21-40 dB HL), moderate (41-60 dB HL) and severe (over 60 dB HL) hearing loss. Based on audiogram configuration five types of audiogram were defined: type 1 flat; type 2 hearing threshold slope at 2 kHz, type 3 hearing threshold slope at 4 kHz; type 4 hearing threshold notch at 2 kHz; type 5 notch at 4 kHz. RESULTS Mild hearing loss was recorded in 163 (62.2%) ears in the acoustic trauma group, while in 78 (29.8%) ears we established moderate hearing loss with the maximum threshold shift at frequencies ranging from 4 kHz to 8 kHz. The least frequent was profound hearing loss, obtained in 21 (8%) audiograms in the acoustic trauma group. Characteristic audiogram configurations in the acoustic trauma patient group were: type 1 (N=66; 25.2%), type 2 (N=71; 27.1%), and type 3 (N=68; 25.9%). Audiogram configurations were significanly different in the acoustic trauma group in comparison to the cochlear ischaemia group of patients (p=0.0005). CONCLUSION Cochlear damage concomitant to acoustic trauma could be assessed by the audiogram configuration. Preserved hearing acuity at low and mild frequency range indicates the limited damage to the hearing cells in Korti's organ in the apical cochlear turn.


2010 ◽  
Vol 2 (2) ◽  
pp. 143-149
Author(s):  
Ashutosh G Pusalkar

Abstract Till about 15 years ago, the only choice of hearing improvement for moderate sensorineural hearing loss with severe speech discrimination defect was a hearing aid. It was only after Mr. Geoff Ball, an electronic engineer who was suffering from a similar defect, started thinking of an alternative to the conventional hearing aid that the Vibrant Soundbridge came into existence, and with the passage of time the indications for the use of the same have increased.


2020 ◽  
Vol 42 (3) ◽  
pp. 38-41
Author(s):  
Yogesh Neupane ◽  
Bijaya Kharel ◽  
Heempali Dutta

Introduction Incidence of sensory neural hearing loss following mastoid surgery varies from 1.2 – 4.5%.There are various causes for postoperative sensorineural hearing loss during mastoid surgery. This study aims to identify whether there is any correlation between drilling and postoperative sensory neural hearing loss. MethodsA retrospective study was conducted in the Department of ENT from January 2018 to June 2019. A total number of 68 patients above five years of age who underwent modified radical mastoidectomy for chronic otitis media squamous were included. Revision surgery, preoperative sensorineural hearing loss, injury to the ossicular chain during surgery, patients with lack of follow up or doubtful reports in mentally challenged were excluded from the study. The average bone conduction threshold was calculated from 500, 1000, 2000, 4000 Hz and compared using the Wilcoxon signed-rank test. ResultsThere were 43 males and 25 females in the study with a median age of 23.5 years (16-55). The mean preoperative bone conduction threshold in the four frequencies of 500 Hz, 1kHz, 2kHz, 4kHz were -2.06dB, -2.06dB, 3.31dB, 4.63 dB respectively and the mean postoperative bone conduction thresholds were 1.03, 1.32, 5.29, 4.04 respectively. There was a decline of mean of 3.09 dB and 3.38dB only at the low-frequencies (500Hz and 1kHz) BC threshold respectively which were statistically significant, whereas at higher frequency there was no decline in average postoperative BC threshold. ConclusionThere is no definite role of drill in inducing hearing loss and if present other causes of hearing loss should be sought in postoperative sensorineural hearing loss.


1997 ◽  
Vol 100 (7) ◽  
pp. 740-746 ◽  
Author(s):  
Masafumi Sakagami ◽  
Hiroshi Ogasawara ◽  
Michiko Node ◽  
Toru Seo ◽  
Yasuo Mishiro

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