Asymmetric Hearing Loss Prompting MRI Referral in a Military Population: Redefining Audiometric Criteria

2018 ◽  
Vol 158 (4) ◽  
pp. 695-701 ◽  
Author(s):  
Anthony M. Tolisano ◽  
Ricardo M. Burgos ◽  
Michael B. Lustik ◽  
Lex A. Mitchell ◽  
Philip D. Littlefield
Keyword(s):  
Hearing Loss ◽  
Military Service ◽  
Noise Exposure ◽  
Medical Center ◽  
Tertiary Care ◽  
Military Population ◽  
Retrospective Case ◽  
Referral Criteria ◽  
Diagnosis Rate ◽  
History Of

Objective To reevaluate asymmetric sensorineural hearing loss (ASNHL) criteria used to justify magnetic resonance imaging (MRI) in the evaluation of retrocochlear tumors in a military population. Study Design Retrospective case-control study. Setting Tertiary care military medical center. Subjects and Methods Patients with military service and a history of ASNHL prompting referral for MRI, with or without retrocochlear tumors, were compared between 2005 and 2016. Predictor variables included pure tone ASNHL, speech audiometry, and a history of noise exposure. Logistic regression models for hearing asymmetries were performed, and receiver operator curves were used to calculate sensitivity and specificity. Results Thirty-eight retrocochlear tumors were identified. The MRI diagnosis rate for patients with ASHNL was 0.85%. Patients with tumors were slightly older (42 vs 37 years, P = .021) and had less noise exposure (47% vs 85%, P < .001). A sensitivity of 0.83 and a specificity of 0.58 were calculated for asymmetries ≥10 dB at 2000 Hz without adjusting for noise exposure. Instituting this imaging threshold would have reduced the number of MRI scans by half while missing 16% of tumors. Conclusion The tumor diagnosis rate among those undergoing MRI for ASNHL is low in the military population, likely because service-related noise exposure commonly causes ASNHL. Optimal MRI referral criteria should conserve resources while balancing the risks of over- and underdiagnosis. For those with a history of military service, an asymmetry ≥10 dB at 2000 Hz among patients meeting current ANSHL referral criteria is most predictive of a retrocochlear tumor.

scholarly journals A retrospective study of noise induced hearing loss in a tertiary care hospital of Jharkhand - an alarming but ignorant truth

2017 ◽  
Vol 3 (2) ◽  
pp. 340
Author(s):  
Pradeep Kumar Singh ◽  
Nishant Kumar ◽  
Dheeraj Kumar ◽  
Nisha Shrivastava ◽  
Abhishek Kumar
Keyword(s):  
Hearing Loss ◽  
Noise Exposure ◽  
Tertiary Care ◽  
Total Sample ◽  
Care Hospital ◽  
Age Group ◽  
Noise Induced Hearing Loss ◽  
Medical Sciences ◽  
Urban Males ◽  
History Of

<p class="abstract"><strong>Background:</strong> Noise induced hearing loss (NIHL) is hearing impairment resulting from exposure to loud sound. People may have a loss of perception of a narrow range of frequencies, impaired cognitive perception of sound, or other impairment, including sensitivity to sound or ringing in the ears. NIHL is 2<sup>nd</sup> most common cause of hearing loss, next to presbycusis. Most of the population of developing countries is ignorant of the hazards of excessive noise exposure. 1) To describe the socio-demograpic profile of patients in the young age group (18-35 years) with noise induced hearing loss in Rajendra Institute of Medical Sciences (RIMS), Ranchi during June 2015- November 2016. 2) To study the major presenting complaints. 3) To categorize the patients on the basis of degree of hearing loss.</p><p class="abstract"><strong>Methods:</strong> Data for study was collected from RIMS Out Patient Department (OPD) register during period June 2015 – November 2016 (18 months).Total sample size for this period was 50. Templates were generated in MS excel sheet and data analysis was done using SPSS software (version 20).  </p><p class="abstract"><strong>Results:</strong> Study showed NIHL was more common in urban (82%) and male (72%) population. More than half (54%) patients presented with hearing loss and 24% with tinnitus. Most of the patients had bilateral mild hearing loss (70%).</p><p><strong>Conclusions:</strong> NIHL is more common in urban males, mostly in age group (26-35 years). More than 2/3<sup>rd</sup> (68% ) of patients had history of exposure to loud noise. </p>

scholarly journals Hearing loss in the elderly: History of occupational noise exposure

2014 ◽  
Vol 17 (02) ◽  
pp. 179-183 ◽  
Author(s):  
Caroline Meneses-Barriviera ◽  
Luciana Marchiori ◽  
Juliana Melo
Keyword(s):  
Hearing Loss ◽  
Noise Exposure ◽  
The Elderly ◽  
Occupational Noise ◽  
Occupational Noise Exposure ◽  
History Of

Efficacy and safety of intravenous pamidronate for parathyroid hormone-dependent hypercalcemia in hospitalized patients

2021 ◽  
Author(s):  
Rachel Chava Rosenblum ◽  
Orit Twito ◽  
Liat Barzilay-Yoseph ◽  
Erez Ramaty ◽  
Noa Klein ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Serum Calcium ◽  
Medical Center ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Safety Data ◽  
Kidney Injury ◽  
Efficacy And Safety ◽  
Retrospective Case ◽  
Tertiary Care Medical Center

Abstract Context Bisphosphonates are effective for hypercalcemia of malignancy (HOM). Efficacy and safety data for bisphosphonates in parathyroid hormone-related hypercalcemia (PTHRH) are rare, including pamidronate, which is not indicated for this condition. Objective To evaluate the efficacy and safety of pamidronate for moderate-to-severe PTHRH. Design Retrospective case-control study. Setting Tertiary care medical center. Patients Adults hospitalized with serum calcium levels ≥12mg/dL, 29/10/2013–17/12/2019. Interventions Etiology was categorized as PTHRH or PTH-independent. Clinical and laboratory data of PTHRH patients treated with pamidronate (PTHRH-Pam+) were compared to pamidronate-untreated counterparts (PTHRH-Pam-). Results Thirty-four patients with 37 hospitalizations for PTHRH (pamidronate-treated and untreated) met the inclusion criteria. Pamidronate was given in 24/37 cases (64.8%). Admission serum calcium levels for the PTHRH-Pam+ group were higher than for PTHRH-Pam- (14.4mg/dL vs. 13.0mg/dL, p=0.005). Median total pamidronate dose was 60mg (range 30–180mg) in the treated group. Serum calcium decreased 3.5mg/dL for PTHRH-Pam+ vs. 1.6mg/dL for PTHRH-Pam- (p=0.003). No PTHRH-Pam+ patients developed hypocalcemia or acute kidney injury. Nadir serum phosphorus levels were lower in the PTHRH-Pam+ vs. PTHRH-Pam- group (1.7mg/dL vs. 2.4mg/dL, respectively, p=0.005). Three PTHRH-Pam+ patients developed severe hypophosphatemia; all resolved with intravenous and oral supplementation. Seventeen patients underwent parathyroidectomy, of whom 10 received pamidronate within 28 days preoperatively. Post-operatively, 4 developed hypocalcemia and 3 hypophosphatemia. Conclusions This study demonstrates that pamidronate is effective and safe for treating PTHRH, while ensuring close laboratory monitoring of calcium and phosphorus metabolism. Larger, prospective studies are needed to establish the role of pamidronate and other potent bisphosphonates in moderate-to-severe PTHRH.

scholarly journals Early Posttreatment Audiometry Underestimates Hearing Recovery after Intratympanic Steroid Treatment of Sudden Sensorineural Hearing Loss

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Benjamin J. Wycherly ◽  
Jared J. Thompkins ◽  
H. Jeffrey Kim
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Sudden Hearing Loss ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Speech Discrimination ◽  
Case Review ◽  
Retrospective Case ◽  
Hearing Recovery ◽  
History Of

Objective. To review our experience with intratympanic steroids (ITSs) for the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL), emphasizing the ideal time to perform follow-up audiograms.Methods. Retrospective case review of patients diagnosed with ISSNHL treated with intratympanic methylprednisolone. Injections were repeated weekly with a total of 3 injections. Improvement was defined as an improved pure-tone average ≥20 dB or speech-discrimination score ≥20%.Results. Forty patients met the inclusion criteria with a recovery rate of 45% (18/40). A significantly increased response rate was found in patients having an audiogram >5 weeks after the first dose of ITS (9/13) over those tested ≤5 weeks after the first dose of ITS (9/27) ().Conclusions. Recovery from ISSNHL after ITS injections occurs more frequently >5 weeks after initiating ITS. This may be due to the natural history of sudden hearing loss or the prolonged effect of steroid in the inner ear.

scholarly journals Association between interleukin-6 polymorphism in the −174 G/C region and hearing loss in the elderly with a history of occupational noise exposure

2014 ◽  
Vol 80 (5) ◽  
pp. 373-378 ◽  
Author(s):  
Miula Portelinha Braga ◽  
Sandra Mara Maciel ◽  
Luciana Lozza de Moraes Marchiori ◽  
Regina Célia Poli-Frederico
Keyword(s):  
Hearing Loss ◽  
Interleukin 6 ◽  
Noise Exposure ◽  
The Elderly ◽  
Occupational Noise ◽  
Occupational Noise Exposure ◽  
History Of

Audiologic Findings in Young Patients with Hypophosphatemic Bone Disease

1986 ◽  
Vol 95 (4) ◽  
pp. 415-420 ◽  
Author(s):  
Martha Meister ◽  
Anita Johnson ◽  
Ghi S. Kim ◽  
Gerald R. Popelka ◽  
Michael P. Whyte
Keyword(s):  
Hearing Loss ◽  
Young Adult ◽  
Bone Disease ◽  
Noise Exposure ◽  
Metabolic Bone Disease ◽  
Young Patients ◽  
Metabolic Bone ◽  
Large Populations ◽  
History Of ◽  
Auditory Impairment

Audiometric tests were conducted on 19 subjects with hypophosphatemic bone disease to investigate whether auditory impairment like that reported in affected adults occurs in young patients. No hearing loss or significant auditory findings were noted among the children or young adult patients. However, sensorineural hearing loss of cochlear origin was identified in the three oldest subjects (40 to 58 years), although a history of noise exposure in two of them could explain the observations. The results indicate that if an association exists between hypophosphatemic bone disease and hearing impairment, the auditory signs will not develop until adulthood in treated patients. Additional studies of large populations of affected adults are needed to identify the incidence and mechanism(s) of the auditory system abnormalities and to assess any effect of medical therapy for the metabolic bone disease.

scholarly journals Development and Initial Validation of the Lifetime Exposure to Noise and Solvents Questionnaire in U.S. Service Members and Veterans

2021 ◽  
pp. 1-15
Author(s):  
Susan E. Griest-Hines ◽  
Naomi F. Bramhall ◽  
Kelly M. Reavis ◽  
Sarah M. Theodoroff ◽  
James A. Henry
Keyword(s):  
Hearing Loss ◽  
Military Service ◽  
Impulse Noise ◽  
Noise Exposure ◽  
Service Members ◽  
Exposure Group ◽  
Validity And Reliability ◽  
Initial Validation ◽  
Lifetime Exposure ◽  
Hearing Difficulties

Purpose A need exists to investigate the short- and long-term impact of noise exposures during and following military service on auditory health. Currently available questionnaires are limited in their ability to meet this need because of (a) inability to evaluate noise exposures beyond a limited time frame, (b) lack of consensus on scoring, (c) inability to assess impulse exposures (e.g., firearm use), (d) lack of a single questionnaire that assesses both military and nonmilitary exposures, and (e) lack of validity and reliability data. To address these limitations, the Lifetime Exposure to Noise and Solvents Questionnaire (LENS-Q) was developed. The purpose of this report is to describe the development and initial validation of the LENS-Q as a measure of self-reported noise exposure. Method Six hundred ninety participants, consisting of current Service members and recently military-separated (within about 2.5 years) Veterans, completed the LENS-Q, additional study questionnaires, and comprehensive audiometric testing. Noise exposure scores were computed from LENS-Q responses using a simple scoring algorithm that distinguishes between different cumulative levels of exposure and allows for the inclusion of both continuous and impulse noise exposures. Results The LENS-Q demonstrates good construct validity as evidenced by measures of hearing loss, tinnitus, and subjective hearing difficulties all increasing with an increase in noise exposure scores. A logistic regression, adjusting for age and sex, revealed that participants in the highest exposure group were 2.4–3.9 times more likely to experience hearing loss, 2.7–2.8 times more likely to experience tinnitus, and 3.0–3.7 times more likely to report hearing difficulties compared with individuals in the lowest exposure group. Conclusions The LENS-Q captures noise exposure over an individual's lifetime and provides an alternative scoring metric capable of representing exposure to both continuous and impulse noise. Findings suggest that the LENS-Q is a valuable tool for capturing and measuring both military and nonmilitary noise exposure. Supplemental Material https://doi.org/10.23641/asha.14582937

scholarly journals Neurotologic Complications Following Microvascular Decompression: A Retrospective Study

2019 ◽  
Vol 81 (01) ◽  
pp. 037-042
Author(s):  
Matthew Bartindale ◽  
Ayah Mohamed ◽  
Jason Bell ◽  
Matthew Kircher ◽  
Jacqueline Hill ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Retrospective Study ◽  
Microvascular Decompression ◽  
Tertiary Care ◽  
Significant Risk ◽  
Complication Rates ◽  
Case Review ◽  
Inclusion Criteria ◽  
Retrospective Case ◽  
Significant Difference

Objective The main purpose of this article is to determine the frequency of neurotologic complications after posterior fossa microvascular decompression (MVD) surgery. Design Retrospective case review. Setting Tertiary care referral center. Participants A total of 215 consecutive MVD operations by a single surgeon between March 1996 and May 2016 were reviewed with 192 surgeries on 183 patients meeting inclusion criteria. Main Outcome Measures Neurotologic complications secondary to MVD. Results The 52 males and 131 females had a mean age of 58.52 years (range, 28–92 years). Indications for MVD were trigeminal neuralgia (n = 162), hemifacial spasm (n = 23), glossopharyngeal neuralgia (n = 13), vagal palsy (n = 1), and tinnitus (n = 1). The outcomes examined were postoperative hearing loss, tinnitus, vertigo, and hemifacial paresis. At least one of these complications was present in 17.7% of patients. There were 4.17% with permanent hearing loss, 6.77% with transient hearing loss, 5.21% with tinnitus, 5.73% with vertigo, and 0.52% with hemifacial paresis. There was no significant difference in complication rates based on surgical indication. Conclusions Neurotologic complications are a significant risk when performing MVD. It is important for otolaryngologists as well as neurosurgeons to be aware of such complications. We recommend perioperative audiometry in all patients undergoing MVD and believe there is utility in routine otolaryngologist involvement.

In-vehicle noise exposure among military personnel depending on type of vehicle, riding compartment and road surface

2019 ◽  
pp. jramc-2018-001091 ◽  
Author(s):  
Assar Luha ◽  
E Merisalu ◽  
M Reinvee ◽  
S Kinnas ◽  
R Jõgeva ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Military Personnel ◽  
Military Service ◽  
Noise Exposure ◽  
Road Surface ◽  
Noise Induced Hearing Loss ◽  
Noise Levels ◽  
Long Distance ◽  
Vehicle Noise ◽  
Paved Road

IntroductionNoise-induced hearing loss is one of the most common health problems among military service personnel. Exposure to noise in military vehicles constitutes a large proportion of total noise exposure. This pilot study aimed to evaluate in-vehicle noise levels depending on the type of vehicle, riding compartment and road surface.MethodNoise levels were measured in armoured personnel carriers and heavy all-terrain trucks, in the cab and rear passenger compartment, while driving on paved or off-road surfaces. The results were compared with national LLV and allowed noise exposure times were calculated per vehicle and surface.ResultsThe equivalent noise levels in the cab of SISU XA-188 (p=0.001) and peak noise levels in MAN 4620 (p=0.0001) and DAF 4440 (p=0.0047) were higher on paved road, compared with off-road. The equivalent noise levels in the canvas covered rear compartment of MAN 4620 were significantly higher than in the cab on both paved (p=0.004) and off-road (p=0.0003). Peak noise levels in the cab of DAF 4440 exceeded the parameters measured in the canvas covered rear compartment on both paved (p=0.002) and off-road (p=0.0002). In most cases, peak noise levels were below the LLV (p=0.02–0.0001). The maximum noise exposure to passengers in the canvas covered rear compartment of MAN 4620 despite road surface was calculated 0.6 hours per working day.ConclusionA high risk of noise-induced hearing loss among military personnel occurs during long distance transportation with vehicles showing noise levels higher than allowed LLV.

Hearing threshold shifts among military pilots of the Israeli Air Force

2017 ◽  
Vol 164 (1) ◽  
pp. 46-51 ◽  
Author(s):  
Liyona Kampel-Furman ◽  
Z Joachims ◽  
H Bar-Cohen ◽  
A Grossman ◽  
Y Frenkel-Nir ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Air Force ◽  
Military Service ◽  
Noise Exposure ◽  
Cohort Analysis ◽  
Mean Shift ◽  
Hearing Threshold ◽  
Hearing Thresholds ◽  
Significant Difference ◽  
Potential Risk Factors

BackgroundMilitary aviators are potentially at risk for developing noise-induced hearing loss. Whether ambient aircraft noise exposure causes hearing deficit beyond the changes attributed to natural ageing is debated. The aim of this research was to assess changes in hearing thresholds of Israeli Air Force (IAF) pilots over 20 years of military service and identify potential risk factors for hearing loss.MethodsA retrospective cohort analysis was conducted of pure-tone air conduction audiograms of pilots, from their recruitment at 18 years of age until the last documented medical check-up. Mean hearing thresholds were analysed in relation to age, total flight hours and aircraft platform. Comparisons were made to the hearing thresholds of air traffic controllers (ATCs) who were not exposed to the noise generated by aircraft while on duty.ResultsOne hundred and sixty-three pilots were included, with flying platforms ranging from fighter jets (n=54), combat helicopters (n=27), transport helicopters (n=52) and transport aircraft (n=30). These were compared with the results from 17 ATCs. A marked notch in the frequency range of 4–6 kHz was demonstrated in the mean audiograms of all platforms pilots, progressing with ageing. Hearing threshold shifts in relation to measurements at recruitment were first noted at the age of 30 years, particularly at 4 kHz (mean shift of 2.97 dB, p=0.001). There was no statistical association between flying variables and hearing thresholds adjusted for age by logistic regression analysis.ConclusionsThe audiometric profile of IAF pilots has a pattern compatible with noise exposure, as reflected by characteristic noise notch. However, no flight variable was associated with deterioration of hearing thresholds, and no significant difference from non-flying controls (ATCs) was seen.

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