Hearing thresholds in patients with drug-resistant tuberculosis: baseline audiogram configurations and associations

ABSTRACT Objective: To use baseline audiogram parameters in order to ascertain whether drug-resistant tuberculosis (DR-TB) has effects on hearing, as well as to describe the configurations of the audiograms and to determine whether there are parameters that can be associated with those configurations. Methods: This was a prospective study involving patients diagnosed with DR-TB at a tuberculosis treatment center in the state of Ogun, in Nigeria. The patients included in the study were submitted to pure tone audiometry at baseline (within two weeks after treatment initiation). For comparative analyses, data regarding demographic and clinical characteristics were collected from the medical records of the patients. Results: The final sample comprised 132 patients. The mean age of the patients was 34.5 ± 12.6 years (range, 8-82 years), and the male:female ratio was 2:1. Of the 132 patients, 103 (78.0%) resided in neighboring states, 125 (94.7%) had previously experienced antituberculosis treatment failure, and 18 (13.6%) were retroviral-positive. Normal audiograms were found in 12 patients (9.1%), whereas sensorineural hearing loss was identified in 104 (78.8%), the two most common configurations being ascending, in 54 (40.9%), and sloping, in 26 (19.7%). Pure-tone averages at low frequencies (0.25-1.0 kHz) and high frequencies (2.0-8.0 kHz) were 33.0 dB and 40.0 dB, respectively. Regarding the degree of hearing loss in the better ear, 36 patients (27.3%) were classified as having normal hearing and 67 (50.8%) were classified as having mild hearing loss (26-40 dB), whereas 29 (21.9%) showed moderate or severe hearing loss. Among the variables studied (age, gender, retroviral status, previous treatment outcome, and weight at admission), only male gender was associated with audiometric configurations. Conclusions: In this sample of patients with DR-TB, most presented with bilateral, mild, suboptimal sensorineural hearing loss, and ascending/sloping audiometric configurations were associated with male gender.

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Hearing recovery from deafness caused by bromate intoxication

The Journal of Laryngology & Otology ◽

10.1017/s0022215118002001 ◽

2018 ◽

Vol 132 (11) ◽

pp. 1039-1041 ◽

Cited By ~ 1

Author(s):

J Suzuki ◽

Y Takanashi ◽

A Koyama ◽

Y Katori

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Pure Tone ◽

Pure Tone Audiometry ◽

Auditory Brainstem ◽

Sensorineural Hearing ◽

Auditory Brainstem Responses ◽

Common Symptom ◽

Hearing Recovery ◽

Continuous Haemodiafiltration

AbstractObjectivesSodium bromate is a strong oxidant, and bromate intoxication can cause irreversible severe-to-profound sensorineural hearing loss. This paper reports the first case in the English literature of bromate-induced hearing loss with hearing recovery measured by formal audiological assessment.Case reportA 72-year-old woman was admitted to hospital with complaints of profound hearing loss, nausea, diarrhoea and anuria after bromate ingestion in a suicide attempt. On admission, pure tone audiometry and auditory brainstem responses showed profound bilateral deafness. Under the diagnosis of bromate-induced acute renal failure and sensorineural hearing loss, continuous haemodiafiltration was performed. When dialysis was discontinued, pure tone audiometry and auditory brainstem responses showed partial threshold recovery from profound deafness.ConclusionSevere-to-profound sensorineural hearing loss is a common symptom of bromate intoxication. Bromate-induced hearing loss may be partially treated, and early application of continuous haemodiafiltration might be useful as a treatment for this intractable condition.

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A Smartphone-Based Approach to Screening for Sudden Sensorineural Hearing Loss: Cross-Sectional Validity Study

JMIR mhealth and uhealth ◽

10.2196/23047 ◽

2020 ◽

Vol 8 (11) ◽

pp. e23047

Author(s):

Heng-Yu Haley Lin ◽

Yuan-Chia Chu ◽

Ying-Hui Lai ◽

Hsiu-Lien Cheng ◽

Feipei Lai ◽

...

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Gold Standard ◽

Pure Tone ◽

Pure Tone Audiometry ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

Clinical Settings ◽

Cross Sectional ◽

Scale Difference

Background Sudden sensorineural hearing loss (SSNHL) is an otologic emergency that warrants urgent management. Pure-tone audiometry remains the gold standard for definitively diagnosing SSNHL. However, in clinical settings such as primary care practices and urgent care facilities, conventional pure-tone audiometry is often unavailable. Objective This study aimed to determine the correlation between hearing outcomes measured by conventional pure-tone audiometry and those measured by the proposed smartphone-based Ear Scale app and determine the diagnostic validity of the hearing scale differences between the two ears as obtained by the Ear Scale app for SSNHL. Methods This cross-sectional study included a cohort of 88 participants with possible SSNHL who were referred to an otolaryngology clinic or emergency department at a tertiary medical center in Taipei, Taiwan, between January 2018 and June 2019. All participants underwent hearing assessments with conventional pure-tone audiometry and the proposed smartphone-based Ear Scale app consecutively. The gold standard for diagnosing SSNHL was defined as the pure-tone average (PTA) difference between the two ears being ≥30 dB HL. The hearing results measured by the Ear Scale app were presented as 20 stratified hearing scales. The hearing scale difference between the two ears was estimated to detect SSNHL. Results The study sample comprised 88 adults with a mean age of 46 years, and 50% (44/88) were females. PTA measured by conventional pure-tone audiometry was strongly correlated with the hearing scale assessed by the Ear Scale app, with a Pearson correlation coefficient of .88 (95% CI .82-.92). The sensitivity of the 5–hearing scale difference (25 dB HL difference) between the impaired ear and the contralateral ear in diagnosing SSNHL was 95.5% (95% CI 87.5%-99.1%), with a specificity of 66.7% (95% CI 43.0%-85.4%). Conclusions Our findings suggest that the proposed smartphone-based Ear Scale app can be useful in the evaluation of SSNHL in clinical settings where conventional pure-tone audiometry is not available.

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

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/559 ◽

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

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Hearing impairment in patients of renal failure

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20214224 ◽

2021 ◽

Vol 7 (11) ◽

pp. 1744

Author(s):

Joshna Thakur ◽

Kavita Sachdeva

Keyword(s):

Diabetes Mellitus ◽

Renal Failure ◽

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Creatinine Level ◽

Pure Tone ◽

Kidney Diseases ◽

Tertiary Care ◽

Pure Tone Audiometry ◽

Sensorineural Hearing

Background: Kidney diseases are emerging public health problems in developing countries. A common complication of renal failure is sensorineural hearing loss which is leading to poor quality of life. The aim of the study was to determine the prevalence of hearing loss in renal failure patients and to see the correlation of dialysis, ototoxic drugs, and creatinine levels.Methods: This observational study was conducted at the department of otorhinolaryngology, tertiary care center, Jabalpur (Madhya Pradesh) for a period of 18 months i.e.; from March 2019 to August 2020. 70 patients with renal failure were registered for study. In all patients hematological tests include hemoglobin, urea, creatinine, random blood sugar, serum electrolytes and pure tone audiometry was done. Results: Out of 70 patients, 51 patients (72.9%) of renal failure had sensorineural hearing loss. Hypertension and diabetes mellitus as comorbidity play important role in hearing loss in renal failure patients. Acoustic reflex was absent in 14.3% of cases which signifying a profound hearing loss and these patients had creatinine level above 6 mg/dl.Conclusions: Senorineural hearing loss is more prevalent in renal failure patients. Significant association was present between raised creatinine level and sensorineural hearings loss. Diabetes mellitus and hypertension were the common comorbidities that have a significant role in hearing loss in renal failure patients. All patients having renal failure have a risk of developing sensorineural hearing loss. So, these patients should be kept under follow up by doing regular pure tone audiometry and taking preventive measures, so that the hearing loss doesn't occur.

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Progressive, reversible sensorineural hearing loss caused by azathioprine

The Journal of Laryngology & Otology ◽

10.1017/s0022215114001807 ◽

2014 ◽

Vol 128 (9) ◽

pp. 838-840 ◽

Cited By ~ 4

Author(s):

P W Jenkinson ◽

M I Syed ◽

L Mcclymont

Keyword(s):

Adverse Effect ◽

Hearing Loss ◽

Case Report ◽

Sensorineural Hearing Loss ◽

Pure Tone ◽

Early Recognition ◽

Pure Tone Audiometry ◽

Sensorineural Hearing ◽

Patient Reported ◽

Clinical Awareness

AbstractObjective:This paper describes the first reported case of progressive sensorineural hearing loss caused by azathioprine, which was reversed on stoppage of the drug.Case report:A female patient with previously normal hearing presented with progressive sensorineural hearing loss after being started on azathioprine. Otological and neurological examination findings were unremarkable. After stopping the drug, the patient reported an improvement in hearing, which was confirmed on pure tone audiometry.Conclusion:This previously unreported side effect of azathioprine is highlighted in order to increase clinical awareness. Early recognition of this adverse effect is important to minimise the possibility of permanent sensorineural hearing loss.

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Bilateral acoustic schwannoma: post-operative hearing in the contralateral ear

The Journal of Laryngology & Otology ◽

10.1017/s002221510011727x ◽

1991 ◽

Vol 105 (9) ◽

pp. 769-771 ◽

Cited By ~ 3

Author(s):

Michael L. Farrell ◽

Meredydd L. L. Harries ◽

David M. Baguley ◽

David A. Moffat

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Acoustic Neuroma ◽

Pure Tone ◽

Pure Tone Audiometry ◽

Sensorineural Hearing ◽

Surgical Removal ◽

Acoustic Schwannoma ◽

Contralateral Ear ◽

Bilateral Acoustic Neuroma

AbstractA patient with neurofibromatosis two (NF2) presented with bilateral acoustic neuroma. Pre-operative audiometry revealed a dead right ear and severe left-sided sensorineural hearing loss. Following surgical removal of the larger right acoustic neuroma we have documented a sensorineural improvement of 45 dB in the contralateral ear on pure tone audiometry, which as far as the authors are aware has not previously been described.

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Examination of Hearing in a Rheumatoid Arthritis Population: Role of Extended-High-Frequency Audiometry in the Diagnosis of Subclinical Involvement

Scientifica ◽

10.1155/2016/5713283 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Mar Lasso de la Vega ◽

Ithzel Maria Villarreal ◽

Julio Lopez-Moya ◽

Jose Ramon Garcia-Berrocal

Keyword(s):

Rheumatoid Arthritis ◽

Hearing Loss ◽

Sensorineural Hearing Loss ◽

High Frequency ◽

Pure Tone ◽

Pure Tone Audiometry ◽

Sensorineural Hearing ◽

Control Group ◽

Immunological Parameters ◽

High Frequency Audiometry

Objective. The aim of this study is to analyze the high-frequency hearing levels in patients with rheumatoid arthritis and to determine the relationship between hearing loss, disease duration, and immunological parameters.Materials and Methods.A descriptive cross-sectional study including fifty-three patients with rheumatoid arthritis was performed. The control group consisted of 71 age- and sex-matched patients from the study population (consecutively recruited in Madrid “Area 9,” from January 2010 to February 2011). Both a pure tone audiometry and an extended-high-frequency audiometry were performed.Results. Extended-high-frequency audiometry diagnosed sensorineural hearing loss in 69.8% of the patients which exceeded the results obtained with pure tone audiometry (43% of the patients). This study found significant correlations in patients with sensorineural hearing loss related to age, sex, and serum anti-cardiolipin (aCL) antibody levels.Conclusion.Sensorineural hearing loss must be considered within the clinical context of rheumatoid arthritis. Our results demonstrated that an extended-high-frequency audiometry is a useful audiological test that must be performed within the diagnostic and follow-up testing of patients with rheumatoid arthritis, providing further insight into a disease-modifying treatment or a hearing loss preventive treatment.

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

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18136768 ◽

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.

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Auditory Neuropathy as the Initial Phenotype for Patients With ATP1A3 c.2452 G > A: Genotype–Phenotype Study and CI Management

Frontiers in Cell and Developmental Biology ◽

10.3389/fcell.2021.749484 ◽

2021 ◽

Vol 9 ◽

Author(s):

Wenjia Wang ◽

Jin Li ◽

Lan Lan ◽

Linyi Xie ◽

Fen Xiong ◽

...

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Pure Tone ◽

De Novo ◽

Pure Tone Audiometry ◽

Auditory Neuropathy ◽

Neurological Symptoms ◽

Sensorineural Hearing ◽

Auditory Brainstem Responses ◽

Capos Syndrome

Objective: The objective of this study is to analyze the genotype–phenotype correlation of patients with auditory neuropathy (AN), which is a clinical condition featuring normal cochlear responses and abnormal neural responses, and ATP1A3 c.2452 G > A (p.E818K), which has been generally recognized as a genetic cause of cerebellar ataxia, areflexia, pes cavus, optic atrophy, and sensorineural hearing loss (CAPOS) syndrome.Methods: Four patients diagnosed as AN by clinical evaluation and otoacoustic emission and auditory brainstem responses were recruited and analyzed by next-generation sequencing to identify candidate disease-causing variants. Sanger sequencing was performed on the patients and their parents to verify the results, and short tandem repeat-based testing was conducted to confirm the biological relationship between the parents and the patients. Furthermore, cochlear implantation (CI) was performed in one AN patient to reconstruct hearing.Results: Four subjects with AN were identified to share a de novo variant, p.E818K in the ATP1A3 gene. Except for the AN phenotype, patients 1 and 2 exhibited varying degrees of neurological symptoms, implying that they can be diagnosed as CAPOS syndrome. During the 15 years follow-up of patient 1, we observed delayed neurological events and progressive bilateral sensorineural hearing loss in pure tone threshold (pure tone audiometry, PTA). Patient 2 underwent CI on his left ear, and the result was poor. The other two patients (patient 3 and patient 4, who were 8 and 6 years old, respectively) denied any neurological symptoms.Conclusion:ATP1A3 p.E818K has rarely been documented in the Chinese AN population. Our study confirms that p.E818K in the ATP1A3 gene is a multiethnic cause of AN in Chinese individuals. Our study further demonstrates the significance of genetic testing for this specific mutation for identifying the special subtype of AN with somewhat favorable CI outcome and offers a more accurate genetic counseling about the specific de novo mutation.

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Evaluation of hearing acuity in patients with chronic renal failure by pure tone audiometry

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20204629 ◽

2020 ◽

Vol 6 (11) ◽

pp. 2046

Author(s):

Netra A. Pathak ◽

Sanjana V. Nemade ◽

Kiran J. Shinde

Keyword(s):

Renal Failure ◽

Hearing Loss ◽

Chronic Renal Failure ◽

Sensorineural Hearing Loss ◽

Pure Tone ◽

Hearing Threshold ◽

Pure Tone Audiometry ◽

Sensorineural Hearing ◽

Significant Difference ◽

Duration Of Disease

Background: Hearing loss is common in patients with chronic renal failure. It is well known that chronic renal failure (CRF) causes different systemic and otorhinolaryngologic manifestations due to the accumulation of nitrogenous waste products. The aim of the study was to evaluate hearing threshold and the severity of hearing loss at different frequencies in patients of chronic renal failure (CRF), and to analyse the role of duration of disease on hearing threshold in patients of CRF.Methods: Fifty two patients of CRF were included in the study. Pure tone audiometry was done in all cases.Results: Majority of the patients were in 21 to 40 year age group (mean: out of 52 patients, 38 patients (73.07%) had sensorineural hearing loss and 14 patients (26.93%) had normal hearing. Majority of the patients with hearing loss had mild (44.73%) or moderate (42.11%) sensorineural hearing loss. On comparison of the mean hearing threshold Group II (duration of disease more than five years- 17 patients) showed a statistically significant difference (P<0.05) in mean hearing threshold at 250 Hz.Conclusions: Hearing loss is present in majority of the patients of CRF. Most of the cases have mild to moderate sensorineural hearing loss. High frequency hearing loss in chronic renal failure is related to the duration of the disease, duration of haemodialysis’ and internal homeostasis, namely hyponatremia.

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