Systemic Absorption of Gentamicin Nasal Irrigations

2006 ◽  
Vol 20 (3) ◽  
pp. 251-254 ◽  
Author(s):  
W. Stites Whatley ◽  
Rakesh K. Chandra ◽  
C. Bruce MacDonald
Keyword(s):  
Otoacoustic Emissions ◽  
Pure Tone Audiometry ◽  
Sinus Surgery ◽  
Systemic Absorption ◽  
Normal Range ◽  
Nasal Irrigation ◽  
Distortion Product ◽  
Patient Reported ◽  
Before And After ◽  
The Right

Objective To determine if gentamicin nasal irrigation is systemically absorbed, and to identify any ototoxic side effects related to its use. Design Retrospective review of 12 patients treated with gentamicin nasal irrigations (30 cc of 80 mg/L solution used bilaterally twice daily). Methods Serum gentamicin levels were assayed after the course treatment. Pure tone audiometry (250–8000 Hz) and distortion product otoacoustic emissions (DP-OAEs) at 7280, 5133, 3640 and 2560 Hz were obtained before and after therapy. Results Twelve patients (age 4 to 74, mean 43) with chronic rhinosinusitis were treated for 3–15 weeks (mean 7 weeks). All patients had undergone previous endoscopic sinus surgery. Ten patients had pretreatment cultures that grew organisms sensitive to gentamicin (Pseudomonas, Proteus, or methacillin resistant Staphylococcus aureus), and three patients had cystic fibrosis. Ten of 12 patients (83%) had detectable posttreatment levels of gentamicin, with a mean serum level of 0.42 mcg/mL (range 0.3 to 0.7 mcg/mL). Four of 12 patients (33%) had serum gentamicin levels within the normal range for gentamicin trough (0.5 to 2 mcg/mL). Comparison of pre- and posttreatment audiologic data revealed no significant change in PTA or DP-OAE, except for the right ear at 8000 Hz on PTA (p = 0.035) where a mean of 7 dB loss was observed. No patient reported hearing loss or vertigo during treatment. Conclusion Gentamicin nasal irrigation may be systemically absorbed. Although the otologic consequences of this finding are questionable, patients receiving gentamicin nasal irrigations should be counseled regarding this hypothetical possibility.

scholarly journals Effects of dexmedetomidine and esmolol on otoacoustic emissions during controlled hypotensive anesthesia: randomized clinical trial

2020 ◽  
Vol 43 (1) ◽  
pp. E9-E17
Author(s):  
Günhan Gökahmetoğlu ◽  
Sibel Pehlivan ◽  
Recep Aksu ◽  
Cihangir Biçer
Keyword(s):  
Frequency Band ◽  
Otoacoustic Emissions ◽  
Otoacoustic Emission ◽  
Sinus Surgery ◽  
Distortion Product Otoacoustic Emission ◽  
Controlled Hypotension ◽  
Double Blind ◽  
Distortion Product ◽  
Arterial Blood ◽  
Before And After

Purpose: The aim of this study was to investigate the ability of esmolol and dexmedetomidine to achieve controlled hypotension on cochlea by measuring otoacoustic emission and stapedius reflex. Methods: In this prospective, double-blind pilot study, patients scheduled for elective tympanoplasty, rhinoplasty and endoscopic sinus surgery operation were randomly assigned to two groups, and received either dexmedetomidine (n=23) or esmolol (n=24) during surgery to maintain a mean arterial blood pressure between 55 and 65 mmHg. Distortion product otoacoustic emission tests (DPOAE) were performed 24 hours before and after the operation and during surgery (in the 20th and 40th minutes of the operation). Results: In the intra-group comparison, a statistically significant decrease was present at t20 (2,000 and 4,000 Hz frequency band) and t40 (1,000 and 1,500 Hz) according to the baseline value in the dexmedetomidine group (n=23); in the esmolol group (n=24), a statistically significant decrease (relative to the baseline value) was also detected at t20 and t40 for the 1,000 Hz frequency band. No damage was found on stapes reflexes with the infusion of these drugs. Conclusions: Infusion of dexmedetomidine and esmolol decreased DPOAE levels during the operations, but DPOAE levels returned to normal in the postoperative period, and had no effect on stapes reflexes. Studies with larger groups of patients are needed to confirm these results in tympanoplasty and other surgeries.

Spontaneous Recovery of Sudden Sensorineural Hearing Loss: Possible Association with Autoimmune Disorders

2006 ◽  
Vol 17 (07) ◽  
pp. 498-505 ◽  
Author(s):  
Jeffrey J. DiGiovanni ◽  
Padmaja Nair
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Otoacoustic Emissions ◽  
White Male ◽  
Pure Tone Audiometry ◽  
Normal Hearing ◽  
Sensorineural Hearing ◽  
Residual Effects ◽  
Distortion Product ◽  
The Right

A 46-year-old white male diagnosed with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) was seen for audiological testing 15 minutes following a sudden onset hearing loss in the right ear. The test battery included pure-tone audiometry, word-recognition testing, speech-recognition threshold (SRT) testing, immittance testing, and distortion-product otoacoustic emissions (DPOAE) testing. Testing revealed a sensorineural hearing loss in the right ear. Shortly after testing, the patient indicated that his condition had improved. Testing was repeated, and the second round of tests revealed normal hearing in both ears. Four days later, a follow-up test again indicated normal hearing in both ears. Possible connections of this brief occurrence of idiopathic hearing loss with the patient's medical conditions are discussed. Specifically, symptoms were consistent with a transient ischemic attack (TIA) affecting his right cochlea in the stria vascularis region, resulting in a temporary, sensorineural hearing loss. No residual effects were observed clinically.

scholarly journals Comparison of Saccular Function in Nonmusicians and Violinists Using cVEMP: A Pilot Study

2021 ◽  
Author(s):  
Eva Eadle D’Souza ◽  
Krishna Yerraguntla
Keyword(s):  
Otoacoustic Emissions ◽  
Pure Tone ◽  
Noise Exposure ◽  
Pure Tone Audiometry ◽  
Vestibular Evoked Myogenic Potential ◽  
Professional Musicians ◽  
Distortion Product ◽  
Significant Comparison ◽  
Mean Differences ◽  
The Right

Abstract Introduction Human auditory and vestibular systems change due to noise exposure. Professional musicians are often subjected to loud music and longer durations as part of their practice. Although the effects of music have been explored extensively on the auditory system, it is important to understand changes in the vestibular system also. The current study is aimed to compare cervical vestibular evoked myogenic potential (cVEMP) findings in nonmusicians and violinists to understand if there are any changes in the P1 and N1 latencies and absolute amplitudes in the violinists’ groups because of their exposure to violin music. Materials and Methods Twelve participants (6 nonmusicians and 6 violinists) of both genders were included in the study. Pure tone audiometry and distortion product otoacoustic emissions (DPOAEs) were performed on all the participants. cVEMP P1 and N1 latencies and absolute amplitudes were obtained, and overall mean differences were compared within and between groups. Results Pure tone average and DPOAE were within the normal range between and within the groups. Results indicate that P1 and N1 absolute amplitudes and latencies were slightly prolonged in the violinists’ group; however, the mean difference was not statistically significant. Comparison of mean absolute amplitudes and latencies between the ears in the violinists’ group showed longer latencies and greater absolute amplitudes in the left ear of violinists as compared with the right ear. In the study, the violinists’ group consisted of participants who had an average daily exposure of about one-and-a-half hours and had an experience of playing the instrument for more than 5 years. Conclusion cVEMP is useful in detecting early changes in the saccule that may occur due to noise exposure. It can be concluded that, even before a clinically detectable hearing loss or vestibular damage, changes in saccule are observed with the help of cVEMP and should be included in the audiovestibular test for early identification.

Evaluation of Efferent Auditory System and Hearing Quality in Parkinson's Disease: Is the Difficulty in Speech Understanding in Complex Listening Conditions Related to Neural Degeneration or Aging?

2020 ◽  
pp. 1-9
Author(s):  
Nuriye Yıldırım Gökay ◽  
Bülent Gündüz ◽  
Fatih Söke ◽  
Recep Karamert
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Auditory System ◽  
Otoacoustic Emissions ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Auditory Pathway ◽  
Normal Hearing ◽  
System Function ◽  
Distortion Product

Purpose The effects of neurological diseases on the auditory system have been a notable issue for investigators because the auditory pathway is closely associated with neural systems. The purposes of this study are to evaluate the efferent auditory system function and hearing quality in Parkinson's disease (PD) and to compare the findings with age-matched individuals without PD to present a perspective on aging. Method The study included 35 individuals with PD (mean age of 48.50 ± 8.00 years) and 35 normal-hearing peers (mean age of 49 ± 10 years). The following tests were administered for all participants: the first section of the Speech, Spatial and Qualities of Hearing Scale; pure-tone audiometry, speech audiometry, tympanometry, and acoustic reflexes; and distortion product otoacoustic emissions (DPOAEs) and contralateral suppression of DPOAEs. SPSS Version 25 was used for statistical analyses, and values of p < .05 were considered statistically significant. Results There were no statistically significant differences in the pure-tone audiometry thresholds and DPOAE responses between the individuals with PD and their normal-hearing peers ( p = .732). However, statistically significant differences were found between the groups in suppression levels of DPOAEs and hearing quality ( p < .05). In addition, a statistically significant and positive correlation was found between the amount of suppression at some frequencies and the Speech, Spatial and Qualities of Hearing Scale scores. Conclusions This study indicates that medial olivocochlear efferent system function and the hearing quality of individuals with PD were affected adversely due to the results of PD pathophysiology on the hearing system. For optimal intervention and follow-up, tasks related to hearing quality in daily life can also be added to therapies for PD.

Effect of mastoid drilling on hearing of the contralateral ear

2013 ◽  
Vol 127 (10) ◽  
pp. 952-956 ◽  
Author(s):  
A Goyal ◽  
P P Singh ◽  
A Vashishth
Keyword(s):  
Hearing Loss ◽  
High Frequency ◽  
Otoacoustic Emissions ◽  
Pure Tone Audiometry ◽  
Otoacoustic Emission ◽  
Prospective Clinical Study ◽  
Distortion Product Otoacoustic Emission ◽  
High Frequencies ◽  
Distortion Product ◽  
Contralateral Ear

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.

Lung and chest wall impedances in the dog in normal range of breathing: effects of pulmonary edema

1992 ◽  
Vol 73 (3) ◽  
pp. 1040-1046 ◽  
Author(s):  
G. M. Barnas ◽  
D. Stamenovic ◽  
K. R. Lutchen
Keyword(s):  
Oleic Acid ◽  
Pulmonary Edema ◽  
Chest Wall ◽  
Mean Airway Pressure ◽  
Normal Range ◽  
Normal Ranges ◽  
Before And After ◽  
Measured Resistance ◽  
The Right ◽  
Severe Pulmonary Edema

We evaluated the effect of pulmonary edema on the frequency (f) and tidal volume (VT) dependences of respiratory system mechanical properties in the normal ranges of breathing. We measured resistance and elastance of the lungs (RL and EL) and chest wall of four anesthetized-paralyzed dogs during sinusoidal volume oscillations at the trachea (50–300 ml, 0.2–2 Hz), delivered at a constant mean airway pressure. Measurements were made before and after severe pulmonary edema was produced by injection of 0.06 ml/kg oleic acid into the right atrium. Chest wall properties were not changed by the injection. Before oleic acid, EL increased slightly with increasing f in each dog but was independent of VT. RL decreased slightly and was independent of VT from 0.2 to 0.4 Hz, but above 0.4 Hz it tended to increase with increasing flow, presumably due to the airway contribution. After oleic acid injection, EL and RL increased greatly. Large negative dependences of EL on VT and of RL on f were also evident, so that EL and RL after oleic acid changed two- and fivefold, respectively, within the ranges of f and VT studied. We conclude that severe pulmonary edema changes lung properties so as to make behavior VT dependent (i.e., nonlinear) and very frequency dependent in the normal range of breathing.

scholarly journals Cochlear function in patients with chronic kidney disease

2013 ◽  
Vol 60 (1) ◽  
Author(s):  
Samantha Marlanie Govender ◽  
Cyril Devdas Govender ◽  
Glenda Matthews
Keyword(s):  
Chronic Kidney Disease ◽  
Hearing Loss ◽  
Kidney Disease ◽  
Otoacoustic Emissions ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Drug Intake ◽  
Cochlear Function ◽  
Distortion Product ◽  
Cochlear Dysfunction

Objective: To evaluate cochlear functioning in patients (18 - 45 years old) with varying stages of chronic kidney disease (CKD). Using purposive sampling, 50 participants, 10 in each of the 5 stages of CKD, were selected and underwent pure tone audiometric testing and distortion product otoacoustic emissions (DPOAEs).Results: Significant differences (p<0.05) were found between pure tone audiometry and DPOAEs in detecting early cochlear dysfunction in the high-frequency range in stages 3 (6 000/5 000 Hz; p=0.00), 4 (6 000/5 000 Hz; p<0.03) and 5 (4 000/3 333 Hz; p<0.01, 8 000/6 667 Hz:p<0.05) with DPOAEs being more sensitive in identifying early cochlear dysfunction. Patients in stages 1 and 2 presented with normal puretone thresholds and DPOAEs, suggesting that cochlear functioning in these patients was normal. Early cochlear dysfunction, thereby indicating a subclinical hearing loss, was identified in stages 3, 4 and 5 by DPOAE testing. In addition, blood test results, drug intake and concomitant conditions were recorded and analysed which suggested a relationship between reduced cochlear functioning and increased electrolyte levels, treatment regimens and concomitant conditions.Conclusion: Participants in the later stages of CKD presented with early cochlear dysfunction, presenting with subclinical hearing loss. It was postulated that this subclinical hearing loss resulted from a combination of electrolytic, urea and creatinine imbalances, together with concomitant medical conditions and ototoxic drug intake. It was concluded that audiological monitoring be included in the management of patients with CKD and that DPOAEs be introduced as part of the test battery to monitor cochlear function in patients with varying degrees of CKD.

Forte Fortissimo for Amateur Musicians: No Effect on Otoacoustic Emissions

2013 ◽  
Vol 28 (1) ◽  
pp. 3-8 ◽  
Author(s):  
Ole J Møllerløkken ◽  
Nils Magerøy ◽  
Magne Bråtveit ◽  
Ola Lind ◽  
Bente E Moen
Keyword(s):  
Otoacoustic Emissions ◽  
Office Workers ◽  
Cochlear Function ◽  
Distortion Product ◽  
Brass Band ◽  
Hearing Ability ◽  
Sound Levels ◽  
Amateur Musicians ◽  
Before And After ◽  
Noise Measurements

Many amateur musicians are likely to be exposed to high sound levels during rehearsals. Measuring otoacoustic emissions (OAE) is an objective technique to assess hearing ability and can be used as an early predictor of hearing loss. This study aimed to record sound levels at an amateur brass band rehearsal and to examine the cochlear function of the musicians by evaluating distortion product (DP) OAE amplitudes before and after sound exposure. Twenty-four brass band musicians and 10 office workers were examined with personal noise measurements and DPOAE tests before and after a music rehearsal or one office workday, respectively. The sound levels in the brass band ranged from 92 to 100 dB(A), LaEQ 96 dB(A). However, the amateur brass band members had no change in DPOAEs after this exposure compared to pre-exposure levels and compared to office workers.

scholarly journals Risk Assessment of Recreational Noise–Induced Hearing Loss from Exposure through a Personal Audio System—iPod Touch

2019 ◽  
Vol 30 (07) ◽  
pp. 619-633 ◽  
Author(s):  
Kamakshi V. Gopal ◽  
Liana E. Mills ◽  
Bryce S. Phillips ◽  
Rajesh Nandy
Keyword(s):  
Hearing Loss ◽  
Otoacoustic Emissions ◽  
Pure Tone ◽  
Risk Indicator ◽  
Noise Induced Hearing Loss ◽  
Ipod Touch ◽  
Distortion Product ◽  
Before And After ◽  
Within Subjects ◽  
Loud Music

AbstractRecreational noise–induced hearing loss (RNIHL) is a major health issue and presents a huge economic burden on society. Exposure to loud music is not considered hazardous in our society because music is thought to be a source of relaxation and entertainment. However, there is evidence that regardless of the sound source, frequent exposure to loud music, including through personal audio systems (PAS), can lead to hearing loss, tinnitus, difficulty processing speech, and increased susceptibility to age-related hearing loss.Several studies have documented temporary threshold shifts (TTS) (a risk indicator of future permanent impairment) in subjects that listen to loud music through their PAS. However, there is not enough information regarding volume settings that may be considered to be safe. As a primary step toward quantifying the risk of RNIHL through PAS, we assessed changes in auditory test measures before and after exposure to music through the popular iPod Touch device set at various volume levels.This project design incorporated aspects of both between- and within-subjects and used repeated measures to analyze individual groups.A total of 40 adults, aged 18–31 years with normal hearing were recruited and randomly distributed to four groups. Each group consisted of five males and five females.Subjects underwent two rounds of testing (pre- and postmusic exposure), with a 30-min interval, where they listened to a playlist consisting of popular songs through an iPod at 100%, 75%, 50%, or 0% volume (no music). Based on our analysis on the Knowles Electronic Manikin for Acoustic Research, with a standardized 711 coupler, it was determined that listening to the playlist for 30 min through standard earbuds resulted in an average level of 97.0 dBC at 100% volume, 83.3 dBC at 75% volume, and 65.6 dBC at 50% volume. Pure-tone thresholds from 500–8000 Hz, extended high-frequency pure tones between 9–12.5 kHz, and distortion product otoacoustic emissions (DPOAE) were obtained before and after the 30-min music exposure. Analysis of variance (ANOVA) was performed with two between-subjects factors (volume and gender) and one within-subjects factor (frequency). Change (shift) in auditory test measures was used as the outcome for the ANOVA.Results indicated significant worsening of pure-tone thresholds following music exposure only in the group that was exposed to 100% volume at the following frequencies: 2, 3, 4, 6 and 8 kHz. DPOAEs showed significant decrease at 2000 and 2822 Hz, also only for the 100% volume condition. No significant changes were found between pre- and postmusic exposure measures in groups exposed to 75%, 50%, or 0% volume conditions. Follow-up evaluations conducted a week later indicated that pure-tone thresholds had returned to the premusic exposure levels.These results provide quantifiable information regarding safe volume control settings on the iPod Touch with standard earbuds. Listening to music using the iPod Touch at 100% volume setting for as little as 30 min leads to TTS and worsening of otoacoustic emissions, a risk for permanent auditory damage.

scholarly journals Does Vincristine affect Cochlear function in children with acute lymphoblastic leukaemia?

2016 ◽  
Vol 27 (1) ◽  
pp. 3-7
Author(s):  
Suchetha Rao ◽  
Ranjith Kumar ◽  
Jayashree Bhat ◽  
Nutan Kamath
Keyword(s):  
High Frequency ◽  
Otoacoustic Emissions ◽  
Lymphoblastic Leukemia ◽  
Statistical Significance ◽  
Pure Tone Audiometry ◽  
Cochlear Function ◽  
Hearing Sensitivity ◽  
Distortion Product ◽  
High Frequency Audiometry

Context: Vincristine chemotherapy has dose dependent ototoxicity. Early detection of ototoxicity is better with otoacoustic emissions and high frequency audiometry than conventional pure tone audiometry. The study was done to see if vincristine treatment interferes with hearing sensitivity in children.Methods and Material: A prospective study was conducted on twenty-three children with acute lymphoblastic leukemia (ALL) on Multi Center Protocol (MCP 841).These were subjected to conventional audiometry, high frequency audiometry and distortion product otoacoustic emissions (DPOAEs) before starting chemotherapy. The follow up audiological evaluation after early intensive phase chemotherapy (approximately 6 months) was conducted in thirteen children, who received 12 doses of vincristine (1.4 mg/m2), cranial irradiation of 1800cGy (>3 years) as per protocol and antibiotics as per clinical demands.Results: Baseline audiological evaluation was normal. Follow-up evaluation DPOAEs showed a declining tendency, however changes did not reach statistical significance. Differences in median hearing thresholds prior and post treatment in higher frequency audiometry were also minimal which was not statistically significant. Conventional audiometric thresholds were not altered.Conclusions: The reduction in the signal noise ratio of DPOAE, and reduced hearing sensitivity in high frequencies in post chemotherapy in comparison with baseline measures cannot be ignored though it has failed to reach the level of statistical significance. children on vincristine should have a pre chemotherapy and follow up audiological evaluation with DPOAE The results of the present study needs to be strengthened by including larger sample and long term follow up.Bangladesh J Medicine Jan 2016; 27(1) : 3-7

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