Cerebrospinal fluid shunting and hearing loss in patients treated for medulloblastoma

Object Cerebrospinal fluid shunting has previously been associated with hearing loss. Although the mechanism for this is unclear, it is thought that changes in CSF pressure can affect cochlear physiology via endolymph expansion in the setting of a patent cochlear aqueduct. Patients undergoing radiation and cisplatin chemotherapy are at risk for hearing loss. The authors hypothesized that the incidence and severity of hearing loss in patients undergoing radiation and chemotherapy for medulloblastoma would be greater in those with shunts than in those without shunts. Methods Baseline and longitudinal audiology data were collected in 33 patients with medulloblastoma who were receiving radiation and cisplatin chemotherapy. Additional data included age, sex, details of shunt placement and revision, and details of chemotherapy and radiation. Hearing sensitivity and peripheral auditory function measures included pure tone audiometry, immittance audiometry, and distortion product evoked otoacoustic emissions. Ototoxicity was determined according to the American Speech-Language-Hearing Association criteria. Severity of hearing loss was determined using the Brock hearing loss grades. Incidence of hearing loss and association with shunting was determined. Results Thirteen (39.4%) of the 33 patients evaluated had undergone shunt placement. Hearing loss occurred in 14 (70%) of 20 patients without shunts and in 13 (100%) of 13 patients with shunts. The difference between the rates of hearing loss in patients with shunts versus those without the devices was highly significant (p = 0.0008). The odds ratio for hearing loss in patients with a CSF shunt compared with those without a shunt was 23.49 (95% CI 4.21–131.15). Age, side of shunt, evidence of dissemination, diameter of cochlear aqueduct, and treatment protocol did not have a significant effect on shunt-related ototoxicity. Conclusions This study suggests an independent association between CSF shunting and hearing loss in children undergoing treatment for medulloblastoma, laying the foundation for a prospective study evaluating hearing loss in children with shunts who are not treated with ototoxic therapy.

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Unilateral Hearing Loss in Children with Shunt-Treated Hydrocephalus

Journal of the American Academy of Audiology ◽

10.3766/jaaa.14.9.6 ◽

2003 ◽

Vol 14 (09) ◽

pp. 510-517 ◽

Cited By ~ 16

Author(s):

Susan E. Spirakis ◽

Raymond M. Hurley

Keyword(s):

Hearing Loss ◽

High Frequency ◽

Otoacoustic Emissions ◽

Pure Tone ◽

Acoustic Reflex ◽

Shunt Placement ◽

Cochlear Aqueduct ◽

Distortion Product ◽

Cochlear Hearing Loss ◽

Air Conduction

This study investigated the characteristics of hearing loss in children with ventriculoperitoneal (VP) shunted hydrocephalus. Twelve hydrocephalic children with patent VP shunts participated. The etiology of the hydrocephalus was either intraventricular hemorrhage or spina bifida. Audiometric examination included pure-tone air conduction thresholds, tympanometry, contralateral and ipsilateral acoustic reflex thresholds (ARTs), and distortion product otoacoustic emissions (DPOAEs). A unilateral, high-frequency, cochlear hearing loss was found in the ear ipsilateral to the shunt placement in 10 (83%) of the 12 shunt-treated hydrocephalic children. No hearing loss was observed in the ear contralateral to shunt placement. Based on the pure-tone audiometric findings, coupled with the decrease in DPOAE amplitude in the shunt ear, the hearing loss appears to be cochlear in nature. We suggest that cochlear hydrodynamics are disrupted as the result of reduced perilymph pressure, a consequence of cerebrospinal fluid (CSF) reduction due to the combined effects of a patent shunt and a patent cochlear aqueduct. In addition, a concomitant brain stem involvement is evidenced in the ART pattern, possibly produced by the patent shunt draining the CSF from the subdural space, resulting in cranial base hypoplasia.

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Effect of mastoid drilling on hearing of the contralateral ear

The Journal of Laryngology & Otology ◽

10.1017/s0022215113001965 ◽

2013 ◽

Vol 127 (10) ◽

pp. 952-956 ◽

Cited By ~ 6

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.

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Cochlear function in patients with chronic kidney disease

South African Journal of Communication Disorders ◽

10.4102/sajcd.v60i1.10 ◽

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.

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

Journal of the American Academy of Audiology ◽

10.3766/jaaa.17.7.5 ◽

2006 ◽

Vol 17 (07) ◽

pp. 498-505 ◽

Cited By ~ 6

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.

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Analysis of Chronic Tinnitus in Noise-Induced Hearing Loss and Presbycusis

Journal of Clinical Medicine ◽

10.3390/jcm10081779 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1779

Author(s):

Hee Jin Kang ◽

Dae Woong Kang ◽

Sung Su Kim ◽

Tong In Oh ◽

Sang Hoon Kim ◽

...

Keyword(s):

Hearing Loss ◽

Otoacoustic Emissions ◽

Pure Tone Audiometry ◽

Auditory Brainstem ◽

Outer Hair Cells ◽

Chronic Tinnitus ◽

Noise Induced Hearing Loss ◽

Distortion Product ◽

Hearing Thresholds ◽

Brainstem Response

The most frequent causes of tinnitus associated with hearing loss are noise-induced hearing loss and presbycusis. The mechanism of tinnitus is not yet clear, although several hypotheses have been suggested. Therefore, we aimed to analyze characteristics of chronic tinnitus between noise-induced hearing loss and presbycusis. Materials and Methods: This paper is a retrospective chart review and outpatient clinic-based study of 248 patients with chronic tinnitus from 2015 to 2020 with noise-induced or presbycusis. Pure tone audiometry (PTA), auditory brainstem response (ABR), distortion product otoacoustic emissions (DPOAE), transient evoked otoacoustic emissions (TEOAE), and tinnitograms were conducted. Results: PTA showed that hearing thresholds at all frequencies were higher in patients with noise-induced hearing loss than the presbycusis group. ABR tests showed that patients with presbycusis had longer wave I and III latencies (p < 0.05 each) than patients with noise-induced hearing loss. TEOAE tests showed lower values in patients with noise-induced hearing loss than presbycusis at 1.5, 2, 3, and 4 kHz (p < 0.05 each). DPOAE tests showed that response rates in both ears at 1.5, 2, and 3 kHz were significantly higher in patients with presbycusis than noise-induced hearing loss (p < 0.05 each). Discussion: This study showed that hearing thresholds were higher, the loudness of tinnitus was smaller, and the degree of damage to outer hair cells was lower in patients with presbycusis than with noise-induced hearing loss. Moreover, wave I and III latencies were more prolonged in patients with presbycusis despite their having lower hearing thresholds. These phenomena may reflect the effects of aging or degeneration of the central nervous system with age. Further studies are needed to evaluate the etiologies of tinnitus.

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Hearing status in patients with rheumatoid arthritis

The Journal of Laryngology & Otology ◽

10.1017/s0022215117001670 ◽

2017 ◽

Vol 131 (10) ◽

pp. 895-899 ◽

Cited By ~ 5

Author(s):

A Ahmadzadeh ◽

M Daraei ◽

M Jalessi ◽

A A Peyvandi ◽

E Amini ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Otoacoustic Emissions ◽

Bone Conduction ◽

Pure Tone Audiometry ◽

Sensorineural Hearing ◽

Speech Discrimination ◽

Distortion Product ◽

Acoustic Reflexes

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.

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Is there auditory impairment in Parkinson's disease?

Revista CEFAC ◽

10.1590/1982-021620182052418 ◽

2018 ◽

Vol 20 (5) ◽

pp. 573-582 ◽

Cited By ~ 1

Author(s):

Marcia da Silva Lopes ◽

Ailton de Souza Melo ◽

Ana Paula Corona ◽

Ana Caline Nóbrega

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Hearing Loss ◽

Auditory Processing ◽

Otoacoustic Emissions ◽

Pure Tone Audiometry ◽

Distortion Product ◽

Biological Variables ◽

Initial Stage ◽

Auditory Impairment

ABSTRACT Objective: to describe the audiological profile of a group of patients with Parkinson's disease and to investigate the association between hearing loss and the disease. Methods: 50 individuals with and 46 without Parkinson's disease underwent Pure Tone Audiometry, Otoacoustic Emissions by Distortion Product, and auditory processing tests. The results of the patients were compared to those obtained in individuals without the disease, according to clinical and biological variables. Results: in individuals with Parkinson's disease, 82% presented hearing loss, 53.5% alterations in Otoacoustic Emissions by Distortion Product, 78%, alterations in temporal processing, and 12%, changes in binaural integration. Individuals with the disease had a greater impairment in the recognition of duration patterns when compared to those without the disease, with a worse performance in men and in individuals aged between 42 and 65 years old and Hoehn and Yahr I and II stages. Conclusions: the profile found corresponds to descending sensorineural hearing loss and alteration in otoacoustic emissions, temporal ordering and noise gaps detection.Only losses in temporal order are associated with the disease, especially in men, individuals under the age of 65 and in the initial stage.

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The Estimation of the Time Constant of the Human Inner Ear Pressure Change by Noninvasive Technique

Modelling and Simulation in Engineering ◽

10.1155/2009/570124 ◽

2009 ◽

Vol 2009 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Raghida Traboulsi ◽

Georges Poumarat ◽

Jean Chazal ◽

Paul Avan ◽

Thierry Mom ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Intracranial Pressure ◽

Inner Ear ◽

Time Constant ◽

Otoacoustic Emissions ◽

Pressure Change ◽

Noninvasive Technique ◽

Cochlear Aqueduct ◽

Distortion Product ◽

Long Time

We propose a noninvasive method to estimate the time constant. The calculation of this factor permits us to understand the pressure variations of the inner ear and also predict the behavior of the flow resistance of the cochlear aqueduct. A set of mathematical relationships incorporating the intralabyrinthine pressure, the intracranial pressure, and the time constant was applied. The modeling process describes the hydrodynamic effects of the cerebrospinal fluid in the intralabyrinthine fluid space, where the input and output of the created model are, respectively, the sinusoidal variation of the respiration signal and the distortion product of otoacoustic emissions. The obtained results were compared with those obtained by different invasive techniques. A long time constant was detected each time when the intracranial pressure increased; this phenomenon is related to the role of the cochlear aqueduct described elsewhere. The interpretation of this model has revealed the ability of these predictions to provide a greater precision for hydrodynamic variation of the inner ear, consequently the variation of the dynamic process of the cerebrospinal fluid.

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Correlation between brainstem evoked response audiometry with other audiological tests in different types of hearing loss

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20201672 ◽

2020 ◽

Vol 6 (5) ◽

pp. 839

Author(s):

Hemal Shah ◽

Pramod Kharadi ◽

Krunal Patel ◽

Sushil Jha ◽

Abhishek Kumar Singh

Keyword(s):

Hearing Loss ◽

Otoacoustic Emissions ◽

Hearing Threshold ◽

Pure Tone Audiometry ◽

Evoked Response ◽

P Value ◽

Brainstem Evoked Response Audiometry ◽

Distortion Product ◽

Different Types ◽

Evoked Response Audiometry

Background: Brainstem evoked response audiometry (BERA) is most specific and sensitive test for brain stem dysfunction. It is most important objective method for evaluating peripheral auditory system in neonates, infants, sedated and comatose patients and other person who doesn’t understand the language. Objective of the study was to evaluate correlation BERA with other audiological tests in different types of hearing loss as well as to study variations of wave forms in different types of hearing loss.Methods: Patients underwent a complete ENT check up to rule out any actively discharging gears, wax, infection or any middle ear problems. Different audiometric tests: pure tone audiometry (PTA), distortion product otoacoustic emissions, auditory steady-state response (ASSR) and BERA were applied to the patients. Results: The majority of the patients (32 cases) belonged to the age group of 0-5 years. Maximum cases were of sensorineural hearing loss (60%). ASSR was highly sensitive (85.1%) for estimation of hearing threshold and specificity was 100% (p<0.001). BERA was also highly significant for estimation of hearing threshold (sensitivity: 83%; specificity: 92.3%; p value <0.001).Conclusions: BERA has high degree of accuracy in detecting hearing threshold as an objective test but not as much accurate as ASSR. It is more valuable in terms of identification of site and size of the lesion in auditory pathway and identification for the type of the deafness.

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Hearing impairment in patients of hypothyroidism in sub Himalayan region

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20203202 ◽

2020 ◽

Vol 6 (8) ◽

pp. 1494

Author(s):

Vikasdeep Gupta ◽

Sunder Singh Dogra ◽

Pardeep Bansal ◽

Kuldeep Thakur ◽

Vidhu Sharma ◽

...

Keyword(s):

Hearing Loss ◽

Hearing Impairment ◽

High Frequency ◽

Otoacoustic Emissions ◽

Pure Tone Audiometry ◽

Transluminal Angioplasty ◽

Prospective Clinical Study ◽

Thyroid Function Tests ◽

Distortion Product ◽

Serum T3

Background: The objective of the study was to assess the hearing impairment in patients of hypothyroidism.Methods: A prospective clinical study has done at a referral centre included 33 diagnosed patients of hypothyroidism in the age group of 15 to 65 years, fulfilling the inclusion and exclusion criteria who attended the outpatient department. The diagnosis of hypothyroidism was confirmed by thyroid function tests i.e., serum T3, T4 and TSH levels while hearing assessment was done using tuning fork tests, pure tone audiometry, impedance audiometry and otoacoustic emissions. Hearing impairment was measured in decibels of hearing loss, or dB HL and graded as mild, moderate, moderately severe, severe, or profound. Results: Percutaneous transluminal angioplasty showed 42.7% of the patients had high frequency sensorineural type of hearing loss. The air bone gap was not significant. On tympanometry, all the patients had type A graph and distortion product otoacoustic emissionss in all patients were pass.Conclusions: Acquired hypothyroidism affects primarily high frequency hearing thresholds causing high frequency sensorineural hearing loss, with little or no effect on lower frequencies.

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