Incidence of high-frequency hearing loss after microvascular decompression for hemifacial spasm

2013 ◽  
Vol 118 (4) ◽  
pp. 719-724 ◽  
Author(s):  
Tingting Ying ◽  
Parthasarathy Thirumala ◽  
Aalap Shah ◽  
Tara Nikonow ◽  
Kelley Wichman ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
High Frequency ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Stepwise Logistic Regression ◽  
Ipsilateral Side ◽  
High Frequency Hearing Loss ◽  
Number Of Patients

Object The primary aim of this study was to evaluate the incidence and discuss the pathogenesis of high-frequency hearing loss (HFHL) after microvascular decompression (MVD) for hemifacial spasm (HFS). Methods Preoperative and postoperative audiogram data and brainstem auditory evoked potentials (BAEPs) from 94 patients who underwent MVD for HFS were analyzed. Pure tone audiometry at 0.25–2 kHz, 4 kHz, and 8 kHz was calculated for all individuals pre- and postoperatively ipsilateral and contralaterally. Intraoperative neurophysiological data were reviewed independently. An HFHL was defined as a change in pure tone audiometry of more than 10 dB at frequencies of 4 and 8 kHz. Results The incidence of HFHL was 50.00% and 25.53% ipsilateral and contralateral to the side of surgery, respectively. The incidence of HFHL adjusted for conductive and nonserviceable hearing loss was 26.6% ipsilaterally. The incidence of HFHL at 4 and 8 kHz on the ipsilateral side was 37.23% and 45.74%, respectively, and it was 10.64% and 25.53%, respectively, on the contralateral side. Maximal change in interpeak latency Waves I–V compared with baseline was the only variable significantly different between groups (p < 0.05). Sex, age, and side did not increase the risk of HFHL. Stepwise logistic regression analysis did not find any changes in intraoperative BAEPs to increase the risk of HFHL. Conclusions High-frequency hearing loss occurs in a significant number of patients following MVD surgery for HFS. Drill-induced noise and transient loss of CSF during surgery may impair hearing in the high-frequency ranges on both the ipsilateral and contralateral sides, with the ipsilateral side being more affected. Changes in intraoperative BAEPs during MVD for HFS were not useful in predicting HFHL. Follow-up studies and repeat audiological examinations may be helpful in evaluating the time course and prognosis of HFHL. Prospective studies focusing on decreasing intraoperative noise exposure, as well as auditory shielding devices, will establish causation and allow the team to intervene appropriately to decrease the risk of HFHL.

scholarly journals The incidence of high-frequency hearing loss after microvascular decompression for trigeminal neuralgia, glossopharyngeal neuralgia, or geniculate neuralgia

2015 ◽  
Vol 123 (6) ◽  
pp. 1500-1506 ◽  
Author(s):  
Parthasarathy Thirumala ◽  
Kristin Meigh ◽  
Navya Dasyam ◽  
Preethi Shankar ◽  
Kanika R. K. Sarma ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Trigeminal Neuralgia ◽  
Microvascular Decompression ◽  
High Frequency ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Contralateral Side ◽  
Glossopharyngeal Neuralgia ◽  
Ipsilateral Side ◽  
High Frequency Hearing Loss

OBJECT The primary aim of this study was to evaluate the incidence and discuss the pathogenesis of high-frequency hearing loss (HFHL) after microvascular decompression (MVD) for trigeminal neuralgia (TGN), glossopharyngeal neuralgia (GPN), or geniculate neuralgia (GN). METHODS The authors analyzed preoperative and postoperative audiogram data and brainstem auditory evoked potentials (BAEPs) from 93 patients with TGN, 6 patients with GPN, and 8 patients with GN who underwent MVD. Differences in pure tone audiometry > 10 dB at frequencies of 0.25, 0.5, 1, 2, 4, and 8 kHz were calculated preoperatively and postoperatively for both the ipsilateral and the contralateral sides. Intraoperative monitoring records were analyzed and compared with the incidence of HFHL, which was defined as a change in pure tone audiometry > 10 dB at frequencies of 4 and 8 kHz. RESULTS The incidence of HFHL was 30.84% on the side ipsilateral to the surgery and 20.56% on the contralateral side. Of the 47 patients with HFHL, 20 had conductive hearing loss, and 2 experienced nonserviceable hearing loss after the surgery. The incidences of HFHL on the ipsilateral side at 4 and 8 kHz were 17.76% and 25.23%, respectively, and 8.41% and 15.89%, respectively, on the contralateral side. As the audiometric frequency increased, the number of patients with hearing loss increased. No significant postoperative difference was found between patients with and without HFHL in intraoperative BAEP waveforms. Sex, age, and affected side were not associated with an increase in the incidence of hearing loss. CONCLUSIONS High-frequency hearing loss occurred after MVD for TGN, GPN, or GN, and the greatest incidence occurred on the ipsilateral side. This hearing loss may be a result of drill-induced noise and/or transient loss of cerebrospinal fluid during the course of the procedure. Changes in intraoperative BAEP waveforms were not useful in predicting HFHL after MVD. Repeated postoperative audiological examinations may be useful in assessing the prognosis of HFHL.

scholarly journals Reduction in high-frequency hearing loss following technical modifications to microvascular decompression for hemifacial spasm

2015 ◽  
Vol 123 (4) ◽  
pp. 1059-1064 ◽  
Author(s):  
Parthasarathy Thirumala ◽  
Andrew M. Frederickson ◽  
Jeffrey Balzer ◽  
Donald Crammond ◽  
Miguel E. Habeych ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
High Frequency ◽  
Auditory Evoked Potentials ◽  
Pure Tone Audiometry ◽  
Brainstem Auditory Evoked Potentials ◽  
Vestibulocochlear Nerve ◽  
High Frequency Hearing Loss ◽  
Technical Modifications

OBJECT Microvascular decompression is a safe and effective procedure to treat hemifacial spasm, but the operation poses some risk to the patient’s hearing. While severe sensorineural hearing loss across all frequencies occurs at a low rate in experienced hands, a recent study suggests that as many as one-half of patients who undergo this procedure may experience ipsilateral high-frequency hearing loss (HFHL), and as many as one-quarter may experience contralateral HFHL. While it has been suggested that drill-related noise may account for this finding, this study was designed to examine the effect of a number of techniques designed to protect the vestibulocochlear nerve from operative manipulation on the incidence of HFHL. METHODS Pure-tone audiometry was performed both preoperatively and postoperatively on 67 patients who underwent microvascular decompression for hemifacial spasm during the study period. A change of greater than 10 dB at either 4 kHz or 8 kHz was considered to be HFHL. Additionally, the authors analyzed intraoperative brainstem auditory evoked potentials from this patient cohort. RESULTS The incidence of ipsilateral HFHL in this cohort was 7.4%, while the incidence of contralateral HFHL was 4.5%. One patient (1.5%; also included in the HFHL group) experienced an ipsilateral nonserviceable hearing loss. CONCLUSIONS The reduced incidence of HFHL in this study suggests that technical modifications including performing the procedure without the use of fixed retraction may greatly reduce, but not eliminate, the occurrence of HFHL following microvascular decompression for hemifacial spasm.

scholarly journals The Relevance of the High Frequency Audiometry in Tinnitus Patients with Normal Hearing in Conventional Pure-Tone Audiometry

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Veronika Vielsmeier ◽  
Astrid Lehner ◽  
Jürgen Strutz ◽  
Thomas Steffens ◽  
Peter M. Kreuzer ◽  
...  
Keyword(s):  
Hearing Loss ◽  
High Frequency ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Normal Hearing ◽  
High Frequency Hearing Loss ◽  
Additional Information ◽  
Tinnitus Severity ◽  
Hearing Thresholds ◽  
High Frequency Audiometry

Objective. The majority of tinnitus patients suffer from hearing loss. But a subgroup of tinnitus patients show normal hearing thresholds in the conventional pure-tone audiometry (125 Hz–8 kHz). Here we explored whether the results of the high frequency audiometry (>8 kHz) provide relevant additional information in tinnitus patients with normal conventional audiometry by comparing those with normal and pathological high frequency audiometry with respect to their demographic and clinical characteristics.Subjects and Methods. From the database of the Tinnitus Clinic at Regensburg we identified 75 patients with normal hearing thresholds in the conventional pure-tone audiometry. We contrasted these patients with normal and pathological high-frequency audiogram and compared them with respect to gender, age, tinnitus severity, pitch, laterality and duration, comorbid symptoms and triggers for tinnitus onset.Results. Patients with pathological high frequency audiometry were significantly older and had higher scores on the tinnitus questionnaires in comparison to patients with normal high frequency audiometry. Furthermore, there was an association of high frequency audiometry with the laterality of tinnitus.Conclusion. In tinnitus patients with normal pure-tone audiometry the high frequency audiometry provides useful additional information. The association between tinnitus laterality and asymmetry of the high frequency audiometry suggests a potential causal role for the high frequency hearing loss in tinnitus etiopathogenesis.

scholarly journals Correlation of the Puretone Audiometry Findings with Intraoperative Findings in Patients with Chronic Suppurative Otitis Media

2015 ◽  
Vol 2 (1) ◽  
pp. 4
Author(s):  
Devashri Uday Patil ◽  
Kiran S. Burse ◽  
Shreeya Kulkarni ◽  
Vandana Sancheti ◽  
Chaitanya Bharadwaj
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Ossicular Chain ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media ◽  
Number Of Patients ◽  
Operative Findings ◽  
Air Conduction

Chronic suppurative otitis media is one of the common otological conditions in India for which patients seek advice from an otorhinolaryngologist. Chronic suppurative otitis media is recurrent and progressive disease which is characterized with tympanic membrane perforation and suppurative discharge. Pure tone audiometry is the most common test used to evaluate auditory sensitivity. Since hearing loss is a common complication of chronic suppurative otitis media, we designed this study to evaluate preoperative pure tone audiometry findings in patients with chronic suppurative otitis media and its correlation with the intra-operative findings. <strong>Aims and Objectives:</strong> 1] To assess the intra-operative findings in patients with chronic suppurative otitis media. 2] To evaluate the correlation between the preoperative pure tone audiometry findings and intra-operative findings in patients with chronic suppurative otitis media. 3] To assess the type of hearing loss and degree of hearing loss in patients with chronic suppurative otitis media. <strong>Materials and Methods:</strong> This is an Observational study carried over a period of 3 years from August 2011 to August 2013. Total number of patients included in this study was 100. <strong>Result:</strong> Out of 100 patients studied 69 % of patients had Tubo-Tympanic type of CSOM, 31 % of patients had Attico-antral type of CSOM. In patients of Safe CSOM; Central perforation was seen in maximum cases 46.4 %, anterior central perforations was seen in 8.7 % cases, posterior central perforations seen in 20.2 % cases, and subtotal perforations seen in 24.63 % cases. In patients of Unsafe CSOM posterosuperior cholesteatoma was seen in maximum cases 67.74 %, and attic cholesteatoma was seen in 32.2 % cases. In safe CSOM patients all ossicles were intact and mobile whereas in unsafe CSOM patients only 4 patients had intact ossicular chain, while maximum patients had ossicular defect. <strong>Conclusion:</strong> Hearing loss depends on size of perforation. Hearing loss increases as the size of perforation increases. Average air conduction threshold and air bone gap did not differ significantly between various groups of ossicular defect. This shows us that neither air conduction nor air bone gap are reliable parameters on basis of which we can predict ossicular status preoperatively.

scholarly journals Clinical and pathophysiological study of patients with vertigo at SAIMS, Indore

2019 ◽  
Vol 5 (4) ◽  
pp. 1009
Author(s):  
Digant Patni ◽  
Alok Tyagi ◽  
Vishal R. Munjal
Keyword(s):  
Hearing Loss ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Descriptive Study ◽  
Medical Sciences ◽  
Myogenic Potential ◽  
Mixed Hearing Loss ◽  
Sri Aurobindo ◽  
Number Of Patients ◽  
Central Hearing Loss

<p class="abstract"><strong>Background:</strong> This was a prospective, descriptive study performed by collecting and analyzing the results of vestibular exams, evoked myogenic potential tests, pure tone audiometry test and impedence test performed in the Otorhinolaryngology Department of Sri Aurobindo Institute of Medical Sciences, Indore.</p><p class="abstract"><strong>Methods:</strong> This was a prospective, descriptive study performed by collecting and analyzing the results of vestibular exams, evoked myogenic potential tests, pure tone audiometry test and impedence test performed in the Otorhinolaryngology Department of Sri Aurobindo Institute of Medical Sciences, Indore.  </p><p class="abstract"><strong>Results:</strong> In age group of 20 to 60, maximum number of patients were in group of 31-40 (16), followed by 51-60 (15), followed by 20-30 (24.) Maximum positive seen in Romberg (07), followed by nystagmus (06), followed by Dix-Hallpike (06). The patients in our study (30 out of 50) were suffering from hypertension. Two patients were of Meniere’s disease and rest 16 were of SNHL, 08 were of SNHL and BPPV combined. The rest of the cases were of mixed hearing loss and other central hearing loss causes will have be ruled out.</p><p class="abstract"><strong>Conclusions:</strong> The main aim of study is to study clinicopathological aspects in patients with vertigo. We also studied incidence of SNHL in our study. It has been established by this study that hypertension is one the major causes of vertigo in patients whereas VEMP has not proven to be very beneficial in our study to see peripheral vertigo patients. Most of the patients with BPPV also had a normal cVEMP which showed that it was not a very reliable instrument in BPPV.</p>

scholarly journals Audiometric Characteristics of Presbycusis: A Hospital-Based Study

2021 ◽  
Vol 10 (3) ◽  
pp. 169-175
Author(s):  
Ghulam Saqulain ◽  
Gul Zahra ◽  
Nazia Mumtaz
Keyword(s):  
Hearing Loss ◽  
High Frequency ◽  
Pure Tone ◽  
Noise Exposure ◽  
Pure Tone Audiometry ◽  
Sampling Technique ◽  
Rehabilitation Medicine ◽  
Speech Discrimination ◽  
Chi Square ◽  
Severe Hearing Loss

Background: Presbycusis is related to degenerative changes of aging resulting from deficient cochlear microcirculation. It is characterized by bilateral, symmetrical, sensorineural hearing loss (SNHL) in which recruitment and speech discrimination is affected in the absence of noise exposure. The objective of this study was to analyze the pure tone audiogram characteristics in Presbycusis. Methods: This descriptive study recruited n=192 cases of presbycusis of both genders, aged 50 to 80 years with convenience sampling technique. The study was conducted at Yusra General Hospital and the National Institute of Rehabilitation Medicine, Islamabad from1st July 2017 to 30th September 2017. Pure tone audiometry was used to collect audiometric data. SPSS-24 was used for data analysis. Chi-square and Pearson’s correlation were used to determine association between variables with p < 0.05 taken as significant. Results: Pure tone audiometry revealed 58 (30.2%) right and 65 (33.9%) left ears with high frequency gently sloping audiogram, while the second commonest configuration being high frequency steeply sloping curve in 51(26.6%) right and 52(27.1%) left ears. There was a significant correlation between the configuration of the audiogram and age with p=0.000, while no significant correlation with gender (p=0.71). The majority,77 (40.10%) right and 71(36.98%) of left ears had moderately severe hearing loss, while severe hearing loss was second commonest with 60(31.25%) right and 70(36.46%) left ears affected. The severity of hearing loss had a significant (P=0.000) positive correlation with age but no significant relationship with gender. Conclusion:  High frequency gently sloping audiogram was the commonest configuration followed by high frequency steeply sloping curve. Moderately severe hearing loss was most commonly seen followed by severe hearing loss.

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

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
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.

scholarly journals Gender-Specific Associations of Speech-Frequency Hearing Loss, High-Frequency Hearing Loss, and Cognitive Impairment Among Older Community Dwellers in China

2021 ◽  
Author(s):  
Jingru Wang ◽  
Feng Wang ◽  
Peipei Han ◽  
Yuewen Liu ◽  
Weibo Ma ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cognitive Impairment ◽  
Confidence Interval ◽  
High Frequency ◽  
Pure Tone ◽  
Community Dwelling ◽  
World Health ◽  
High Frequency Hearing Loss ◽  
Hearing Sensitivity ◽  
Community Dwellers

Abstract Objectives The purpose of this study was to investigate the relationship between speech-frequency hearing loss (SFHL), high-frequency hearing loss (HFHL), and cognitive impairment (CI). Then to determine whether there are any differences in gender among older community dwellers in China. Methods This study involved 1,012 adults aged ≥ 60 years (428 male; average age, 72.61 ± 5.51 years). The participants had their hearing and cognition measured using pure tone audiometry and Mini Mental State Examination (MMSE), respectively. We used the audiometric definition of hearing loss (HL) adopted by the World Health Organization (WHO). Speech-frequencies were measured as 0.5 kHz, 1 kHz, 2 kHz, and 4 kHz; high-frequencies were measured as 4 kHz and 8 kHz. Pure tone average (PTA) was measured as hearing sensitivity. Results Our studies demonstrated a 37.6% prevalence of HL in males and a 36.0% prevalence of HL in females. Adjusted for confounding variables, the results from a multivariate analysis showed that SFHL was associated with CI in females (OR = 2.400, 95% Confidence Interval = 1.313–4.385) and males (OR = 2.189, 95% Confidence Interval = 0.599–2.944). However, HFHL was associated with CI only in females (OR = 2.943, 95% Confidence Interval = 1.505–5.754). HL was associated with poorer cognitive scores (P < 0.05). “Registration” (P < 0.05) in MMSE was associated with speech- and high-frequency hearing sensitivity. Conclusion The associations between HL and CI varied according to gender in older community-dwellers, suggesting that different mechanisms are involved in the etiology of HL. Moreover, hearing sensitivity was negatively associated with cognition scores; therefore, early screening for HL and CI among older community-dwelling adults is advised.

scholarly journals Sex differences in Speech and High-frequency Hearing Loss Association With Cognitive Impairment Among Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 716-716
Author(s):  
Wang Jingru ◽  
Yu Ying ◽  
Guo Qi
Keyword(s):  
Hearing Loss ◽  
Cognitive Impairment ◽  
Confidence Interval ◽  
High Frequency ◽  
Pure Tone ◽  
Community Dwelling ◽  
World Health ◽  
High Frequency Hearing Loss ◽  
Hearing Sensitivity ◽  
Community Dwellers

Abstract Objectives The purpose of this study was to investigate the relationship between speech-frequency hearing loss (SFHL), high-frequency hearing loss (HFHL), and cognitive impairment (CI). Then to determine whether there are any differences in gender among older community dwellers in China. Methods This study involved 1,012 adults aged ≥60 years (428 male; average age, 72.61±5.51 years). The participants had their hearing and cognition measured using pure tone audiometry and Mini Mental State Examination (MMSE), respectively. We used the audiometric definition of hearing loss (HL) adopted by the World Health Organization (WHO). Speech-frequencies were measured as 0.5 kHz, 1 kHz, 2 kHz, and 4 kHz; high-frequencies were measured as 4 kHz and 8 kHz. Pure tone average (PTA) was measured as hearing sensitivity. Results Our studies demonstrated a 37.6% prevalence of HL in males and a 36.0% prevalence of HL in females. Adjusted for confounding variables, the results from a multivariate analysis showed that SFHL was associated with CI in females (OR=2.400, 95% Confidence Interval=1.313–4.385) and males (OR=2.189, 95% Confidence Interval=0.599–2.944). However, HFHL was associated with CI only in females (OR=2.943, 95% Confidence Interval=1.505–5.754). HL was associated with poorer cognitive scores (P&lt;0.05). “Registration” (P&lt;0.05) in MMSE was associated with speech and high-frequency hearing sensitivity. Conclusion The associations between HL and CI varied according to gender in older community-dwellers, suggesting that different mechanisms are involved in the etiology of HL. Moreover, hearing sensitivity was negatively associated with cognition scores; therefore, early screening for HL and CI among older community-dwelling adults is advised.

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