Unilateral Hearing Loss in Children with Shunt-Treated Hydrocephalus

2003 ◽  
Vol 14 (09) ◽  
pp. 510-517 ◽  
Author(s):  
Susan E. Spirakis ◽  
Raymond M. Hurley

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.

2012 ◽  
Vol 9 (4) ◽  
pp. 421-427 ◽  
Author(s):  
Daniel J. Guillaume ◽  
Kristin Knight ◽  
Carol Marquez ◽  
Dale F. Kraemer ◽  
Dianna M. E. Bardo ◽  
...  

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.


2013 ◽  
Vol 127 (10) ◽  
pp. 952-956 ◽  
Author(s):  
A Goyal ◽  
P P Singh ◽  
A Vashishth

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.


2013 ◽  
Vol 60 (1) ◽  
Author(s):  
Samantha Marlanie Govender ◽  
Cyril Devdas Govender ◽  
Glenda Matthews

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.


2019 ◽  
Vol 30 (07) ◽  
pp. 619-633 ◽  
Author(s):  
Kamakshi V. Gopal ◽  
Liana E. Mills ◽  
Bryce S. Phillips ◽  
Rajesh Nandy

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.


1997 ◽  
Vol 106 (3) ◽  
pp. 220-225 ◽  
Author(s):  
Xue Zhong Liu ◽  
Valerie E. Newton

Eight patients with Waardenburg's syndrome (WS) with normal hearing and 3 additional patients exhibiting a low-frequency hearing loss were tested for the level of the acoustic distortion product 2f1-f2 by means of the Otodynamics Distortion Product Analyser (ILO92). Wide notches in distortion product otoacoustic emissions (DPOAEs) between 1,000 and 3,000 Hz were found in 7 (12 ears, 87.5%) examined patients with normal audiograms, which was a significantly higher rate than that found in the control group (10%). The 3 patients with low-frequency hearing loss gave a consistent pattern in audiometric configuration shown by both pure tone audiograms and DPOAEs. It is concluded from these initial results that DPOAEs may be a useful approach to identifying subclinical pathologic aberrations in the inner ear in WS patients, and may be a predictor of low-frequency sensorineural hearing loss.


Author(s):  
Ö Gedik ◽  
H Hüsam ◽  
M Başöz ◽  
N Tas ◽  
F Aksoy

Abstract Objective This study aimed to evaluate different auditory regions with audiological tests, based on the presumption that there may be damage to the structures in the hearing system after coronavirus disease 2019. Methods Twenty individuals with no history of coronavirus disease 2019 and 27 individuals diagnosed with coronavirus disease 2019 were compared. Pure tone, speech and extended high-frequency audiometry, acoustic immitansmetry, transient evoked and distortion product otoacoustic emissions testing, and auditory brainstem response testing were conducted. Results The pure tone audiometry and extended high-frequency mean threshold values were higher in the coronavirus disease 2019 group. The transient evoked otoacoustic emissions signal-to-noise ratios were bilaterally lower at 4 kHz in individuals with a coronavirus disease 2019 history. In the auditory brainstem response test, only the interpeak latencies of waves III–V were significantly different between groups. Conclusion Coronavirus disease 2019 may cause damage to the hearing system. Patients should be followed up in the long term with advanced audiological evaluation methods in order to determine the extent and level of damage.


2015 ◽  
Vol 5 (2) ◽  
Author(s):  
Ritvik P. Mehta ◽  
Sara L. Mattson ◽  
Brian A. Kappus ◽  
Robin L. Seitzman

The objective of the study was to assess the safety of the HyperSound® Audio System (HSS), a novel audio system using ultrasound technology, in normal hearing subjects under normal use conditions; we considered preexposure and post-exposure test design. We investigated primary and secondary outcome measures: i) temporary threshold shift (TTS), defined as >10 dB shift in pure tone air conduction thresholds and/or a decrement in distortion product otoacoustic emissions (DPOAEs) >10 dB at two or more frequencies; ii) presence of new-onset otologic symptoms after exposure. Twenty adult subjects with normal hearing underwent a pre-exposure assessment (pure tone air conduction audiometry, tympanometry, DPOAEs and otologic symptoms questionnaire) followed by exposure to a 2-h movie with sound delivered through the HSS emitter followed by a post-exposure assessment. No TTS or new-onset otological symptoms were identified. HSS demonstrates excellent safety in normal hearing subjects under normal use conditions.


2013 ◽  
Vol 22 (1) ◽  
pp. 125-134 ◽  
Author(s):  
Fatima T. Husain

Purpose The aim of this study was to measure the effect of tinnitus, while accounting for the effect of hearing loss and aging, on distortion product otoacoustic emissions (DPOAEs). Method DPOAEs were measured twice in both ears in 5 groups of participants: young adults with normal hearing, middle-age adults with normal hearing, adults with high-frequency sensorineural hearing loss, age-matched adults with similar hearing loss and tinnitus, and adults with normal hearing and chronic tinnitus. Results Multivariate analysis revealed a main effect of hearing loss and age, but no effect of tinnitus, across all 5 groups. Separate tests revealed significant effects of age and tinnitus in the normal-hearing groups and hearing loss in adults with or without tinnitus, but no effect of tinnitus in those with hearing loss. Conclusion DPOAE levels in the group of adults with hearing loss and tinnitus were diminished, but those in the group with normal hearing and tinnitus were enhanced, relative to DPOAE levels in the controls. Outer hair cell function, as indexed by DPOAEs, exhibits a complex association with tinnitus, and this has implications in the use of DPOAEs as a tool both for testing for tinnitus presence and for creating a model of neural mechanisms underlying tinnitus.


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