Assessment of Objective Pulsatile Tinnitus in a Patient with Syringohydromyelia

2007 ◽  
Vol 18 (03) ◽  
pp. 197-205
Author(s):  
James R. Steiger ◽  
Patricia A. Saccone ◽  
Karen N. Watson
Keyword(s):  
Hearing Loss ◽  
Fluid Pressure ◽  
Low Frequency ◽  
Pulsatile Tinnitus ◽  
Cochlear Aqueduct ◽  
Endolymphatic Duct ◽  
Stapes Footplate ◽  
Vascular Structures ◽  
Cochlear Partition ◽  
Tinnitus Masking

We examined a 38-year-old male with syringohydromyelia and concomitant symptoms suggestive of intracranial hypertension including unilateral low-frequency sensorineural hearing loss and objective pulsatile tinnitus. The tinnitus was heard by the authors (through a hearing aid stethoscope tube), measured objectively (with a probe microphone), measured subjectively (as minimum masking levels and with fixed frequency Bekesy), and altered by changes in ear canal pressure (subjectively reported and measured objectively with a probe microphone). The audiologic symptoms were likely associated with elevated cerebrospinal fluid pressure that traveled to the cochlea through the cochlear aqueduct. The tinnitus may have originated from pulsations of central vascular structures that traveled through the cochlear aqueduct or the endolymphatic duct. Hearing loss likely resulted from tinnitus masking or a stiffening of the cochlear partition or stapes footplate. Examinamos un hombre de 38 años con siringohidromielia y con síntomas concomitantes sugestivos de hipertensión intracraneana, que incluían una hipoacusia sensorineural unilateral de bajas frecuencia y un acúfeno pulsátil. El acúfeno fue escuchado por los autores (por medio de un estetoscopio para auxiliares auditivos), medido objetivamente (con una sonda micrófono), medido subjetivamente (como niveles mínimos de enmascaramiento y con un Bekesy de frecuencia fija), y alterado por cambios en la presión del canal auditivo (reportados subjetivamente y medidos objetivamente por una sonda micrófono). Los síntomas audiológicos estuvieron asociados con elevaciones en la presión del líquido cefalorraquídeo que viaja a la cóclea a través del acueducto coclear. El acúfeno debe haberse originado a partir de pulsaciones en las estructuras vasculares centrales, que viajaban por el acueducto coclear o el ducto endolinfático. La hipoacusia debe haber resultado del enmascaramiento del acúfeno o de un aumento en la rigidez en la partición coclear o en la platina del estribo.

Pseudo-low Frequency Hearing Loss and Its Improvement After Treatment May Be Objective Signs of Significant Vascular Pathology in Patients With Pulsatile Tinnitus

2016 ◽  
Vol 37 (9) ◽  
pp. 1344-1349 ◽  
Author(s):  
Hyoung Won Jeon ◽  
So Young Kim ◽  
Byung Se Choi ◽  
Yun Jung Bae ◽  
Ja-Won Koo ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Low Frequency ◽  
Vascular Pathology ◽  
Pulsatile Tinnitus

Persistent bilateral hearing loss after shunt placement for hydrocephalus

1999 ◽  
Vol 90 (4) ◽  
pp. 773-775 ◽  
Author(s):  
Sandro J. Stoeckli ◽  
Andreas Böhmer
Keyword(s):  
Cerebrospinal Fluid ◽  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Low Frequency ◽  
Content Type ◽  
Bilateral Hearing Loss ◽  
Shunt Placement ◽  
Cochlear Aqueduct ◽  
Fine Print

✓ Transient hearing decrease following loss of cerebrospinal fluid (CSF) has been reported in patients undergoing lumbar puncture, spinal anesthesia, myelography, and/or different neurosurgical interventions. The authors present the first well-documented case of a patient with persistent bilateral low-frequency sensorineural hearing loss after shunt placement for hydrocephalus and discuss the possible pathophysiological mechanisms including the role of the cochlear aqueduct. These findings challenge the opinion that hearing decreases after loss of CSF are always transient. The authors provide a suggestion for treatment.

The Occlusion Effect in Unilateral Functional Hearing Loss

1970 ◽  
Vol 13 (1) ◽  
pp. 37-40
Author(s):  
Gary Thompson ◽  
Marie Denman
Keyword(s):  
Hearing Loss ◽  
Bone Conduction ◽  
Low Frequency ◽  
Clinical Implications ◽  
The Right ◽  
Occlusion Effect

Bone-conduction tests were administered to subjects who feigned a hearing loss in the right ear. The tests were conducted under two conditions: With and without occlusion of the non-test ear. It was anticipated that the occlusion effect, a well-known audiological principle, would operate to draw low frequency bone-conducted signals to the occluded side in a predictable manner. Results supported this expectation and are discussed in terms of their clinical implications.

scholarly journals Treatment Outcomes of Patients with Glomus Tympanicum Tumors Presenting with Pulsatile Tinnitus

2021 ◽  
Vol 10 (11) ◽  
pp. 2348
Author(s):  
Seung-Jae Lee ◽  
Sang-Yeon Lee ◽  
Gwang-Seok An ◽  
Kyogu Lee ◽  
Byung-Yoon Choi ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Low Frequency ◽  
Temporal Analysis ◽  
Endovascular Embolization ◽  
Preoperative Embolization ◽  
Surgical Removal ◽  
Pulsatile Tinnitus ◽  
Post Intervention ◽  
Hearing Thresholds ◽  
Glomus Tympanicum

We reviewed the clinical characteristics and treatment outcomes of patients with glomus tympanicum tumors (GTTs) presenting with pulsatile tinnitus (PT). We explored whether transcanal sound recording-spectro-temporal analysis (TSR-STA) usefully evaluated changes in PT. The medical records of 13 patients who underwent surgical removal of GTTs were reviewed retrospectively. Two patients underwent preoperative endovascular embolization. Changes in PT, pre- and postoperative audiometry data, TSR-STA results, and clinical outcomes were evaluated. PT was the chief complaint in eight patients (61.5%) and resolved immediately after surgical intervention in all. Two patients exhibited ipsilateral, pseudo-low-frequency hearing loss (PLFHL); surgical GTT removal elicited postoperative improvements in the ipsilesional low-frequency hearing thresholds. Five patients underwent TSR-STA using previously described methods. TSR-STA revealed definite rise-and-fall patterns; surgical tumor removal abated this pattern in one patient, but, for the other four, the patterns did not change greatly post-intervention. Thus, GTT-related PT can be treated successfully (via surgical GTT removal) without complications. In selected cases, preoperative embolization reduces intraoperative hemorrhage. In PT patients with PLFHL, a detailed otoendoscopic examination of the middle ear is required to rule out a GTT. TSR-STA may usefully (and objectively) assess postoperative improvements in GTT-related PT.

Observations on the Relations among Occlusion Effect, Compliance, and Vent Size

2002 ◽  
Vol 13 (01) ◽  
pp. 025-037 ◽  
Author(s):  
Roberto Carle ◽  
Søren Laugesen ◽  
Claus Nielsen
Keyword(s):  
Hearing Loss ◽  
Simple Model ◽  
Laboratory Experiment ◽  
Hearing Aid ◽  
Low Frequency ◽  
Minimum Size ◽  
Similar Relationship ◽  
Profound Influence ◽  
Occlusion Effect ◽  
Clinical Experiment

In a clinical experiment, it was found that there is a high correlation between the compliance measured by tympanometry and the minimum size of the earmold vent, which just solves the client's occlusion problem related to his/her own voice when using a hearing aid. For ears with sensorineural hearing losses, compliance explained 59 percent of the variation in vent size, whereas the average low-frequency hearing loss explained as little as 0.3 percent. In a laboratory experiment, the objective occlusion effect measured with the participants' own voices showed a similar relationship with compliance. Whereas the former relationship between compliance and vent size may be explained by a simple model, the latter relationship turns out to be the opposite of what a firstorder model predicts. Hence, compliance must be indicative of another aspect of the occlusion mechanism, which has a more profound influence on the observed occlusion effect than compliance itself.

scholarly journals Hearing at threshold intensities: by slow mechanical traveling waves or by fast cochlear fluid pressure waves

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Haim Sohmer
Keyword(s):  
Soft Tissue ◽  
Hair Cells ◽  
Traveling Wave ◽  
Basilar Membrane ◽  
Fluid Pressure ◽  
Low Frequency ◽  
Frequency Discrimination ◽  
Outer Hair Cells ◽  
Common Mechanism ◽  
Frequency Stimulation

The three modes of auditory stimulation (air, bone and soft tissue conduction) at threshold intensities are thought to share a common excitation mechanism: the stimuli induce passive displacements of the basilar membrane propagating from the base to the apex (slow mechanical traveling wave), which activate the outer hair cells, producing active displacements, which sum with the passive displacements. However, theoretical analyses and modeling of cochlear mechanics provide indications that the slow mechanical basilar membrane traveling wave may not be able to excite the cochlea at threshold intensities with the frequency discrimination observed. These analyses are complemented by several independent lines of research results supporting the notion that cochlear excitation at threshold may not involve a passive traveling wave, and the fast cochlear fluid pressures may directly activate the outer hair cells: opening of the sealed inner ear in patients undergoing cochlear implantation is not accompanied by threshold elevations to low frequency stimulation which would be expected to result from opening the cochlea, reducing cochlear impedance, altering hydrodynamics. The magnitude of the passive displacements at threshold is negligible. Isolated outer hair cells in fluid display tuned mechanical motility to fluid pressures which likely act on stretch sensitive ion channels in the walls of the cells. Vibrations delivered to soft tissue body sites elicit hearing. Thus, based on theoretical and experimental evidence, the common mechanism eliciting hearing during threshold stimulation by air, bone and soft tissue conduction may involve the fast-cochlear fluid pressures which directly activate the outer hair cells.

Downward spread of masking and low‐frequency hearing loss

1984 ◽  
Vol 76 (S1) ◽  
pp. S61-S61
Author(s):  
M. J. Collins ◽  
J. L. Yanda ◽  
H. Fryauf ◽  
D. J. Schum
Keyword(s):  
Hearing Loss ◽  
Low Frequency

NEW ETIOLOGICAL FACTORS OF OCCUPATIONAL HEARING LOSS

2021 ◽  
Author(s):  
V.B. Pankova ◽  
◽  
М.F. Vilk ◽  
◽  
◽  
...  
Keyword(s):  
Hearing Loss ◽  
Low Frequency ◽  
Evidence Base ◽  
Frequency Noise ◽  
Labor Intensity ◽  
Etiological Factors ◽  
Hearing Organ ◽  
The Relationship ◽  
Vascular Stria ◽  
Occupational Hearing Loss

Annotation. On the example of railway and air transport, a number of new issues of occupational hearing loss are shown, requiring study and subsequent implementation in practical health care, as new etiological factors in the development of hearing loss. This concerns the factor of labor intensity, which has a potentiating, pathogenetic significance, along with noise, in the development of hearing loss due to the formation of chronic stress, leading to additional ischemia of the vascular stria and damage to the neuroepithelium of the inner ear. There is a need, along with the development of a methodology for assessing the factor of labor intensity for SOUT of workplaces, to determine the criteria for its negative action when used for the examination of the connection between the disease of the organ of hearing and the profession. In the «List of occupational diseases» in clause 2.4.2. indicated diseases associated with exposure to infrasound (IZ), among the manifestations of which, called sensorineural hearing loss bilateral. However, IZ, as well as low-frequency noise (LFN), were not previously considered as significant adverse factors in relation to the hearing organ in mass clinical trials, therefore, there are no expert criteria for the relationship between hearing loss and their impact, which could be applied in practice, which requires accumulation of evidence base for the subsequent substantiation of an independent nosological form of a disease of the organ of hearing, associated with mechanoacoustic exposure.

Hearing Loss, Pulsatile Tinnitus, and Otalgia

2021 ◽  
Author(s):  
A. Claire Chapel ◽  
J. Cody Page ◽  
Alex D. Sweeney
Keyword(s):  
Hearing Loss ◽  
Pulsatile Tinnitus
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