Quantification of hearing loss associated with superior semi-circular canal dehiscence

Introduction

Superior semi-circular canal dehiscence (SSCD) is a known cause of hearing loss. This study quantifies hearing loss in SSCD ears in a frequency-specific fashion.

Methods

A meta-analysis of English language literature pertaining to SSCD was performed, with extraction and evaluation of available human audiometric data. Our own institution's case series of SSCD patients was also similarly analysed. Hearing loss in SSCD ears was compared to same patient control ears and to age-matched normative audiometric data.

Results

Ears with SSCD had statistically significant worse hearing as compared to both normative data and to own normal ear controls at 2000 Hz and below. The effect appears to diminish with increasing frequency.

Discussion

The presence of statistically significant conductive hearing loss in the low frequencies was confirmed for SSCD ears. SSCD may also predispose ears to high frequency sensorineural hearing loss.     

AM‐111 prevents hearing loss from semicircular canal injury in otitis media

Objectives/Hypothesis:

Iatrogenic semicircular canal (SC) transection during mastoidectomy for chronic otitis media often leads to profound hearing loss. AM‐111, an apoptosis inhibitor, has been shown to mitigate hearing loss resulting from a variety of inner ear injuries. The goal of this study was to determine if round window application of AM‐111 following SC transection in the presence of Pseudomonas aeruginosa otitis media (PA‐OM) may reduce the associated hearing loss.

Study Design:

Prospective, randomized, controlled study in an animal model.

Methods:

PA‐OM was induced bilaterally in 34 guinea pigs. After 3 days, both bullae were opened and the lateral SC of one ear was transected. AM‐111 or vehicle was applied topically to the round window of the ear that had undergone SC transection. Hearing was assessed with auditory brainstem responses.

Results:

The mean change in hearing thresholds was significantly less in transected ears treated with AM‐111 than those receiving vehicle alone when testing with clicks (22.1 dB vs. 35.0 dB; P = .019) and at 4kHz (11.3 dB vs. 40.0 dB; P = .021). A similar trend was shown with 16 kHz tone pips (27.7 dB vs. 41.1 dB; P = .119).

Conclusions:

AM‐111 prevents hearing loss from SC transection in the guinea pig model of PA‐OM. Laryngoscope, 2010     

Sensorineural hearing loss in chronic otitis media.

Although many studies have demonstrated an association between chronic otitis media (COM) and sensorineural hearing loss (SNHL), there still remains disagreement about the relationship. A retrospective study was conducted to examine the relationship between sensorineural hearing loss and chronic otitis media. Forty-one patients met the following criteria: unilateral COM and no history of head injury, meningitis or previous otological surgery. The differences in preoperative bone conduction threshold between diseased and control (contralateral normal) ear were statistically significant (P < 0.01) and varied from 5.24 to 9.02 dB across the frequency range. The effect of duration of disease on the degree of SNHL was also analysed but no correlation was found. The presence of cholesteatoma and/or ossicular erosion was not associated with a significantly increased risk of sensorineural hearing loss.     

Sensorineural hearing loss associated with otitis media with effusion.

The clinical records of 1,372 cases of otitis media with effusion (OME) treated during the past 10 years were reviewed in search of associations with sensorineural hearing loss (SNHL). In 14 cases (1.0%), the development of SNHL was considered to be etiologically related to OME. These 14 cases were classified into two groups. In group A, which consisted of 5 cases, the clinical feature was acute onset of SNHL and gradual improvement. In group B of 9 cases, SNHL progressed gradually or insidiously and did not improve. Different pathophysiology may be assumed to underlie these two groups. The results of this study demonstrate that we have to pay attention to a possible development of SNHL during the course of OME.     

Sensorineural hearing loss in chronic otitis media

Although many studies have demonstrated an association between chronic otitis media (COM) and sensorineural hearing loss (SNHL), there still remains disagreement about the relationship. A retrospective study was conducted to examine the relationship between sensorineural hearing loss and chronic otitis media. Forty-one patients met the following criteria: unilateral COM and no history of head injury, meningitis or previous otological surgery. The differences in preoperative bone conduction threshold between diseased and control (contralateral normal) ear were statistically significant (P < 0.01) and varied from 5.24 to 9.02 dB across the frequency range. The effect of duration of disease on the degree of SNHL was also analysed but no correlation was found. The presence of cholesteatoma and/or ossicular erosion was not associated with a significantly increased risk of sensorineural hearing loss.     

Sensorineural hearing loss in chronic otitis media

A statistical study was done on the sensorineural component in hearing loss, using 595 patients suffering from Chronic Otitis Media (COM); of these, 195 with monolateral COM were taken into consideration. They presented criteria of valuation which excluded other possible causes of sensorineural hearing loss, such as exposure to acoustic trauma, ototoxic drugs, cardiovascular disease, past head injury and hereditary causes. The contralateral (healthy) ear served as a control. We determined the average sensorineural component in the hearing losses in relation to the age of onset and duration of the disease, examining it in relation to other eventual aural complications such as cholesteatoma. On the basis of the data obtained, we believe that the sensorineural component in hearing loss does not change with respect to the age of onset of COM, but the duration of COM does exert a significant influence.     

Sensorineural hearing loss in patients with chronic otitis media

Chronic otitis media is generally associated with some degree of hearing loss, which is often the patient’s chief complaint. This hearing loss is usually conductive, resulting from tympanic membrane rupture and/or changes in the ossicular chain due to fixation or erosion caused by the chronic inflammatory process. When cholesteatoma or granulation tissue is present in the middle ear cleft, the degree of ossicular destruction is even greater. An issue that has recently gained attention is additional sensorineural hearing loss due to chronic otitis media. While the conductive loss can be minimized through surgery, sensorineural hearing loss constitutes a permanent after effect, attenuated only through the use of a hearing aid. However, a few groups have reported a decrease in sensorineural function in these patients as well. This survey study performed at a referral center evaluates the occurrence of sensorineural hearing loss in ambulatory patients with this disease. We reviewed the files of patients with unilateral chronic otitis media. One hundred and fifty patients met the inclusion criteria: normal otoscopy and normal hearing in the contralateral ear. Main outcome measure: bone-conduction threshold averages were calculated for frequencies of 500, 1,000, 2,000, 3,000 and 4,000 Hz, with comparison between the normal ear and the ear with chronic otitis media. Thresholds were examined separately for each frequency. The bone-conduction threshold averages for the normal side were lower than those for the ear with chronic otitis media. The threshold shift was statistically significant for each frequency (P < 0.0001, Student’s t test). There were differences between the groups when analyzed for age (500 and 1,000 Hz) or the presence of cholesteatoma (1,000 Hz). This study shows that chronic otitis media is associated with a decrease in cochlear function.     

儿童分泌性中耳炎致骨导听力下降的临床特征分析

目的 探讨儿童分泌性中耳炎致骨导听力下降的特点、病因和预后.方法 回顾性分析75例(82耳)分泌性中耳炎患儿骨导听力下降的临床资料,并对其发病年龄、病程、积液性质和积液量与骨导听阈的关系进行观察.结果 75例患儿(82耳)骨导听力下降,平均骨导阈值在2.0 kHz和4.0kHz处增高最明显.骨导听阈与病程和积液性质显著相关(P＜0.01或P＜0.05),与年龄、积液量无关.75例患儿均采取鼓膜切开置管术和(或)腺样体切除术,术后给予药物治疗.随访6月,听力恢复正常者76耳,气导听阈下降但骨导听阈无改善者6耳.结论 分泌性中耳炎可导致儿童骨导阈值增高,是导致儿童耳聋的危险因素之一,及早干预可避免病情发展.     

Sensorineural hearing loss associated with otitis media with effusion in children

Sensorineural hearing loss (SNHL) is known to occur in various types of otitis media. Although the mechanism by which SNHL develops in association with otitis media with effusion (OME) is unknown, several hypotheses have been advocated up to now. We reviewed the clinical records of children with otitis media with effusion (OME) to reveal the association with sensorineural hearing loss. The material consisted of 71 children (119 ears) who were diagnosed as having OME and gave reliable audiograms in our clinic during an 11 month period from February 1997 through January 1998. From these cases those which showed bone conduction loss of 25 dB or higher at any one of the frequencies of 250 through 4 kHz were selected and considered to be cases of SNHL. Eight cases (9%) which had temporary threshold shift (TTS) or permanent threshold shift (PTS) were considered to be etiologically related to OME. The clinical course in each of these cases with SNHL was reviewed and evaluated in detail. We noted that all children with TTS improved completely. The result of this study indicates that we have to be aware of a possible development of SNHL during the course of OME.     

Acute otitis media associated with bone conduction hearing loss]

Eleven patients (12 ears) with acute otitis media associated with raised bone conduction were studied. The patients were from 19 to 70 years old and came to our hospital between November 1996 through May 1997. Pure tone audiometry revealed mixed hearing loss, but there was no bullous myringitis in all cases. They were treated by oral or intravenous antibiotics, steroids, and myringotomy. Bacteriological examination was done in seven cases, and revealed penicillin resistant Streptococcus pnumoniae in three cases. Complete recovery of hearing loss was obtained in 10 of 12 ears, but sensorineural hearing loss remained in 2 patients. Bacteriological examination and pure tone audiometry in acute otitis media are important for detecting the severity of the disease, determining the administration of steroids, and for the selection of antibiotics.     

Speech perception after early-life otitis media with fluctuating hearing loss

The present study examined the effect of early-life otitis media and its associated fluctuating hearing loss on categorical speech perception in 7-year-old Dutch children. The middle ear status of these children had been followed prospectively in their first 2 years of life. Identification and discrimination of speech sounds differing in place of articulation were tested at school age and outcomes were significantly related to otitis media-related hearing loss. Results revealed that phoneme identification and discrimination were affected by early-life hearing loss. It is not otitis media per se, but rather the relative severity of hearing loss resulting from early-life otitis media which is related to poorer categorical speech perception abilities in school-age children.     

Factors influencing sensorineural hearing loss in chronic otitis media

Sensorineural hearing loss was studied in 874 chronically infected ears and was found to occur more frequently in cases of cholesteatoma and in the presence of discharge. Sensorineural hearing loss is not dependent on the type of causative microorganism. Older patients exhibited sensorineural hearing loss more often than did younger patients, this disorder being more common in affected ears than in control ears (the contralateral ear in unilateral cases).     

Sensorineural hearing loss and acute otitis media in children

Sensorineural hearing of 359 otoscopically and tympanometrically normal 5-year-old children with known otitis-history was studied under ideal conditions. In the subgroups of children with a different number (0, 1-2, 3-7, greater than or equal to 8) of attacks of acute otitis media (AOM) in their history, the mean bone conduction thresholds unregularly varied from 0.1 dB to 7.4 dB, depending on the frequency and the subgroup studied. The proportion of the ears with a bone conduction threshold greater than 10 dB at 0.5, 1, 2 or kHz ranged, also unregularly, from 10.8% to 0.5%, the greatest percentages being found at 0.5 and 1 kHz in the children without a history of AOM. Thus, neither AOM nor its treatment, even if frequently occurring, seem to cause permanent sensorineural hearing loss in children.     

Pleomorphic adenoma of the external auditory canal complicated by hearing loss secondary to chronic otitis media

Pleomorphic adenoma (PA) rarely occurs in the external auditory canal (EAC). A case of PA complicated with chronic otitis media is reported. The patient was a 36-year-old male who began to experience a hearing loss in the left ear in 1996. He sought medical attention only after ear pain developed in April 2003. At the initial examination, a tumor covered by smooth skin was seen filling the left EAC. Pure-tone audiometry showed residual hearing at low frequencies and scale-out across middle to high frequency range. The CT and MRI findings led to a diagnosis of a tumor of the left EAC complicated with an inflammatory middle-ear lesion. The tumor was excised en bloc with the overlying skin, and tympanoplasty was performed. The pathological diagnosis was PA of the left EAC and inflammatory granuloma of the middle ear.     

慢性化脓性中耳炎与感音神经性聋的相关性分析

目的：探讨慢性化脓性中耳炎与感音神经性聋之间的相关性。方法：回顾分析174例单侧慢性化脓性中耳炎患者的骨导阈值改变。采用配对t检验分析0．5kHz，1．0kHz，2．0kHz，4．0kHz患耳与健耳骨导阈值的差异，单因素方差分析法分析胆脂瘤存在及听骨链破坏对语频(0．5kHz，1．0kHz，2．0kHz)和4．0kHz骨导阈值的影响，直线回归法讨论了语频和4．0kHz骨导阈值改变与年龄和病程之间的相关性。结果：患耳与健耳各频率骨导阈值之间差异有统计学意义。语频骨导听力损失程度随着患者年龄的增加而逐渐加重。胆脂瘤的存在以及听骨链破坏亦未增加感音神经性聋的发生概率。结论：慢性化脓性中耳炎可引起感音神经性聋。高频骨导听阈较低频更易受到影响。