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PubMed2005

[Clinical observation of sensorineural hearing loss in patients suffering from nasopharyngeal carcinoma after radiotherapy].

OBJECTIVE: To study the extent and incidence of sensorineural hearing loss (SNHL) after radiotherapy (RT). METHODS: Twenty-eight patients with diagnosed nasopharyngeal carcinoma (NPC) were selected. The pure-tone audiography, auditory brain stem evoked response (ABR), impedance audiometry and evoked otoacoustic emissions (EOAE) recordings were performed before RT, 1 month, 1, 2 and 5 years after RT. RESULTS: At 1 month after RT, there were 7.1 and 25.7 dB increased mean bone conduction (BC) thresholds at speech (0.5 - 4.0 kHz) and at high frequency (8.0 kHz), and their BC thresholds were statistically significant increase than those before RT, respectively (P < 0.001). At 1 year after RT, there were 17.6 and 28.1 dB increased respectively, and their thresholds were statistically significant increase than those at pre-irradiation (P < 0.001). There were also significant increases in thresholds than those at 1 month of post-irradiation (P <0.001 or P < 0.05). At 2 years after RT, 21 and 27.4 dB were increased at respective those two frequencies, and there was a statistically difference only at speech frequencies when compared with those at 1 year after RT (P < 0.05). At 5 years after RT, 26.7 and 35.8 dB were increased at these two frequencies, and there were significant increases in threshold than those before, 1 month, 1 and 2 years after RT, respectively (P < 0.001). From 1 month to 5 years after RT, 37. 5% to 94. 7% of ears had a BC hearing threshold of at least 15 dB losses at speech frequency, whereas the percentage at high frequency was 85.4 to 97.4%. Up to 63.2% and 73.7% of ears had 30 dB SNHL at least at speech and high frequency, respectively. Furthermore, the degree of mean threshold loss was greater at high frequency than at speech frequency. The mean value of wave I, III and V latency, and I -V interpeak latency intervals of ABR had no significant difference between at 1 month after RT and before RT (P > 0.05). The wave I , III and V latency, and I - V interpeak latency intervals at 1 year and 2 years were significantly prolonged when compared with those before and 1 month after RT (P < 0.05), but there were no significant difference between 1 year and 2 years after RT (P > 0.05). The wave I, III and V latency, and I -V interpeak latency intervals at 5 years after RT were also significantly longer than those before RT (P < 0.001). There were significant difference in wave I , III and V latency (P < 0.05), and no significant difference in wave I - V interpeak latency intervals (P > 0. 05) between 5 years after RT and 1 year or 2 years after RT. Seven of 10 ears at 1 year after RT and 4 of 7 ears at 5 years after RT had normal EOAE, but they all had abnormal ABR response. CONCLUSIONS: SNHL in NPC patients start soon after completion of RT, especially more commonly in high frequency. The incidence and the extent of hearing loss are increased with time of follow-up. The hearing impairment could occur in the cochlea and/or the retrocochlear auditory pathway, which show that the sensitivity of radiation damage may be different in different patient and anatomic site of auditory system.

Adult↗
PubMed1991

[Tonal audiometry in hearing evaluation with a microcomputer system].

The own experiences with the computer microsystem for hearing evaluation "Audiocomp" were presented. The air and bone conduction thresholds as well as the others suprathreshold testing were performed by computer. The reproducibility of results were better than in standard audiometry. The influence of the examined person is lowered making the testing more objective.

Adult↗
PubMedDate not supplied

[Principles of age-related changes in the surgical approach to the antrum].

The present authors maintain that the surgical approach to the antrum via the mastoid bone as a method of treating chronic purulent otitis media is very promising because it saves bone conduction structures of the middle ear. In order to provide accurate and safe dissection of the antrum, the authors measured the angle between the external auditory meatus and the horizontal skull plane. As they have previously demonstrated, this angle is correlated with the antrum displacement upwards or downwards. On the basis of over 500 observations, the authors have concluded that the angle increases on the average from 13 degrees to 25 degrees at the age of 5 to 40 years and then decreases, reaching 18 degrees by the age of 70 years. The authors recommend to measure the surgical angle for all types of antrotomic intervention, using contrast X-ray ++ of the auditory meatus in the normal anterior projection of the skull.

Adolescent↗
PubMed1990

Therapeutic role of carbogen in impaired hearing.

The therapeutic role of carbogen was evaluated in subjects with sensorineural hearing loss by administering carbogen, a gas mixture of 95 per cent O2 and 5 per cent CO2, for seven consecutive days (30 min/day) and monitoring puretone audiometry before and after the administration. Significant improvement was observed both in air and bone conduction threshold levels on seventh day, indicating that there was some recoverable portion in the hearing level of these subjects. The improvement in hearing may be due to action of CO2 as an otic vasodilator coupled with supplementation of the O2 requirement of degenerating hair cells. Carbogen thus appears to be useful in persons with impaired hearing, involving the inner ear.

Adult↗
PubMed1990

Non-ossicle homograft bone prostheses in the middle ear.

This thesis proposes the use of human cadaver non-ossicle temporal homograft bone as middle ear reconstructive material. Bone obtained from the otic capsule histologically resembles that of the ossicles more so than any other bone in the body. The otic capsule, due to its proximity to the middle ear, can be harvested with the middle ear structures when bone cores are obtained, making it easily accessible. These prostheses are cost effective because multiple prostheses can be sculptured from one temporal bone core. This paper further proposes the use and introduction of non-ossicle homografts in primary stapedectomy, as well as in selected cases to bypass the incus and the superstructure of the stapes. Audiological data is provided. Some of the grafts have been in the middle ear for up to 5 years. There have been no extrusions and no complications. The method of harvesting, preservation, and sterilization is presented, as well as a pictorial illustration of the finished product and its relation to the natural ossicles. One histological specimen is presented. On the basis of the audiologic results, as well as the fact that no ossicles have extruded and none have been resorbed, it is proposed that non-ossicle temporal bone homografts have a place in transplantation surgery.

Animals↗
PubMedDate not supplied

[Branemark-type osteo-integrated implants for the adaptation of endosseous hearing aids].

This study presents four cases of bone-anchored implants for hearing aid amplification and reviews indications and results. The study concludes that bone implanted hearing aids are superior to the classic hearing aids. They are also indicated in a larger number of cases of mixed hearing loss and with an average bone conduction as high as 45 dB.

Adolescent↗
PubMed1989

[Evoked otoacoustic emissions from normal-hearing young Chinese].

Evoked otoacoustic emissions (EOAE) were recorded in normal-hearing young Chinese. Incidences and thresholds of EOAE responses, interaural threshold differences and latencies were calculated. The results were compared with other reports in the literature. The average threshold of EOAEs evoked by 1 kHz bone-conducted tone-burst stimuli was found about 4.43 dB below the subjective thresholds for the stimuli. This result is quite different from that reported by Rossi in 1988. The cause of the result is yet not clear.

Acoustic Stimulation↗
PubMed1989

[Surgery of otospongiosis in the elderly].

This paper only deals with patients suffering from otosclerosis, operated upon by stapes footplate piston procedure. We have been using this technique since 1963 and described it in 1966 stressing on the necessity of performing an accurately cut and circular footplate orifice, perfectly calibrated to the prosthesis diameter. The patients are considered as elderly if they are 70 or more, the oldest one was 84. Always performed under local anesthetic with a practically bloodless field, this surgery never induced any general complication. The patient gets up the day after surgery. Amongst 5,000 cases operated on by the same otologist between 1963 and 1987, 5.5% were 70 or more, 0.5% 80 or more. The immediate results are the same as in the younger patients for the majority frequencies and seems even better later on for the 4,000 Hz frequency. Also, the late bone conduction threshold in often much better than the preoperative one. So, we believe that all otosclerosis in the elderly can be operated on using our surgical procedure.

Age Factors↗
PubMed1985

[Endogenous steroids and otosclerosis].

The level of serum hydrocortisone dehydroepiandrosteron-sulphate and testosterone was measured in 11 men and 11 women suffering from otosclerosis, whose surgically removed stapes were histologically proven to be otosclerotic. In one third of the cases, the serum levels of steroid hormones were abnormal. Men had lower levels of dehydroepiandrosteron-sulphate, i.e. adrenocortical hypofunction, while women had higher levels of testosterone. Significant correlation was not shown with duration of symptoms, age, speech discrimination, pure tone audiogram, air-bone gap and/or any connection between otosclerosis and adrenocortical hypofunction. In patients with normal hormone serum levels the mean values of bone conduction did not exceed 15 dB on the speech frequencies, whereas in patients with otosclerosis, and altered levels of steroid hormone the threshold values on pure tone audiometry showed a hearing loss of 25 dB.

Adult↗
PubMed1988

High-frequency audiometric changes after stapedectomy.

It is possible that, when the labyrinth is opened in stapedectomy, some form of alteration may occur within it, even if it is not detected postoperatively by routine audiometry. Injuries against the inner ear usually impair the hearing at the highest frequencies. We can assess bone-conduction hearing up to 20 kHz by means of a high-frequency audiometer. Twenty-five patients were examined with conventional and high-frequency audiometry (HFA) before and after successful stapedectomy. Conventional audiometry showed a good postoperative improvement in the low and middle frequencies. HFA showed a lowering of the auditory thresholds above 8 kHz in 20 patients (83.4%), which was not evident with conventional audiometry because it occurred above its upper frequency limit. HFA is a very valuable means of assessing the results of ear surgery, and can be used to compare different surgical techniques.

Adult↗
PubMed1986

[Cortical deafness following bilateral hypertensive putaminal hemorrhage].

A case of cortical deafness is reported, which was caused by two episodes of bilateral hypertensive putaminal hemorrhage. Such a case has not appeared in literature up to this time. The patient was a right-handed, 69-year-old man, admitted to us after the stroke with right hemiparesis and disturbance of consciousness. CT scans showed right putaminal hemorrhage. After recovery of consciousness, the patient complained of hearing difficulty of the right ear. The right hemiparesis improved and he was followed ambulatorily after two months hospitalization. He returned to his work and was able to drive a car. His hearing difficulty of the right ear progressed and became stone deaf six months after onset of the initial stroke. Two years after the first stroke, he was attacked by the second stroke with left hemiparesis. CT scans showed left putaminal hemorrhage larger than the previous one in the right. When the patient recovered consciousness, he complained of total deafness. Audiometry test showed that hearing was lost completely to both high and low notes, and there was absence of bone conduction bilaterally. Auditory brain stem response test revealed normal pattern from wave I through wave V bilaterally. Middle latency response showed normal component Po on the right ear and it was absent on the left. The component Pa was not identified on both ears. He showed skill and reliance on lip reading two years after the onset of the complete deafness. Now he can speak fluently and communicate with lip reading and written language, although no improvement of the complete deafness being noticed.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1985

[Operations to improve hearing in auricular malformations. A catamnestic study of 89 operations].

In the last 20 years 89 middle ear operations were performed on 71 patients with unilateral or bilateral microtia (grade II or III). The methods and the results are described and discussed. In 79.5% we produced a wide auditory canal and achieved an overall hearing gain of 17 dB. We usually do not carry out middle ear surgery in unilateral atresia. In bilateral atresia the child is fitted with a bone conduction hearing aid as soon as possible and is operated on at the age of 4 or 5 years. After middle ear surgery we reconstruct the auricle at an age of 5 or 6 years. If necessary these children are then fitted with an air conduction hearing aid.

Child↗
PubMed1985

[Bilateral complete deafness following head injury in a child].

A case of head injury is reported because it presented such an unusual symptom as sudden, bilateral complete deafness. An 11-year-old boy was involved in a traffic accident while riding on a bicycle. He was admitted immediately after the accident in semicomatose state. The pupils were isocoric and pupillary light reflex was normal. Conjugate deviation to the right was seen. Oculo-cephalic response was absent. X-rays of his skull showed two linear fractures in the occipital bone. CT scan of the head showed symmetrical ventricular dilatation which was suspected to be a sequela of asphyxia at his birth although there was no obvious finding of cerebral contusion. His mental and physical development had been uneventful. One week after admission, his consciousness improved to some extent and at that time right hemiparesis and right infranuclear facial palsy were revealed. One month after the accident, he became alert and able to eat and to read the books on the bed, and then bilateral deafness was noticed. Audiometry showed that hearing was lost completely to both high and low notes, and there was absence of bone conduction bilaterally. Auditory brainstem response test revealed no response from wave I through wave V bilaterally. Right hemiparesis and right infranuclear facial palsy completely subsided and his mental and intellectual state became normal. He was discharged ambulatorily in good condition except for bilateral complete deafness. Now he is leading a useful life and attending a prefectural deaf and mute school.(ABSTRACT TRUNCATED AT 250 WORDS)

Audiometry↗
PubMed1985

[Improvement in hearing as a function of type of platinectomy or platinotomy performed in the surgical treatment of otospongiosis].

The footplate fenestra should be performed in its posterior third part to avoid pressure of the piston on the membranous labyrinth, situated very close to the footplate in 2% of the cases in otosclerotic patients. Gain in bone conduction differs according to the size of the fenestra performed. Low frequencies improve most when the whole posterior third part of the footplate is removed; the audiometric gain is better for high frequencies when a 0.8 mm stapedotomy is performed. These findings demonstrate the interest of a more or less enlarged fenestra according to the language spoken by the patient, since the different languages use mainly high or low frequency phonemes.

Audiometry↗
PubMed1977

On the cross hearing of spondaic words.

Twelve adults with unilateral hearing losses were tested to determine interaural attenuation for spondaic words. Low-pass and band-pass filters were used to simulate hearing loss at the normal ear. Results suggest that in deciding on the possibility of cross hearing, the spondee threshold at the test ear should be compared to the most sensitive bone-conduction threshold at the nontest ear, excluding .25 kc/s.

Adolescent↗
PubMed1978

[Quantitative results of the brainstem audiometry in middle ear, cochlear, and retrocochlear hearing damage (author's transl)].

After a discussion of the technique and validity of the objective audiometry using acoustically evoked brainstem potentials, we demonstrate the shape of potentials at various locations of the scalp. We compare the objective findings for middle and inner ear hearing losses with the subjective audiogram. Disturbances in the middle ear are marked through a letency shift corresponding to the hearing loss with normal bone conducted reaction. When the cochlea is damaged we notice a quick decrease in amplitude from the loudnesscompensation to the threshold with normal latencies. As examples for retro-cochlear damages we give the cases of a child, retarded after encephalitis, of an infant and of a patient with stato-acoustic neurinoma, whereby also the cochlear, subcortical and cortical potentials are evaluated.

Acoustic Stimulation↗
PubMed1983

[Overview of functional results of tympanoplasty].

The postoperative functional results of 448 tympanoplasties of Type 1-4, among them the late results, were reviewed via computer for the 1968-1977 decade. The average air-bone-gap decreased from 30.7 to 25.0 dB. There were no significant changes in the bone conduction of single frequencies in the long-term results. The proportion of social hearing increased from 35 per cent (pre-operative) to 52 per cent (post-operative) and to 55 per cent in the long-term results. In 27 patients (6 per cent) residual conditions were seen as in spontaneous tympanoplasty. The results reported in literature are discussed in detail.

Adolescent↗
PubMed1983

Early detection of otosclerosis by impedance-audiometry screening.

The basis of the early detection of otosclerosis is dual: first, a better knowledge of the mechanism of the disease itself, which is of enzymatic origin, and the starting point of which is an antigen-antibody conflict between the otic capsule and the embryonic cartilaginous remnants; - second, the fact that the otospongiotic disease appears to be a genetic deafness with an autosomal inheritance and about 40% of genes penetrance. Consequently an early detection is absolutely essential to combat the disease at its beginning and to assure its prevention. The early diagnosis of the otospongiotic/otosclerotic disease is twofold: first, the early detection of stapedial fixation is given by systematic impedance-audiometry screening on school-children by means of stapedius reflex elicitation in order to detect a possible diphasic impedance change (on-off effect); - second, the early diagnosis of progressive cochlear deterioration is yielded through systematic bone-conducted audiometry testing in young children in families with an otospongiotic/otosclerotic history.

Acoustic Impedance Tests↗