Publication date 28-09-2021
Objectives: This study was conducted to explore the effectiveness of hyperbaric oxygen (HBO) in the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL) and recommend the appropriate course of treatment.
Methods: 102 patients (105 diseased ears) with ISSNHL were recruited from the Department of Neurology and Otorhinolaryngology, West China Fourth Hospital, Sichuan University, between January 2018 and September 2020. Of them, 45 patients (group A) received intravenous steroid (IVS), and the remaining patients (group B) received IVS and HBO therapy (HBOT). Pure-tone audiometry (PTA) was performed twice at baseline and 10 days after treatment. Patients in group B were subdivided into group 1 (≤10 sessions) and group 2 (#x3e;11 sessions) to verify the correlation between the efficacy and course of HBOT, at the follow-up endpoint, the PTA was performed again. The multivariate logistical regression model was used to analyze the related factors of prognosis.
Results: Compared with the control group, significantly larger hearing gains and better hearing recovery rate were observed in the IVS + HBOT group (p #x3c; 0.05). The time of treatment and course of HBOT were significantly correlated with the hearing threshold after treatment (p #x3c; 0.05) and had no significant relationship with tinnitus and age (p #x3e; 0.05).
Conclusion: HBOT + IVS is an effective method for ISSNHL, especially for the recovery of low-frequency hearing and initial hearing levels of severe and profound. Tinnitus is the most common concomitant symptom of ISSNHL, and prolonging the course of HBOT did not significantly improve it. Initiating HBOT within 7 days for 10–25 sessions of treatment was more beneficial. Audiol Neurotol
SG Guven,O Ersoy,RD Topuz,E Bulut,G Kizilay,C Uzun
Publication date 14-09-2021
Introduction: The effect of orally consumed monosodium glutamate (MSG), which is a common additive in the food industry, on the cochlea has not been investigated. The present study aimed to investigate the possible cochleotoxic effects of oral MSG in guinea pigs using electrophysiological, biochemical, and histopathological methods.
Methods: Thirty guinea pigs were equally divided into control and intervention groups (MSG 100 mg/kg/day; MSG 300 mg/kg/day). At 1 month, 5 guinea pigs from each group were sacrificed; the rest were observed for another month. Electrophysiological measurements (distortion product otoacoustic emission DPOAE and auditory brainstem response ABR), glutamate levels in the perilymph and blood samples, and histopathological examinations were evaluated at 1 and 2 months.
Results: Change in signal-to-noise ratio at 2 months was significantly different in the MSG 300 group at 0.75 k Hz and 2 k Hz (p = 0.013 and p = 0.044, respectively). There was no statistically significant difference in ABR wave latencies of the guinea pigs given MSG compared to the control group after 1 and 2 months; an increase was noted in ABR thresholds, although the difference was not statistically significant. In the MSG groups, moderate-to-severe degeneration and cell loss in outer hair cells, support cells, and spiral ganglia, lateral surface junction irregularities, adhesions in stereocilia, and partial loss of outer hair cell stereocilia were noted.
Conclusion: MSG, administered in guinea pigs at a commonly utilized quantity and route of administration in humans, may be cochleotoxic. Audiol Neurotol
TN Tamati,AC Moberly
Publication date 14-09-2021
Introduction: Talker-specific adaptation facilitates speech recognition in normal-hearing listeners. This study examined talker adaptation in adult cochlear implant (CI) users.
Three hypotheses were tested: (1) high-performing adult CI users show improved word recognition following exposure to a talker (“talker adaptation”), particularly for lexically hard words, (2) individual performance is determined by auditory sensitivity and neurocognitive skills, and (3) individual performance relates to real-world functioning.
Methods: Fifteen high-performing, post-lingually deaf adult CI users completed a word recognition task consisting of 6 single-talker blocks (3 female/3 male native English speakers); words were lexically “easy” and “hard.” Recognition accuracy was assessed “early” and “late” (first vs. last 10 trials); adaptation was assessed as the difference between late and early accuracy. Participants also completed measures of spectral-temporal processing and neurocognitive skills, as well as real-world measures of multiple-talker sentence recognition and quality of life (QoL).
Results: CI users showed limited talker adaptation overall, but performance improved for lexically hard words. Stronger spectral-temporal processing and neurocognitive skills were weakly to moderately associated with more accurate word recognition and greater talker adaptation for hard words. Finally, word recognition accuracy for hard words was moderately related to multiple-talker sentence recognition and QoL.
Conclusion: Findings demonstrate a limited talker adaptation benefit for recognition of hard words in adult CI users. Both auditory sensitivity and neurocognitive skills contribute to performance, suggesting additional benefit from adaptation for individuals with stronger skills. Finally, processing differences related to talker adaptation and lexical difficulty may be relevant to real-world functioning. Audiol Neurotol
G Psillas,GG Dimas,M Daniilidis,P Binos,T Tegos,J Constantinidis
Publication date 10-09-2021
Introduction: The aim of this study was to illustrate clinical and audiological patterns of hearing impairment in patients with autoimmune hearing loss (AIHL).
Methods: Fifty-three patients with AIHL were retrospectively recruited, and a tapering schema of steroid treatment was administered in all these patients. The diagnosis of AIHL was essentially based on clinical symptoms, such as recurrent, sudden (sensorineural hearing loss SSHL), fluctuating, or quickly progressing (#x3c;12 months) SSHL (uni-/bilateral), in association with the coexistence of autoimmune diseases, high antinuclear antibodies (ANA) and the presence of human leukocyte antigen (HLA) B27, B35, B51, C04, and C07. Logistic regression analysis was applied to correlate the clinical data and laboratory features of AIHL with final outcomes.
Results: The onset of AIHL was mainly progressive (49%), followed by SSHL (39.6%) or fluctuating (11.3%). The pure-tone audiogram showed more commonly a downsloping pattern (42.6% of ears), but also an upsloping, flat, cookie-bite, or inverse cookie-bite shape. Bilateral progressive AIHL was more frequently simultaneous (23 patients) than heterochronous (4 patients). Nineteen patients (35.8%) showed a favorable response to steroid therapy. The presence of recurrent, bilateral SSHL versus recurrent, unilateral SSHL had statistically negative effect on hearing recovery (OR = 0.042, p #x3c; 0.05). The heterochronous bilateral SSHL may have better prognosis than simultaneous bilateral SSHL (OR = 10.000, p = 0.099). The gender, age, concomitant autoimmune disease, high ANA, HLA alleles, tinnitus, and vestibular symptoms had no statistical effect on a favorable outcome of AIHL.
Conclusions: A bilateral, simultaneous, and progressive hearing loss combined with downsloping audiogram occurred more often in patients with AIHL. Bilateral simultaneous SSHL with recurrences represents the worse prognostic form of AIHL. Audiol Neurotol
D Xie,MS Welgampola,LA Miller,AS Young,M D'Souza,N Breen,SM Rosengren
Publication date 10-09-2021
Introduction: Patients with vestibular disorders sometimes report cognitive difficulties, but there is no consensus about the type or degree of cognitive complaint. We therefore investigated subjective cognitive dysfunction in a well-defined sample of neuro-otology patients and used demographic factors and scores from a measure of depression, anxiety, and stress to control for potential confounding factors.
Methods: We asked 126 neuro-otology clinic outpatients whether they experienced difficulties with thinking, memory, or concentration as a result of dizziness or vertigo. They and 42 nonvertiginous control subjects also completed the Neuropsychological Vertigo Inventory (NVI, which measures cognitive, emotional, vision, and motor complaints), the Everyday Memory Questionnaire (EMQ), and Depression, Anxiety, and Stress Scales (DASS).
Results: In the initial interview questions, 60% of patients reported experiencing cognitive difficulties. Cognitive questionnaire scores were positively correlated with the overall DASS score and to a lesser extent with age and gender. Therefore, we compared patients and controls on the NVI and EMQ, using these mood and demographic variables as covariates. Linear regression analyses revealed that patients scored significantly worse on the total NVI, NVI cognitive composite, and 3 individual NVI cognition subscales (Attention, Space Perception, and Time Perception), but not the EMQ. Patients also scored significantly worse on the NVI Emotion and Motor subscales.
Conclusions: Patients with dizziness and vertigo reported high levels of cognitive dysfunction, affecting attention, perceptions of space and time. Although perceptions of cognitive dysfunction were correlated with emotional distress, they were significantly elevated in patients over and above the impact of depression, anxiety, or stress. Audiol Neurotol
DJ Morris,M Agirrezabal,JK Brännström,PA Gade
Publication date 06-09-2021
Introduction: Preparatory motor cortical responses like the lateralized readiness potential (LRP) may be useful in revealing persistent attempts to feign hearing loss. Previous studies suggest only a marginal effect of stimulus intensity on the amplitude of the LRP. However, this has not been investigated using low-intensity auditory stimuli to cue No Go trials. We address this in an experiment where subjects were instructed not to give a manual response to low-instensity stimuli, a situation that is akin to simulating hearing loss.
Methods: The LRP was recorded from normal hearing listeners (N = 10) with 500 and 4,000-Hz pure tones and trains of 4,000 Hz (2-1-2) tonebursts. Electrophysiologic data underwent processing to (i) analyze the effect of the stimulus type on the LRP, (ii) classify results according to manual response with both logistic regression and linear support vector machine (SVM) models, and (iii) derive auditory brainstem responses (ABRs) from the tonebursts.
Results: The amplitude of the LRP did not differ between the 3 stimuli used to elicit the response. Single-trial electrode data from Go and No Go trials were submitted to supervised binary classification, and the logistic regression model gave a mean accuracy of close to 0.7. The Jewett wave V latencies of the resultant ABRs from some subjects were found to increase between the high (Go) and low (No Go) intensity tonebursts.
Conclusion: This study shows that auditory stimulus type does not affect the amplitude of the LRP and that the response can be recorded with stimuli that are near the auditory threshold. It can also be recorded with transient stimuli, and this allows for the possibility of simultaneously recording other confirmatory measurements, like ABR. Audiol Neurotol
JE Choi,YR Chang,IK Mun,JY Jung,MY Lee,JH Yun
Publication date 26-08-2021
Introduction: The purpose of this article was to determine the prevalence of inner ear symptoms in patients with blunt head trauma and to explore whether the severity of head trauma was associated with the incidence of such symptoms.
Methods: We performed a retrospective review of 56 patients admitted with blunt head trauma who underwent audiovestibular evaluation within 1 month after injury. Two scales were used to measure the severity of trauma; these were the Glasgow Coma Scale (GCS) and the Head Abbreviated Injury Scale (H-AIS). Patients with sensorineural-type hearing loss, or dizziness with nystagmus, were considered to have inner ear symptoms.
Results: About half of all patients (45%) with blunt head trauma showed trauma-related inner ear symptoms. Patients with inner ear symptoms were significantly more likely to have H-AIS scores ≥4 than those without inner ear symptoms (p = 0.004), even without concomitant temporal bone fracture (p #x3e; 0.05). Also, patients with inner ear symptoms required a statistically significantly longer time (measured from admission) before undergoing their ontological evaluations than did those without such symptoms (p = 0.002), possibly due to prolonged bed rest and use of sedatives.
Conclusion: Thus, detailed history-taking and early evaluation using trauma scales are essential for all patients suffering from severe head trauma. It may be necessary to initiate early treatment of traumatic inner ear diseases. Audiol Neurotol
A Hammond-Kenny,D Borsetto,JG Manjaly,T Panova,A Vijendren,M Bance,JR Tysome,PR Axon,NP Donnelly
Publication date 20-08-2021
Introduction: The prevalence of hearing loss and its consequences is increasing as the elderly population grows. As the guidelines for cochlear implantation (CI) expand, the number of elderly CI recipients is also increasing. We report complication rates, survival duration, and audiological outcomes for CI recipients aged 80 years and over and discuss the cost utility of CI in this age group.
Methods: A retrospective cohort study was undertaken of all CI recipients (126 cases), aged 80 years and over at the time of their surgery, implanted at our institution (Cambridge University Hospitals) during a period from January 1, 2001, to March 31, 2019. Data on survival at 1, 3, and 5 years post-implantation, post-operative complications and functional hearing outcomes including audiometric and speech discrimination outcomes (Bamford-Kowal-Bench sentence test) have been reported.
Results: The mean age at implantation was 84 years. The mean audiometric score improved from 108 dB HL to 28 dB HL post-implantation. The mean Bamford-Kowal-Bench score improved from 14% to 66% and 73% at 2 and 12 months post-implantation, respectively. The complication rate was 15.3%. The survival probability at 1 year post-implantation was 0.95 for females and 0.93 for males, at 3 years was 0.89 for females and 0.81 for males, and at 5 years was 0.74 for females and 0.54 for males.
Conclusion: CI is safe and well-tolerated in this age group and elderly patients gain similar audiometric and functional benefit as found for younger age groups. Audiol Neurotol
SA Hamed,AF ElHadad,AM Oseily
Publication date 18-08-2021
Background: Vestibular system is critical for maintaining balance and learning complex tasks. This study aimed to determine the frequencies, types, and predictors of vestibular dysfunctions (VDs) in children with type 1 diabetes (T1D) using videonystagmography (VNG).
Patients and Methods: This study included 65 patients (children with T1D = 40; controls = 25). The patients underwent VNG.
Results: Patients (boys = 15; girls = 25) had a mean age of 14.05 ± 1.82 years and duration of illness of 6.30 ± 2.84 years. The majority had frequent attacks of diabetic ketoacidosis (DKA) (65%) and hypoglycemia (40%). Dizziness was reported in 20%. VNG abnormalities were reported in 70% (n = 28), of them 71.43 and 28.57% had central and peripheral VDs, respectively. Dizziness was associated with peripheral VD. Compared to patients without VDs, those with VDs were older and had earlier age at onset and longer duration of diabetes (#x3e;5 years), higher levels of HbA1c (#x3e;7%), higher frequencies of DKA and hypoglycemic attacks, comorbid medical conditions, and diabetic complications. Multiple logistic regression analysis showed that presence of VNG abnormalities (VDs) was independently correlated with diabetes duration #x3e;5 years (odds ratio OR = 4.52 95% confidence interval CI = 3.55–7.04, p = 0.001), HbA1c% levels #x3e;7% (OR = 3.42 95% CI = 2.84–5.75, p = 0.001), and presence of hypoglycemic attacks (OR = 4.65 95% CI = 2.85–7.55).
Conclusions: -VDs are prevalent in children with T1D and correlated with the duration and severity of diabetes and the occurrence of hypoglycemic attacks. Therefore, optimizing glycemic control and prevention and treatment of diabetic complications and comorbidities are important. Multidisciplinary follow-ups are required for early detection and management of diabetic VDs. Audiol Neurotol
C Tian,D Zha
Publication date 18-08-2021
Background: The auditory system processes how we hear and understand sounds within the environment. It comprises both peripheral and central structures. Sympathetic nervous system projections are present throughout the auditory system. The function of sympathetic fibers in the cochlea has not been studied extensively due to the limited number of direct projections in the auditory system. Nevertheless, research on adrenergic and noradrenergic regulation of the cochlea and central auditory system is growing. With the rapid development of neuroscience, auditory central regulation is an extant topic of focus in research on hearing.
Summary: As such, understanding sympathetic nervous system regulation of auditory function is a growing topic of interest. Herein, we review the distribution and putative physiological and pathological roles of sympathetic nervous system projections in hearing.
Key Messages: In the peripheral auditory system, the sympathetic nervous system regulates cochlear blood flow, modulates cochlear efferent fibers, affects hair cells, and influences the habenula region. In central auditory pathways, norepinephrine is essential for plasticity in the auditory cortex and affects auditory cortex activity. In pathological states, the sympathetic nervous system is associated with many hearing disorders. The mechanisms and pathways of sympathetic nervous system modulation of auditory function is still valuable for us to research and discuss. Audiol Neurotol