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Journal of Zhejiang University....The incidence of blast injury has increased recently. As the ear is the organ most sensitive to blast overpressure, the most frequent injuries seen after blast exposure... (Review)
Review
The incidence of blast injury has increased recently. As the ear is the organ most sensitive to blast overpressure, the most frequent injuries seen after blast exposure are those affecting the ear. Blast overpressure affecting the ear results in sensorineural hearing loss, which is untreatable and often associated with a decline in the quality of life. Here, we review recent cases of blast-induced hearing dysfunction. The tympanic membrane is particularly sensitive to blast pressure waves, since such waves exert forces mainly at air-tissue interfaces within the body. However, treatment of tympanic membrane perforation caused by blast exposure is more difficult than that caused by other etiologies. Sensorineural hearing dysfunction after blast exposure is caused mainly by stereociliary bundle disruption on the outer hair cells. Also, a reduction in the numbers of synaptic ribbons in the inner hair cells and spiral ganglion cells is associated with hidden hearing loss, which is strongly associated with tinnitus or hyperacusis.
Topics: Blast Injuries; Ear; Hearing Loss, Conductive; Hearing Loss, Sensorineural; Humans; Tympanic Membrane Perforation
PubMed: 29770646
DOI: 10.1631/jzus.B1700051 -
Neuroscience May 2019The effects of traumatic noise-exposure and deafening on auditory system function have received a great deal of attention. However, lower levels of noise as well as... (Review)
Review
The effects of traumatic noise-exposure and deafening on auditory system function have received a great deal of attention. However, lower levels of noise as well as temporary conductive hearing loss also have consequences on auditory physiology and hearing. Here we review how abnormal acoustic experience at early ages affects the ascending and descending auditory pathways, as well as hearing behavior.
Topics: Animals; Auditory Pathways; Auditory Threshold; Hearing; Hearing Loss, Conductive; Hearing Loss, Noise-Induced; Humans; Noise
PubMed: 30685543
DOI: 10.1016/j.neuroscience.2019.01.020 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Mar 2023To investigate the etiology, diagnosis and treatment of noninflammatory conductive hearing loss in children. The clinical data of children patients admitted to the Eye &...
To investigate the etiology, diagnosis and treatment of noninflammatory conductive hearing loss in children. The clinical data of children patients admitted to the Eye & ENT Hospital of Fudan University from January 2019 to November 2022 were retrospectively analyzed. A total of 179 cases(189 ears) were analyzed. The main symptoms from high to low were: ear tightness, hearing loss, earache, and facial paralysis. The degree of hearing loss was mild in 34 ears(19.5%), moderate in 70 ears(40.2%), moderate-severe in 52 ears(29.9%), severe in 18 ears(10.3%). The mean hearing threshold of otosclerosis was the highest(63.5±7.8) dB HL, and the mean air-bone gap of ossicular chain malformation was the largest(35.4±9.8) dB HL. The mean hearing threshold of the affected ear was(50.4±14.5) dB HL, and the mean air bone gap was(30.3±10.4) dB HL. After operation, the results were(36.1± 14.5) dB HL and(20.0±8.6) dB HL, respectively. Distribution of surgical methods for ossicular chain reconstruction: 88 ears(46.6%) of TORP, 49 ears(25.9%) of PORP, 8(4.2%) ears of Piston, 9 ears(4.8%) of autogenous ossicular reconstruction, and 35 ears(18.5%) of ossicular chain relaxation. CT diagnostic rate showed more sensitivity to malleus and incus abnormalities, the diagnosis rate of congenital middle ear cholesteatoma was the highest. The mean duration time of diagnosis was(2.2±2.9) years, while the diagnosis of ossicular chain malformation([5.2±4.2]years), otosclerosis([4.4±4.1]years), tympanosclerosis([5.4±0.9]years) took longer. In the diagnosis and treatment of noninflammatory conductive hearing loss in children, the combination of detailed medical history, specialized examination and imaging examination can maximize the accuracy of diagnosis and achieve the purpose of personalized comprehensive treatment. Surgical intervention with appropriate timing is important to remove lesions and improve hearing.
Topics: Humans; Child; Hearing Loss, Conductive; Otosclerosis; Retrospective Studies; Ear, Middle; Ear Ossicles; Ossicular Replacement; Deafness; Ossicular Prosthesis; Treatment Outcome
PubMed: 36843520
DOI: 10.13201/j.issn.2096-7993.2023.03.010 -
Australian Family Physician Jun 2016Hearing loss is the most common sensory deficit in elderly patients, and is often under-recognised and poorly managed. It is essential for all clinicians to have... (Review)
Review
BACKGROUND
Hearing loss is the most common sensory deficit in elderly patients, and is often under-recognised and poorly managed. It is essential for all clinicians to have awareness and knowledge in this field to enable the institution of early and appropriate care.
OBJECTIVE
The goal of this article is to review the causes, diagnosis and management of hearing loss as it applies to elderly patients. The review describes a useful approach that clinicians can apply to daily practice.
DISCUSSION
For elderly patients presenting with hearing loss, the basic assessment should include history, physical examination and pure tone audiometry. Management depends on the cause and type of hearing loss, and options include medical therapy, surgery and amplification. In the absence of a simple and correctable cause, consider referring patients to an otolaryngologist for further assessment.
Topics: Aged; Aged, 80 and over; Audiometry; Female; Hearing Loss; Hearing Loss, Conductive; Hearing Loss, Sensorineural; Humans; Male
PubMed: 27622223
DOI: No ID Found -
International Journal of Pediatric... Jun 2020Analyze reasons for unilateral conductive hearing loss (CHL) with unknown etiology in children.
OBJECTIVES
Analyze reasons for unilateral conductive hearing loss (CHL) with unknown etiology in children.
INTRODUCTION
Unilateral conductive hearing loss (HL) without known etiology can be undiagnosed despite of hearing screening programs. It can be difficult to find the reason for HL and to make a treatment plan. Middle ear endoscopy gives hard-evidence diagnosis and basis for an individual treatment plan.
METHODS AND MATERIAL
Prospective clinical follow-up study for a cohort of generally healthy elementary school age children with unilateral conductive HL with unknown etiology. The study population was 192 children, of which 46 had a HL of at least 25 dB with more than 10 dB conductive component. Mean age was 8.7 years. Preoperative tests included otomicroscopy, bone- and air-conduction audiogram, tympanometry, stapes reflex tests, Rinne and Weber test and Otoacoustic emissions. The children underwent endoscopy of the middle ear with an individual treatment plan and long-term follow-up. The aim was to explore etiology and to give a treatment plan for hearing loss. Follow-up included air- and bone conduction hearing tests annually or every other year. Mean follow-up was 5.2 years.
RESULTS
A clear etiological finding was found in 36 (78%) ears, stapes anomaly (23) as the most common (64%) finding. Other findings were two cholesteatomas, 2 status after trauma, 5 middle ear anomalies, 5 incus fixations and one incus erosion. Air conduction hearing improved spontaneously during follow-up in 81% (17/21, 2 dropouts) of the stapes anomaly ears (mean 11,3 dB, range 4-32 dB), and none of these ears showed hearing deterioration. In the incus fixation group, one ear showed hearing deterioration. There were no major complications for exploration, and 5 minor postoperative infections.
CONCLUSIONS
The most common reason for pediatric unilateral conductive hearing loss was stapes anomaly/fixation. The HL does not deteriorate. Hearing loss in stapes anomalies shows a tendency for spontaneous recovery. Stapes surgery can be postponed or avoided.
Topics: Adolescent; Audiometry; Child; Child, Preschool; Cohort Studies; Ear, Middle; Endoscopy; Female; Hearing Loss, Conductive; Hearing Loss, Unilateral; Humans; Incus; Male; Stapes
PubMed: 32200311
DOI: 10.1016/j.ijporl.2020.109983 -
Acta Otorhinolaryngologica Italica :... Dec 2022To investigate whether patients with conductive hearing loss (CHL) and normal preoperative investigations may benefit from exploratory tympanotomy (ET) and tailored...
OBJECTIVE
To investigate whether patients with conductive hearing loss (CHL) and normal preoperative investigations may benefit from exploratory tympanotomy (ET) and tailored treatment performed according to intraoperative findings.
METHODS
Patients treated with ET for CHL with normal pre-operative otoscopy, tympanometry and CT scan from 2011 to 2019 were reviewed. Data regarding demographics, audiometry, intraoperative findings and surgery were collected and analysed to assess if they can predict post-operative air bone gap (ABG) closure and patient satisfaction.
RESULTS
Forty-eight cases were included. Mean ABG significantly reduced (p < 0.001) from preoperative (38.4 dB) to postoperative (14.8 dB). Post-operative ABG closure within 10 dB was observed in 20 cases (41.7%). Overall satisfaction was reported in 60% of cases. Stapes fixation was the most common diagnosis (47.9%) and significantly associated with lower post-operative ABG and higher satisfaction.
CONCLUSIONS
In CHL with normal pre-operative investigations, ET represents the mainstay of treatment, even if audiological outcomes may widely vary. Intraoperative finding of stapes fixation (thus stapedotomy) ensures the best audiological and satisfaction outcomes.
Topics: Humans; Hearing Loss, Conductive; Otosclerosis; Ear, Middle; Stapes Surgery; Audiometry; Retrospective Studies; Treatment Outcome
PubMed: 36654524
DOI: 10.14639/0392-100X-N1933 -
Brazilian Journal of Otorhinolaryngology 2017There is inconclusive evidence whether osteoporosis increases risk of hearing loss in current literature. (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
There is inconclusive evidence whether osteoporosis increases risk of hearing loss in current literature.
OBJECTIVE
We conducted this meta-analysis to determine whether there is an association between hearing loss and osteoporosis.
METHODS
This systematic review and meta-analysis was conducted from studies of MEDLINE, EMBASE, and LILACS. Osteoporosis was defined as having a bone mineral density with a T-score of less than -2.5 standard deviation. The outcome was hearing loss as assessed by audiometry or self-reported assessment. Random-effects model and pooled hazard ratio, risk ratio, or odds ratio of hearing loss with 95% confidence intervals were compared between normal bone mineral density and low bone mineral density or osteoporosis.
RESULTS
A total of 16 articles underwent full-length review. Overall, there was a statistically significant increased odds of hearing loss in the low bone mineral density or osteoporosis group with odds ratio of 1.20 (95% confidence intervals 1.01-1.42, p=0.04, I=82%, P=0.01). However, the study from Helzner et al. reported significantly increase odds of hearing loss in the low bone mineral density in particular area and population included femoral neck of black men 1.37 (95% confidence intervals 1.07-1.76, p=0.01) and total hip of black men 1.36 (95% confidence intervals 1.05-1.76, p=0.02).
CONCLUSION
Our study proposed the first meta-analysis that demonstrated a probable association between hearing loss and bone mineral density. Osteoporosis could be a risk factor in hearing loss and might play an important role in age-related hearing loss.
Topics: Age Factors; Bone Density; Female; Hearing Loss, Conductive; Hearing Loss, Mixed Conductive-Sensorineural; Hearing Loss, Sensorineural; Humans; Male; Osteoporosis; Risk Factors; Sex Factors
PubMed: 27670202
DOI: 10.1016/j.bjorl.2016.08.012 -
Ear, Nose, & Throat Journal Feb 2021Otosclerosis is a disease process that usually starts around the oval window, causing fixation of the stapes, resulting in conductive hearing loss. Treatment of the... (Review)
Review
OBJECTIVES
Otosclerosis is a disease process that usually starts around the oval window, causing fixation of the stapes, resulting in conductive hearing loss. Treatment of the conductive hearing loss caused by otosclerosis consists of either rehabilitation with hearing aids or performing surgery. Given the risks of hearing impairment and vertigo associated with the surgery, there has been a desire to advance the practice to minimize the complications. The so-called "non-contact" or "no touch" techniques with the use of various lasers are in current practice. This review article will cover the surgical aspects, the theory behind laser and the various types used in stapes surgery. It will also review the evidence of laser versus conventional stapes surgery and the comparison of different laser types.
METHODS
A literature search up to December 2019 was performed using Pubmed and a nonsystematic review of appropriate articles was undertaken. Keywords used were stapes, surgery, laser, stapedectomy, and stapedotomy.
RESULTS
Overall, there is no evidence to say laser fenestration is better than conventional fenestration techniques; however, with the micro drill, there is an increased risk of footplate fracture and sensorineural hearing loss. There is an increased risk of tinnitus with the laser compared to conventional techniques. Studies have favored the CO laser over potassium titanyl phosphate (KTP) and erbium-doped yttrium aluminium garnet (Erbium-YAG) lasers for postoperative closure of the air-bone gap; and KTP laser has less thermal, mechanical, and sound effects compared with the thulium and carbon dioxide (CO) lasers. There is an increased risk if inner ear complications with the thulium laser.
CONCLUSIONS
It can be deduced that theoretically and practically, the thulium laser is less safe compared to the KTP and CO lasers. The choice of laser used depends on the surgeon's preference, as well as availability, cost, side effects profile, as well as ease of use.
Topics: Hearing Loss, Conductive; Humans; Laser Therapy; Otosclerosis; Stapes Surgery; Treatment Outcome
PubMed: 32603217
DOI: 10.1177/0145561320937828 -
Hearing Research Mar 2017While many mouse models of hearing loss have been described, a significant fraction of the genetic defects in these models affect both the inner ear and middle ears. A...
While many mouse models of hearing loss have been described, a significant fraction of the genetic defects in these models affect both the inner ear and middle ears. A common method used to separate inner-ear (sensory-neural) from middle-ear (conductive) pathologies in the hearing clinic is the combination of air-conduction and bone-conduction audiometry. In this report, we investigate the use of air- and bone-conducted evoked auditory brainstem responses to perform a similar separation in mice. We describe a technique by which we stimulate the mouse ear both acoustically and via whole-head vibration. We investigate the sensitivity of this technique to conductive hearing loss by introducing middle-ear lesions in normal hearing mice. We also use the technique to investigate the presence of an age-related conductive hearing loss in a common mouse model of presbycusis, the BALB/c mouse.
Topics: Acceleration; Acoustic Stimulation; Aging; Animals; Bone Conduction; Disease Models, Animal; Evoked Potentials, Auditory, Brain Stem; Hearing Loss, Conductive; Hearing Loss, Mixed Conductive-Sensorineural; Mice; Mice, Inbred BALB C; Mice, Inbred CBA; Presbycusis; Species Specificity
PubMed: 28167132
DOI: 10.1016/j.heares.2017.02.001