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Araújo ALPKD, Cordeiro FP, da Costa Monsanto R, Penido NDO. Audiometric evaluation in different clinical presentations of otitis media. Braz J Otorhinolaryngol 2024; 90:101359. [PMID: 38070239 PMCID: PMC10755540 DOI: 10.1016/j.bjorl.2023.101359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/21/2023] [Accepted: 10/20/2023] [Indexed: 01/01/2024] Open
Abstract
OBJECTIVES To assess the hearing thresholds in acute otitis media, otitis media with effusion and chronic otitis media (non-suppurative, non-cholesteatomatous suppurative and cholesteatomatous) and to compare the hearing outcomes with non-diseased ears (in bilateral cases) or contralateral healthy ears (in unilateral cases), since hearing loss is the most frequent sequel of otitis media and there is no previous study comparing the audiometric thresholds among the different forms of otitis media. METHODS Cross sectional, controlled study. We performed conventional audiometry (500-8000Hz) and tympanometry in patients with otitis media and healthy individuals (control group). Hearing loss was considered when the hearing thresholds were > 25 dBHL. RESULTS Of the 112 patients diagnosed with otitis media (151 ears), 48 were men (42.86%) and 64 were women (57.14%). The average age was 42.72 years. Of those, 25 (22.32%) were diagnosed as AOM, 15 (13.39%) were diagnosed with OME and the remaining 72 (63.28%) were diagnosed with COM (non-suppurative COM, n=31; suppurative COM, n=18; cholesteatomatous COM, n=23). As compared with controls, all forms of otitis media had significantly higher bone-conduction thresholds (500-4000Hz). Conductive hearing loss was the most frequent type of hearing loss (58.94%). However, the number of patients with mixed hearing loss was also relevant (39.07%). We noted that the presence of sensorioneural component occurred more frequently in 1) Higher frequencies; and 2) In groups of otitis media that were more active or severe in the inflammatory/infective standpoint (AOM, suppurative COM and cholesteatomatous COM). CONCLUSION All types of otitis media, even those with infrequent episodes of inflammation and otorrhea, had worse bone conduction thresholds as compared with nondiseased ears (p<0.01). We observed worse hearing outcomes in ears with recurrent episodes of otorrhea and in ears with AOM, especially in high frequencies.
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Affiliation(s)
| | | | - Rafael da Costa Monsanto
- Universidade Federal de São Paulo - Escola Paulista de Medicina (UNIFESP), São Paulo, SP, Brazil; Otopathology Laboratory - University of Minnesota, Minneapolis, MN, USA
| | - Norma de Oliveira Penido
- Universidade Federal de São Paulo - Escola Paulista de Medicina (UNIFESP), São Paulo, SP, Brazil
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Dogan S, Huber AM, Roosli C. Treatment of Acute Otitis Media with Inner Ear Involvement in Adults. J Clin Med 2023; 12:7590. [PMID: 38137659 PMCID: PMC10743793 DOI: 10.3390/jcm12247590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/29/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Inner ear involvement (IED) is a rare local complication of the very common acute otitis media (AOM). The most beneficial treatment for IED remains a matter of debate. The aim of this study is to analyze different treatment modalities based on hearing outcomes to contribute to the discussion of therapy for IED in AOM. This retrospective study includes 112 adult patients diagnosed with AOM with IED between 2000 and 2020. Patients either received conservative (systemic antibiotic and systemic steroid therapy), interventional (conservative plus myringotomy and tympanic tube) or operative (interventional plus antrotomy) treatment. Pre- and post-treatment pure tone audiometry was performed. The hearing outcome was compared, and hearing recovery was analyzed based on modified Siegel's criteria. The pre-treatment pure tone average (PTA) was significantly (p < 0.05) higher in the operative group than in the other groups. All treatment modalities led to a significant hearing improvement (p < 0.001). The pre- and post-treatment hearing loss was predominantly observed in high frequencies 2-4 kHz. The operative group showed the highest rate of complete hearing recovery. While all treatment modalities led to a significant improvement in hearing, the operative group showed the most beneficial hearing results in patients with high pre-treatment hearing loss. It remains to be shown if the findings in patients with high pre-treatment hearing loss can be generalized to patients with mild or moderate pre-treatment hearing loss.
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Affiliation(s)
| | | | - Christof Roosli
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (S.D.)
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Philipose R, Varghese A, Kumar N, Varghese SS. Determinants of Cochlear Dysfunction in Chronic Otitis Media: Mucosal Disease. Indian J Otolaryngol Head Neck Surg 2023; 75:3733-3738. [PMID: 37974794 PMCID: PMC10646060 DOI: 10.1007/s12070-023-04093-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 07/14/2023] [Indexed: 11/19/2023] Open
Abstract
The nature of association between chronic otitis media (COM)-mucosal disease and sensorineural hearing loss is controversial. Identifying the risk factors which influence the bone conduction threshold in these patients can help the clinician in counselling the patients for surgery at the earliest to achieve optimum hearing outcomes. The present study was undertaken to determine the association between COM-mucosal disease and cochlear dysfunction. The study also aimed at identifying the determinants and their influence on the bone conduction thresholds of the diseased ear. In this study, 72 patients with unilateral chronic otitis media-mucosal disease were enrolled consecutively. All patients were enquired in detail about their presenting ear symptoms. All the patients underwent a pure tone audiogram in a sound treated room. Patients were categorised into two groups according to the presence of conductive hearing loss only or with a sensorineural component. The bone conduction thresholds were calculated and compared for frequencies at 0.5, 1, 2 and 4 kHz. The average hearing threshold for air conduction and bone conduction were calculated across 0.5, 1 and 2 kHz. Bone conduction threshold more than 20 decibels (dB) in any of the frequencies were considered significant and indicative of having sensorineural hearing loss component. The contralateral healthy ear served as control to cancel out the confounding factors such as presbyacusis, noise induced hearing loss, congenital hearing loss, etc. Multivariate linear regression models were used to evaluate the relationships between bone conduction thresholds and chronic otitis media-mucosal disease. In the present study, 18.05% of participants had a sensorineural component. The difference between the bone conduction threshold in the diseased ear and normal ear ranged from 5.41 dB at 0.5 kHz to 3.77 dB at 4 kHz (p < 0.001). Bone conduction thresholds at 4 kHz were greater than that for speech frequencies (p < 0.5). 84.6% of participants with sensorineural component had a disease duration of less than 5 years and the remaining 15.4% had a duration of greater than 15 years. There was no statistically significant difference in the incidence of sensorineural component based on the site of the perforation (p = 0.341). 21.9% of participants who used topical antibiotic drops developed a sensorineural component, while 15% of participants who did not use antibiotic ear drop preparation developed a sensorineural component. Multivariate linear regression analysis revealed that increasing age was the only factor associated with increase in bone conduction thresholds of the diseased ear (p = 0.002). Chronic otitis media- mucosal disease appears to be associated with higher bone conduction thresholds, signifying cochlear dysfunction. A statistically significant higher bone conduction thresholds are seen across 0.5 to 4 kHz in the diseased ears compared to the normal ears, signifying the vulnerability of the inner ear against chronic otitis media. In our analysis increasing age is the most significant predisposing factor associated with higher bone conduction thresholds. Higher frequencies are more affected than lower speech frequencies. Sensorineural hearing loss can occur early in the disease process and early surgical intervention in COM-mucosal disease is recommended to prevent increase in bone conduction thresholds and achieve optimum hearing outcomes.
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Affiliation(s)
- Rebecca Philipose
- Department of E.N.T., Christian Medical College, Ludhiana, Punjab India
| | - Ashish Varghese
- Department of E.N.T., Christian Medical College, Ludhiana, Punjab India
| | - Navneet Kumar
- Department of E.N.T., Christian Medical College, Ludhiana, Punjab India
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Findlay C, Edwards M, Hough K, Grasmeder M, Newman TA. Leveraging real-world data to improve cochlear implant outcomes: Is the data available? Cochlear Implants Int 2023:1-12. [PMID: 37088565 DOI: 10.1080/14670100.2023.2198792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
OBJECTIVES A small but persistent proportion of individuals do not gain the expected benefit from cochlear implants(CI). A step-change in the understanding of factors affecting outcomes could come through data science. This study evaluates clinical data capture to assess the quality and utility of CI user's health records for data science, by assessing the recording of otitis media. Otitis media was selected as it is associated with the development of sensorineural hearing loss and may affect cochlear implant outcomes. METHODS A retrospective service improvement project evaluating the medical records of 594 people with a CI under the care of the University of Southampton Auditory Implant Service between 2014 and 2020. RESULTS The clinical records are suitable for data science research. Of the cohort studied 20% of Adults and more than 40% of the paediatric cases have a history of middle ear inflammation. DISCUSSION Data science has potential to improve cochlear implant outcomes and improve understanding of the mechanisms underlying poor performance, through retrospective secondary analysis of real-world data. CONCLUSION Implant centres and the British Cochlear Implant Group National Hearing Implant Registry are urged to consider the importance of consistently and accurate recording of patient data over time for each CI user. Data where links to hearing loss have been identified, such as middle ear inflammation, may be particularly valuable in future analyses and to inform clinical trials.
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Affiliation(s)
- Callum Findlay
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Building 85, Highfield Campus, Southampton S017 1BJ, UK
- Department of Otolaryngology, University Hospital Southampton NHS FT, Tremona Road, Southampton SO16 6YD, UK
| | - Mathew Edwards
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Building 85, Highfield Campus, Southampton S017 1BJ, UK
| | - Kate Hough
- Faculty of Engineering and Physical Sciences, Highfield Campus, University of Southampton, Building 85, Southampton, UK
| | - Mary Grasmeder
- Faculty of Physical Sciences, Highfield Campus, University of Southampton Auditory Implant Services, B19, Southampton SO171BJ, UK
| | - Tracey A Newman
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Building 85, Highfield Campus, Southampton S017 1BJ, UK
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Szpak K, Wiatr A, Wiatr M. Audiometric Variability of the Carhart Effect in Middle Ear Diseases - Pretreatment Analysis. EAR, NOSE & THROAT JOURNAL 2023:1455613231167243. [PMID: 37046387 DOI: 10.1177/01455613231167243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
OBJECTIVE The assessment of bone conduction thresholds in patients with conductive hearing loss is not a full measure of the function of the inner ear due to the weakening of the influence of middle ear components on bone conduction. This relationship has been called the 'Carhart effect'. METHODS The retrospective analysis covered 977 patients diagnosed and treated for middle ear diseases from 2010 to 2020. The Carhart effect was considered to be an increase in the bone conduction threshold by a minimum of 10 dB relative to adjacent frequencies. The study was performed with the aim of assessing the presence of the Carhart effect in the course of middle ear diseases in pretreatment analysis. RESULTS The Carhart effect was observed in 532 cases, most often in patients with chronic otitis media and otosclerosis. It was least often observed in patients with otitis media with effusion. In otitis media with effusion, the Carhart effect was more often noted for the frequency of 4000 Hz, in otosclerosis for the frequency of 2000 Hz. In patients with chronic otitis media, this effect for the frequency of 4000 Hz was correlated with the location of inflammatory changes in the attic area. The presence of inflammatory lesions in the oval window area was associated with the presence of the Carhart effect for the frequency of 2000 Hz. CONCLUSIONS 1. The frequency of the Carhart effect observed in diseases of the middle ear does not depend on the disease entity but on the type and location of abnormalities in the middle ear. 2. The Carhart effect observed for the frequency of 4000 Hz coexists with the localization of lesions in the range of the malleus and incus, and for the frequency of 2000 Hz, it is partially associated with abnormalities in the range of stapes and oval window.
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Affiliation(s)
- Kamila Szpak
- Department of Otolaryngology, Jagiellonian University Medical College, Kraków, Poland
| | - Agnieszka Wiatr
- Department of Otolaryngology, Jagiellonian University Medical College, Kraków, Poland
| | - Maciej Wiatr
- Department of Otolaryngology, Jagiellonian University Medical College, Kraków, Poland
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Nathan AS, Hubbell RD, Levi JR. Management of children with co-occurring sleep disordered breathing and hearing loss. Int J Pediatr Otorhinolaryngol 2022; 163:111367. [PMID: 36327913 DOI: 10.1016/j.ijporl.2022.111367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/27/2022] [Accepted: 10/19/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To examine hearing loss incidence in a pediatric otolaryngology patients with sleep disordered breathing, and secondarily, identify possible disparities in management. METHODS A retrospective case-control study of pediatric patients with sleep-disordered breathing or obstructive sleep apnea from 2012 to 2019 was conducted at a private, not-for-profit, academic, tertiary care center. Study parameters were extracted from the electronic medical record and compared in study groups of patients with sleep-disordered breathing generated based on presence of hearing loss (cases) versus absence (controls). Study parameters were also compared in study groups based on timing of hearing loss onset. RESULTS 14.8% of patients with sleep disordered breathing had hearing loss. Hearing loss was associated with an increased risk of undergoing adenotonsillectomy (OR 1.632 [1.294-2.058], p < 0.001, adjusted for age). In patients who underwent polysomnographic testing, 9.8% patients had pre-existing hearing loss and 12% patients developed hearing loss over the study period. Patients with pre-existing hearing loss and those who developed hearing loss had significantly more visits with otolaryngology compared to controls (p < 0.001). Hearing loss did not significantly delay adenotonsillectomy. More patients who developed hearing loss had adenotonsillectomies (OR 2.475 [1.672-3.663], p < 0.001, adjusted for age) versus controls. This difference was not identified in patients with pre-existing hearing loss. CONCLUSION Patients with evidence of hearing loss in addition to sleep disordered breathing had more adenotonsillectomies performed and more clinic visits. Further work must be done to understand the associations and implications of hearing loss in this population.
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Affiliation(s)
- Ajay S Nathan
- Boston University School of Medicine, Boston, MA, USA
| | - Richard D Hubbell
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, IA, USA
| | - Jessica R Levi
- Boston University School of Medicine, Boston, MA, USA; Department of Otolaryngology/Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
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Manayan RC, Ladd-Luthringshauser OH, Packer A, Tribulski K, Winans A, Vecchiotti MA, Scott AR. Ambient noise limits efficacy of smartphone-based screening for hearing loss in children at risk. Am J Otolaryngol 2022; 43:103223. [PMID: 34560596 DOI: 10.1016/j.amjoto.2021.103223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/06/2021] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To determine if hearScreen®, a smartphone-based pure tone audiometric screen, serves as an effective hearing screen for identifying hearing loss in children at risk, such as those with chronic otitis media and/or craniofacial anomalies. METHODS A cross-sectional, single-center, prospective study at an urban tertiary care hospital was completed. From June to October 2019, a total of 208 pediatric ears at risk for hearing loss were evaluated by both hearScreen® and conventional pure tone audiometry. The efficacy of hearScreen® for detecting hearing loss in a pediatric population at risk was determined. RESULTS A total of 208 pediatric ears at risk for hearing loss were screened. HearScreen® demonstrated a sensitivity of 85%, a specificity of 41%, a positive predictive value of 36%, and a negative predictive value of 87%. Subgroup analysis stratified by hearing loss type showed that hearScreen® screens for conductive hearing loss with increased sensitivity. CONCLUSIONS This investigation suggests that hearScreen® may serve as a an accessible, low-cost, and sensitive pure tone audiometric screen for hearing loss in children at risk, particularly those with conductive hearing loss, with the caveat that it may generate a high proportion of false positives due to the influence of ambient noise, especially when screening at 500 Hz. Future investigations should weigh the utility of including 500 Hz in the screening protocol as well as assess methods that may mitigate the influence of ambient noise during a pure-tone audiometric screen.
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Al-Shehri AM, Al-Zomia AS, Alayash AF, M Al Hunaif A, A Mansour A, Alqahtani M, A Asiri O, A Alserhan S. Association Between Acute Otitis Media and Inner Ear Disorders Among Adults in Aseer Region. Cureus 2021; 13:e19556. [PMID: 34926038 PMCID: PMC8671081 DOI: 10.7759/cureus.19556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Acute otitis media (AOM) is an infection of the middle ear that produces pain, fever, and discharge, as well as hearing loss. It is one of the most common problems that pediatricians encounter. Almost 80% of children have had at least one episode of AOM, and between 80% and 90% have had at least one episode of otitis media with effusion before entering school. Methods The cross-sectional study is conducted among male and female patients, adults, and children who visited two of the largest government hospitals in the Aseer region in Southern Saudi Arabia (Aseer Central Hospital and Khamis Mushait General Hospital). The children and adults with AOM who visited the hospitals were traced by searching the medical record system by the keyword "acute otitis media." Two authors extracted data from the medical record and patients. After extracting data, the patient will be called through mobile phone to invite them to participate in the study. If the patient agrees to participate, she/he would be sent through email link containing an encrypted and high-security electronic signature to obtain his/her consent. Conclusion One of the most common pediatric infections is otitis media (inflammation of the middle ear). Children are more often than adults to get otitis media, and the majority of cases are treated with antibiotics. Clinicians commonly miss the acute stage of the disease, especially in children under the age of five. Delay or omission of diagnoses leads to inefficient management and an increased risk of negative effects.
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Affiliation(s)
| | - Ahmed S Al-Zomia
- Surgery, College of Medicine, King Khalid University (KKU), Abha, SAU
| | - Ahmed F Alayash
- Surgery, College of Medicine, King Khalid University (KKU), Abha, SAU
| | | | | | - Mushary Alqahtani
- Medicine, College of Medicine, King Khalid University (KKU), Abha, SAU
| | - Omar A Asiri
- ENT, College of Medicine, King Khalid University (KKU), Abha, SAU
| | - Saeed A Alserhan
- ENT, College of Medicine, King Khalid University (KKU), Abha, SAU
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Elzinga HBE, van Oorschot HD, Stegeman I, Smit AL. Relation between otitis media and sensorineural hearing loss: a systematic review. BMJ Open 2021; 11:e050108. [PMID: 34385254 PMCID: PMC8362691 DOI: 10.1136/bmjopen-2021-050108] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 07/26/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES This systematic review summarises the evidence on the correlation between recurrent acute otitis media (rAOM) or chronic suppurative otitis media (CSOM) and sensorineural hearing loss (SNHL). RESEARCH METHODS PubMed, Embase and Cochrane Library databases were searched from inception to 15 January 2021. Two authors independently identified articles, extracted data and performed quality assessment for included studies. Studies comparing the sensorineural hearing levels of patients with a history of rAOM/CSOM for >3 months to a control group were included. RESULTS Screening of 4168 articles lead to inclusion of two case-control studies (control-group: patients non-OM) and seven cohort-studies (control group: contralateral ear). Quality assessment indicated considerable risk of bias in all studies. Reported populations varied (sample size 13-607, mean age 22-41.5 years, mean duration of disease 6.1-12.4 years). The OR for SNHL in the OM-group was 3.30-7.86 (95% CI 1.16 to 9.40, p<0.05) in cohort studies (n=2), and 0.05 (95% CI 0 to 0.78, p<0.05) in a case-control study. Mean/median bone conduction thresholds were respectively 1.19-32.21/0-10 dB higher on all frequencies (0.5-4 kHz) for the OM-group in four cohort studies (p<0.05). Two other studies reported no statistical test outcomes. CONCLUSION Due to the high risk of bias of included studies, effect estimates heterogeneity and suboptimal research designs, no conclusion on the correlation between OM and SNHL can be made. It emphasises the need for future prognostic studies.
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Affiliation(s)
| | | | - Inge Stegeman
- Department of Otorhinolaryngology, Head and Neck Surgery, UMC Utrecht, Utrecht, The Netherlands
- Department of Translational Neuroscience, UMC Utrecht Brain Center, Utrecht, The Netherlands
| | - Adriana L Smit
- Department of Otorhinolaryngology, Head and Neck Surgery, UMC Utrecht, Utrecht, The Netherlands
- Department of Translational Neuroscience, UMC Utrecht Brain Center, Utrecht, The Netherlands
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Okada M, Welling DB, Liberman MC, Maison SF. Chronic Conductive Hearing Loss Is Associated With Speech Intelligibility Deficits in Patients With Normal Bone Conduction Thresholds. Ear Hear 2021; 41:500-507. [PMID: 31490800 PMCID: PMC7056594 DOI: 10.1097/aud.0000000000000787] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The main objective of this study is to determine whether chronic sound deprivation leads to poorer speech discrimination in humans. DESIGN We reviewed the audiologic profile of 240 patients presenting normal and symmetrical bone conduction thresholds bilaterally, associated with either an acute or chronic unilateral conductive hearing loss of different etiologies. RESULTS Patients with chronic conductive impairment and a moderate, to moderately severe, hearing loss had lower speech recognition scores on the side of the pathology when compared with the healthy side. The degree of impairment was significantly correlated with the speech recognition performance, particularly in patients with a congenital malformation. Speech recognition scores were not significantly altered when the conductive impairment was acute or mild. CONCLUSIONS This retrospective study shows that chronic conductive hearing loss was associated with speech intelligibility deficits in patients with normal bone conduction thresholds. These results are as predicted by a recent animal study showing that prolonged, adult-onset conductive hearing loss causes cochlear synaptopathy.
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Affiliation(s)
- Masahiro Okada
- Department of Otolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Toon Ehime, Japan
- Department of Otolaryngology, Harvard Medical School and Eaton-Peabody Laboratories, Massachusetts Eye & Ear Infirmary, Boston, USA
| | - D. Bradley Welling
- Department of Otolaryngology, Harvard Medical School and Eaton-Peabody Laboratories, Massachusetts Eye & Ear Infirmary, Boston, USA
| | - M. Charles Liberman
- Department of Otolaryngology, Harvard Medical School and Eaton-Peabody Laboratories, Massachusetts Eye & Ear Infirmary, Boston, USA
| | - Stéphane F. Maison
- Department of Otolaryngology, Harvard Medical School and Eaton-Peabody Laboratories, Massachusetts Eye & Ear Infirmary, Boston, USA
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Monsanto RDC, Kasemodel ALP, Tomaz A, Elias TGA, Paparella MM, Penido NDO. Evaluation of vestibular symptoms and postural balance control in patients with chronic otitis media. J Vestib Res 2021; 30:35-45. [PMID: 32083607 DOI: 10.3233/ves-200691] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Evidence to support potential links between chronic otitis media (COM) and vestibular impairment/postural balance control issues is lacking. OBJECTIVE To investigate whether COM associates with vestibular symptoms, balance problems, and abnormalities in vestibular function tests. METHODS We selected 126 patients with COM and excluded patients with any identifiable underlying causes for vestibular dysfunction. Fifty-two healthy volunteers were included as controls. All subjects underwent anamnesis, physical examination, posturography, and video-head impulse tests. RESULTS We found a high prevalence of vestibular symptoms (58.4%) among patients with COM, while only 2% of the controls had vestibular symptoms. There was a positive correlation between COM activity with the presence of tinnitus and vestibular symptoms (P < 0.05). Clinical vestibular tests were abnormal in 63% of patients with COM, and those positively associated with presence of vestibular symptoms. Posturography results shown worse postural balance control in patients with COM as compared with controls, especially in the limit of stability (LOS) (Mean LOS, COM = 157.56 cm2; controls = 228.98 cm2; p < 0.001) and worse results in the test with eyes closed while standing on a foam mattress (sway area, COM = 10.91 cm2; controls = 5.90 cm2; p < 0.001) in patients with COM as compared with controls. We did not observe differences in the average vestibuloocular reflex gains in the video-head impulse test between our COM and control groups. CONCLUSIONS Our results show that COM associates with higher prevalence of vestibular symptoms and abnormalities in clinical vestibular function tests, and worse postural control as compared with controls. Among patients with COM, the activity of the middle-ear inflammation seemed to positively associate with the severity of hearing and balance problems.
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Affiliation(s)
- Rafael da Costa Monsanto
- Department of Otolaryngology, Head & Neck Surgery, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM) (São Paulo, SP, Brazil).,Department of Otolaryngology Head & Neck Surgery, University of Minnesota (Minnesota, MN, USA)
| | - Ana Luiza Papi Kasemodel
- Department of Otolaryngology, Head & Neck Surgery, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM) (São Paulo, SP, Brazil)
| | - Andreza Tomaz
- Department of Otolaryngology, Head & Neck Surgery, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM) (São Paulo, SP, Brazil)
| | - Thais Gomes Abrahão Elias
- Department of Otolaryngology, Head & Neck Surgery, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM) (São Paulo, SP, Brazil)
| | - Michael Mauro Paparella
- Department of Otolaryngology Head & Neck Surgery, University of Minnesota (Minnesota, MN, USA).,Paparella Ear Head & Neck Institute (Minnesota, MN, USA)
| | - Norma de Oliveira Penido
- Department of Otolaryngology, Head & Neck Surgery, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM) (São Paulo, SP, Brazil)
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Eroglu S, Cevizci R, Turan Dizdar H, Tansuker HD, Bulut E, Dilci A, Ustun S, Sirvanci S, Kaya OT, Bayazit D, Cakir BO, Oktay MF, Bayazit YA. Association of Conductive Hearing Loss with the Structural Changes in the Organ of Corti. ORL J Otorhinolaryngol Relat Spec 2021; 83:272-279. [PMID: 33784680 DOI: 10.1159/000513871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 12/17/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate the association of conductive hearing loss (CHL) with the structural changes in the organ of Corti. METHODS Twenty ears of 10 healthy adult Wistar albino rats were included in the study. The right ears (n = 10) of the animals served as controls (group 1), and no surgical intervention was performed in these ears. A tympanic membrane perforation without annulus removal was performed under operative microscope on the left ears (n = 5) in 5 of 10 animals (group 2). A tympanic membrane perforation with annulus removal was performed under operative microscope on the left ears (n = 5) of the remaining 5 animals (group 3). Auditory brainstem response testing was performed in the animals before the interventions. After 3 months, the animals were sacrificed, their temporal bones were removed, and inner ears were investigated using scanning electron microscopy (SEM). The organ of Corti was evaluated from the cochlear base to apex in the modiolar axis, and the parameters were scored semiquantitatively. RESULTS In group 1, the pre- and post-intervention hearing thresholds were similar (p > 0.05). In group 2, a hearing decrease of at least 5 dB was encountered in all test frequencies (p > 0.05). In group 3, at the frequency range of 2-32 kHz, there was a significant hearing loss after 3 months (p < 0.01). After 3 months, the hearing thresholds in group 2 and 3 were higher than group 1 (p < 0.01). The hearing threshold in group 3 was higher than group 2 (p < 0.01). On SEM evaluation, the general cell morphology and stereocilia of the outer hair cells were preserved in all segments of the cochlea in group 1 with a mean SEM score of 0.2. There was segmental degeneration in the general cell morphology and outer hair cells in group 2 with a mean SEM score of 2.2. There was widespread degeneration in the general cell morphology and outer hair cells in group 3 with a mean SEM score of 3.2. The SEM scores of group 2 and 3 were significantly higher than group 1 (p < 0.05). The SEM scores of group 3 were significantly higher than group 2 (p < 0.05). CONCLUSION CHL may be associated with an inner ear damage. The severity of damage appears to be associated with severity and duration of CHL. Early correction of CHL is advocated in order to reverse or prevent progression of the inner ear damage, which will enhance the success rates of hearing restoration surgeries. Subjective differences and compliance of the hearing aid users may be due to the impact of CHL on inner ear structures.
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Affiliation(s)
- Sinan Eroglu
- Department of Otolaryngology, Istanbul Bahcelievler State Hospital, Istanbul, Turkey
| | - Rasit Cevizci
- Department of Otolaryngology, Faculty of Medicine, Beykent University, Istanbul, Turkey
| | | | - Hasan Deniz Tansuker
- Department of Otolaryngology, University of Health Sciences Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Erdogan Bulut
- Department of Otolarygology, University of Miami Ear Institute, Miami, Florida, USA
| | - Alper Dilci
- Department of Otolarygology, Osmaniye State Hospital, Osmaniye, Turkey
| | - Selin Ustun
- Department of Otolaryngology, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Serap Sirvanci
- Department of Histology & Embryology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Ozlem Tugce Kaya
- Department of Histology & Embryology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Dilara Bayazit
- Department of Audiology, Istanbul Medipol University, Istanbul, Turkey
| | - Burak Omur Cakir
- Department of Otolaryngology, Faculty of Medicine, Beykent University, Istanbul, Turkey
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Keskin Yılmaz N, Albasan H, Börkü MK, Paparella MM, Cüreoğlu S. Three-Dimensional Analysis of Round Window Membrane in the Chinchilla Model with Acute Otitis Media Induced with Streptococcus Pneumoniae 7F. Turk Arch Otorhinolaryngol 2021; 59:43-48. [PMID: 33912860 PMCID: PMC8054926 DOI: 10.4274/tao.2021.5998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 01/23/2021] [Indexed: 12/01/2022] Open
Abstract
Objective: The purpose of this study was to investigate the morphological changes of round window membrane (RWM) in chinchillas with Streptococcus pneumoniae (S. pneumoniae) serotype 7F induced acute otitis media (AOM) by two dimensional (2D) and three dimensional (3D) measurements. Methods: Temporal bone specimens taken from 12 chinchillas were divided into two groups. The control group consisted of healthy animals that were injected with intrabullar saline. The subjects in the experimental group were induced with AOM by intrabullar injection of S. pneumoniae 7F. The 2D and 3D measurements of RWM were compared between the groups. Results: Dramatic changes were noted in the RWM of the experimental group compared to the control group. The thickness [mean ± standard deviation (SD)] of the RWM was significantly (p<0.05) increased in the experimental group compared to the control group by 2D measurements taken at three different points of RWM. Moreover, 3D measurements revealed that the volume (mean ± SD) of RWM was significantly (p=0.009) increased in the experimental group. Conclusion: The results of our study, which indicated significant change in RWM in both 2D and 3D measurements, may shed light on the relationship between AOM and inner ear diseases. Based on our results, we recommend evaluating 3D analyses of RWM, which provide useful data, to better understand the changes in the membrane.
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Affiliation(s)
- Nevra Keskin Yılmaz
- Department of Internal Medicine, Ankara University, Faculty of Veterinary Medicine, Ankara, Turkey.,Department of Otorhinolaryngology, Head and Neck Surgery, University of Minnesota Medical School, Minneapolis/Minnesota, USA
| | - Hasan Albasan
- Pet Depot Veterinary Group, La Verne, California, USA
| | - Mehmet Kazım Börkü
- Department of Internal Medicine, Ankara University, Faculty of Veterinary Medicine, Ankara, Turkey
| | - Michael Mauro Paparella
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Minnesota Medical School, Minneapolis/Minnesota, USA
| | - Sebahattin Cüreoğlu
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Minnesota Medical School, Minneapolis/Minnesota, USA
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Thielker J, Heuschkel A, Boeger D, Buentzel J, Esser D, Hoffmann K, Jecker P, Mueller A, Radtke G, Guntinas-Lichius O. Patients with non-idiopathic sudden sensorineural hearing loss show hearing improvement more often than patients with idiopathic sudden sensorineural hearing loss. Eur Arch Otorhinolaryngol 2021; 279:663-675. [PMID: 33683448 PMCID: PMC8794920 DOI: 10.1007/s00405-021-06691-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 02/08/2021] [Indexed: 11/27/2022]
Abstract
Introduction To compare inpatient treated patients with idiopathic (ISSNHL) and non-idiopathic sudden sensorineural hearing loss (NISSNHL) regarding frequency, hearing loss, treatment and outcome. Methods All 574 inpatient patients (51% male, median age: 60 years) with ISSNHL and NISSNHL, who were treated in federal state Thuringia in 2011 and 2012, were included retrospectively. Univariate and multivariate statistical analyses were performed. Results ISSNHL was diagnosed in 490 patients (85%), NISSNHL in 84 patients (15%). 49% of these cases had hearing loss due to acute otitis media, 37% through varicella-zoster infection or Lyme disease, 10% through Menière disease and 7% due to other reasons. Patients with ISSNHL and NISSNHL showed no difference between age, gender, side of hearing loss, presence of tinnitus or vertigo and their comorbidities. 45% of patients with ISSNHL and 62% with NISSNHL had an outpatient treatment prior to inpatient treatment (p < 0.001). The mean interval between onset of hearing loss to inpatient treatment was shorter in ISSNHL (7.7 days) than in NISSNHL (8.9 days; p = 0.02). The initial hearing loss of the three most affected frequencies in pure-tone average (3PTAmax) scaled 72.9 dBHL ± 31.3 dBHL in ISSNHL and 67.4 dBHL ± 30.5 dBHL in NISSNHL. In the case of acute otitis media, 3PTAmax (59.7 dBHL ± 24.6 dBHL) was lower than in the case of varicella-zoster infection or Lyme disease (80.11 dBHL ± 34.19 dBHL; p = 0.015). Mean absolute hearing gain (Δ3PTAmaxabs) was 8.1 dB ± 18.8 dB in patients with ISSNHL, and not different in NISSNHL patients with 10.2 dB ± 17.6 dB. A Δ3PTAmaxabs ≥ 10 dB was reached in 34.3% of the patients with ISSNHL and to a significantly higher rate of 48.8% in NISSNHL patients (p = 0.011). Conclusions ISSNHL and NISSNHL show no relevant baseline differences. ISSNHL tends to have a higher initial hearing loss. NISSHNL shows a better outcome than ISSNHL. Supplementary Information The online version contains supplementary material available at 10.1007/s00405-021-06691-y.
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Affiliation(s)
- Jovanna Thielker
- Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Anne Heuschkel
- Department of Otorhinolaryngology, HELIOS-Klinikum, Erfurt, Germany
| | - Daniel Boeger
- Department of Otorhinolaryngology, Zentralklinikum, Suhl, Germany
| | - Jens Buentzel
- Department of Otorhinolaryngology, Südharz-Krankenhaus gGmbH, Nordhausen, Germany
| | - Dirk Esser
- Department of Otorhinolaryngology, HELIOS-Klinikum, Erfurt, Germany
| | - Kerstin Hoffmann
- Department of Otorhinolaryngology, Sophien/Hufeland-Klinikum, Weimar, Germany
| | - Peter Jecker
- Department of Otorhinolaryngology, Klinikum Bad Salzungen, Bad Salzungen, Germany
| | - Andreas Mueller
- Department of Otorhinolaryngology, SRH Wald-Klinikum, Gera, Germany
| | - Gerald Radtke
- Department of Otorhinolaryngology, Ilm-Kreis-Kliniken, Arnstadt, Germany
| | - Orlando Guntinas-Lichius
- Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
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Kasemodel ALP, Costa LEM, Monsanto RDC, Tomaz A, Penido NDO. Sensorineural hearing loss in the acute phase of a single episode of acute otitis media. Braz J Otorhinolaryngol 2020; 86:767-773. [PMID: 31324458 PMCID: PMC9422693 DOI: 10.1016/j.bjorl.2019.06.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 05/17/2019] [Accepted: 06/06/2019] [Indexed: 02/06/2023] Open
Abstract
Introduction Acute otitis media is a disease with high global prevalence, that can lead to several acute complications and auditory sequelae. Data regarding the auditory evaluation in the acute phase of acute otitis media are scarce. Objective To evaluate the main audiometric changes (air and bone conduction thresholds) in the initial phase of an acute otitis media episode. Methods A case-control study was performed. Patients diagnosed with acute otitis media with less than 7 days of evolution in relation to the complaint onset were selected, and healthy volunteers were selected as controls. The acute otitis media and control groups were submitted to pure tone and vocal audiometry. Results The acute otitis media group included a total of 27 patients (30 ears). Hearing loss was present in 90.0% of the ears with acute otitis media, with conductive loss in 14 (46.67%) and mixed loss in 13 (43.33%). Both the air and bone conduction thresholds obtained with the tonal audiometry in the acute otitis media group were significantly worse than the controls at all tested frequencies (p < 0.05). In patients with acute otitis media, we observed that the thresholds for frequency >1 kHz (bone conduction) and 3 kHz (air conduction) were significantly worse in patients with tinnitus compared to patients without tinnitus. Conclusion During the first 7 days of evolution after the onset of an isolated episode of acute otitis media, we observed significant increases in bone and air thresholds at all frequencies, especially >2 kHz, compared to healthy ears.
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16
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Rajput MSEA, Rajput MSA, Arain AA, Zaidi SS, Hatem A, Akram S. Mucosal Type of Chronic Suppurative Otitis Media and the Long-Term Impact on Hearing Loss. Cureus 2020; 12:e10176. [PMID: 33029456 PMCID: PMC7529491 DOI: 10.7759/cureus.10176] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction Worldwide the chronic suppurative otitis media (CSOM) is one of the most common infectious diseases in childhood and is a common cause of impaired hearing. The disease remains a challenging entity for the healthcare system of resource-limited nations despite the advances in modern medicine. The nature of hearing loss in CSOM is mainly conductive, the sensorineural hearing loss (SNHL) is also reported in such patients. The purpose of the study was to identify SNHL in patients with the mucosal type of CSOM and to find the impact of long-term discharging ears on bone conduction (BC) thresholds. Methods Patients with a diagnosis of the mucosal type of CSOM were identified from the record of ENT, Head and Neck Surgery clinic between January 2019 and January 2020. The patients were divided into three groups based on the duration of the disease: groups I, II, and III for 1-5 years, 5-10 years, and 10-15 years, respectively. Pure tone audiogram was reviewed, and data of BC was recorded for 500, 1000, and 2000 Hz. The descriptive frequency was calculated for SNHL in each group and group I was compared with other groups using a chi-square test. The mean BC threshold of group I was compared with other groups using a t-test. SPSS version 26 (IBM Corp., Armonk, New York) was used for statistical analysis. Results A total of 154 patients were included in the study. There were 73 males and 81 females. The mean age was 26 years. The minimum age was 12 years and the maximum age was 58 years. Active ear discharge was the presenting complaint in 84 patients. The right ear was involved in 88 patients, and the left ear was involved in 66 patients. SNHL was present in 30 out of 154 patients, i.e., 19.5%. The number of patients in each of the groups I, II, and III was 95, 28, and 31, respectively. The group I was compared with group II using the chi-square test, the p-value was found not significant, i.e., >0.05. The group I was then compared with group III using the same statistical test, and the p-value was found significant, i.e., <0.05. The mean BC threshold for an average of three speech frequencies for each of the three groups was 16.9, 18.7, and 22.9, respectively. The mean BC threshold of group I was compared with that of group II using a t-test, and the p-value was found not significant, i.e., >0.05. The mean BC threshold of group I was then compared with that of group III using a t-test, and the p-value was found significant, i.e., <0.05. Conclusions The findings of our study reproduce the presence of SNHL in a sizable proportion of the patients with a mucosal type of CSOM. Furthermore, the elevation of the BC threshold also appears statistically significant on analysis in association with the protracted duration of CSOM, highlighting the adverse impact of delaying the surgical repair. However, the clinical importance remains unclear because the maximum losses in the BC threshold seen in the patients are not severe enough to necessarily make them hard of hearing. Nevertheless, these statistically significant results influence clinical thought process and measures for an early remedy, including surgery, and need to be considered in time to prevent progressively worsening hearing loss in such cases.
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Affiliation(s)
| | - Muhammad Shaheryar Ahmed Rajput
- Otolaryngology and Head & Neck Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, PAK.,Otolaryngology and Head & Neck Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU.,Otolaryngology and Head & Neck Surgery, Aga Khan University Hospital, Karachi, PAK
| | - Asif Ali Arain
- Otolaryngology and Head & Neck Surgery, The Indus Hospital, Karachi, PAK
| | - Syed S Zaidi
- Otolaryngology and Head & Neck Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
| | - Ahmad Hatem
- Otolaryngology and Head & Neck Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
| | - Saeed Akram
- Internal Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
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Boron A, Skladzien J, Wiatr M. Pre- and Post-operative Speech Audiometry Evaluation in Patients with Chronic Otitis Media. J Int Adv Otol 2020; 16:241-247. [PMID: 32784163 DOI: 10.5152/iao.2020.8150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The primary function of the human auditory system is to ensure proper speech comprehension. Speech audiometry enables the assessment of the conductive and the sensory aspects of the ears, providing some insight into the central auditory processing function. MATERIALS AND METHODS We conducted an analysis of 79 patients with chronic otitis media (COM) undergoing surgery at the Department of Otolaryngology, Jagiellonian University Medical College, in Kraków between 2005 and 2014. Tonal audiometry and speech audiometry were used as part of the hearing assessment. The pre-operative and long-term post-operative findings were compared, focusing mainly on speech audiometry. RESULTS At the end of the mean 10-year follow-up, a significant percentage worsening in speech comprehension from the baseline was demonstrated in group III (hearing loss > 70 dB(decibels)), as compared with the remaining groups. There was a significant (p = 0.017) difference in speech comprehension between the treated and contralateral ears, with the mean maximum speech comprehension rates of 80% in the treated ear versus 92% in the contralateral ear. CONCLUSION We demonstrated a correlation between the findings of tonal audiometry and speech audiometry. The severe damage caused by chronic middle ear diseases not only leads to conductive hearing loss but also acts as a significant contributor to poor speech comprehension in a long-term follow-up. The speech comprehension in a healthy ear is significantly better than in a diseased ear. Middle ear reconstructive surgery offers the maximum improvement in speech comprehension at the hearing loss of 41 to 70 dB in speech audiometry.
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Affiliation(s)
- Aleksandra Boron
- Department of Otolaryngology, Jagiellonian University Medical College in Kraków, Poland
| | - Jacek Skladzien
- Department of Otolaryngology, Jagiellonian University Medical College in Kraków, Poland
| | - Maciek Wiatr
- Department of Otolaryngology, Jagiellonian University Medical College in Kraków, Poland
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Abstract
OBJECTIVES This study tested the hypothesis that undetected peripheral hearing impairment occurs in children with idiopathic listening difficulties (LiDs), as reported by caregivers using the Evaluation of Children"s Listening and Processing Skills (ECLiPS) validated questionnaire, compared with children with typically developed (TD) listening abilities. DESIGN Children with LiD aged 6-14 years old (n = 60, mean age = 9.9 yr) and 54 typical age matched children were recruited from audiology clinical records and from IRB-approved advertisements at hospital locations and in the local and regional areas. Both groups completed standard and extended high-frequency (EHF) pure-tone audiometry, wideband absorbance tympanometry and middle ear muscle reflexes, distortion product and chirp transient evoked otoacoustic emissions. Univariate and multivariate mixed models and multiple regression analysis were used to examine group differences and continuous performance, as well as the influence of demographic factors and pressure equalization (PE) tube history. RESULTS There were no significant group differences between the LiD and TD groups for any of the auditory measures tested. However, analyses across all children showed that EHF hearing thresholds, wideband tympanometry, contralateral middle ear muscle reflexes, distortion product, and transient-evoked otoacoustic emissions were related to a history of PE tube surgery. The physiologic measures were also associated with EHF hearing loss, secondary to PE tube history. CONCLUSIONS Overall, the results of this study in a sample of children with validated LiD compared with a TD group matched for age and sex showed no significant differences in peripheral function using highly sensitive auditory measures. Histories of PE tube surgery were significantly related to EHF hearing and to a range of physiologic measures in the combined sample.
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19
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Seidel DU, Bode S, Kostev K, Park JJH. Incidence of Inner Ear Disorders in Various Forms of Acute Otitis Media in ENT Practices in Germany. EAR, NOSE & THROAT JOURNAL 2020; 100:325S-332S. [PMID: 32579395 DOI: 10.1177/0145561320930568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The aim of this study was to determine the incidence of inner ear involvement in various forms of acute otitis media (AOM) in ear, nose, and throat (ENT) practices in Germany. METHODS Patients who had been diagnosed with various forms of AOM in the years 2010 to 2017 were enrolled in the study from a nationwide, representative practice database (Disease Analyzer, IQVIA). In these patients, the incidence of simultaneous or subsequent inner ear disorders (IED) was determined within 7 days and within 12 months from the date of an AOM diagnosis. RESULTS A total of 286 186 patients with AOM were enrolled. The most frequent diagnoses were "nonsuppurative otitis media, unspecified" (47.6%) and "otitis media, unspecified" (39.0%). The diagnoses of hemorrhagic bullous myringitis (BM) or influenza-induced AOM were very rarely found in the database. The highest incidence of IED after 7 days and 12 months was found in "nonsuppurative otitis media, unspecified" (7.7% and 15.9%, respectively), followed by "otitis media, unspecified" (5.6% and 13.5%, respectively). The incidences of the most frequent IED "hearing loss, unspecified" and "sensorineural hearing loss, unspecified" increased proportionally with increasing patient age, while the rare diagnoses of "labyrinthitis" and "ototoxic hearing loss" were evenly distributed among the age groups. CONCLUSION In ENT practices in Germany, both various forms of AOM, as well as simultaneous or subsequent IED, are mostly being coded in an unspecific way, while specific forms such as hemorrhagic BM, influenza-induced AOM, and labyrinthitis are coded very rarely. Older patients have a higher risk of IED in AOM. A visit due to AOM seems to be a regular occasion for the initial diagnosis of hearing impairment in the elderly individuals. The highest risk of IED was found in nonsuppurative AOM.
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Affiliation(s)
- David Ulrich Seidel
- Medical Center of Otorhinolaryngology and Facial Plastic Surgery, Rheinland Klinikum Dormagen, Dormagen, Germany
| | - Simon Bode
- Medical Center of Otorhinolaryngology and Facial Plastic Surgery, Rheinland Klinikum Dormagen, Dormagen, Germany
| | | | - Jonas Jae-Hyun Park
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Witten/Herdecke, 39778Catholic Hospital Hagen gGmbH, Hagen, Germany
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20
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Baisakhiya N, Singh G. Study the Effect of Tubotympanic Disease on Bone Conduction Threshold. Indian J Otolaryngol Head Neck Surg 2019; 71:1357-1363. [DOI: 10.1007/s12070-018-1424-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 06/04/2018] [Indexed: 11/28/2022] Open
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21
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Rana AK, Singh R, Upadhyay D, Prasad S. Chronic Otitis Media and its Correlation with Unilateral Sensorineural Hearing Loss in a Tertiary Care Centre of North India. Indian J Otolaryngol Head Neck Surg 2019; 71:1580-1585. [PMID: 31750220 DOI: 10.1007/s12070-019-01671-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 05/03/2019] [Indexed: 11/24/2022] Open
Abstract
Relation between chronic otitis media and sensorineural hearing loss is controversial. Otitis media can cause threshold shift in high frequency range. Also this correlation with patient's age, disease duration and normal ear is of importance for early prevention of hearing loss. The aim of this study was to evaluate relationship between sensorineural hearing loss and chronic otitis media. We also studied association of bone conduction between diseased ear and contralateral normal ear. In this study, 840 patients of unilateral COM were included. Audiometry was done and data analyzed. Majority of patients showing SNHL had COM for over a period of 5 years. Squamosal disease showed early progression to SNHL than mucosal disease. Higher frequencies were found to be more affected and maximum bone gap was seen at 4000 Hz. There was significant difference in mean bone conduction threshold between diseased ear and normal ear at all frequencies (p value < 0.001). Contradicting studies have emerged about association of SNHL with COM. Studies suggest that SNHL does not change with age but with duration. Bone conduction threshold tends to increase with increasing frequency. Few authors also pointed that this may be due to Carhart's effect and not due to disease damaging inner ear.
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Affiliation(s)
- Amit Kumar Rana
- Department of Otorhinolaryngology and Head Neck Surgery, SRMS Institute of Medical Sciences, Bhojipura, Bareilly, 243202 Uttar Pradesh India
| | - Rachana Singh
- 2Department of Otorhinolaryngology, Apollo Hospital, Jasola, New Delhi, India
| | - Deepak Upadhyay
- 3Department of Community Medicine, Rohilkhand Medical College and Hospital, Bareilly, UP India
| | - Surendra Prasad
- Department of Otorhinolaryngology, National Medical College, Birgunj, Nepal
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Cordeiro FP, da Costa Monsanto R, Kasemodel ALP, de Almeida Gondra L, de Oliveira Penido N. Extended high-frequency hearing loss following the first episode of otitis media. Laryngoscope 2018; 128:2879-2884. [DOI: 10.1002/lary.27309] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 04/18/2018] [Accepted: 05/03/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Francisco Polanski Cordeiro
- Department of Otolaryngology-Head and Neck Surgery; Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM); São Paulo Brazil
| | - Rafael da Costa Monsanto
- Department of Otolaryngology-Head and Neck Surgery; Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM); São Paulo Brazil
| | - Ana Luiza Papi Kasemodel
- Department of Otolaryngology-Head and Neck Surgery; Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM); São Paulo Brazil
| | - Luiza de Almeida Gondra
- Department of Otolaryngology-Head and Neck Surgery; Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM); São Paulo Brazil
| | - Norma de Oliveira Penido
- Department of Otolaryngology-Head and Neck Surgery; Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM); São Paulo Brazil
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23
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Monsanto RDC, Schachern P, Paparella MM, Cureoglu S, Penido NDO. Progression of changes in the sensorial elements of the cochlear and peripheral vestibular systems: The otitis media continuum. Hear Res 2017; 351:2-10. [PMID: 28578877 DOI: 10.1016/j.heares.2017.05.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 04/10/2017] [Accepted: 05/03/2017] [Indexed: 12/16/2022]
Abstract
Our study aimed to evaluate pathologic changes in the cochlear (inner and outer hair cells and stria vascularis) and vestibular (vestibular hair cells, dark, and transitional cells) sensorial elements in temporal bones from donors who had otitis media. We studied 40 temporal bones from such donors, which were categorized in serous otitis media (SOM), serous-purulent otitis media (SPOM), mucoid/mucoid-purulent otitis media (MOM/MPOM), and chronic otitis media (COM); control group comprised 10 nondiseased temporal bones. We found significant loss of inner and outer cochlear hair cells in the basal turn of the SPOM, MOM/MPOM and COM groups; significant loss of vestibular hair cells was observed in the MOM/MPOM and COM groups. All otitis media groups had smaller mean area of the stria vascularis in the basal turn of the cochlea when compared to controls. In conclusion, our study demonstrated more severe pathologic changes in the later stages of the continuum of otitis media (MOM/MPOM and COM). Those changes seem to progress from the basal turn of the cochlea (stria vascularis, then inner and outer hair cells) to the middle turn of the cochlea and to the saccule and utricle in the MOM/MPOM and COM stages.
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Affiliation(s)
- Rafael da Costa Monsanto
- Department of Otolaryngology, University of Minnesota, 2001 6th St. SE, Lions Research Building, Room 210, Otopathology Laboratory, Minneapolis, MN 55455, USA; Department of Otorhinolaryngology Head and Neck Surgery, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Rua dos Otonis, 700 - Piso Superior - Vila Clementino, São Paulo, SP 04025 002, Brazil
| | - Patricia Schachern
- Department of Otolaryngology, University of Minnesota, 2001 6th St. SE, Lions Research Building, Room 210, Otopathology Laboratory, Minneapolis, MN 55455, USA
| | - Michael M Paparella
- Department of Otolaryngology, University of Minnesota, 2001 6th St. SE, Lions Research Building, Room 210, Otopathology Laboratory, Minneapolis, MN 55455, USA
| | - Sebahattin Cureoglu
- Department of Otolaryngology, University of Minnesota, 2001 6th St. SE, Lions Research Building, Room 210, Otopathology Laboratory, Minneapolis, MN 55455, USA.
| | - Norma de Oliveira Penido
- Department of Otorhinolaryngology Head and Neck Surgery, Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Rua dos Otonis, 700 - Piso Superior - Vila Clementino, São Paulo, SP 04025 002, Brazil
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Lee HS, Hong SD, Hong SH, Cho YS, Chung WH. Ossicular chain reconstruction improves bone conduction threshold in chronic otitis media. The Journal of Laryngology & Otology 2017; 122:351-6. [PMID: 17623495 DOI: 10.1017/s0022215107009474] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractThis study aimed to assess the elevation of bone conduction threshold in patients with chronic otitis media and to investigate the mechanism of this phenomenon. One hundred and six patients with unilateral chronic otitis media who had undergone a tympanomastoidectomy were reviewed retrospectively. The differences in the bone conduction thresholds between the diseased and normal sides were assessed and compared according to the duration of the disease and the presence of cholesteatoma. Post-operative changes in the bone conduction threshold were also assessed. The mean bone conduction thresholds were significantly elevated on the diseased side, ranging from 3.4 to 11.6 dB across frequencies, with a maximal elevation at 2000 Hz. The duration of disease and the presence of cholesteatoma did not affect the degree of the bone conduction elevation. After ossicular reconstruction, bone conduction thresholds improved significantly at all frequencies, with the greatest improvement being observed at 2000 Hz. These results suggest that the elevation in the bone conduction threshold in chronic otitis media is mainly caused by a change in the conductive mechanism in the middle ear.
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Affiliation(s)
- H-S Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Pundang Jesaeng Hospital, Daejin Medical Center, Sungnam, Korea
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Amali A, Hosseinzadeh N, Samadi S, Nasiri S, Zebardast J. Sensorineural hearing loss in patients with chronic suppurative otitis media: Is there a significant correlation? Electron Physician 2017; 9:3823-3827. [PMID: 28465813 PMCID: PMC5410912 DOI: 10.19082/3823] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 01/11/2017] [Indexed: 11/20/2022] Open
Abstract
Introduction Hearing loss as a sequel of chronic suppurative otitis media (CSOM) is often conductive, but recent studies have found an additional sensorineural component in these patients, thus demonstrating inner ear damage. The aim of the study was to determine the association between CSOM and sensorineural hearing loss (SNHL) and to assess the influence of patient’s age, duration of disease, and presence of cholesteatoma and ossicular erosion on the degree of SNHL. Methods In a retrospective study, the medical records of 119 patients who underwent surgery was reviewed. Seventy patients met the inclusion criteria of unilateral otorrhea, normal contralateral ear on otoscopy, and age between 10–65 years with no history of head trauma or ear surgery or familial hearing loss. Bone conduction (BC) thresholds for affected and contralateral ear were measured at frequencies of 500, 1000, 2000, and 4000 Hz. Data analysis was performed using SPSS 13 with independent-samples t-test, Pearson correlation test, and two-tailed analysis. A p ≤ 0.05 was considered statistically significant. Results Significant higher BC thresholds were found in the affected ear than in the normal ear for each frequency (p < 0.001), which increased with increasing frequency (7.00 dB at the 500 Hz and 9.71 dB at the 4000 Hz). There was a significant correlation between age and degree of SNHL (r = 0.422, p < 0.001) but no significant correlation was in duration of the disease (r = 0.119, p > 0.05). There was no relationship between presence of cholesteatoma and ossicular erosion with SNHL (p > 0.05). Conclusion These findings demonstrate that CSOM is associated with some degree of SNHL and cochlear damage, and higher frequencies are more affected. Aging can act as a precipitating factor in this pathological process.
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Affiliation(s)
- Amin Amali
- Associate Professor of Otorhinolaryngology, Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nima Hosseinzadeh
- Medical Student, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahram Samadi
- Assistant Professor, Department of Anesthesiology and Intensive Care, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Nasiri
- Medical Student, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Jayran Zebardast
- Researcher Nurse, Deputy of research, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Sviriaeva EN, Korneev KV, Drutskaya MS, Kuprash DV. Mechanisms of Changes in Immune Response during Bacterial Coinfections of the Respiratory Tract. BIOCHEMISTRY (MOSCOW) 2016; 81:1340-1349. [PMID: 27914459 DOI: 10.1134/s0006297916110110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Acute diseases of the respiratory tract are often caused by viral pathogens and accompanying secondary bacterial infections. It is known that the development of such bacterial complications is caused mainly by a decreased infiltration with immune system cells and by suppressed inflammation in the lungs. There are significant advances in understanding the mechanisms of secondary infections, although many details remain unclear. This review summarizes current knowledge of the molecular and cellular changes in the host organism that can influence the course of bacterial coinfections in the respiratory tract.
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Affiliation(s)
- E N Sviriaeva
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, 119991, Russia.
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Ghaheri BA, Kempton JB, Pillers DAM, Trune DR. Cochlear Cytokine Gene Expression in Murine Chronic Otitis Media. Otolaryngol Head Neck Surg 2016; 137:332-7. [PMID: 17666266 DOI: 10.1016/j.otohns.2007.03.020] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2006] [Accepted: 03/13/2007] [Indexed: 11/22/2022]
Abstract
OBJECTIVE: To investigate chronic otitis media (COM) induction of cochlear cytokine genes. STUDY DESIGN: RNA from cochleas of five C3H/HeJ mice with and without COM was isolated for cytokine expression in gene arrays. Immunohistochemistry was performed for the protein products of up-regulated genes to confirm their expression in cochlear tissues. RESULTS: Cochleas from COM mice showed increased expression of 29 genes (>2X normal) and decreased expression of 19 genes (<0.5X normal). Cytokines expressed were largely those related to inflammation and tissue remodeling. Cochlear immuno-histochemistry confirmed the presence of numerous cytokines, as well as NF- kB, a major inflammatory transcription factor that drives cytokine expression. CONCLUSION: COM causes elevated levels of cochlear cytokine mRNA, which demonstrates that inner ear tissues are capable of NF- kB activation and cytokine production. This may be another mechanism of otitis media-induced cochlear cytotoxicity in addition to that caused by migration of inflammatory cytokines from the middle ear. SIGNIFICANCE: Cochlear tissues are capable of mounting an immunological response to middle ear inflammatory stimuli.
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Affiliation(s)
- Bobak A Ghaheri
- Department of Otolaryngology--Head and Neck Surgery, Oregon Hearing Research Center, Portland, Oregon 97239, USA.
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28
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Ruben RJ, Bagger-Sjoback D, Downs MP, Gravel JS, Karakashian M, Klein JO, Morizono T, Paparella MM. 8. Complications and Sequelae. Ann Otol Rhinol Laryngol 2016. [DOI: 10.1177/00034894890980s412] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Sone M, Hayashi H, Tominaga M, Nakashima T. Changes in Cochlear Blood Flow Due to Endotoxin-Induced Otitis Media. Ann Otol Rhinol Laryngol 2016; 113:450-4. [PMID: 15224827 DOI: 10.1177/000348940411300606] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to elucidate the influence of otitis media on blood flow in the lateral wall of the cochlea by means of a model of endotoxin-induced otitis media. The cochlear blood flow (CBF) following lipopolysaccharide inoculation into the middle ear cavities of rats was measured by laser-Doppler flowmetry and compared with that of untreated ears. After this evaluation, the influence on CBF of concomitant use of a nitric oxide synthase inhibitor was also investigated. The first day after inoculation, the CBF of treated ears decreased significantly. This decrease recovered gradually between the 7th and 14th days. With concomitant use of a nitric oxide synthase inhibitor, the decrease in CBF was prevented to some extent. The results showed a functional influence upon CBF by endotoxin-induced otitis media. The significance of prophylactic use of the drug is also discussed in regard to the effect on CBF following otitis media.
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Affiliation(s)
- Michihiko Sone
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
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Malaty J, Lee JC, Zhang MEI, Stevens G, Antonelli PJ. Hearing loss and extent of labyrinthine injury in Pseudomonas otitis media. Otolaryngol Head Neck Surg 2016. [DOI: 10.1016/j.otohns.2004.09.088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES: To determine if the severity of hearing loss due to semicircular canal transection (SCT) in Pseudomonas otitis media (POM) is a function of the extent of the labyrinthine injury. METHODS: POM was induced bilaterally in 45 guinea pigs. After 2 to 4 days, SCT was performed in one 1 on the horizontal canal, the superior canal, or both the horizontal and the superior canals. Auditory-evoked brainstem responses were measured before and after SCT. RESULTS: POM was induced bilaterally in all animals. Elevation of click thresholds was found in almost all SCT ears of all 3 groups; however, there were no significant differences between groups. Comparing the SCT ear to the contralateral, control ear, mean hearing losses in the horizontal, superior, and horizontal + superior SCT groups were 23 dB, 27 dB, and 24 dB, respectively. CONCLUSIONS Hearing loss does not correlate with extent of labyrinthine injury in POM in the guinea pig. EBM rating: B-2.
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Affiliation(s)
- John Malaty
- From the Department of Otolaryngology, University of Florida, Gainesville, FL
| | - James C. Lee
- From the Department of Otolaryngology, University of Florida, Gainesville, FL
| | - MEI Zhang
- Department of Communicative Disorders, University of Florida, Gainesville, FL
| | - Gary Stevens
- Department of Biostatistics, University of Florida, Gainesville, FL
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da Costa Monsanto R, Erdil M, Pauna HF, Kwon G, Schachern PA, Tsuprun V, Paparella MM, Cureoglu S. Pathologic Changes of the Peripheral Vestibular System Secondary to Chronic Otitis Media. Otolaryngol Head Neck Surg 2016; 155:494-500. [PMID: 27165677 DOI: 10.1177/0194599816646359] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 04/05/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the histopathologic changes of dark, transitional, and hair cells of the vestibular system in human temporal bones from patients with chronic otitis media. STUDY DESIGN Comparative human temporal bone study. SETTING Otopathology laboratory. SUBJECTS AND METHODS To compare the density of vestibular dark, transitional, and hair cells in temporal bones with and without chronic otitis media, we used differential interference contrast microscopy. RESULTS In the chronic otitis media group (as compared with the age-matched control group), the density of type I and type II hair cells was significantly decreased in the lateral semicircular canal, saccule, and utricle (P < .05). The density of type I cells was also significantly decreased in the chronic otitis media group in the posterior semicircular canal (P = .005), but that of type II cells was not (P = .168). The mean number of dark cells was significantly decreased in the chronic otitis media group in the lateral semicircular canal (P = .014) and in the posterior semicircular canal (P = .002). We observed no statistically significant difference in the density of transitional cells between the 2 groups (P > .1). CONCLUSION The findings of our study suggest that the decrease in the number of vestibular sensory cells and dark cells could be the cause of the clinical symptoms of imbalance of some patients with chronic otitis media.
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Affiliation(s)
- Rafael da Costa Monsanto
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA Department of Otolaryngology and Head and Neck Surgery, Banco de Olhos de Sorocaba Hospital, Sorocaba, Brazil
| | - Mehmet Erdil
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA Department of Otolaryngology, Head and Neck Surgery, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Henrique F Pauna
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA Department of Otolaryngology and Head and Neck Surgery, Campinas State University, Campinas, Brazil
| | - Geeyoun Kwon
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Patricia A Schachern
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Vladimir Tsuprun
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Michael M Paparella
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA Paparella Ear Head and Neck Institute, Minneapolis, Minnesota, USA
| | - Sebahattin Cureoglu
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA
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Lou ZC, Chang J. The preservation of swollen middle ear mucosa could be important to the post-tympanoplasty audiologic outcome. Eur Arch Otorhinolaryngol 2016; 273:4649-4650. [PMID: 27139699 DOI: 10.1007/s00405-016-4070-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 04/23/2016] [Indexed: 11/25/2022]
Affiliation(s)
- Zheng-Cai Lou
- Department of Otorhinolaryngology, The Affiliated YiWu Hospital of Wenzhou Medical University, 699 Jiangdong Road, Yiwu, 322000, Zhejiang, China.
| | - Jiang Chang
- Department of Pediatric Otolaryngology, Children's Hospital of Dongguan, Dongguan, 523325, Guangdong, China
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Kaya S, Tsuprun V, Hızlı Ö, Schachern PA, Paparella MM, Cureoglu S. Cochlear changes in serous labyrinthitis associated with silent otitis media: A human temporal bone study. Am J Otolaryngol 2016; 37:83-8. [PMID: 26954857 DOI: 10.1016/j.amjoto.2015.10.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 10/03/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE To determine histopathological findings in the cochlea of human temporal bones with serous labyrinthitis. MATERIALS AND METHODS We compared human temporal bones with serous labyrinthitis (20 cases) associated with silent otitis media and without serous labyrinthitis (20 cases) to study location of serous labyrinthitis, the degree of endolymphatic hydrops, number of spiral ganglion cells and hair cells, loss of fibrocytes in the spiral ligament, and areas of the spiral ligament and stria vascularis. RESULTS The serous labyrinthitis caused significant loss of outer hair cells in the lower basal (P=0.006), upper basal (P=0.005), and lower middle (P=0.011) cochlear turns, and significant increase in the degree of endolymphatic hydrops than the control group (P=0.036). No significant difference was found in the loss of inner hair cells, in the number of spiral ganglion cells and fibrocytes in the spiral ligament, and in areas of the stria vascularis and spiral ligament (P>0.05). CONCLUSIONS Serous labyrinthitis resulted in significant loss of outer hair cells and significant increase in the degree of endolymphatic hydrops.
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Urrutia RA, Kalinec F. Biology and pathobiology of lipid droplets and their potential role in the protection of the organ of Corti. Hear Res 2015; 330:26-38. [PMID: 25987503 PMCID: PMC5391798 DOI: 10.1016/j.heares.2015.04.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 04/17/2015] [Accepted: 04/21/2015] [Indexed: 12/20/2022]
Abstract
The current review article seeks to extend our understanding on the role of lipid droplets within the organ of Corti. In addition to presenting an overview of the current information about the origin, structure and function of lipid droplets we draw inferences from the collective body of knowledge about this cellular organelle to build a conceptual framework to better understanding their role in auditory function. This conceptual model considers that lipid droplets play a significant role in the synthesis, storage, and release of lipids and proteins for energetic use and/or modulating cell signaling pathways. We describe the role and mechanism by which LD play a role in human diseases, and we also review emerging data from our laboratory revealing the potential role of lipid droplets from Hensen cells in the auditory organ. We suggest that lipid droplets might help to develop rapidly and efficiently the resolution phase of inflammatory responses in the mammalian cochlea, preventing inflammatory damage of the delicate inner ear structures and, consequently, sensorineural hearing loss.
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Affiliation(s)
- Raul A Urrutia
- Epigenetics and Chromatin Dynamics Laboratory, Translational Epigenomic Program, Center for Individualized Medicine (CIM) Mayo Clinic, Rochester, MN 55905, USA
| | - Federico Kalinec
- Laboratory of Auditory Cell Biology, Department of Head & Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
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Jung J, Kim HS, Lee MG, Yang EJ, Choi JY. NovelCOCHp.V123E Mutation, Causative of DFNA9 Sensorineural Hearing Loss and Vestibular Disorder, Shows Impaired Cochlin Post-Translational Cleavage and Secretion. Hum Mutat 2015; 36:1168-75. [DOI: 10.1002/humu.22855] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 07/27/2015] [Indexed: 01/07/2023]
Affiliation(s)
- Jinsei Jung
- Department of Otorhinolaryngology; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Han Sang Kim
- Department of Pharmacology; Yonsei University College of Medicine; Seoul Republic of Korea
- Brain Korea 21 PLUS Project for Medical Science; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Min Goo Lee
- Department of Pharmacology; Yonsei University College of Medicine; Seoul Republic of Korea
- Brain Korea 21 PLUS Project for Medical Science; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Eun Jin Yang
- Clinical Research Division; Korea Institute of Oriental Medicine; Daejeon Republic of Korea
| | - Jae Young Choi
- Department of Otorhinolaryngology; Yonsei University College of Medicine; Seoul Republic of Korea
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Mittal R, Lisi CV, Gerring R, Mittal J, Mathee K, Narasimhan G, Azad RK, Yao Q, Grati M, Yan D, Eshraghi AA, Angeli SI, Telischi FF, Liu XZ. Current concepts in the pathogenesis and treatment of chronic suppurative otitis media. J Med Microbiol 2015; 64:1103-1116. [PMID: 26248613 DOI: 10.1099/jmm.0.000155] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Otitis media (OM) is an inflammation of the middle ear associated with infection. Despite appropriate therapy, acute OM (AOM) can progress to chronic suppurative OM (CSOM) associated with ear drum perforation and purulent discharge. The effusion prevents the middle ear ossicles from properly relaying sound vibrations from the ear drum to the oval window of the inner ear, causing conductive hearing loss. In addition, the inflammatory mediators generated during CSOM can penetrate into the inner ear through the round window. This can cause the loss of hair cells in the cochlea, leading to sensorineural hearing loss. Pseudomonas aeruginosa and Staphylococcus aureus are the most predominant pathogens that cause CSOM. Although the pathogenesis of AOM is well studied, very limited research is available in relation to CSOM. With the emergence of antibiotic resistance as well as the ototoxicity of antibiotics and the potential risks of surgery, there is an urgent need to develop effective therapeutic strategies against CSOM. This warrants understanding the role of host immunity in CSOM and how the bacteria evade these potent immune responses. Understanding the molecular mechanisms leading to CSOM will help in designing novel treatment modalities against the disease and hence preventing the hearing loss.
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Affiliation(s)
- Rahul Mittal
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Christopher V Lisi
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Robert Gerring
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jeenu Mittal
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kalai Mathee
- Department of Human and Molecular Genetics, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Giri Narasimhan
- Bioinformatics Research Group (BioRG), School of Computing and Information Sciences, Florida International University, Miami, FL, USA
| | - Rajeev K Azad
- Department of Biological Sciences and Mathematics, University of North Texas, Denton, TX, USA
| | - Qi Yao
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - M'hamed Grati
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Denise Yan
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Adrien A Eshraghi
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Simon I Angeli
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Fred F Telischi
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Xue-Zhong Liu
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
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Woo JI, Kil SH, Oh S, Lee YJ, Park R, Lim DJ, Moon SK. IL-10/HMOX1 signaling modulates cochlear inflammation via negative regulation of MCP-1/CCL2 expression in cochlear fibrocytes. THE JOURNAL OF IMMUNOLOGY 2015; 194:3953-61. [PMID: 25780042 DOI: 10.4049/jimmunol.1402751] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 02/16/2015] [Indexed: 12/19/2022]
Abstract
Cochlear inflammatory diseases, such as tympanogenic labyrinthitis, are associated with acquired sensorineural hearing loss. Although otitis media is extremely frequent in children, tympanogenic labyrinthitis is not commonly observed, which suggests the existence of a potent anti-inflammatory mechanism modulating cochlear inflammation. In this study, we aimed to determine the molecular mechanism involved in cochlear protection from inflammation-mediated tissue damage, focusing on IL-10 and hemoxygenase-1 (HMOX1) signaling. We demonstrated that IL-10Rs are expressed in the cochlear lateral wall of mice and rats, particularly in the spiral ligament fibrocytes (SLFs). The rat SLF cell line was found to inhibit nontypeable Haemophilus influenzae (NTHi)-induced upregulation of monocyte chemotactic protein-1 (MCP-1; CCL2) in response to IL-10. This inhibition was suppressed by silencing IL-10R1 and was mimicked by cobalt Protoporphyrin IX and CO-releasing molecule-2. In addition, IL-10 appeared to suppress monocyte recruitment through reduction of NTHi-induced rat SLF cell line-derived chemoattractants. Silencing of HMOX1 was found to attenuate the inhibitory effect of IL-10 on NTHi-induced MCP-1/CCL2 upregulation. Chromatin immunoprecipitation assays showed that IL-10 inhibits NTHi-induced binding of p65 NF-κB to the distal motif in the promoter region of MCP-1/CCL2, resulting in suppression of NTHi-induced NF-κB activation. Furthermore, IL-10 deficiency appeared to significantly affect cochlear inflammation induced by intratympanic injections of NTHi. Taken together, our results suggest that IL-10/HMOX1 signaling is involved in modulation of cochlear inflammation through inhibition of MCP-1/CCL2 regulation in SLFs, implying a therapeutic potential for a CO-based approach for inflammation-associated cochlear diseases.
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Affiliation(s)
- Jeong-Im Woo
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095
| | - Sung-Hee Kil
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095
| | - Sejo Oh
- Division of Clinical and Translational Research, House Research Institute, Los Angeles, CA 90057; and
| | - Yoo-Jin Lee
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095
| | - Raekil Park
- Department of Microbiology and Center for Metabolic Function Regulation, Wonkwang University School of Medicine, Iksan, Jeonbuk 570-749, South Korea
| | - David J Lim
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095
| | - Sung K Moon
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095;
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Yoshida H, Miyamoto I, Takahashi H. Relationship between CT findings and sensorineural hearing loss in chronic otitis media. Auris Nasus Larynx 2013; 41:259-63. [PMID: 24387800 DOI: 10.1016/j.anl.2013.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Revised: 12/04/2013] [Accepted: 12/08/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To investigate the relationships between the temporal bone CT findings and sensorineural hearing loss in ears with non-cholesteatomatous chronic otitis media (COM). METHODS Preoperative bone conduction (BC) hearing thresholds of 266 patients (304 ears) with COM were compared with those of 342 normal individuals (440 ears) by audiometry. The incidence of abnormal BC threshold at lower frequencies (250-1000 Hz) and at higher frequencies (2000-4000 Hz) were examined and the differences between control and COM groups were compared by using χ2 test. In the COM group, the cross-sectional area of the mastoid air cells based on the axial CT image (n=255) were correlated with the results of BC threshold. RESULTS The percentage in the COM group exceeds 15% in their 50s at lower frequencies while in their 40s at higher frequencies. The BC thresholds were significantly better in the group with normal mastoid area than in those with smaller mastoid area at each decadal age group. The BC impairment from COM becomes worse as the course of the disease progresses and deteriorated from 40s rapidly, especially at higher frequencies and in the group with smaller mastoid area. CONCLUSION These results recommend that early treatment, including surgery, should be considered as early as possible before BC impairment occurs, especially for COM cases with smaller mastoid area, which may indicate the existence of more severe otitis media since earlier childhood.
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Affiliation(s)
- Haruo Yoshida
- Department of Otolaryngology Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
| | - Ikue Miyamoto
- Department of Otolaryngology Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Haruo Takahashi
- Department of Otolaryngology Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Schick B, Dlugaiczyk J. Surgery of the ear and the lateral skull base: pitfalls and complications. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2013; 12:Doc05. [PMID: 24403973 PMCID: PMC3884540 DOI: 10.3205/cto000097] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Surgery of the ear and the lateral skull base is a fascinating, yet challenging field in otorhinolaryngology. A thorough knowledge of the associated complications and pitfalls is indispensable for the surgeon, not only to provide the best possible care to his patients, but also to further improve his surgical skills. Following a summary about general aspects in pre-, intra-and postoperative care of patients with disorders of the ear/lateral skull base, this article covers the most common pitfalls and complications in stapes surgery, cochlear implantation and surgery of vestibular schwannomas and jugulotympanal paragangliomas. Based on these exemplary procedures, basic "dos and don'ts" of skull base surgery are explained, which the reader can easily transfer to other disorders. Special emphasis is laid on functional aspects, such as hearing, balance and facial nerve function. Furthermore, the topics of infection, bleeding, skull base defects, quality of life and indication for revision surgery are discussed. An open communication about complications and pitfalls in ear/lateral skull base surgery among surgeons is a prerequisite for the further advancement of this fascinating field in ENT surgery. This article is meant to be a contribution to this process.
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Affiliation(s)
- Bernhard Schick
- Dept. of Otorhinolaryngology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Julia Dlugaiczyk
- Dept. of Otorhinolaryngology, Saarland University Medical Center, Homburg/Saar, Germany
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Luntz M, Yehudai N, Haifler M, Sigal G, Most T. Risk factors for sensorineural hearing loss in chronic otitis media. Acta Otolaryngol 2013; 133:1173-80. [PMID: 24125189 DOI: 10.3109/00016489.2013.814154] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSIONS Risk factors for sensorineural hearing loss (SNHL) development in patients with chronic otitis media (COM) are longer duration of disease, older age and the presence of cholesteatoma. To prevent the expected development of SNHL, it is imperative to treat COM actively. OBJECTIVES To assess the severity of SNHL in patients with unilateral COM and to define risk factors for its development. METHODS The study included 317 patients with unilateral COM. Mean age was 28.7 ± 16.7 years (range 7-78 years) and mean duration of disease was 12.2 ± 11.3 years (range 0.25-60 years). In all patients, air conduction (AC) and bone conduction (BC) thresholds in both ears were measured at 500, 1000, 2000 and 4000 Hz. The parameters evaluated were demographics, duration of disease, presence and location of cholesteatoma and otologic history. RESULTS The difference in mean BC thresholds between the diseased ears and the healthy ears was statistically significant, ranging from 4.55 ± 10.89 dB to 12.55 ± 19.09 dB across the measured frequency range (p < 0.0001). Multivariate regression analysis revealed statistically significant correlations between advanced age, longer duration of disease and presence of cholesteatoma, and the BC threshold differences between the affected and healthy ears.
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Affiliation(s)
- Michal Luntz
- Cochlear Implant Program, Department of Otolaryngology-Head & Neck Surgery, Bnai-Zion Medical Center, Technion-Bruce Rappaport Faculty of Medicine , Haifa , Israel
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MacArthur CJ, Hausman F, Kempton JB, Choi D, Trune DR. Otitis media impacts hundreds of mouse middle and inner ear genes. PLoS One 2013; 8:e75213. [PMID: 24124478 PMCID: PMC3790799 DOI: 10.1371/journal.pone.0075213] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 08/11/2013] [Indexed: 12/14/2022] Open
Abstract
Objective Otitis media is known to alter expression of cytokine and other genes in the mouse middle ear and inner ear. However, whole mouse genome studies of gene expression in otitis media have not previously been undertaken. Ninety-nine percent of mouse genes are shared in the human, so these studies are relevant to the human condition. Methods To assess inflammation-driven processes in the mouse ear, gene chip analyses were conducted on mice treated with trans-tympanic heat-killed Hemophilus influenza using untreated mice as controls. Middle and inner ear tissues were separately harvested at 6 hours, RNA extracted, and samples for each treatment processed on the Affymetrix 430 2.0 Gene Chip for expression of its 34,000 genes. Results Statistical analysis of gene expression compared to control mice showed significant alteration of gene expression in 2,355 genes, 11% of the genes tested and 8% of the mouse genome. Significant middle and inner ear upregulation (fold change >1.5, p<0.05) was seen in 1,081 and 599 genes respectively. Significant middle and inner ear downregulation (fold change <0.67, p<0.05) was seen in 978 and 287 genes respectively. While otitis media is widely believed to be an exclusively middle ear process with little impact on the inner ear, the inner ear changes noted in this study were numerous and discrete from the middle ear responses. This suggests that the inner ear does indeed respond to otitis media and that its response is a distinctive process. Numerous new genes, previously not studied, are found to be affected by inflammation in the ear. Conclusion Whole genome analysis via gene chip allows simultaneous examination of expression of hundreds of gene families influenced by inflammation in the middle ear. Discovery of new gene families affected by inflammation may lead to new approaches to the study and treatment of otitis media.
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Affiliation(s)
- Carol J. MacArthur
- Department of Otolaryngology Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, United States of America
- Oregon Hearing Research Center, Oregon Health & Science University, Portland, Oregon, United States of America
- * E-mail:
| | - Fran Hausman
- Oregon Hearing Research Center, Oregon Health & Science University, Portland, Oregon, United States of America
| | - J. Beth Kempton
- Oregon Hearing Research Center, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Dongseok Choi
- Department of Public Health & Preventive Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Dennis R. Trune
- Department of Otolaryngology Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, United States of America
- Oregon Hearing Research Center, Oregon Health & Science University, Portland, Oregon, United States of America
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Sensorineural hearing loss: a complication of acute otitis media in adults. Eur Arch Otorhinolaryngol 2013; 271:1879-84. [DOI: 10.1007/s00405-013-2675-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 08/19/2013] [Indexed: 12/13/2022]
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Zhou H, Chen ZB, Tian HQ, Xu X, Wang YQ, Xing GQ, Cheng L. Effects of hypoxia-inducible factor 1α on bone conduction impairment in otitis media with effusion. Acta Otolaryngol 2012; 132:938-43. [PMID: 22568633 DOI: 10.3109/00016489.2012.675085] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
CONCLUSION Elevated levels of hypoxia-inducible factor 1α (HIF-1α) in middle ear effusion may play an important role in the pathogenesis of bone conduction impairment associated with otitis media with effusion (OME). The mechanism may be related to the up-regulation of nitric oxide (NO) expression. OBJECTIVES This study was undertaken to investigate the role of HIF-1α in the pathogenesis of sensorineural hearing loss associated with OME. METHODS One hundred and eight OME patients were divided into two groups: OME without bone conduction impairment (group 1) and OME with bone conduction impairment (group 2). The levels of HIF-1α, NO, and quinolinic acid (QUIN) in the middle ear effusion and serum of these patients were investigated. The relationship between these factors and the bone conduction threshold (BCT) differences were analyzed. RESULTS The levels of HIF-1α and NO concentrations in the middle ear effusion were found to be significantly higher in group 2 than in group 1 (both p < 0.05). The OME patients' BCT differences at 4000 Hz were correlated with the levels of HIF-1α and the NO concentrations in the middle ear effusion. Furthermore, the HIF-1α levels were correlated with the levels of NO but not with the levels of QUIN in the effusion.
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Affiliation(s)
- Han Zhou
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
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Oh S, Woo JI, Lim DJ, Moon SK. ERK2-dependent activation of c-Jun is required for nontypeable Haemophilus influenzae-induced CXCL2 upregulation in inner ear fibrocytes. THE JOURNAL OF IMMUNOLOGY 2012; 188:3496-505. [PMID: 22379036 DOI: 10.4049/jimmunol.1103182] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The inner ear, composed of the cochlea and the vestibule, is a specialized sensory organ for hearing and balance. Although the inner ear has been known as an immune-privileged organ, there is emerging evidence indicating an active immune reaction of the inner ear. Inner ear inflammation can be induced by the entry of proinflammatory molecules derived from middle ear infection. Because middle ear infection is highly prevalent in children, middle ear infection-induced inner ear inflammation can impact the normal development of language and motor coordination. Previously, we have demonstrated that the inner ear fibrocytes (spiral ligament fibrocytes) are able to recognize nontypeable Haemophilus influenzae, a major pathogen of middle ear infection, and upregulate a monocyte-attracting chemokine through TLR2-dependent NF-κB activation. In this study, we aimed to determine the molecular mechanism involved in nontypeable H. influenzae-induced cochlear infiltration of polymorphonuclear cells. The rat spiral ligament fibrocytes were found to release CXCL2 in response to nontypeable H. influenzae via activation of c-Jun, leading to the recruitment of polymorphonuclear cells to the cochlea. We also demonstrate that MEK1/ERK2 signaling pathway is required for nontypeable H. influenzae-induced CXCL2 upregulation in the rat spiral ligament fibrocytes. Two AP-1 motifs in the 5'-flanking region of CXCL2 appeared to function as a nontypeable H. influenzae-responsive element, and the proximal AP-1 motif was found to have a higher binding affinity to nontypeable H. influenzae-activated c-Jun than that of the distal one. Our results will enable us better to understand the molecular pathogenesis of middle ear infection-induced inner ear inflammation.
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Affiliation(s)
- Sejo Oh
- Division of Clinical and Translational Research, House Research Institute, Los Angeles, CA 90057, USA
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Kong JHK, Kumar S, Chung M, Axon PR, Gray RF, Donnelly N. Contralateral recovery of cochlear function after cochlear implantation. Cochlear Implants Int 2011; 12:181-4. [PMID: 21917208 DOI: 10.1179/1754762811y.0000000008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Significant recovery of sensorineural hearing loss in either ear after cochlear implantation (CI) is rare. We present the case of a 57-year-old lady with medically treated depression and a background of chronic suppurative otitis media (CSOM) in the non-implanted ear, who clearly fulfilled audiological criteria for CI. Two years post-implantation her CSOM in the non-implanted ear was addressed with blind sac closure of the ear. Post-operatively the hearing thresholds in this ear had improved to the extent that a bone-anchored hearing aid became a viable option. The literature is carefully reviewed to consider possible explanations of this phenomenon.
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Affiliation(s)
- Jonathan H K Kong
- Cambridge Hearing Implant Program, The Emmeline Centre, Addenbrookes Hospital, Cambridge University Hospitals, Cambridge, UK
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Frequency-specific hearing results after surgery for chronic ear diseases. Clin Exp Otorhinolaryngol 2011; 4:126-30. [PMID: 21949578 PMCID: PMC3173703 DOI: 10.3342/ceo.2011.4.3.126] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Accepted: 03/27/2011] [Indexed: 11/18/2022] Open
Abstract
Objectives To analyze frequency-specific hearing results after surgery for chronic ear diseases while considering pathological findings and various surgical factors. Methods Patients who underwent surgical management of chronic otitis media were reviewed retrospectively (n=559). Using pure tone audiometry, air conduction (AC), bone conduction (BC), and air bone gap (ABG) change between pre- and post-operative tests were calculated for the frequencies of 250, 500, 1,000, 2,000, 3,000, 4,000 (AC and BC), and 6,000 Hz (AC). Frequency-specific results were investigated, considering various surgical factors, such as type of surgery, type of ossiculoplasty and pathological findings. Results AC results in the intact canal wall mastoidectomy showed improvement at each frequency except 4,000, 6,000 Hz. AC results in the tympanoplasty showed improvement at each frequency except 6,000 Hz. AC and ABG results in the open cavity mastoidectomy showed improvement only at the frequencies of 250, 500, 2,000 Hz. AC and ABG improved at low and mid frequencies but not in high frequencies above 3,000 Hz when ossicular reconstruction was conducted. AC and ABG results also improved at low and mid frequencies in the cholesteatoma, and ABG results improved at all frequencies except 3,000 Hz in the non-cholesteatoma. Conclusion After chronic ear surgery, AC and ABG changes improved, primarily in the low and mid frequencies. Further evaluation and studies for post-operative hearing loss at high frequencies are recommended for rehabilitation of hearing ability after surgery.
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Vijayendra H, Parikh B. Bone conduction improvement after surgery for conductive hearing loss. Indian J Otolaryngol Head Neck Surg 2011; 63:201-4. [PMID: 22754794 PMCID: PMC3138966 DOI: 10.1007/s12070-011-0130-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2009] [Accepted: 01/31/2010] [Indexed: 10/18/2022] Open
Abstract
The objective is to evaluate change in post-operative bone conduction in patients who underwent surgery for conductive/mixed hearing loss due to various reasons. The study design is of retrospective case review and tertiary referral center setting. Five-hundred patients with unilateral conductive/mixed hearing loss were divided into five equal groups (each representing different causes for pre-operative hearing loss), who underwent appropriate surgical correction and had a follow-up audiogram available. The intervention comprises surgery (like myringoplasty and ossiculoplasty with closed or open cavity mastoidectomy for chronic otitis media, stapes mobilization for tympanosclerosis and stapedotomy for otosclerosis) for conductive/mixed hearing loss. Significant improvement or worsening in bone conduction was defined as 15 dB or more improvement or worsening of bone conduction threshold at least in two frequencies between 500 and 4000 Hz. All the other groups also showed a consistent pre-operative bone conduction reduction with an equally consistent improvement in post-operative bone conduction improvement to a varying degree with otosclerosis group having maximum percentage of patients with post-operative bone conduction improvement (60%). The measurement of bone conduction is not necessarily a true reflection of the function of the inner ear. Middle ear makes a contribution to bone conduction and correction of a middle ear conductive lesion causes an apparent improvement in inner ear function. The apparent inner ear hearing loss caused in this way may be reversible to some extent.
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Affiliation(s)
- H. Vijayendra
- Vijaya ENT Care Centre, 9th Cross, No. 1, Malleswaram, Bangalore, India
| | - Bhavin Parikh
- Vijaya ENT Care Centre, 9th Cross, No. 1, Malleswaram, Bangalore, India
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Saliba I, Abela A, Arcand P. Tympanic membrane perforation: size, site and hearing evaluation. Int J Pediatr Otorhinolaryngol 2011; 75:527-31. [PMID: 21257210 DOI: 10.1016/j.ijporl.2011.01.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Revised: 01/10/2011] [Accepted: 01/10/2011] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess different clinical scales of TM perforation size; to evaluate the effect of the size and the site of a perforation on the hearing level and frequencies. METHODS Prospective study. Observers had subjectively estimated the size in millimeter and in percentage of a particular perforation; objectively computerized measures of TM perforations area were analyzed. Agreement between different measures was studied. Cases with postoperative intact TM and an air-bone gap (ABG) of 10 dB or less were studied. RESULTS Global mean preoperative ABG was 21.8 ± 17 dB. Preoperative ABG was different between small-large and small-total perforations (p=0.001). Difference of the preoperative ABG was statistically significant between perforations filling up the four quadrants and perforation limited to one quadrant in the postero-inferior, antero-superior and antero-inferior site. No statistically difference between perforation sites was identified for each affected frequency. Difference is statistically significant (p=0.001) between the 250 Hz and the other frequencies for the medium, large and total perforations. After myringoplasty bone conduction improvement was statistically significant for the frequencies 500 (p=0.04), 1000 (p=0.04) and 2000 Hz (p=0.011). Agreement was large enough when TM perforation size was expressed in percentage and absent when expressed in millimeter. CONCLUSION TM perforation can be clinically estimated quite precisely as a percentage of the TM area. Conductive hearing loss is frequency dependent; with the greatest loss occurring at the lowest sound frequencies. Hearing loss does not depend on the perforation's location.
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Affiliation(s)
- Issam Saliba
- Sainte-Justine University Hospital Center (CHU SJ), 3175, Côte Sainte-Catherine, Department of Otorhinolaryngology, Montreal, QC, H3T 1C5, Canada.
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MacArthur CJ, Pillers DAM, Pang J, Kempton JB, Trune DR. Altered expression of middle and inner ear cytokines in mouse otitis media. Laryngoscope 2011; 121:365-71. [PMID: 21271590 DOI: 10.1002/lary.21349] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Revised: 08/31/2010] [Accepted: 09/01/2010] [Indexed: 12/20/2022]
Abstract
OBJECTIVES/HYPOTHESIS The inner ear is at risk for sensorineural hearing loss in both acute and chronic otitis media (OM), but the mechanisms underlying sensorineural hearing loss are unknown. Previous gene expression array studies have shown that cytokine genes might be upregulated in the cochleas of mice with acute and chronic OM. This finding implies that the inner ear could manifest a direct inflammatory response to OM that may cause sensorineural damage. Therefore, to better understand inner ear cytokine gene expression during OM, quantitative real-time polymerase chain reaction and immunohistochemistry were used in mouse models to evaluate middle and inner ear inflammatory and remodeling cytokines. STUDY DESIGN Basic science experiment. METHODS An acute OM model was created in Balb/c mice by a transtympanic injection of Streptococcus pneumoniae in one ear; the other ear was used as a control. C3H/HeJ mice were screened for unilateral chronic OM, with the noninfected ear serving as a control. RESULTS Both acute and chronic OM caused both the middle ear and inner tissues in these two mouse models to overexpress numerous cytokine genes related to tissue remodeling (tumor necrosis factor-α, bone morphogenetic proteins, fibroblast growth factors) and angiogenesis (vascular endothelial growth factor), as well as inflammatory cell proliferation (interleukin [IL]-1α,β, IL-2, IL-6). Immunohistochemistry confirmed that both the middle ear and inner ear tissues expressed these cytokines. CONCLUSIONS Cochlear tissues are capable of expressing cytokine mRNA that contributes to the inflammation and remodeling that occur in association with middle ear disease. This provides a potential molecular basis for the transient and permanent sensorineural hearing loss often reported with acute and chronic OM.
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Affiliation(s)
- Carol J MacArthur
- Department of Otolaryngology, Oregon Hearing Research Center, Oregon Health and Science University, Portland, Oregon 97239-3098, USA.
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Spiral ligament fibrocyte-derived MCP-1/CCL2 contributes to inner ear inflammation secondary to nontypeable H. influenzae-induced otitis media. BMC Infect Dis 2010; 10:314. [PMID: 21029462 PMCID: PMC2988798 DOI: 10.1186/1471-2334-10-314] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2010] [Accepted: 10/28/2010] [Indexed: 12/20/2022] Open
Abstract
Background Otitis media (OM), one of the most common pediatric infectious diseases, causes inner ear inflammation resulting in vertigo and sensorineural hearing loss. Previously, we showed that spiral ligament fibrocytes (SLFs) recognize OM pathogens and up-regulate chemokines. Here, we aim to determine a key molecule derived from SLFs, contributing to OM-induced inner ear inflammation. Methods Live NTHI was injected into the murine middle ear through the tympanic membrane, and histological analysis was performed after harvesting the temporal bones. Migration assays were conducted using the conditioned medium of NTHI-exposed SLFs with and without inhibition of MCP-1/CCL2 and CCR2. qRT-PCR analysis was performed to demonstrate a compensatory up-regulation of alternative genes induced by the targeting of MCP-1/CCL2 or CCR2. Results Transtympanic inoculation of live NTHI developed serous and purulent labyrinthitis after clearance of OM. THP-1 cells actively migrated and invaded the extracellular matrix in response to the conditioned medium of NTHI-exposed SLFs. This migratory activity was markedly inhibited by the viral CC chemokine inhibitor and the deficiency of MCP-1/CCL2, indicating that MCP-1/CCL2 is a main attractant of THP-1 cells among the SLF-derived molecules. We further demonstrated that CCR2 deficiency inhibits migration of monocyte-like cells in response to NTHI-induced SLF-derived molecules. Immunolabeling showed an increase in MCP-1/CCL2 expression in the cochlear lateral wall of the NTHI-inoculated group. Contrary to the in vitro data, deficiency of MCP-1/CCL2 or CCR2 did not inhibit OM-induced inner ear inflammation in vivo. We demonstrated that targeting MCP-1/CCL2 enhances NTHI-induced up-regulation of MCP-2/CCL8 in SLFs and up-regulates the basal expression of CCR2 in the splenocytes. We also found that targeting CCR2 enhances NTHI-induced up-regulation of MCP-1/CCL2 in SLFs. Conclusions Taken together, we suggest that NTHI-induced SLF-derived MCP-1/CCL2 is a key molecule contributing to inner ear inflammation through CCR2-mediated recruitment of monocytes. However, deficiency of MCP-1/CCL2 or CCR2 alone was limited to inhibit OM-induced inner ear inflammation due to compensation of alternative genes.
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