Prognostic and Evolutive Factors of Tinnitus Triggered by Sudden Sensorineural Hearing Loss.

Introduction: The association between sudden sensorineural hearing loss (SSNHL) and tinnitus is frequent. Its correlation with the auditory prognosis remains controversial. The objective of the study is to evaluate tinnitus of which onset is concurrent with SSNHL and analyze it as a prognostic factor and its correlation with hearing recovery. Materials and Methods: A prospective cohort study was conducted with 30 patients with SSNHL. Serial audiometry was performed and the Tinnitus Handicap Inventory (THI) was applied at the initial consultation and after treatment. Results: Tinnitus had an incidence of 93.3%, with an initial mean THI of 63.6%. The mean decrease in THI was significant in all scale domains. However, there was no statistically significant difference between the degrees of tinnitus and hearing loss, as well as between hearing recovery percentage in relation to the degree of tinnitus. The correlation of THI gain with the hearing recovery rate was negative (the greater the decrease in the level of tinnitus discomfort, the greater the hearing recovery rate), being significant only in the emotional domain of THI, but showing a poor correlation. Discussion: There was a reduction in the level of tinnitus discomfort, as measured by THI, after treatment of SSNHL. There is a correlation between tinnitus and hearing improvement in patients with SSNHL only in the emotional domain of THI, but this correlation is considered poor. The degree of tinnitus severity as measured by THI was not proportional to the hearing loss and is not a prognostic factor for hearing improvement. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Functional Testing of Subcutaneous Piezoelectrically Actuated Hearing Aid: Comparison With BAHA and Potential for Treating Single-sided Deafness.

Objective: To compare the performance of a subcutaneous piezoelectrically actuated hearing aid (SPAHA) with the bone-anchored hearing aid (BAHA) and assess its effectiveness as a treatment option for conductive loss and single-sided deafness (SSD). Background: To validate the use of the SPAHA as a bone conduction implant, its performance was compared with a widely used bone conduction implant, the BAHA. Maximum dynamic range, power consumed to deliver standard speech signals and total harmonic distortion (THD) was assessed. The transcranial attenuation was also measured to assess the SPAHA's potential to treat SSD. Method: Functional testing of the SPAHA and BAHA was conducted using cadaver heads. Ipsilateral and contralateral promontory velocity and the power consumption by the devices were measured at 111 different frequencies in the range of 200 to 9600 Hz. Performance metrics were derived from these measurements. Result: The maximum dynamic range for SPAHA was within 10 dB of that of BAHA. The THD for the SPAHA was at most 3%, slightly better than the BAHA. The power consumption by the SPAHA, whereas highly variable, was not statistically different than that of the BAHA. Transcranical attenuation in case of SPAHA was 5 to 10 dB across the measured frequency range. Conclusion: From observed dynamic range and THD, the speech quality delivered by the SPAHA should equal or exceed that delivered by the BAHA. To attain equivalent hearing sensation at lower frequencies, the drive voltage for SPAHA would have to be significantly higher than that for BAHA. For typical speech inputs the power consumption requirements of the SPAHA should be roughly equal to those of the BAHA. Given its performance at high frequencies, the SPAHA seems well-suited to treating SSD. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Sudden Pediatric Hearing Loss: Comparing the Results of Combined Treatment (Intratympanic Dexamethasone and Systemic Steroids) With Systemic Steroid Treatment Alone.

Objective: The aim of the present study was to compare hearing improvements obtained with combined intratympanic and systemic steroid therapy, and systemic steroid therapy alone in pediatric patients with idiopathic sudden sensorineural hearing loss (SSHL). Study Design: Retrospective. Setting: Tertiary referral hospital. Patients: Pediatric patients with SSHL. Interventions: The patients were divided into two groups, based on the method of steroid administration: Group 1 (systemic therapy group, n = 23) was treated with oral methylprednisolone alone whereas Group 2 (combination therapy group, n = 26) was treated with combination of oral methylprednisolone and intratympanic dexamethasone injections. Main Outcome Measures: Pre- and post-treatment audiograms were compared with pure-tone averages (PTAs) in each group. Two treatment groups were also compared. The final hearing assessment was performed 4 weeks after completion of the treatment. Results: The mean PTAs before and after the treatment were 61.86 +/- 23.99 and 42.65 +/- 32.69 dB in Group 1 (p = 0.001), and 70.07 +/- 29.74 and 38.85 +/- 32.28 dB in Group 2 (p = 0.001). Pure-tone gain was 20.00 +/- 15.02 dB in Group 1, and 31.69 +/- 28.29 dB in Group 2. Comparison of two groups for post-treatment PTA and pure-tone gains did not yield any statistically significant differences (p = 0.388 and p = 0.132, respectively). Conclusion: Significant hearing improvement may be obtained with use of systemic steroids alone, or simultaneous administration of systemic and intratympanic steroids in pediatric patients with SSHL. Although we did not have a control group, two treatment options appear to offer similar hearing improvements in the pediatric age group higher than the rates obtained with placebo when previous studies in the literature are taken into account. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Malignant Peripheral Nerve Sheath Tumor of the Jugular Foramen.

No abstract available

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Does Tinnitus Increase In Intensity?

 

Many people with tinnitus wonder, “Does tinnitus increase in intensity over time?” There is no surefire way to determine whether the volume of your tinnitus will increase in the future. However, in most people, tinnitus volume does increase as time passes. If a medical condition is the cause of your tinnitus, then your physician and audiologist may be able to provide you with detailed information about how your tinnitus will change over time.

When Does Tinnitus Increase in Intensity?
In most people, tinnitus increases in volume as the months and years go by. You may experience life changes such as increased stress, hypertension or heart disease that cause your tinnitus to worsen. If you are a smoker, continuing to smoke may also cause your tinnitus to increase in intensity over time. Temporary medical issues such as a migraine headache can also lead to temporary or permanent increases in tinnitus volume. You might also notice that the pitch of your tinnitus changes. A higher pitch of tinnitus may make it sound louder than it did previously.

Variable Symptoms of Tinnitus
In some people, tinnitus volume varies. General changes in your health may affect the loudness of tinnitus, as can your level of rest and relaxation. When you are healthy, getting enough sleep and have a low level of stress in your life, you may find that your tinnitus volume decreases. If you can maintain good health and work with your medical team, you may be able to maintain the lower volume of tinnitus. Adjusting your tinnitus masker may also help with the management of tinnitus symptoms that change.

Protecting Your Hearing
There is no guarantee of how your tinnitus will change over time. However, the answer to the question of, “Does tinnitus increase in intensity over time?” is a resounding “Yes” for most people. The best action that you can take to prevent your tinnitus from worsening is to protect your hearing. Protect your hearing by avoiding loud noises whenever possible. When loud noise cannot be avoided, use hearing protection. If you are a carpenter, you may want to invest in the highest grade of noise elimination headphones available. If you plan to visit a music concert, you may wish to wear headphones or physician-approved ear plugs. Avoiding smoking and only taking medications as prescribed by your physician can also help to protect your hearing and minimize your risk of worsening tinnitus.

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Analysis of Temporal Change in Voice Quality After Thyroidectomy: Single-institution Prospective Study

Publication date: Available online 25 May 2016
Source:Journal of Voice
Author(s): Doh Young Lee, Ki Jeong Lee, Soo Min Hwang, Kyoung Ho Oh, Jae-Gu Cho, Seung-Kuk Baek, Soon-Young Kwon, Jeong-Soo Woo, Kwang-Yoon Jung
ObjectivesThis study analyzed the temporal changes of voice quality after thyroidectomy and assessed the predictive perioperative parameters of postthyroidectomy voice disorder (PTVD).Study designThis is a prospective cohort study.MethodsFrom March 2011 to July 2014, 559 patients who underwent thyroidectomy with or without central neck dissection were prospectively enrolled. All patients underwent prospective voice evaluation using the subjective and objective comprehensive battery of assessments, preoperatively and postoperatively at 1 week, 1 month, 3 months, 6 months, and 12 months.ResultsFundamental frequency (F0) was not significantly decreased during the postoperative follow-up. Maximal vocal pitch (MVP) and maximal intensity were not recovered, even at 1 year postoperatively, whereas the Grade, Roughness, Breathiness, Asthenia, Strain scale reached preoperative value at postoperative 3–6 months and voice handicap index at 1 year. Postoperative 1-month MVP was the best predictor for PTVD, and the cut-off value was 80% of preoperative value. Wide surgical extent and high preoperative F0 were the parameters that significantly correlated with PTVD (P = 0.021 and P < 0.001, respectively), and large tumor, higher preoperative MVP, and lower postoperative 1-month F0 were significantly associated with permanent PTVD (P = 0.028, P < 0.001, and P = 0.003, respectively).ConclusionsDifferent recovery patterns of voice parameters should be considered in preoperative counseling. Intensive voice therapy may be needed for patients with the ability to produce higher pitch than normal preoperatively and wide surgical extent.



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Spectrum and Frequency of the GJB2 Gene Pathogenic Variants in a Large Cohort of Patients with Hearing Impairment Living in a Subarctic Region of Russia (the Sakha Republic)

by Nikolay A. Barashkov, Vera G. Pshennikova, Olga L. Posukh, Fedor M. Teryutin, Aisen V. Solovyev, Leonid A. Klarov, Georgii P. Romanov, Nyurgun N. Gotovtsev, Andrey A. Kozhevnikov, Elena V. Kirillina, Oksana G. Sidorova, Lena M. Vasilyevа, Elvira E. Fedotova, Igor V. Morozov, Alexander A. Bondar, Natalya A. Solovyevа, Sardana K. Kononova, Adyum M. Rafailov, Nikolay N. Sazonov, Anatoliy N. Alekseev, Mikhail I. Tomsky, Lilya U. Dzhemileva, Elza K. Khusnutdinova, Sardana A. Fedorova

Pathogenic variants in the GJB2 gene, encoding connexin 26, are known to be a major cause of hearing impairment (HI). More than 300 allelic variants have been identified in the GJB2 gene. Spectrum and allelic frequencies of the GJB2 gene vary significantly among different ethnic groups worldwide. Until now, the spectrum and frequency of the pathogenic variants in exon 1, exon 2 and the flanking intronic regions of the GJB2 gene have not been described thoroughly in the Sakha Republic (Yakutia), which is located in a subarctic region in Russia. The complete sequencing of the non-coding and coding regions of the GJB2 gene was performed in 393 patients with HI (Yakuts—296, Russians—51, mixed and other ethnicities—46) and in 187 normal hearing individuals of Yakut (n = 107) and Russian (n = 80) populations. In the total sample (n = 580), we revealed 12 allelic variants of the GJB2 gene, 8 of which were recessive pathogenic variants. Ten genotypes with biallelic recessive pathogenic variants in the GJB2 gene (in a homozygous or a compound heterozygous state) were found in 192 out of 393 patients (48.85%). We found that the most frequent GJB2 pathogenic variant in the Yakut patients was c.-23+1G>A (51.82%) and that the second most frequent was c.109G>A (2.37%), followed by c.35delG (1.64%). Pathogenic variants с.35delG (22.34%), c.-23+1G>A (5.31%), and c.313_326del14 (2.12%) were found to be the most frequent among the Russian patients. The carrier frequencies of the c.-23+1G>A and с.109G>A pathogenic variants in the Yakut control group were 10.20% and 2.80%, respectively. The carrier frequencies of с.35delG and c.101T>C were identical (2.5%) in the Russian control group. We found that the contribution of the GJB2 gene pathogenic variants in HI in the population of the Sakha Republic (48.85%) was the highest among all of the previously studied regions of Asia. We suggest that extensive accumulation of the c.-23+1G>A pathogenic variant in the indigenous Yakut population (92.20% of all mutant chromosomes in patients) and an extremely high (10.20%) carrier frequency in the control group may indicate a possible selective advantage for the c.-23+1G>A carriers living in subarctic climate.

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