The present study was to explore the functional and morphological changes in cochleas of guinea pig models of early endolymphatic hydrops. Thirty albino guinea pigs were randomly divided into three groups: control, 4-week model and 8-week model groups. For each group, n = 10. Model groups were operated on the right ears to result in endolymphatic hydrops with the method of slight destruction of endolymphatic sac and duct from extradural posterior cranial fossa approach, and the animals in control group were sham operated. Electrocochleogram recorded by trans-tympanic approach and auditory brainstem response (ABR) were tested in preoperative model groups, control group, 4-week model group and 8-week model group to assess the hearing changes. Histologic morphometry was used to quantify hydrops by testing scala media area (SMA) ratio. Scanning electron microscope was used to assess the changes of cochlea hair cells. The results showed that the summating potential/compound action potential (SP/AP) ratio of electrocochleogram in 4-week model group (0.33 ± 0.14) and 8-week model group (0.43 ± 0.14) increased significantly, compared with that in control group (0.07 ± 0.06). The maximum SMA ratio in 4-week model group (2.64 ± 0.10) and 8-week model group (3.54 ± 0.13) increased significantly, compared with that in control group (1.06 ± 0.08). The results of maximum SMA ratio correlated with SP/AP ratio of electrocochleogram (r = 0.86). The results of hearing threshold of ABR revealed that the operated ears of model groups were higher than the preoperative results at frequencies of 2 kHz and 4 kHz. And the damage of cochlea hair cells in operated ears occurred in apical and subapical turns. These results suggest the increased SP/AP ratio of electrocochleogram can indicate early endolymphatic hydrops. There is low-tone hearing loss in guinea pig models of early endolymphatic hydrops, and it may be associated with the abnormalities of the stereocilia among the outer hair cells in operated ears which occurs in apical and subapical turns.
Animals ; Cochlea ; pathology ; physiopathology ; Endolymphatic Hydrops ; complications ; physiopathology ; Guinea Pigs ; Hair Cells, Auditory, Outer ; pathology ; Hearing Loss, Sensorineural ; etiology ; pathology ; physiopathology ; Male

Auditory rehabilitation is fast gaining importance in the elderly because hearing loss in the elderly is common and the population of the elderly is increasing due to prolonged life expectancy. Hearing aids have been proven to be effective for mild to moderate hearing loss but, for the patients with severe to profound hearing loss, cochlear implantation is the most suitable among the auditory rehabilitation options. It has been recently accepted that cochlear implantation improves auditory performance and quality of life, and is well tolerated in the elderly aged 60 and older at the time of implantation even though the elderly have poorer auditory performance as compared to a younger control group. Medical records of 43 postlingually deafened patients who were 60 years and older at the time of implantation were retrospectively analyzed from April 1992 to June 2010. They had an average age of 67 years at the time of cochlear implantation and a mean duration of deafness of 85.2 months. Seventy-nine percent of the patients were deaf for less than 10 years. The most common postoperative complication was dizziness, which was successfully treated conservatively. Speech performance improved from the time of postoperative 3 months compared to the preoperative result and showed no difference as compared to the younger control group. Therefore, based on the literature and our results, it is recommended that cochlear implantation be considered in the elderly with severe to profound hearing loss.
Aged ; Cochlear Implantation ; Cochlear Implants ; Deafness ; Dizziness ; Hearing Aids ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Life Expectancy ; Medical Records ; Postoperative Complications ; Quality of Life ; Retrospective Studies

Sudden sensorineural hearing loss has been reported to occur following anesthesia and various non-otologic surgeries, mostly after procedures involving cardiopulmonary bypass. Unilateral sensorineural hearing loss resulting from microembolism is an infrequent complication of cardiopulmonary bypass surgery that has long been acknowledged. Moreover, there are few reports on the occurrence of bilateral sensorineural hearing loss without other neurologic deficits and its etiology has also not been determined. We describe here a rare case of bilateral hearing loss without other neurologic deficits in an otherwise healthy 27-year-old woman who underwent cardiopulmonary bypass surgery for repair of severe mitral valve stenosis. The patient suffered from profound sensorineural hearing loss in both ears that was recognized immediately upon extubation, and audiometry tests confirmed the diagnosis. Without any treatment, her hearing recovered almost completely by the time of her discharge one week after surgery.
Adult ; Anesthesia ; Audiometry ; Cardiopulmonary Bypass ; Ear ; Female ; Hearing ; Hearing Loss ; Hearing Loss, Bilateral ; Hearing Loss, Sensorineural ; Humans ; Mitral Valve Stenosis ; Neurologic Manifestations ; Postoperative Complications

Acupuncture Therapy ; methods ; Adult ; Craniocerebral Trauma ; complications ; therapy ; Electroacupuncture ; Female ; Hearing Loss, Sensorineural ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Scalp ; Young Adult

OBJECTIVETo analyze clinical pure tone test data in patients with Meniere disease and study the changes in the audiometic curve configuration.

METHODSA retrospective analysis was conducted of the pure tone test data in 75 cases (82 ears) from 1984 to 2008. The audiometic curve configuration was divided into 6 categories to analyze the relationship between the main curve types and the clinical stages. RESULTS The most common audiogram was the peak type (46.34%), followed by the falling type (19.51%) and the mountain type (12.19%), and the dip type was relatively rare (2.43%). No significant differences were found in the rate of peak audiograms between the clinical stages. The common audiogram peak frequency occurred at 2 kHz (47.39%). The top curve of 1-2 kHz had the largest proportion in mountain type audiograms (70%, 7/10 ears).

CONCLUSIONThe peak type and mountain type configuration are one of the audiological characteristics of Meniere disease, especially for 2 kHz peak, which may serve as the diagnostic features of Meniere disease in the vertigo patients on their first visit.

Adolescent ; Adult ; Aged ; Audiometry, Pure-Tone ; methods ; Female ; Hearing Loss, Sensorineural ; diagnosis ; etiology ; Humans ; Male ; Meniere Disease ; complications ; physiopathology ; Middle Aged ; Retrospective Studies ; Young Adult

Adolescent ; Adult ; Brain Hemorrhage, Traumatic ; complications ; etiology ; Craniocerebral Trauma ; complications ; diagnostic imaging ; Hearing Loss, Sensorineural ; diagnosis ; etiology ; physiopathology ; therapy ; Humans ; Male ; Radiography

INTRODUCTIONSensori-neural hearing loss (SNHL) is a frequent complication of conventional radiotherapy for head and neck tumours, especially nasopharyngeal carcinoma. To manage radiation-induced ototoxicity appropriately, an understanding of the cellular and molecular basis of this complication is necessary.

MATERIALS AND METHODSA medline search of relevant literature was done, focusing on the radiation-induced cellular and molecular processes that lead to hair cell death in the cochlea.

RESULTSRadiation-induced SNHL occurs in the cochlea, with the retro-cochlear pathways remaining functionally intact. By simulating radiotherapy regimes used clinically, radiation-induced cochlear cell degeneration in the absence of damage to the supporting structures and blood vessels has been demonstrated in animals. This could be due to apoptotic cochlear cell death, which has been shown to be associated with p53 upregulation and intra-cellular reactive oxygen species (ROS) generation. Oxidative stress may initiate the upstream processes that lead to apoptosis and other cell death mechanisms.

CONCLUSIONSA model of radiation-induced SNHL based on a dose and ROS-dependent cochlear cell apoptosis, is proposed. This model supports the feasibility of cochlear implantation, should one be clinically indicated. It can explain clinical observations such as radiation-induced SNHL being dose-dependent and affects the high frequencies more than the lower frequencies. It also opens up the possibility of preventive strategies targeted at different stages of the apoptotic process. Antioxidants look promising as effective agents to prevent radiation-induced ototoxicity; they target upstream processes leading to different cell death mechanisms that may co-exist in the population of damaged cells.

Animals ; Cell Death ; Cell Line ; Cochlea ; radiation effects ; Genes, p53 ; Hair Cells, Auditory ; radiation effects ; Hearing Loss, Sensorineural ; etiology ; genetics ; physiopathology ; Humans ; Mice ; Radiation Injuries ; complications ; Reactive Oxygen Species ; metabolism

INTRODUCTIONRadiation injury resulting in sudden, late onset sensorineural hearing loss is a recognised complication in patients who have received head and neck irradiation. We describe the magnetic resonance imaging (MRI) of the internal acoustic canal (IAC) of 3 such patients and postulate a cause for these findings.

CLINICAL PICTUREA total of 63 patients were referred for MRI IAC for sudden-onset sensorineural hearing loss. Of these patients, only 5 patients had abnormal MRI finding in the affected ear and the remaining patients had normal studies. Two patients had acoustic neuromas. Three patients demonstrated high T1-weighted signal in the labyrinths of the affected ears and had past histories of head and neck irradiation. The MRI findings and medical records of these 3 patients were reviewed and described in this case series.

OUTCOMEHigh labyrinthine signal on unenhanced T1-weighted images in the symptomatic ear of these patients was observed, suggesting the possibility of haemorrhage. In the patient who had a history of brain tumour, susceptibility artifacts were also seen in the right hemipons on the gradient-echo images, indicating the presence of paramagnetic substances from previous therapy.

CONCLUSIONWe postulate that labyrinthine haemorrhage is a rare, late complication of head and neck irradiation, resulting in sudden sensorineural hearing loss.

Female ; Head and Neck Neoplasms ; radiotherapy ; Hearing Loss, Sensorineural ; etiology ; Hearing Loss, Sudden ; etiology ; Hemorrhage ; complications ; Humans ; Labyrinth Diseases ; complications ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Radiotherapy ; adverse effects ; Radiotherapy Dosage ; Time Factors

OBJECTIVETo evaluate the clinical features, pathologic diagnosis and laboratory test of otologic manifestation in Wegener's granulomatosis (WG).

METHODSFourteen eases of WG with ear involvement were reviewed. The clinical course, method of treatment and outcomes in all cases were evaluated. Diagnosis of WG was made when the patients had clinical findings, clear histologic findings and a positive titer of antineutrophil cytoplasmic autoantibodies (ANCA). RESULTS In all 14 cases, the most frequent finding was chronic otitis media Sensorineural hearing loss was present in 1 case and facial nerve paralysis was present in 2 cases separately. There were 5 patients whose otologic manifestations were the primary involvement of WG. Fourteen cases had positive histologic diagnosis of WC while 13 cases were confirmed positive for ANCA. All patients were treated with glucocorticoids, immunosuppressive drugs, and finally got marked improvement.

CONCLUSIONSWG should he included in the differential diagnosis in cases of atypical inflammatory states of the ear, facial nerve paralysis and sensorineural hearing loss. Early diagnosis was made basing on the histologic findings and a positive titer of ANCA. Appropriate treatment were important to improve the otologic manifestations of WG.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Facial Paralysis ; etiology ; Female ; Granulomatosis with Polyangiitis ; complications ; Hearing Loss, Sensorineural ; etiology ; Humans ; Male ; Middle Aged ; Otitis Media ; etiology ; Retrospective Studies ; Young Adult

Adult ; Cochlear Implantation ; Female ; Hearing Loss, Sensorineural ; etiology ; surgery ; Humans ; Meniere Disease ; complications ; surgery