Evaluation of the efferent system with contralateral suppression in auditory neuropathy spectrum disorder

Amaç: İşitsel nöropati spektrum bozukluğunun (ANSD) medial olivokoklear efferent sistem aktivitesi üzerine olan etkilerini anlık uyarılmış otoakustik emisyon (TEOAE) ve kontralateral supresyon (KLS) kullanarak değerlendirmek amaçlandı. Gereç ve Yöntemler: TEOAE yanıtları 2 gruba ayrılmış 48 kulakta kaydedildi. İşitsel nöropati grubundan 24 kulağı (ortalama 51,2 ay), kontrol grubu ise 24 kulağı (ortalama 55,9 ay) araştırmaya dahil edildi. Her iki grubun TEOAE ölçümleri karşı kulakta gürültülü (geniş band gürültü, 60 dB SPL şiddetinde) ve gürültüsüz olarak kaydedildi. Bulgular: ANSD ve kontrol grupları arasında kontralateral supresyon değerleri karşılaştırıldığında, istatistiksel olarak anlamlı fark gözlendi. KLS sonrası kontrol grubunun değerleri, öncekinden istatistiksel olarak anlamlı derecede düşüktü. ANSD grubunun KLS öncesi ve sonrası TEOAE sinyal-gürültü oranları (SNR) karşılaştırıldığında, ölçülen frekanslarda istatistiksel olarak anlamlı bir fark gözlenmedi. Sonuç: ANSD olgularında KLS uygulandığında anlamlı bir supresyon gözlenmemektedir. Kontrol grubunda KLS uygulandığında ise istatistiksel olarak da anlamlı supresyon görülmektedir. İşitsel nöropatili olgularda supresyon gözlenmemesi, efferent sistemin işlevsel olmamasından kaynaklanabileceği gibi hem afferent hem de efferent sistemin işlevselliğini yitirmesine bağlı olabilir. KLS, işitsel nöropatinin tanısında kullanılabilecek bir test bataryası olarak değerlendirilebilir. Ancak, işitsel nöropati tanısında kullanımına ilişkin daha fazla araştırmaya ihtiyaç vardır.Objective: It was aimed to examine the effects of Auditory Neurophaty Spectrum Disorder (ANSD) on medial olivocochlear efferent system activity by using Transient Evoked Otoacoustic Emission (TEOAE) and Contralateral Suppression (CLS). Material and Methods: TEOAEs were recorded in a total of 48 ears, divided into two groups. Twenty-four ears of the ANSD group (mean 51.2 months) and 24 ears of the control group (mean 55.9 months) were included in the study. TEOAE measuremens of both groups were recorded with (broadband noise, 60 dB SPL) and without noise in the contralateral ear. Results: When the contraateral supression values were compared between the ANSD and control groups, statistically significant difference was observed. The values of the control group after CLS were statistically significantly lower than before. When the TEOAE signal-to-noise ratios (SNR) of the ANSD group before and after KLS were compared, no statistically significant difference was observed in the measured frequencies. Conclusion: No significant suppression effect was found when CLS is performed to patients with ANSD. The absence of suppression in the ANSD grup may be due to the non-functionality of the efferent system as well as the loss of functionality of both afferent and efferent system. CLS can be considered as a test battery that may be used in the diagnosis of auditory neuropathy. However, there is need further research on its use in the diagnosis for auditory neuropathy

The Effect of Tympanic Membrane Perforation Site, Size and Middle Ear Volume on Hearing Loss

Objective:The aim of this study was to analyze the location and the size of perforation in cases with tympanic membrane perforation, its relation to the manubrium mallei and middle ear volume, and to investigate how these are correlated with the severity and frequencies of conductive hearing loss.Methods: This prospectively designed study included the patients who presented to the the Department of Otorhinolaryngology at the Dokuz Eylül University with hearing loss or tinnitus complaints in the period from June 2014 through June 2017 and were identified to have tympanic membrane perforation in their otoscopic examination. Patients who underwent myringoplasty and type 1 tympanoplasty and whose air-bone gap was found lower than 10 dB in the postoperative audiological examination were included in the study. Effects of the perforation size, the perforation site, and the relationship of the perforation with the manubrium, as well as the effects of the middle ear volume on the severity and frequency of conductive hearing loss were compared.Results: The study included 44 ears of 38 patients (13 male and 25 female) of whom six had tympanic membrane perforation in both ears. Air conduction threshold and air-bone gap were significantly found higher if the perforation area was wide (p<0.05), the perforation involved both the anterior and the posterior quadrants (p<0.05), had contact with the manubrium mallei (p<0.05), and the middle ear volume reduced (p<0.05).Conclusion: Solely tympanic membrane perforation affects hearing function; nevertheless, hearing function are better in cases, which have perforations small in size, no contact with manubrium mallei and well pneumatized middle ears

Comparison of Audiological Findings in Patients with Vestibular Migraine and Migraine

Objective:The aim of this study was to investigate and compare the auditory findings in vestibular migraine (VM) and migraine patients without a history of vertigo.Methods:This study was conducted on 44 patients diagnosed with definite VM and 31 patients diagnosed with migraine who were followed and treated between January 2011 and February 2015. Also, 52 healthy subjects were included in this study as a control group. All participants underwent a detailed otorhinolaryngological examination followed by audiological evaluation, including pure tone audiometry, speech reception threshold, speech recognition score, and acoustic immitancemetry.Results:In the VM group, there were 16 patients (36.4%) with tinnitus, while in the other groups we did not observe any patients with tinnitus. The rate of tinnitus in the VM group was significantly higher in comparison to other groups (p<0.05). None of the groups had any patients with permanent or fluctuating sensorineural hearing loss.Conclusion:We conclude that patients with VM should be closely and longitudinally followed up for the early detection of other otological symptoms and possible occurrence of sensorineural hearing loss in the long term

Effect of Korean Red Ginseng on Noise-Induced Hearing Loss

Objective:Noise-induced hearing loss (NIHL) is one of the most important problems affecting both social and professional life of patients. There is no treatment method considered to be successful on the hearing loss that has become a permanent nature. Aim of this study is to evaluate protective effect of Korean Red Ginseng (KRG) against NIHL in an animal model.Methods:Twenty-eight rats were separated into four groups [control saline (group I), control KRG (group II), saline + noise (group III), KRG + noise (group IV)]. Rats in the saline and KRG groups were fed via oral gavage with a dose of 200 mg/kg/day throughout for 10 days. Fourteen rats (group III and IV) were exposed to 4 kHz octave band noise at 120 dB SPL for 5 hours. Hearing levels of rats were evaluated by distortion product otoacoustic emissions (DPOAE) and auditory brainstem responses (ABR) at 4, 8, 12, 16 and 32 kHz frequencies prior to and on days 1, 7 and 10 after the noise exposure. Rats were sacrificed on 10th day, after the last audiological test. Cochlea and spiral ganglion tissues were evaluated by light microscopy.Results:Audiological and histological results demonstrated that after noise the group IV showed better results than group III. In the noise exposed groups, the most prominent damage was seen at the 8 kHz frequency region than other regions. After the noise exposure, DPOAE responses were lost in 1st, 7th and 10th measurements in both group III and IV. Thus, we were not able to perform any statistical analyses for DPOAE results.Conclusion:Our findings suggest that KRG seems to be an efficient agent against NIHL. There is need for additional research to find out about the mechanisms of KRG’s protective effect

Presmiakuzide orta latans işitsel uyarılmış potansiyeller

Bu çalışmada, presbiakuzili 2 grup olguda, fonetik dengeli kelimeler ve cümlelerle elde edilen performans-şiddet fonksiyonları ile işitsel uyarılmış orta latans davranım odyometrisi (MLR) bulguları arasındaki ilişki araştırılmıştır.Konuşmayı anlama puanı normal (%80-100) 15 presbiakuzili ve konuşmayı anlama puanı düşük (%80'in altında) 15 presbiakuzili olmak üzere iki çalışma grubunun bulguları ile iki kontrol grubunun bulguları karşılaştırılmıştır.Birinci kontrol grubu, çalışma grubundaki olgularla yaş ve cinsiyetin bire bir eşlendiği normal işiten 15 olgudan oluşmaktadır. İkinci kontrol grubu ise, yüksek frekanslara doğru artan işitme kayıplı, yaşları 20-35 arasında, çalışma grubu ile cinsiyetin bire bir eşlendiği genç kontrol grubudur.Olgular, saf ses davranım odyometrisi, cümle-kelime şiddet performans testi ve işitsel uyarılmış orta latans odyometrisi ile değerlendirilmiştir.Çalışma sonucunda, konuşmayı anlama puanı normal presbiakuzili grubun ve konuşmayı anlama puanı düşük presbiakuzili grubun, kelimeler ve cümlelerle elde edilen performans-şiddet fonksiyon bulguları ve MLR bulguları, normal işiten yaşlı kontrol grubun bulguları ile karşılaştırıldığında, konuşmayı anlama puanı düşük presbiakuzili grubun konuşma testi bulgularında ve MLR'de sadece Na latansında istatistiksel olarak anlamlı fark bulunmuştur. Konuşmayı anlama puanı düşük presbiakuzililerde, hem konuşma testlerinde hem de MLR Na latansındaki farklılığın nedeni, bu grupda nöral etkilenmenin daha fazla olmasına bağlı olabilir. Presbiakuzililerde periferal ve santral etkilenmenin değerlendirilebilmesi için, objektif bir test olan MLR Na latansının tesbit edilmesi, subjektif bir test olan konuşma testlerinden şiddet-performans fonksiyonunun tesbit edilmesine tercih edilebilir. Anahtar kelime: Presbiakuzi, konuşmayı anlama puanı, işitsel uyarılmış orta latans davranım. SUMMARYMiddle Latency Evoked Responses in a Group of Patients with PresbycusisThis study examined the relationship between the auditory middle latency response audiometry results with the performance-intensity functions for sentences and phonetically balanced words obtained from two groups of subjects with presbycusis in the age range of 50 to 70 years.One of the study group was compared with fifteen subjects having a good speech understanding (%80-100), while the other study group consisted of fifteen subjects with poor speech understanding ( %80). The control group consisted of fifteen adult subjects having normal hearing matched for age and sex with the study groups. The second control group consisted of fifteen young adults in the age range of 20 to 35 years and having a high frequency hearing loss.Data were collected from all described groups using pure tone audiometry, performance-intensity test for sentences and words, and auditory evoked middle latency audiometry . Result of the present study revealed that there is significant difference between performance-intensity scores for sentences and phonetically-balanced word scores obtained from the study group with poor understanding. When study group was compared with the corresponding control groups were compared, a single parameter of middle latency evoked response, namely Na latency, obtained from presbycusis group with poor speech understanding were significantly different from those of the fully matched normally hearing group.The reason for the difference both in speech tests and the Na latency in MLR tests in presbycusis patients with poor speech discrimination may be due to the more pronounced neural involvement in this group of subjects. In subjects, with presbycusıs,determination of Na latency with an objective MLR test may be preferred to performance-intensity determination in speech tests for the evaluation of peripheral and central involvement.Key words: Presbycusis, speech understanding score, auditory middle latency response

Presmiakuzide orta latans işitsel uyarılmış potansiyeller

Bu çalışmada, presbiakuzili 2 grup olguda, fonetik dengeli kelimeler ve cümlelerle elde edilen performans-şiddet fonksiyonları ile işitsel uyarılmış orta latans davranım odyometrisi (MLR) bulguları arasındaki ilişki araştırılmıştır. Konuşmayı anlama puanı normal (%80-100) 15 presbiakuzili ve konuşmayı anlama puanı düşük (%80'in altında) 15 presbiakuzili olmak üzere iki çalışma grubunun bulguları ile iki kontrol grubunun bulguları karşılaştırılmıştır. Birinci kontrol grubu, çalışma grubundaki olgularla yaş ve cinsiyetin bire bir eşlendiği normal işiten 15 olgudan oluşmaktadır. İkinci kontrol grubu ise, yüksek frekanslara doğru artan işitme kayıplı, yaşları 20-35 arasında, çalışma grubu ile cinsiyetin bire bir eşlendiği genç kontrol grubudur. Olgular, saf ses davranım odyometrisi, cümle-kelime şiddet performans testi ve işitsel uyarılmış orta latans odyometrisi ile değerlendirilmiştir. Çalışma sonucunda, konuşmayı anlama puanı normal presbiakuzili grubun ve konuşmayı anlama puanı düşük presbiakuzili grubun, kelimeler ve cümlelerle elde edilen performans-şiddet fonksiyon bulguları ve MLR bulguları, normal işiten yaşlı kontrol grubun bulguları ile karşılaştırıldığında, konuşmayı anlama puanı düşük presbiakuzili grubun konuşma testi bulgularında ve MLR'de sadece Na latansında istatistiksel olarak anlamlı fark bulunmuştur. Konuşmayı anlama puanı düşük presbiakuzililerde, hem konuşma testlerinde hem de MLR Na latansındaki farklılığın nedeni, bu grupda nöral etkilenmenin daha fazla olmasına bağlı olabilir. Presbiakuzililerde periferal ve santral etkilenmenin değerlendirilebilmesi için, objektif bir test olan MLR Na latansının tesbit edilmesi, subjektif bir test olan konuşma testlerinden şiddet-performans fonksiyonunun tesbit edilmesine tercih edilebilir. Anahtar kelime: Presbiakuzi, konuşmayı anlama puanı, işitsel uyarılmış orta latans davranım. SUMMARY Middle Latency Evoked Responses in a Group of Patients with Presbycusis This study examined the relationship between the auditory middle latency response audiometry results with the performance-intensity functions for sentences and phonetically balanced words obtained from two groups of subjects with presbycusis in the age range of 50 to 70 years. One of the study group was compared with fifteen subjects having a good speech understanding (%80-100), while the other study group consisted of fifteen subjects with poor speech understanding ( %80). The control group consisted of fifteen adult subjects having normal hearing matched for age and sex with the study groups. The second control group consisted of fifteen young adults in the age range of 20 to 35 years and having a high frequency hearing loss. Data were collected from all described groups using pure tone audiometry, performance-intensity test for sentences and words, and auditory evoked middle latency audiometry . Result of the present study revealed that there is significant difference between performance-intensity scores for sentences and phonetically-balanced word scores obtained from the study group with poor understanding. When study group was compared with the corresponding control groups were compared, a single parameter of middle latency evoked response, namely Na latency, obtained from presbycusis group with poor speech understanding were significantly different from those of the fully matched normally hearing group. The reason for the difference both in speech tests and the Na latency in MLR tests in presbycusis patients with poor speech discrimination may be due to the more pronounced neural involvement in this group of subjects. In subjects, with presbycusıs,determination of Na latency with an objective MLR test may be preferred to performance-intensity determination in speech tests for the evaluation of peripheral and central involvement. Key words: Presbycusis, speech understanding score, auditory middle latency response