1,721,238 research outputs found
New frontiers in tinnitus, hearing loss and hyperacusis
Full text linkAlthough considerable progresses have been made in the recent years, there are still wide-open pathways for research in tinnitus, hearing loss and hyperacusis. Among them, I’d like to put particular focus on basic and clinical research on the predisposing elements to ac- quired hearing loss to favour understanding in prevention and treatment, on the exploration of the pathophysiological basis of tinnitus necessary for future possible treatments, and on the correlation between tinnitus and hyperacusis, an interesting direction that could rise questions and give answers to identify target mechanisms able to help in therapeutic strategies
Hearing disorders in Turner’s syndrome
Full text linkIntroduction: Turner’s Syndrome (TS) is associated with hearing disorders in about 20 to 50% of affected individuals. The most common hearing disorders include congenital auricular malformations, recurrent otitis media and sensorineural hearing loss, although altered vestibular function and tinnitus have also been reported. Objectives: The aim of this paper is to provide an up-to-date overview of the principal ndings and research perspectives about the association between TS and hearing disorders. Review: Middle ear disorders, found in a range between 21 and 91% of subjects, are a consequence of morphological cranio-facial alterations resulting in middle ear ventilation dysfunc- tion. Sensorineural hearing loss follows 2 main audiological pro les: a bilateral symmetrical mid-frequency dip and a high frequency down-sloping curve. Although the pathophysiologic basis of sensorineural hearing loss in TS patients are still unclear, several hypothesis have been made so far and are reviewed in this paper. Conclusion: Literature confirms that hearing disorders, although not the most relevant clinical problem in these patients, have a high incidence in patients with TS and should therefore undergo early evaluation and monitoring over time
Noise induced hearing loss: the role of oxidative stress
Full text linkIntroduction: Noise-induced hearing loss (NIHL) is a relevant source of hearing disability affecting the general population, and accounts for about 16% of all the reported cases of disabling hearing loss in the adult population worldwide. NIHL can follow workplace-related and recreational noise exposure, and can be influenced by individual factors such as age, sex, genetic predisposition and socio-economic factors. Objectives: The aim of this paper is to provide a quick overview of the principal ndings in noise induced hearing loss, focusing on the role of oxidative stress and antioxidant intervention. Review: Oxidative stress plays a central role in leading to a condition of NIHL. Reactive oxygen species (ROS) and reactive nitrogen species (RNS) largely participate in cellular mechanisms that underlie mainly the outer hair cell death after noise exposure and lead to sensorineural hearing loss. The beneficial effects of antioxidant supplementation have been demonstrated by several experimental studies in animals, while the observed results in humans are mixed. Conclusion: NIHL still represents a widespread condition among the general population; with a higher prevalence in developing countries among workers, and in developed countries among young adults exposed to leisure noise. Extensive literature confirms that increasing antioxidant levels in the organ of Corti may be an appropriate approach towards understanding NIHL in humans by increasing the endogenous antioxidant response or by administering antioxidant molecules systemically or locally
Systemic lupus erythematosus and hearing disorders: literature review and meta-analysis of clinical and temporal bone findings
Full text linkObjective: This literature review and meta-analysis was performed to evaluate the correlations among hearing and vestibular clinical symptoms, temporal bone findings, and pathological mechanisms in patients with systemic lupus erythematosus (SLE). Study design: Relevant papers in the literature were retrospectively reviewed. Clinical hearing aspects in patients with SLE and relevant temporal bone studies in the same field were analyzed. Methods: PubMed and Google Scholar searches were performed using the following keywords: “auto-immune disease,” “systemic lupus erythematosus (SLE),” “hearing loss,” “temporal bone study,” “vertigo,” “dizziness,” “tinnitus,” “ear symptoms,” “treatment,” “diagnosis,” “symptoms,” “etiopathogenesis,” “Wegener granulomatosis,” “Sjogren,” “polyarteritis nodosa,” “Cogan syndrome,” and “granulomatosis.” Also included were reviews in which the following terms were present: “SLE,” “temporal bone,” and “hearing symptoms.” Review and conclusion: This literature review and meta-analysis focused on the pathological mechanisms through which SLE can damage inner ear structures and determinate hearing and vestibular symptoms. The main mechanisms involved in inner ear damage include the autoimmune response, deposition of immune complexes in the vessels and, to a lesser extent, cytotoxic damage
Ocular Vestibular Evoked Myogenic Potentials and Intralabyrinthine Intravestibular Schwannomas
No full textIntralabyrinthine intravestibular schwannomas are uncommon benign tumors arising from the saccular, the utricular or the lateral and superior ampullary nerves. Diagnosis relies on audiovestibular examination and Magnetic Resonance Imaging; literature reports a delay of 8 years between the onset of symptoms and diagnosis. The aim of this paper is to present a case of intralabyrinthine intravestibular schwannoma in which we included in the diagnostic protocol the Ocular Vestibular Evoked Myogenic Potential (oVEMP) test, a new neurophysiological diagnostic exam that measures utricular function and contralateral superior vestibular nerve afferent fibers. We report the case of a patient presenting with progressive sensorineural hearing loss, dizziness, tinnitus and fullness in the right ear. Audiovestibular examination and MRI were performed to diagnose a right intralabyrinthine intravestibular schwannoma; oVEMPs were absent in the side contralateral to lesion and contributed to the diagnostic process in our patient. oVEMP can provide detailed information on the functionality of the superior and lateral ampullary nerves and the macula of utricle with a precise identification of the affected area. Based on this findings, we discuss the role of oVEMPs in the diagnosis of intravestibular intralabyrinthine schwannoma
L’acufene nell’anziano
No full textL’acufene è una condizione comune nella popolazione anziana; la maggior parte degli studi ne dimostra un progressivo aumento
con l'età fino a 70-75 anni. La presbiacusia è il principale fattore di rischio. Nell’anziano l’acufene presenta alcune peculiarità
di natura epidemiologica, etiologica, diagnostica e terapeutica che è necessario tenere in considerazione. La qualità
della vita nei soggetti anziani con acufene viene profondamente influenzata dalla sintomatologia ansiosa e depressiva
che sembra essere la sequela più comune nell’acufene nell’anziano.
La maggior parte dei fattori favorenti l’acufene nell’anziano sono in comune con quelli alla base della presbiacusia, e
del suo grado di severità individuale. Tra questi, è utile menzionare l’attività dei radicali liberi dell’ossigeno; la disfunzione dei
recettori NMDA con conseguente aumento dell’eccitotossicità; le alterazioni dei meccanismi GABA-mediati e DOPA-mediati,
con successiva diminuzione dell’attività del sistema efferente e, quindi dell’aumentata vulnerabilità di fronte alle noxae traumatiche,
ischemiche e tossiche; l’attività dei meccanismi serotoninergici coinvolti nell’umore e nell’emotività; il ruolo dell’attività
limbo-amigdala per l’attenzione e la vigilanza emotività; e ovviamente i fenomeni di neuroplasticità. È inoltre importante ricordare
i fattori artrosici e muscolo-scheletrici e gli effetti ototossici ed acufenogeni di alcuni farmaci. La gestione clinica del
paziente anziano con acufene non ha particolari differenze metodologiche rispetto alla gestione del paziente giovane; tuttavia,
è opportuno considerare alcune peculiarità utili per ottenere migliori risultati nella compliance e nel trattamento che verranno
approfondite in questo lavoro.Tinnitus is a common condition in the elderly population; most studies show a gradual increase of tinnitus in age groups up to 70-75 years. Presbycusis is the main risk factor for tinnitus. In the elderdy, tinnitus has some epidemiological, etiologic, diagnostic and therapeutic peculiarities that need to be considered. The quality of life in elderly subjects with tinnitus is deeply influenced by the anxiety and depressive symptoms that appear to be the most common sequelae of tinnitus. Most tinnitus favoring factors in the elderly are in common with those at the base of presbycusis. Among these, it is useful to mention the activity of free oxygen radicals; the dysfunction of NMDA receptors resulting in increased excitotoxicity; alterations of GABA-mediated and DOPA-mediated mechanisms, with subsequent diminution of the efferent system activity and hence of increased vulnerability to traumatic, ischemic and toxic noxae; the activity of serotoninergic mechanisms involved in mood and emotion; the role of limbo-amygdala activity for attention and vigilance emotion; and of course the phenomena of neuroplasticity. It is also important to remember the musculoskeletal factors and ototoxic effects of certain drugs. Clinical management of tinnitus in the elderly population has no particular methodological differences compared to the management of young patients; however, some useful peculiarities should be considered to obtain better results in compliance and treatment that will be discussed in this paper
Double ring in cochlear otosclerosis: a limit to cochlear implantation? The solution is the surgical approach
Full text linkWe present a case of a 50-year patient with a severe form of otosclerosis (double ring) that was successfully implanted. We used a bone-anchored hearing implant for restoring the hearing in the right side and a cochlear implant in the left side; both surgeries did not show any complications. For reducing the risk of a secondary bone ossification related to the trauma of cochleostomy for electrode's insertion, we used a round window approach. The patient recovered a normal auditory threshold and normal speech perception capacity both in silence and noise conditions 1 year after surgery
La pianificazione terapeutica dei pazienti con Otite Media Suppurativa Cronica. Il ruolo della Qualità della Vita: aspetti controversi.
No full textHearing loss in Takayasu's arteritis: a role for hyperbaric oxygen therapy?
Full text linkIn the scientific community, there is growing interest regarding associated symptoms in Takayasu’s arteritis (TA), an autoimmune condition that mainly affects the medium and large arteries. Hearing loss (HL) is a rare complication of TA that is often overlooked and has severe consequences on the quality of life. HL mainly presents as sudden sensorineural hearing loss (SSNHL) and responds to corticosteroid therapy. In the authors’ opinion, the reasons for misdiagnosing HL in patients with TA are lack of evidence re- garding this rare complication and because TA involves large caliber arteries, instead of small vessels that are typical of the inner ear. We recently used HBOT for a 36-year-old woman with TA, who had two SSNHL episodes in different ears in an 11-month period and observed a significant improvement in the patient's hearing. Although this was a single case finding and HBOT was administered together with steroid therapy, the significant recovery of HL in both ears following this therapeutic approach may be worth sharing with the scientific community. In conclusion, we recommend that awareness for inner ear involvement in TA should increase and that HL should be considered a possible complication of TA and should be treated with corticosteroid therapy and, after collecting further evidence, HBOT
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