[Show abstract][Hide abstract] ABSTRACT: Arterial sclerosis contributes to inadequate blood supply to multiple organs, suggesting that general atherosclerosis may play an important role in the inner ear. Since noise is a major etiology for hearing loss, the aim of this study was to evaluate both the respective and the combined effects of arterial sclerosis and occupational noise exposure on hearing after accounting for age in middle-aged and elderly men.
The evaluation was conducted using 773 subjects from a population-based sample of 1189 men, aged 40-83 years. The impact of carotid atherosclerosis (CA) or retinal arteriolosclerosis (RA) on hearing was assessed according to history of occupational noise exposure (Noise) obtained in a questionnaire. Differences in the mean pure-tone thresholds at each frequency, between the CA (+) and CA (-) groups or between the RA (+) and RA (-) groups, based on noise exposure were compared using the general linear model (GLM) Procedure in SAS, with adjustments for age. Then, the main effect of CA or RA, and the interactive effect of noise and either CA or RA on pure-tone threshold at seven frequencies were analyzed using an analysis of covariance (ANCOVA), after adjusting for age.
In the Noise (+) group, a statistically significant deterioration in hearing was found in the CA (+) group compared with the CA (-) group at 500 and 1000 Hz. The results in RA were significant at even lower frequencies than in CA. In the results from ANCOVA, the significant main effect of CA was shown in the pure-tone threshold at 8000 Hz, but not in the analysis of RA. A significant interactive effect of either CA or RA and Noise was observed in hearing at the range from 125 to 1000 Hz.
The present study suggests that the impact of arterial sclerosis on hearing is limited but significantly hazardous in middle-aged and elderly men, and that arterial sclerosis exacerbates the deleterious effects of noise on hearing. Early recognition of arterial sclerosis might be contributory to the hearing prognosis after middle age, especially for noise-exposed men.
No preview · Article · Oct 2010 · Auris, nasus, larynx
[Show abstract][Hide abstract] ABSTRACT: Many recent studies have reported on intratympanic gentamicin therapy for the treatment of intractable Ménière's disease. Intratympanic administration of steroids has also been used to treat sudden sensorineural hearing loss. These intratympanic drug therapies are based on the assumption that the drug administered intratympanically enters the inner ear through the round window membrane. We used magnetic resonance imaging (MRI) to evaluate whether and how intratympanically administered gadolinium (Gd) enters the inner ear.
GD hydrate was injected intratympanically through the tympanic membrane using a 23-G needle into 61 ears of 55 patients with inner ear diseases. The injected Gd was diluted 8-fold in saline for injection into 58 ears and 16-fold for 3 ears. Three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) imaging was performed using a 3-Tesla MRI unit 1 day after the intratympanic injection.
In 53 of 61 ears, the Gd-containing inner ear was detected well as a high signal on 3D-FLAIR imaging. However, Gd was not visible in 2 ears with Ménière's disease and in 1 ear with profound deafness. The concentration of Gd in the perilymph was lower in 4 ears with Ménière's disease and 1 ear with delayed endolymphatic hydrops than after intratympanic administration of the 16-fold Gd dilution.
Round window permeability was absent in 5% of ears, and 13% of ears had poor round window permeability. These results should be considered when planning intratympanic drug administration therapy to treat inner ear diseases.
No preview · Article · Jun 2009 · Otology & neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
[Show abstract][Hide abstract] ABSTRACT: Using three-dimensional real inversion recovery (3D-real IR) and three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) magnetic resonance imaging (MRI), various degrees of endolymphatic hydrops were observed in the basal and upper turns of the cochlea and in the vestibular apparatus after intratympanic gadolinium (Gd) injection. MRI may contribute to our understanding of inner ear diseases and may be a useful addition to intratympanic drug therapy in the management of inner ear diseases.
To evaluate 3D-real IR MRI and 3D-FLAIR MRI with clinical symptoms and signs in patients with inner ear disease. Patients and methods: Gd was diluted in saline and injected intratympanically in 73 patients with inner ear disease. The endolymphatic space was evaluated with 3-Tesla MRI at 1 day after the intratympanic Gd injection.
3D-real IR MRI was generally better than 3D-FLAIR MRI in discriminating between the perilymphatic space and endolymphatic space in the cochlear turns and in the vestibular apparatus. However, when Gd concentration was insufficient in the perilymph, it was more difficult to visualize the Gd with 3D-real IR MRI than with 3D-FLAIR MRI. Endolymphatic hydrops was observed using MRI in patients with 'probable' Meniere's disease based on the criteria.
No preview · Article · Feb 2009 · Acta oto-laryngologica. Supplementum
[Show abstract][Hide abstract] ABSTRACT: The use of hearing aids, regardless actual implementation, may be interpreted as a cry for help in hearing difficulty. We assessed factors contributing to hearing aid possession and predicted needs of hearing assistance from the distribution of hearing level in self-estimated (subjective) hearing loss and hearing loss pointed out by others (objective) in a population-based aging cohort. Of 1192 men and 1163 women aged 40 to 84 years, the prevalence of hearing loss using the criteria of a mean hearing threshold>25dB at frequencies of 0.5, 1, 2, and 4 kHz in the better ear was 23.6%. Hearing aids were possessed by 11.0% in the hearing loss group. Statistical analysis by gender was done to identify factors associated with hearing aid possession using stepwise multiple regression in which independent variables were age, hearing in the better and worse ear, and items from response to a questionnaire on self-estimated hearing loss, hearing loss pointed out by others, job, household income, financial satisfaction, education, housemate, how often others were talked to and how often those surveyed went out. Age, better-ear hearing, worse-ear hearing, and education statistically influenced hearing aid possession in men, and age, better-ear hearing, and hearing loss pointed out by others statistically influenced women. Age had a negative effect on hearing aid possession in both men and women, indicating that possession decreased with aging. Scattergrams were plotted with worse-ear hearing on the y axis and better-ear hearing on the x axis for 4 groups of respondents divided into groups with self-estimated hearing loss or hearing loss pointed out by others: (1) no subjective and objective hearing loss, (2) subjective but no objective hearing loss, (3) objective but no subjective hearing loss, and (4) both subjective and objective hearing loss. Many respondents had either subjective or objective or both subjective and objective hearing loss, even within 20 dB of hearing level of both ears in their 40s. These facts implied that early-stage candidates for hearing aids may not require threshold reduction, although aided thresholds were commonly used indicators in fitting.
No preview · Article · Jun 2008 · Nippon Jibiinkoka Gakkai Kaiho
[Show abstract][Hide abstract] ABSTRACT: There is evidence of an inverse association between cerebral infarction and tinnitus in this study. The effects of cerebral infarction on tinnitus could be explained by a neurophysiological model of tinnitus.
We examined the relationship between tinnitus and brain MRI findings including cerebral infarction, brain atrophy, ventricular dilatation, and white matter lesions.
This was a cross-sectional population-based study of 2193 subjects aged 41-82 years living in Aichi prefecture, Japan. Detailed questionnaires, pure tone audiometry, and brain MRI were performed.
After adjusting for potential confounders in a multiple logistic analysis, cerebral infarction was inversely associated with tinnitus (odds ratio (OR)=0.649, 95% confidence interval (CI)=0.477-0.884). Cerebral infarctions of the basal ganglia (OR=0.542), thalamus (OR=0.441), and pons (OR=0.319) were especially associated with tinnitus. Brain atrophy, ventricular dilatation, and white matter lesions had no significant effects on the prevalence of tinnitus.
No preview · Article · Jun 2008 · Acta Oto-Laryngologica