Sensorineural Hearing Loss
It is characterized by a reduction in sound sensitivity and clarity, making it difficult to hear and understand speech.
This condition can result from a variety of factors, including noise exposure, aging, genetic factors, and certain medical conditions.
Effective management of Sensorineural Hearing Loss often involves the use of hearing aids, cochlear implants, or other assistive devices to improve auditory function and enhance quality of life.
Reseach in this area focuses on understanding the underlying mechanisms, developing better diagnostic tools, and improving treatment options to address this common and often debilitating form of hearing loss.
Most cited protocols related to «Sensorineural Hearing Loss»
Children were excluded from the sample if they met any of the following criteria: WASI nonverbal ability (performance IQ) more than two SDs below the population mean; diagnosis of autism spectrum disorder (ASD) in one or both twins; sensorineural hearing loss or failure of a hearing test on the day of testing; and brain injury or a serious medical condition affecting one or both twins. In order to test our main hypothesis that DLD was related to cerebral laterality as measured by fTCD, it was necessary to exclude individuals in a second stage of exclusions if we did not obtain useable fTCD data from them, defined as fewer than 12 accepted trials. We also excluded participants with extreme laterality indices (above 10 or below −10); 3 individuals were excluded based on this criterion. Useable fTCD data were obtained from 107 (80%) of the children with DLD, and 156 (82%) of the TD children.
Menière’s disease: duration of the attacks from 20 min to 12 hours, low- to medium-frequency sensorineural hearing loss (>30 dB, <2000 Hz) [28 (link)].
Tumarkin’s otolithic crisis (“vestibular drop attacks”). These sudden falls are usually not accompanied by vertigo and occur most often in patients with known Menière’s disease, typically while standing, whereas in VP the attacks occur in any body positions.
Paroxysmal brainstem attacks with vertigo, dysarthria or ataxia (after stroke or in MS) may be difficult to distinguish, as they also respond to low doses of sodium-channel blockers. It was shown that they may be caused by a brainstem lesion due to MS plaques or lacunar infarctions [27 (link)], which also leads to ephaptic discharges of neighboring fibers of the brainstem paths. In such cases the use of MRI with thin brainstem slices is useful for establishing the diagnosis.
Vestibular migraine [26 (link)]: officially the duration of the attacks is 5 min to 72 hours, current or previous history of migraine, most attacks being accompanied by other migrainous symptoms. In vestibular migraine, short spells of vertigo may be induced by changes of head or body position when patients are motion sensitive during an episode of vestibular migraine.
Vertebrobasilar transient ischemic attacks: vertigo frequently occurs in isolation in this condition [33 (link)].
Panic attacks: according to DSM-5, the diagnostic criteria for a panic attack include a discrete period of intense fear or discomfort, in which four (or more) of the following symptoms develop abruptly and reach a peak within minutes: feeling dizzy, unsteady, lightheaded, or faint; nausea or abdominal distress; palpitations, and/or accelerated heart rate; sweating; trembling or shaking; sensations of shortness of breath or being smothered; feeling of choking; chest pain or discomfort; de-realization or depersonalization; fear of losing control or going insane; sense of impending death; paresthesias; chills or hot flashes. Panic attacks are often longer than typical attacks of VP. It may be helpful to ask the patient which of the symptoms come first to differentiate between the two.
Perilymph fistula: The cardinal symptoms of perilymph fistula (and superior canal dehiscence syndrome) are attacks of vertigo caused by changes in pressure, for example, by coughing, pressing, sneezing, lifting, or loud noises and accompanied by illusory movements of the environment (oscillopsia) and instability of posture and gait with or without hearing disorders. The attacks, which can last seconds to days, may also occur during changes in the position of the head (e.g., when bending over) and when experiencing significant changes in altitude (e.g., mountain tours, flights) [6 ].
Episodic ataxia type 2: the duration of the attacks varies from several minutes to hours and more than 90% of the patients have cerebellar signs, in particular gaze-evoked nystagmus and downbeat nystagmus [20, 40 (link)]. The onset of manifestations after the age of 20 is unusual. The much rarer episodic ataxia type 1 is another differential diagnosis. It is characterized by recurrent attacks of ataxia, dizziness and visual blurring, provoked by abrupt postural changes, emotion, vestibular stimulation and lasting minutes. These patients also have neuromyotonia, i.e. continuous spontaneous muscle fiber activity [19 (link)].
Epilepsy with vestibular aura: Vestibular auras can manifest with short attacks of vertigo and nystagmus. Vestibular aura with additional symptoms, so-called non-isolated vestibular aura, is much more prevalent than isolated vestibular aura, which is rare. Vestibular aura is primarily associated with temporal lobe seizures. Isolated vestibular aura spells often last only a few seconds, but longer spells are also reported [41 (link)].
Most recents protocols related to «Sensorineural Hearing Loss»
years old) with sensorineural hearing loss who received their first CI in our
hospital from September 2018 to June 2020 were included in this study. These
children were right-handed according to an assessment with the Edinburgh
Handedness Inventory (Oldfield, 1971 (link)). They started to use hearing aids at a mean age of
2.30 ± 1.21 years old, and had used hearing aids with a mean duration of
2.79 ± 3.26 years and for at least 4 h per day in their daily life. These
children had auditory responses to environmental sounds during the initial
period of hearing aid fitting. To confirm the effectiveness of hearing aid
fitting in the daily life, their auditory performance was reexamined by the
Meaningful Auditory Integration Scale (MAIS) and Categories of Auditory
Performance (CAP) at least every 8 months. The MAIS includes 10 questions
reflecting children's confidence in hearing devices, auditory sensitivity and
ability to connect sounds with meaning. The highest score is 40 and indicates
the best performance for meaningful sound use in everyday situations. The CAP is
an eight-score hierarchical scale that evaluates receptive auditory abilities
and ranges from no awareness of environmental sounds (1 score) to telephone use
with a familiar talker (8 scores). When hearing aid outcomes were poor and the
ABR thresholds estimated by the click and 500-Hz tone burst were above 90 dB
nHL, the hearing-impaired child received a CI. Before the CI surgery, the ABR,
40-Hz auditory evoked potential, multi-frequency steady state potential (MFSSP),
distortion product otoacoustic emission (DPOAE) and acoustic impedance had been
performed to confirm profound sensorineural hearing loss (hearing threshold ≥90
dB nHL). The 40-Hz auditory evoked potential (Lynn et al., 1984 (link)) and MFSSP (
2005
500-Hz tone burst and sinusoidally amplitude modulated tones (1, 2 and 4 kHz),
respectively. Only 24 children finished the pure-tone audiometry and their
unaided pure tone averages (averaged over 0.25, 0.5, 1, 2, 4 and 8 kHz) were
above 90 dB HL. Participants who had a mental disability, intracranial lesions
or head trauma were excluded from this study. Of children in our study, 20 had
IEMs assessed by computerized tomography (CT) and magnetic resonance imaging
(MRI) according to previously published criteria (Sennaroglu & Bajin, 2017 (link)).
Detailed information for all children is provided in
this study involving human participants were in accordance with the ethical
standards of the institutional and/or national research committee and with the
1964 Helsinki declaration and its later amendments or comparable ethical
standards. The protocols and experimental procedures in the present study were
reviewed and approved by the Anhui Provincial Hospital Ethics Committee. Each
participant's guardians provided written informed consent.
Then, within the third month of life, every newborn was evaluated in the Audiology Department, where otoscopy, ABR and impedance tests were performed bilaterally. ABR was recorded during spontaneous sleep, using Medelec® Synergy software. Acoustic wide range click stimuli of 21 pps were applied by headphones. Action potentials were detected using vertex-mastoid ipsilateral derivations. At least two runs were obtained at any stimulus intensity and compared to each other, in order to assess waveform repeatability. The exam was conducted presenting medium intensity stimuli, then decreasing gradually until the V wave peak threshold was obtained; lastly, a high intensity stimulus was presented to detect wave’ latencies. With regards to ABR results, the following parameters were evaluated: identification of I, III and V wave peaks at different stimulus intensity and their replicability; identification of V wave threshold expressed in dB nHL; measurements of peak latencies of I, III and V waves expressed in ms; interaural difference of V wave latency (IT-5) expressed in ms.
Thresholds of V wave identification ≤30 dB nHL, without pathological delay of latency, were considered indicative of normal results.
An acoustic immittance test was conducted in order to rule-out potential overestimations of the auditory threshold caused by middle or external ear dysfunctions. A Madsen Zodiac device (Natus® Medical Incorporated, Denmark) at 1000 Hz probe tone frequency was used to test acoustic immittance. Tympanograms were classified according to the Jerger classification and acoustic reflex (AR) measures were taken using the same instrument [23 (link)].
All families with normal results were invited, as usual practice for children at risk for hearing loss, to take their children to the hospital for repeat audiological evaluation at the age of 1 year. Basically, all children underwent visual reinforcement audiometry (VRA) using a two-channel diagnostic audiometer (Piano Plus VRA, Audiology and Balance, Inventis Srl, Padova, Italy) and an immittance test.
The severity of sensorineural hearing loss was defined according to the WHO classification: mild (≥26 to <40 dB), moderate (≥41 to <55 dB), moderate-severe (≥56 to <70 dB), severe (≥71 to <90 dB) and profound (>90 dB) [24 ].
25 with usual care (oral analgesics, with/without antibiotics); or (2) usual care. Analgesic ear drops will be provided by the study team. These drops should not be used in children with a tympanic membrane perforation or ventilation tube as they carry a risk of inner ear damage causing hearing loss or tinnitus. These children will therefore be excluded, as well as those with ear wax obscuring visualisation of the tympanic membrane. Parents of children allocated to the intervention group are expressly instructed to stop applying the drops if their child develops ear discharge.
The study team will notify the GP about the result of the randomisation. The local pharmacist will be notified in case the child is allocated to the analgesic ear drops, in order to check any known sensitivities/allergies and any interactions (with current or future drugs). Any treatment decisions other than the use of analgesic ear drops, that is, antibiotics and oral analgesics, will be left to the GP’s discretion in both groups. To those allocated to the intervention group, the study physician will not provide any treatment advice other than instructions about the use of analgesic ear drops. To those allocated to the control group, the study physician will not provide any treatment advice.
During follow-up, parents and GPs will be encouraged to manage AOM symptoms according to current clinical practice guidance on AOM in children issued by the Dutch College of General Practitioners. Lidocaine ear drops are currently not recommended in this guideline due to the lack of evidence.23
The query included data for adults referred to the CI center for their first cochlear implantation candidacy evaluation between April 2017 and July 2019. Patients in consideration for revision surgery or second‐side evaluation were excluded to control for additional factors that may influence attendance to the cochlear implantation evaluation appointment and adherence to the recommended post‐activation follow‐up. More recent data (i.e., after 2019) were excluded due to the confounding nature and implications of variables introduced by the COVID‐19 pandemic. The query was limited to data for patients residing in North Carolina for consistency of criteria used to determine county‐level socioeconomic and geographic data. The query included the following data: age at time of referral, insurance/payer type, zip code, county, and referral source (e.g., primary care physician, ENT physician, audiologist). For the patients who attended the cochlear implantation candidacy evaluation, the type of candidate was grouped by the audiologic findings, including conventional criteria (i.e., bilateral moderate‐to‐profound sensorineural hearing loss [SNHL]), expanded indications (i.e., unilateral moderate‐to‐profound SNHL or asymmetric SNHL), or not a candidate. If surgery was pursued, the duration of time between device activation and the initial post‐activation follow‐up visit was calculated. Patients who did not attend the initial evaluation were classified as “Did Not Attend” and were not grouped based on audiologic findings. Patients who met the cochlear implantation candidacy criteria and decided not to pursue cochlear implantation were classified as “Did Not Pursue” and by their respective audiologic candidate type.
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More about "Sensorineural Hearing Loss"
This type of hearing impairment is caused by damage to the delicate structures within the inner ear, such as the hair cells or auditory nerve, which are responsible for converting sound waves into electrical signals that the brain can interpret.
SNHL can result from a variety of factors, including exposure to loud noises, aging, genetic disorders, certain medical conditions (e.g., Ménière's disease, otosclerosis, or acoustic neuroma), and ototoxic medications.
Symptoms of SNHL often include difficulty hearing soft sounds, understanding speech in noisy environments, and perceiving high-pitched voices or sounds.
Diagnosis of SNHL typically involves a comprehensive audiological evaluation, which may include pure-tone audiometry (using an audiometer), speech testing, and possibly imaging studies like CT scans or MRI.
Treatment options for SNHL can include the use of hearing aids, cochlear implants, assistive listening devices, and in some cases, surgical interventions.
Ongoing research in this field focuses on developing better diagnostic tools, such as the ALGO 2e or ALGO 3 systems, and improving treatment strategies, including the use of genetic therapies and stem cell-based approaches.
Software like ORBIS, SPSS, and Stata are often utilized in data analysis and study design.
Additionally, the QIAamp DSP DNA Blood Mini Kit may be employed in genetic research related to SNHL.
By understanding the underlying mechanisms and advancing treatment options, researchers and clinicians aim to improve the quality of life for individuals affected by this common and often debilitating form of hearing loss.