Episodes of repeated sudden deafness following pregnancies

Can Pregnancy Lead to Changes in Hearing Threshold?

PURPOSE

This study explores the changes in hearing thresholds in pregnancy.

MATERIALS AND METHODS

A prospective hospital-based observational study was performed with a total of 69 patients in the age-group of 18 to 40 years. Patients underwent hearing assessment twice during the study period. Conventional pure tone audiometry and impedance audiometry were performed, first during the antepartum period (28-32 weeks of gestational age) and second time during the postpartum period (6 weeks postpartum).

RESULTS

Significant difference was seen between the average of air conduction threshold values at speech frequencies when antepartum values were compared with postpartum values.

CONCLUSION

The alterations in hearing sensitivity in pregnant females which improved during the postpartum period can be attributed to pregnancy.

Clinical management and progress in sudden sensorineural hearing loss during pregnancy

Sudden sensorineural hearing loss (SSNHL) is a relatively rare, but distressing, disease in pregnant women. Little is known about the causes, clinical manifestations, treatments, and prognosis of SSNHL. Some hypotheses have been proposed to explain the pathophysiological mechanism of SSNHL, but most of them have not been identified. This article reviews the existing literature to present a summary of this clinical problem. Most patients suffer from SSNHL in the second or third trimester, and show moderate to profound hearing loss. The interval between the initial treatment and onset of hearing loss is less than 10 days in most patients. Some patients with SSNHL show tinnitus, vertigo, or dizziness, and fullness of the ear. Although some patients have a tendency for self-cure, treatment with intravenous dextran 40 combined with intratympanic corticosteroids is probably a safe and effective therapeutic strategy for pregnant patients with SSNHL. Further clinical research is necessary to identify the best therapeutic strategy for these patients.

Sudden sensorineural hearing loss during pregnancy: clinical characteristics, management and outcome

BACKGROUND

Sudden sensorineural hearing loss (SSNHL) may occur during pregnancy with a rare prevalence, and little is known about it.

AIMS

To retrospectively analyze cases of SSNHL during pregnancy and investigate their clinical characteristics, management and outcome.

MATERIAL AND METHODS

Records of 30 SSNHL patients during pregnancy were reviewed, including age, localization, duration from onset to treatment, gestation period, accompanying symptoms, initial hearing threshold, final hearing threshold, audiogram, treatment and outcome.

RESULTS

Twenty-four patients (80.0%) suffered SSNHL in the second trimester or the last trimester with a high rate of tinnitus (70.0%). The initial hearing threshold was 63.4 ± 25.1 dB, and most audiograms were flat and profound. The overall recovery rate was 60.0%, including complete recovery (33.3%) and partial recovery (26.7%). Further, 16 patients received adjuvant intratympanic steroid showed a better audiologic outcome (improvement 27.1 ± 16.4 vs. 15.7 ± 12.0 dB, p = .042) than those who had not.

CONCLUSIONS AND SIGNIFICANCE

SSNHL during pregnancy often occurred in the second trimester or the last trimester with a severe hearing loss, the most audiogram configurations are flat and profound. Dextran-40 is a safe and beneficial therapy for SSNHL patients during pregnancy and adjuvant intratympanic steroid increase the probability of hearing recovery.

[Blocked Nose, Nosebleeds, Ringing in the Ear: ENT Diseases During Pregnancy]

Blocked Nose, Nosebleeds, Ringing in the Ear: ENT Diseases During Pregnancy Abstract. In this overview the clinical pictures of ear, nose and throat diseases and their symptoms, which occur frequently but also particularly during pregnancy, are presented. In addition, the respective therapy options in this partially vulnerable phase of mother and child are discussed. The primary principle is 'as much as necessary, but as little as possible'. Even if the complaints often disappear with the birth of the child, there may be considerable suffering of the pregnant woman and therapy may be necessary. Moreover, an adequate therapy should be applied with all ENT diseases, even for those not specifically associated with pregnancy.

Audiological Functions in Pregnancy

Introduction

During pregnancy virtually every organ system undergoes anatomical and physiological changes that can alter appreciably the criteria for diagnosis and treatment of diseases. Hormonal fluctuations alter the composition of endolymph and perilymph, and ion transport process. Hence, audiological functions in pregnancy need evaluation.

Materials and methods

After approval of Institutional Ethics Committee, 100 pregnant women were recruited in the 1st trimester. Tuning tests were done using 128, 256, 512, and 1024 Hz tuning forks. Pure tone audiometry was done and hearing thresholds measured for 125, 250, 500, 1000, 2000, and 4000 Hz. Finally, impedance audiometry was done in all the women in each trimester.

Results

There was no air—bone gap. There was gradual reduction in hearing acuity at low frequencies (125, 250, 500, and 1000 Hz) from 1st to 3rd trimester of pregnancy. The hearing thresholds got stabilized in the 3rd trimester and returned to normal in postpartum period. For 2000 Hz and higher frequencies, there was no significant difference in relation to pregnant subjects. Number of pregnancies did not affect the audiological functions.

Conclusion

Low-frequency hearing loss during pregnancy appears to be transient in nature with complete resolution in the postpartum period in most cases. For better understanding of these changes, obstetricians and otolaryngologists can team-up and avoid use of drugs for their symptoms during pregnancy.

How to cite this article

Verma A, Thakur R, Dogra SS, Sharma S, Singhal A. Audiological Functions in Pregnancy. J South Asian Feder Obst Gynae 2017;9(1):42-46.

Sudden hearing loss and pregnancy: a review

Background:

Acute hearing loss is a distressing albeit rare occurrence in pregnancy. Due to its infrequent presentation, little is known of its cause, and the best management is unclear.

Objective:

To present a summary of current knowledge regarding sudden hearing loss in pregnancy and its management, by reviewing the published literature.

Data sources:

The following electronic databases: PubMed (MEDLINE), Ovid (MEDLINE), all EBM Reviews (Cochrane DSR, ACP Journal Club, DARE and CCTR) and Embase; plus a hand search of reference lists of retrieved papers.

Study selection and data extraction:

All papers retrieved using key word searches for ‘sudden hearing loss and pregnancy’ and ‘sudden deafness and pregnancy’ were reviewed. Due to the scarcity of literature, all studies identified were included in this review.

Data synthesis and conclusions:

All retrieved papers were reviewed. Sudden hearing loss is a rare occurrence during pregnancy, leading to a dearth of literature due to limited clinical experience. Audiological investigation findings for such patients remain equivocal. Recovery can be spontaneous during the postpartum period. In patients who require medical treatment, a dextran 40 infusion can be employed. There remains scope for further research, in the form of larger studies, to ascertain the best management option for this clinical problem.

A new disease: pregnancy-induced sudden sensorineural hearing loss?

Sudden sensorineural hearing loss (SSNHL) may occur during pregnancy, but its prevalence is very low. It is conjectured that SSNHL is closely related to the changes in the cardiovascular system, hematological system, endocrine system, and/or some other systems due to pregnancy. These changes possibly evoke disorders of cochlear circulation or cochlear fluid homeostasis leading to SSNHL. Two SSNHL cases were observed in our clinic, and their clinical features were analyzed. In one patient the SSNHL was likely to be related to the disturbance of cochlear fluid homestasis and in the other it might be induced by some disorders in cochlear circulation. Based on their distinct clinic profiles, we defined a new disease, called "pregnancy-induced sudden sensorineural hearing loss," similar to the definition of "pregnancy-induced hypertension." This study also deepened our understanding of the etiology of SSNHL.

Ear, Nose, and Throat Manifestations during Pregnancy

Objective. The objective of this clinical review is to highlight the otolaryngological symptoms that occur in pregnancy. Where available, the authors discuss the current evidence of the etiology and management of the various presentations. While it is appreciated that many of these complaints are transient, their impact on the maternal quality of life can be significant, and therefore, medical practitioners should be aware of what to expect in order to provide reassurance to patients and also to safely manage such symptoms.

Data Sources. MEDLINE and EMBASE databases were searched for publications related to otolaryngology and pregnancy.

Review Methods. All literature was searched for and reviewed by 2 authors independently. Search results were then cross-examined, and any differences were settled by consensus.

Results. Pregnancy leads to circulatory changes and increased susceptibility to viral reactivation, and along with the exertion of parturition, it can lead to tinnitus, facial palsies, and deafness. Rising levels of sex hormones and heightened sensitivity to allergens may influence the nasal mucosa, precipitating epistaxis and rhinitis. Increased progesterone and the increased intra-abdominal pressure of the growing fetus can lead to symptoms and sequelae of laryngopharyngeal reflux. Evidence for the treatment of pregnancy-induced symptoms is principally restricted to case reports and retrospective studies.

Conclusion. Recognition and understanding of pregnancy-related ear, nose, and throat complaints will allow otolaryngologists to reassure and manage these patients, improving their experience of the gestational period. High-quality evidence for their management is limited, with further research required.

Sudden sensorineural hearing loss

Sudden sensorineural hearing loss is usually unilateral and can be associated with tinnitus and vertigo. In most cases the cause is not identified, although various infective, vascular, and immune causes have been proposed. A careful examination is needed to exclude life threatening or treatable causes such as vascular events and malignant diseases, and patients should be referred urgently for further assessment. About half of patients completely recover, usually in about 2 weeks. Many treatments are used, including corticosteroids, antiviral drugs, and vasoactive and oxygen-based treatments. Although no treatment is proven, we recommend a short course of oral high-dose corticosteroids. There is much to learn about pathogenesis of sudden sensorineural hearing loss, and more clinical trials are needed to establish evidence-based management.