Tuning in to cochlear hair cells

Hearing Profile in Patients with Dilated and Hypertrophic Cardiomyopathies

INTRODUCTION

Cardiomyopathy may cause disruptions in the micro-vascular system of the stria vascularis in the cochlea, and, subsequently, may result in cochlear degeneration. Degeneration in the stria vascularis affects the physical and chemical processes in the organ of Corti, thereby causing a possible hearing impairment. The objective of this study was to assess the hearing profiles of patients with dilated and hypertrophic cardiomyopathies to determine the relationship between the degree of hearing loss and the degree and duration of the disease and to compare the dilated and hypertrophic cardiomyopathies as regards hearing profile.

METHODS

In this case control study, we studied 21 patients (cases/study group/group 1) and 15 healthy individuals (controls/group 2). Six patients (group 1a) had hypertrophic cardiomyopathy (HCM), and 15 patients (group 1b) had dilated cardiomyopathy (DCM). The data were analyzed using the t-test, chi-squared test, Kruskal-Wallis test, and the Multiple Mann-Whitney test.

RESULTS

The results of this study showed that 80% of those patients with DCM (group 1b) had bilateral sensorineural hearing loss (SNHL), and 100% of the patients with HCM (group 1a) had mild to severe bilateral sloping SNHL. Distortion Product Otoacoustic Emissions (DPOAEs) were present in 14% of the study group and in 100 % of the control group. The results of the measurements of auditory brainstem response (ABR) showed that 50% of the study group had abnormal latencies compared to the control group, and there was no correlation between the duration of the disease and the degree of hearing loss or DPOAE. Fifty percent of the patients with HCM and 35% of the patients with DCM had positive family histories of similar conditions, and 35% of those with HCM had a positive family history of sudden death.

CONCLUSION

The results of this study suggested that the link between heart disease and hearing loss and early identification of hearing loss in patients with cardiomyopathy may reduce morbidity since hearing deficits sometimes precede heart disease.

Biophysical parameters modification could overcome essential hearing gaps

A majority of hearing defects are due to malfunction of the outer hair cells (OHCs), those cells within the mammalian hearing sensor (the cochlea) that provide an active amplification of the incoming signal. Malformation of the hearing sensor, ototoxic drugs, acoustical trauma, infections, or the effect of aging affect often a whole frequency interval, which leads to a substantial loss of speech intelligibility. Using an energy-based biophysical model of the passive cochlea, we obtain an explicit description of the dependence of the tonotopic map on the biophysical parameters of the cochlea. Our findings indicate the possibility that by suitable local modifications of the biophysical parameters by microsurgery, even very salient gaps of the tonotopic map could be bridged.

The cochlea, the mammalian hearing sensor, is a formidable biophysical construct in many respects. Its task is to pick up environmental auditory information, which provides us with a sensory communication channel without which we experience great problems in our every day life. In its extreme form, the lack of hearing capability often leads to social isolation. Mending hearing deficits—increasingly important in societies of growing average age—is difficult, not least because of a delicate interplay between the brain and the sensor. Here, we investigate to what extent the hearing sensor could be tuned in such a way that regions of malfunction are circumvented by relaying the signal to areas of normal functionality. The means by which we envisage achieving this goal is through local changes of the biophysical parameters of the cochlea. By investigation of a detailed biophysical model of the cochlea, we find that nature indeed appears to offer such a possibility.