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Speck I, Gundlach E, Schmidt S, Spyckermann N, Lesinski-Schiedat A, Rauch AK, Aschendorff A, Thangavelu K, Reimann K, Arndt S. Auditory capacity of the better-hearing ear in asymmetric hearing loss. Eur Arch Otorhinolaryngol 2024; 281:2303-2312. [PMID: 38006462 PMCID: PMC11024001 DOI: 10.1007/s00405-023-08342-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 11/06/2023] [Indexed: 11/27/2023]
Abstract
PURPOSE Our aim was to investigate the course of the hearing capacity of the better-hearing ear in single-sided deafness (SSD) and asymmetric hearing loss (AHL) over time, in a multicenter study. METHODS We included 2086 pure-tone audiograms from 323 patients with SSD and AHL from four hospitals and 156 private practice otorhinolaryngologists. We collected: age, gender, etiology, duration of deafness, treatment with CI, number and monosyllabic speech recognition, numerical rating scale (NRS) of tinnitus intensity, and the tinnitus questionnaire according to Goebel and Hiller. We compared the pure tone audiogram of the better-hearing ear in patients with SSD with age- and gender-controlled hearing thresholds from ISO 7029:2017. RESULTS First, individuals with SSD showed a significantly higher hearing threshold from 0.125 to 8 kHz in the better-hearing ear compared to the ISO 7029:2017. The duration of deafness of the poorer-hearing ear showed no relationship with the hearing threshold of the better-hearing ear. The hearing threshold was significantly higher in typically bilaterally presenting etiologies (chronic otitis media, otosclerosis, and congenital hearing loss), except for Menière's disease. Second, subjects that developed AHL did so in 5.19 ± 5.91 years and showed significant reduction in monosyllabic word and number recognition. CONCLUSIONS Individuals with SSD show significantly poorer hearing in the better-hearing ear than individuals with NH from the ISO 7029:2017. In clinical practice, we should, therefore, inform our SSD patients that their disease is accompanied by a reduced hearing capacity on the contralateral side, especially in certain etiologies.
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Affiliation(s)
- Iva Speck
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Killianstr. 5, 79110, Freiburg, Germany.
| | - Elisabeth Gundlach
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Killianstr. 5, 79110, Freiburg, Germany
| | - Sandra Schmidt
- Department of Oto-Rhino-Laryngology, Central Army Hospital Koblenz, Ruebenacher Str. 170, 56072, Koblenz, Germany
| | - Nadine Spyckermann
- Department of Oto-Rhino-Laryngology, Central Army Hospital Koblenz, Ruebenacher Str. 170, 56072, Koblenz, Germany
| | - Anke Lesinski-Schiedat
- Department of Otorhinolaryngology, Medical University Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Ann-Kathrin Rauch
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Killianstr. 5, 79110, Freiburg, Germany
| | - Antje Aschendorff
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Killianstr. 5, 79110, Freiburg, Germany
| | - Kruthika Thangavelu
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-University Marburg, Marburg, Germany
| | - Katrin Reimann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-University Marburg, Marburg, Germany
| | - Susan Arndt
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Killianstr. 5, 79110, Freiburg, Germany
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Darjazini Nahas L, Trabulsi M, Alsawah R, Hamsho A, Al-Masalmeh MS, Omar A. The Clinical Picture of Otosclerosis and the Surgery Effect on Bone Conduction Thresholds on Audiograms. Indian J Otolaryngol Head Neck Surg 2023; 75:3628-3635. [PMID: 37974740 PMCID: PMC10645766 DOI: 10.1007/s12070-023-04034-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 06/23/2023] [Indexed: 11/19/2023] Open
Abstract
Our study aims to illustrate the clinical picture of otosclerosis in patients and the effect of surgery on the bone conduction thresholds compared to audiometry tests before surgery. A retrospective study included 36 patients that fit the inclusion criteria based on the patient's files and Pure Tone Audiometry of the patients before and after surgery. The questionnaire used is attached at the end of the study. According to Our sample, 77.8% were females, and 22.2% were males. The youngest was 17 years old, the eldest was 61, and the mean age was 38.2 years old. Hearing loss was the most common symptom in 100% of patients, while tinnitus was found in 66.7% and vertigo in 11%. The Injury was bilateral in 72% of the cases. Before surgery, the mean air conduction threshold (ACT) was 54.7 dB, the mean value of the air-bone gap (ABG) was 38.3 dB, and the mean bone conduction threshold (BCT) was 16.1 dB. Meanwhile, after the surgery, the mean BCT was 18.2 dB. Otosclerosis is more common in middle-aged females. Most cases are bilateral. Two-thirds of the cases of hearing loss were associated with tinnitus, while only a few had vertigo. A slight increase was noticed in BCTs after surgeries, especially at 4000 Hz. Stapedectomy caused a noticeable decrease in the values of BCTs on the frequency 4000 Hz. Stapedotomy improved the BCTs after surgery by about 5.3 dB at 4000 Hz.
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Affiliation(s)
- Louei Darjazini Nahas
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
- Department of Otorhinolaryngology, Syrian Private University, Damascus, Syrian Arab Republic
| | - Mouhammad Trabulsi
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
- Department of Urology, Damascus, Syrian Arab Republic
| | - Rama Alsawah
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
- Department of Internal Medicine, Damascus University, Damascus, Syrian Arab Republic
| | - Ahmad Hamsho
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
- Department of Otorhinolaryngology, Damascus, Syrian Arab Republic
| | - Mohammad Sadek Al-Masalmeh
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
- Department of Otorhinolaryngology, Damascus University, Damascus, Syrian Arab Republic
| | - Abdullah Omar
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
- Department of Dermatology and Venerology, Damascus, Syrian Arab Republic
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Genome-wide screen of otosclerosis in population biobanks: 27 loci and shared associations with skeletal structure. Nat Commun 2023; 14:157. [PMID: 36653343 PMCID: PMC9849444 DOI: 10.1038/s41467-022-32936-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 08/24/2022] [Indexed: 01/19/2023] Open
Abstract
Otosclerosis is one of the most common causes of conductive hearing loss, affecting 0.3% of the population. It typically presents in adulthood and half of the patients have a positive family history. The pathophysiology of otosclerosis is poorly understood. A previous genome-wide association study (GWAS) identified a single association locus in an intronic region of RELN. Here, we report a meta-analysis of GWAS studies of otosclerosis in three population-based biobanks comprising 3504 cases and 861,198 controls. We identify 23 novel risk loci (p < 5 × 10-8) and report an association in RELN and three previously reported candidate gene or linkage regions (TGFB1, MEPE, and OTSC7). We demonstrate developmental stage-dependent immunostaining patterns of MEPE and RUNX2 in mouse otic capsules. In most association loci, the nearest protein-coding genes are implicated in bone remodelling, mineralization or severe skeletal disorders. We highlight multiple genes involved in transforming growth factor beta signalling for follow-up studies.
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Hansen LJ, Bloch SL, Frisch T, Sørensen MS. Distribution of microcrack surface density in the human otic capsule. Acta Otolaryngol 2021; 141:567-571. [PMID: 33825609 DOI: 10.1080/00016489.2021.1905875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The bony otic capsule is comprised of highly mineralized and dense compact bone. It is rarely remodelled and degenerative changes, therefore, accumulate around the inner ear. It is also a predilection site for the pathological remodelling seen in otosclerosis. Morphometric studies have documented increased numbers of dead osteocytes and microcracks in the human otic capsule. Microcracks may disrupt the lacuno-canalicular network and cause osteocyte apoptosis ultimately breaking up the perilabyrinthine bone signalling pathways and dynamics. This may be important to understand the pathogenesis of remodelling diseases like otosclerosis. AIMS/OBJECTIVES This study describes the spatial and regional distribution of microcrack surface density in relation to the inner ear and compares it to that previously recorded for otosclerosis. MATERIAL AND METHODS Forty-two temporal bones and five ribs were used. All samples were undecalcified, bulk stained in basic fuchsin and plastic embedded. Unbiased stereology was used to estimate the true surface density of microcracks (mm2/mm3) in perilabyrinthine bone. RESULTS The surface density of microcracks accumulates around the inner ear spaces, particularly in the lateral window regions, and increases with age. CONCLUSIONS AND SIGNIFICANCE This study documents the spatial and temporal association between microfractures and otosclerosis in the otic capsule.
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Affiliation(s)
- Lars Juul Hansen
- Otopathology Laboratory, Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, University Hospital of Copenhagen, Rigshospitalet, Denmark
| | - Sune Land Bloch
- Otopathology Laboratory, Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, University Hospital of Copenhagen, Rigshospitalet, Denmark
| | - Thomas Frisch
- Otopathology Laboratory, Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, University Hospital of Copenhagen, Rigshospitalet, Denmark
| | - Mads Sølvsten Sørensen
- Otopathology Laboratory, Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, University Hospital of Copenhagen, Rigshospitalet, Denmark
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Lucidi D, Paludetti G, Settimi S, De Corso E, Picciotti PM, Sergi B. How Long Is Otosclerosis Surgery Effective? Hearing Results after a 22-Year Follow-Up. Audiol Neurootol 2020; 26:121-126. [PMID: 32882686 DOI: 10.1159/000509106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/02/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Stapes surgery is a safe procedure, with favourable hearing outcome. The objective of the study is to assess the long-term hearing results, addressing the bone conduction (BC) decay and the need for hearing aids in otosclerosis patients. METHODS We enrolled patients who underwent stapes surgery by means of stapedectomy or stapedotomy between 1991 and 2001. All enrolled patients underwent pure-tone audiometry (PTA) between September 2017 and June 2018. A set of questions was administered to record the prevalence of subjective symptoms and the need for hearing aids. RESULTS Seventy patients were enrolled for a long-term evaluation; 37 patients underwent bilateral surgery; therefore, 107 ears were included in the analysis. The average follow-up period was 22 years. No statistically significant difference was found between early and late post-operative air conduction (AC) PTA (41 vs. 49 dB; p > 0.05) nor between early and late post-operative BC-PTA (29 vs. 37 dB; p > 0.05). A significant difference was observed for AC at 8 kHz (65 vs. 78 dB; p < 0.05) and BC at 2 and 4 kHz (28 vs. 40 dB and 45 vs. 58 dB, respectively; p < 0.05). CONCLUSIONS This is, to our knowledge, the longest mean follow-up time in the literature. A mild decrease in both AC and BC threshold can be expected and the sensorineural decay is more pronounced on the high frequencies. The subjective hearing symptoms and overall sound perception are satisfactory.
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Affiliation(s)
- Daniela Lucidi
- Head & Neck Department, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gaetano Paludetti
- Head & Neck Department, Università Cattolica del Sacro Cuore, Rome, Italy.,Otorhinolaryngology and Head & Neck Surgery Unit, Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Rome, Italy
| | - Stefano Settimi
- Head & Neck Department, Università Cattolica del Sacro Cuore, Rome, Italy,
| | - Eugenio De Corso
- Otorhinolaryngology and Head & Neck Surgery Unit, Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Rome, Italy
| | - Pasqualina Maria Picciotti
- Head & Neck Department, Università Cattolica del Sacro Cuore, Rome, Italy.,Otorhinolaryngology and Head & Neck Surgery Unit, Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Rome, Italy
| | - Bruno Sergi
- Head & Neck Department, Università Cattolica del Sacro Cuore, Rome, Italy.,Otorhinolaryngology and Head & Neck Surgery Unit, Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Rome, Italy
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Abstract
OBJECTIVE To analyse the epidemiology of otosclerosis in a British cohort collected between 2011 and 2017. DESIGN Retrospective cohort study. SETTING Five UK ENT Departments. PATIENTS Patients with surgically confirmed otosclerosis. MAIN OUTCOME MEASURES Questionnaire data documented family history of otosclerosis, age of onset, medical history, and information on associated risk factors for 657 patients. Pre and post-surgical pure-tone audiometry was collected for 154 of these patients. RESULTS The age of onset, incidence of bilateral disease, tinnitus and vertigo, a higher prevalence of women (65%) than men (35%) are similar to those reported previously for otosclerosis cohorts. No association with measles infection was detected. Patients with a family history (40%) have an earlier age of onset and a higher incidence of bilateral disease and vertigo than non-familial subjects. Pedigree analysis is consistent with an autosomal dominant inheritance with reduced penetrance being apparent in 44/91 pedigrees studied. Women who associate their hearing loss with pregnancy have an earlier age of onset than those that do not (p = 6 × 10). CONCLUSIONS This study confirms that otosclerosis is an early adult onset disease that is more prevalent in women than men with a large minority of patients having a family history of otosclerosis. We report new evidence to support a relationship between pregnancy and otosclerosis progression in a proportion of women. In addition, this is the first study to identify differences in severity between familial and non-familial cases of otosclerosis, highlighting the possibility that more than one etiology may be involved.
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