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EDITORIAL
Noise-induced hearing loss
Mahendra K Taneja
October-December 2014, 20(4):151-154
DOI:10.4103/0971-7749.146928  
  13,731 7,383 -
ORIGINAL ARTICLES
Disability certificate for individuals with hearing impairment – Time to rethink
Hemanth Narayan Shetty, Jijo Pottackal Mathai, Ajith Kumar Uppunda
January-March 2017, 23(1):7-12
DOI:10.4103/0971-7749.199509  
Background: A retrospective research design was used to investigate the effect of degree of hearing loss on speech identification scores (SISs) and aided improvement in individuals with sensorineural hearing loss (SNHL) and auditory neuropathy spectrum disorder (ANSD). The present criteria (PWD Act, 2001) to issue disability certificate is suitable for individuals with SNHL, as there is a good agreement between their degree of hearing loss and speech understanding. In contrast, individuals with ANSD show severe speech understanding problems irrespective of their degree of hearing loss. Despite their problem, there are denied in giving disability certificate. The study also analyzed number of clients who have received the certificate of hearing disability, in both groups. Subjects and Methods: Clinical records of 165 clients who visited the Department of Audiology, All India Institute of Speech and Hearing, Mysore, India between October 2011 and October 2013 were reviewed. Results: Revealed that unlike SNHL, those with ANSD had no relation between the degree of hearing loss and SIS. In addition, aided improvement in ANSD was very limited and was not related to degree of hearing loss. All the individuals with SNHL, who had hearing loss above moderately severe degree received disability certificate. However, only 2 of the 36 clients with ANSD received disability certificate, although their hearing thresholds were above moderately severe degree. Conclusion: Pure-tone thresholds are not a deciding factor of speech understanding in ANSD. Thus, issue of disability certificate for ANSD should be based on SIS rather than pure-tone thresholds.
  18,013 489 1
EDITORIAL
Role of vitamin D in prevention of deafness
Mahendra K Taneja, Vivek Taneja
April-June 2012, 18(2):55-57
DOI:10.4103/0971-7749.100692  
  16,390 743 9
ORIGINAL ARTICLES
False negative Rinne's in unilateral conductive hearing loss
Rajagopalan Raman, Carren Teh Sui Lin
October-December 2012, 18(4):212-213
DOI:10.4103/0971-7749.104801  
Aims: It is accepted that Rinne's test is negative in the same ear having a conductive hearing loss (CHL). It is also accepted that false negative Rinne's occurs in the ear with severe sensorineural hearing loss (SNHL). However, we wanted to demonstrate the presence of false negative RInne in unilateral CHL. Materials and Methods: Observational study with 13 patients with unilateral, moderate to severe CHL and ten patients with severe to profound SNHL of 40db-115 db in the frequency range of 250/500/1000 Hz. Results: The patients with CHL demonstrated a false negative Rinne on the better hearing ear at a minimum threshold of 50 dB while patients with SNHL demonstrated false negative Rinne on the worse hearing ear with a minimum threshold of 70 dB. Conclusions: Based on our observation, false negative RInne can occur in patients with conductive hearing loss and this phenomenon needs to have a different name.
  15,548 413 -
EDITORIAL
Deafness in India
Saurabh Varshney
April-June 2016, 22(2):73-76
DOI:10.4103/0971-7749.182281  
  14,542 1,240 5
Holistic approach to deafness
MK Taneja, Sameer Qureshi
January-March 2015, 21(1):1-4
DOI:10.4103/0971-7749.152847  
  13,481 294 1
REVIEW ARTICLES
Dental care for the deaf pediatric patient
Rajat K Singh, Kritika Murawat, Rahul Agrawal
October-December 2012, 18(4):171-173
DOI:10.4103/0971-7749.104791  
Great strides have been accomplished recently in providing better medical services for handicapped children. As the dentist begins to understand the complexity of each particular form of handicap and its characteristics, he is able to plan more efficiently for satisfactory treatment. Because many dentists do not understand deafness and the unique problems that deaf children exhibit, inadequate dental care for deaf children still ensues. Handicapped persons are at a greater risk for dental disease, for the most part, because of greater neglect or poor oral hygiene and access to routine dental care. Deaf patients in particular often fail to obtain needed care because of communication difficulties experienced in the treatment situation.
  4,732 8,037 1
EDITORIAL
Role of ENT surgeons in the national program for prevention and control of deafness
Mahendra K Taneja, Vivek Taneja
July-September 2012, 18(3):119-121
DOI:10.4103/0971-7749.103436  
  11,939 473 7
CASE REPORT
Auditory neuropathy/Auditory dyssynchrony - An underdiagnosed condition: A case report with review of literature
Vinish Agarwal, Saurabh Varshney, Sampan Singh Bist, Sanjiv Bhagat, Sarita Mishra, Vivek Jha
July-September 2012, 18(3):156-160
DOI:10.4103/0971-7749.103445  
Auditory neuropathy (AN)/auditory dyssynchrony (AD) is a very often missed diagnosis, hence an underdiagnosed condition in clinical practice. Auditory neuropathy is a condition in which patients, on audiologic evaluation, are found to have normal outer hair cell function and abnormal neural function at the level of the eighth nerve. These patients, on clinical testing, are found to have normal otoacoustic emissions, whereas auditory brainstem response audiometry reveals the absence of neural synchrony. Unlike space-occupying lesions, radiologic evaluation reveals normal results. Patients with auditory neuropathy require a different management approach to their auditory and communication problems from approaches used with patients with usual peripheral hearing losses.
  11,919 364 -
ORIGINAL ARTICLES
Is sensorineural hearing loss related with thyroid metabolism disorders
Canan Filiz Karakus, Emine Elif Altuntaş, Fatih Kılıçlı, Kasım Durmuş, Zekiye Hasbek
April-June 2015, 21(2):138-143
DOI:10.4103/0971-7749.155310  
Objectives: In this study, we measured hearing thresholds in patients diagnosed with hyperthyroidism or hypothyroidism with high-frequency audiometry and otoacoustic emission before and after treatment to determine whether hearing losses were cochlear or retrocochlear and whether they would improve with medical therapy. Materials and Methods: This study was conducted on patients diagnosed with hyperthyroidism and hypothyroidism at Cumhuriyet University, Faculty of Medicine, Department of Endocrinology and Metabolism and accepting to participate in the study. We measured the hearing thresholds of the study population during the pretreatment period and in posttreatment euthyroid period. Result: The audiometric findings of patients with hyperthyroidism were better than those of the control group especially at high frequencies. Sensorineural hearing loss was detected in the euthyroid period. We compared the audiometric findings of the patients with hypothyroidism and the controls. We found sensorineural hearing loss in patients with hypothyroidism, especially at low frequencies. Conclusions: The results of this study showed that both hyperthyroidism and hypothyroidism may have an effect on hearing pathway disorders. Medical therapy may lead to hearing loss in patients with hyperthyroidism, and the underlying factors should be investigated in detailed future studies. It was shown in our study that the hearing loss induced by hypothyroidism may improve with medical therapy. Therefore, in all patients with thyroid dysfunction, hearing levels should be monitored closely with audiometric tests.
  11,820 392 2
Radiological study of the temporal bone in chronic otitis media: Prospective study of 50 cases
Thripthi Rai
April-June 2014, 20(2):48-55
DOI:10.4103/0971-7749.131865  
Aim: To assess radiological findings in Chronic otitis media (COM), its involvement in middle ear and adjacent structure and to compare with similar published data. The ability of the radiological investigations to detect the various pathological and anatomical variations were evaluated and compared with intraoperative findings. COM is a long standing inflammation of the middle ear cleft without reference to etiology or pathogenesis. Due to the strategic location of the tympanomastoid compartment, separated from the middle and posterior cranial fossa by the thinnest of bony partitions, otitis media has the potential for intracranial extension. Hence, it becomes very important to know the location and extent of the disease before proceeding to surgical treatment. Radiological examination of the temporal bone helps us to achieve this objective. The present work has been undertaken to study the role of radiological imaging of the temporal bone as a diagnostic modality in COM and its use in determining the lines of management as in the type of surgical intervention required. Materials and Methods: This is a prospective study in which total of 50 cases with COM were studied. Results: HRCT is reliable for all the parameters like scutum erosion, ossicular erosion, mastoid pneumatisation, low lying dura, anterior lying sigmoid, Korner's septum, cholesteatoma extension in the middle ear and mastoid, and presence of complications such as mastoiditis and mastoid abscess, mastoid cortex dehiscence, sigmoid sinus plate erosion, facial canal dehiscence, tegmen mastoideum erosion and labyrinthine fistula and intracranial complications with a P < 0.05 but not reliable for tegmen tympani erosion and posterior fossa dural plate erosion. Conclusion: HRCT is highly reliable and findings are in par with intraoperative findings in this study.
  10,928 1,273 5
EDITORIAL
Ototoxicity, drugs, chemicals, mobile phones and deafness
MK Taneja, Himanshu Varshney, Vivek Taneja, Jitendra Varshney
July-September 2015, 21(3):161-164
DOI:10.4103/0971-7749.161014  
  11,808 380 1
ORIGINAL ARTICLES
Effect of mobile phone usage on hearing threshold: A pilot study
CS Ramya, Kutty Karthiyanee, Shankar Vinutha
October-December 2011, 17(4):159-161
DOI:10.4103/0971-7749.94494  
Introduction: Mobile phones use electromagnetic radiation in the microwave range, which can be harmful to hearing. Earlier studies have showed an increase in hearing threshold with more than 30 minutes usage of mobile phones per day. Objective: To evaluate the relationship between the duration of usage of mobile phones per day and the change in auditory threshold. Materials and Methods: After obtaining institutional ethical committee clearance, 50 subjects, aged between 15 and 40 years, from institutional campus using mobile phones for more than 5 years were selected for this study. 25 subjects who used mobile phones for <30 min/day formed the control group, while 25 subjects who used their mobile phones for >30 min/day formed the test group. Pure-tone audiometry was done on all the subjects. Results: There was a significant increase in the hearing thresholds at all frequencies in air conduction and bone conduction in right ear in test group compared with the control group. Similarly, there was a significant increase in the hearing thresholds at all frequencies in air conduction and bone conduction in left ear also except for bone conduction at frequency 4 and 6 kHz. Conclusions: There is a significant increase in the hearing threshold in mobile phone users associated with duration of usage.
  10,700 1,362 4
EDITORIAL
Bhramari (Shanmukhi Mudra) Pranayama in presbyacusis and dementia
MK Taneja
July-September 2016, 22(3):145-147
DOI:10.4103/0971-7749.187985  
  10,201 1,248 -
ORIGINAL ARTICLES
Prevalence of sensorineural deafness in habitual mobile phone users
GC Sahoo, Honeymol Sebastian
July-September 2011, 17(3):97-100
DOI:10.4103/0971-7749.91182  
Introduction : Mobile phone usage is widespread and concerns have been raised on the safety of its long-term usage. The electromagnetic fields emitted from mobile can penetrate skull and deposit energy 4-6 cm into the brain resulting in heating of the tissue. In this study, we explore a possible relationship between prolonged mobile phone usage and sensorineural deafness. Materials and Methods: The study was conducted in a medical college situated in rural India. A total of 100 persons between the age group of 20-45years using mobile phone for at least 5 years are selected and screened for sensorineural deafness. Use of cellular phones was assessed by a questionnaire. Mean number of daily calls and minutes were asked for to calculate the cumulative use in hours for all years. The most frequently used ear during cellular phone calls was noted, or whether both ears were used equally. Otoscopic examinations were performed by an otolaryngologist before testing in order to rule out any external or middle ear pathology that could affect audiometric measurements. The hearing levels of subjects were tested using pure tone audiometry. Results : One hundred subjects who are habitual mobile phone users were screened by pure tone audiometry. It is found that the prevalence of sensorineural deafness was 3% and there is a linear relationship between the duration of mobile phone use and the degree of the severity of deafness. Conclusion : The prevalence of sensorineural deafness in our study in habitual mobile users is 3%. It is not clearly known whether mobile phone use is the direct cause of deafness in these subjects but the absence of other causes might point towards its etiological role.
  10,744 504 1
CASE REPORTS
Epidermoid cyst of the outer ear: A case report and review of literature
Alka M Dive, Shughangi Khandekar, Rohit Moharil, Shrutal Deshmukh
January-March 2012, 18(1):34-37
DOI:10.4103/0971-7749.98297  
The purpose of this article is to present a rare case of epidermoid cyst of the outer ear in a 38-year-old male patient. During clinical examination, a soft, cystic, globular, and non-tender swelling with restricted motility and well-defined margins was seen in the retroauricular region. Skin over the swelling was normal and not attached to it. The chosen treatment was total surgical removal. The histopathological findings confirmed the diagnosis of epidermoid cyst, characterized by presence of cyst cavity lined by stratified squamous epithelium with orthokeratin production. The lumen was filled with keratin. The connective tissue capsule consisted of fibrocellular stroma with numerous endothelial lined blood capillaries, which were engorged with red blood cells. The proposed treatment was considered successful, as there was no recurrence.
  10,653 460 2
EDITORIAL
Role of canaloplasty
MK Taneja
October-December 2013, 19(4):159-163
DOI:10.4103/0971-7749.124503  
  3,298 7,447 1
ORIGINAL ARTICLES
Connexin 26 mutations in congenital SNHL in Indian population
SS Nayyar, S Mukherjee, N Moorchung, E James, MD Venkatesh, PS Sukthankar, K Sabarigirish, RB Batra
October-December 2011, 17(4):145-148
DOI:10.4103/0971-7749.94491  
Introduction: Hearing impairment is a sensory disability that affects millions of people all over the world. Fifty percent of these cases are hereditary. Two genes have been localized to DFNB locus (GJB2 & GJB6) on chromosome 13 which have been commonly implicated in autosomal recessive causes of deafness among which the Connexin 26 mutation is the most common. Materials and Methods: Twenty-seven unrelated Indian patients between the ages of 1 and 23 years with nonsyndromic congenital sensorineural hearing loss for GJB2 mutations, specifically for W24X. Analysis was done by the polymerase chain reaction (PCR) Restriction fragment length polymorphism RFLP and sequencing methods. Results: Seven out of these 27 subjects were found to have the W24X mutation, implying a frequency of 26% (7/27). Conclusion: Our results are in concordance with what has been reported in world literature. We also showed a 100% concordance between the PCR RFLP and sequencing methods.
  3,110 7,174 1
Temporal bone dissection skill: A necessity for life otologic surgeries?
Samuel A Adoga, Nuhu D Maan, Benjamin T Ugwu, Babatanko M Umar, George O Nwaorgu
April-June 2011, 17(2):71-74
DOI:10.4103/0971-7749.91041  
Background: The anatomy of the temporal bone is complex and not easily learned. Hours of study in the temporal bone laboratory are required for a good grasp by the intending otologic surgeon in order to avoid predictable complications. Aim and Objective: This study aims at highlighting the steps involved toward acquiring the necessary skills and understanding this complex anatomy before embarking on life otological surgeries (temporal bones surgeries and cochlear implant) in our center. Materials and Methods: This was a prospective study of cadaver temporal bone dissection conducted over a period of 3 months. A total of 10 dry, formalin-fixed cadavers were used for the dissection. A team of doctors headed by a consultant otolaryngologist carried out the dissections on the cadavers. The landmark of importance for the dissections was the McEwen's triangle. From this starting point, various otologic surgeries were performed hands-on on the cadavers using the appropriate burs and their sizes. Anatomic features encountered during the dissection were noted and recorded. Results: The 10 cadavers (100%) were all adult males. The youngest and oldest cadavers were aged 25 and 45 years, respectively, with an overall mean age of 38.9 years. The interval between death and embalmment varied from 5 to 79 days. The suprameatal crest, dural plate, aditus and antrum were all present in the 20 temporal bones dissected. Cribrifossae and wide marrow mastoid cavity were noted in 17 (85%) temporal bones each, highly pneumatized mastoid, herald air cells and incus were seen in 14 (70%) each, tympanic remnant was seen in 13 (65%) and stapes in 6 (30%). Conclusion: Temporal bone dissection provides an avenue in understanding the anatomic features and the variations that may pose a challenge in cochlear implant and other otologic surgeries and it enhances the dexterity of the otologic surgeon.
  9,692 516 1
CASE REPORTS
Intradiploic epidermoid tumor of temporal bone X-ray, CT, MR Imaging
Shibani Mehra, Garga Umesh Chandra, Suresh Kumar
April-June 2012, 18(2):98-102
DOI:10.4103/0971-7749.100738  
Intradiploic epidermoid tumors are extremely uncommon. About 200 cases have been reported in literature. These lesions are caused by inclusion of ectodermal cells in the bone tissue during neural tube closure. These tumors either remain asymptomatic or are incidentally detected or they may present as a palpable lump. They can erode the bone and involve the brain parenchyma due to their proximity to the brain. Radiological imaging is very helpful in accurate diagnosis of these lesions and in differentiating intradural from intradiploic varieties of epidermoids.
  9,645 464 -
High-riding jugular bulb: A rare entity
Vivek Sasindran, Antony Joseph, Shobin S Abraham, Shivaprakash B Hiremath
July-September 2014, 20(3):129-131
DOI:10.4103/0971-7749.136863  
We present a case of high-riding jugular bulb that obscured the round window niche causing gradual hearing loss. Encounters with the jugular bulb in ear surgery are uncommon.
  9,620 474 2
ORIGINAL ARTICLES
Tympanometric patterns in patients undergoing cartilage tympanoplasty of 0.6 mm thickness
Bandar Al Qahtani, Mohammed Al Tuwaijri, Fahad Al Tamimi, Abdullah Al Majed, Mohammed Wasi, Ameer Al Jabber
October-December 2015, 21(4):233-237
DOI:10.4103/0971-7749.167408  
Background: Tympanoplasty has been reported as early as in 1640 by Marcus Banzer, since then many different techniques have been developed for this procedure. The aim of this study is to analyze the tympanometric findings in those patients who underwent cartilage tympanoplasties of 0.6 mm thickness and in order to check different tympanometric patterns obtained in these patients. Materials and Methods: A prospective study was conducted on 60 patients diagnosed clinically with chronic suppurative otitis media in outpatient clinic between 2010 and 2013, in which a cartilage tympanoplasty of 0.6 mm thickness was planned. These patients were evaluated clinically and by pure tone audiograms and tympanograms for cartilage uptake and any late complications. Results: A total of 26 patients were included in our study. The male to female ratio was 3:1 and mean age was 36.1 years. The mean external canal volume of these patients was 0.928, and all of them had a closed air-bone gap. Ten patients had Type As tympanogram which represented 41.6%, 8 of these patients were females. The mean external canal volume of the patients with Type As tympanogram was 1.61. Only one patient had Type A tympanogram with external canal volume of 1.9 and a closed air-bone gap, he was a case of left cartilage tympanoplasty. Type B tympanogram was also found in only one patient who had left cartilage tympanoplasty, with external canal volume of 1.3 and a closed air-bone gap. No patients had Type C or Type Ac. Conclusion: Use of cartilage of 0.6 mm thickness in tympanoplasty for tympanic membrane perforation repair results in excellent outcomes and most common pattern of tympanogram is non-A, B, C postoperatively.
  8,606 1,240 1
Preauricular sinus: When to operate?
Anuj Kumar Goel, Subhash Chand Sylonia, Ajay Garg, Kamal Rattan
April-June 2011, 17(2):63-65
DOI:10.4103/0971-7749.91038  
Purpose: Experiences with preauricular sinus (PAS) excision in pediatric age group. Materials and Methods: A retrospective analysis of 110 patients who underwent PAS excision was done. A total of 112 excisions (63 left, 49 right) were performed by standard surgical technique. All the patients were operated upon in an infection-free period under general anesthesia. Results: A total of 32 excisions had bad surgical results in the form of bad scar or recurrence, out of which 28 had history of symptomatic sinus infection preoperatively. Conclusions: Surgical excision of PAS should be done in quiescent phase; once infected, it becomes very difficult to eradicate the infection and also the chances of bad surgical results (bad scar or recurrence) increase manifold.
  9,037 434 -
Audiometric notching at 4 kHz: Good screening test for assessment of early onset of occupational hearing loss
Gaurav Agarwal, Prakash S Nagpure, Kamana Sindhu Pal, Amit Kumar Kaushal, Manish Kumar
October-December 2015, 21(4):270-273
DOI:10.4103/0971-7749.164552  
Context: In noise induced hearing loss (NIHL), cochlear hair cells are damaged by exposure to loud sound. The basilar membrane is tonotopically organized with the lowest frequencies preferentially transduced at the apex and the highest frequencies at the base. On the basilar membrane, the outer hair cells area corresponding to the 4 kHz and the adjacent areas of 3 and 6 kHz are most susceptible to damage. Aims: To screen the factory workers for early onset of NIHL. Subjects and Methods: Study was done over a period of 2 years that is, from September 01, 2011 to August 31, 2013 on 341 steel factory workers. Workers having a minimum of 5 years of noise exposure were included whereas workers having age >45 years or with conductive hearing loss that is, air-bone gap >10 dB were excluded from the study. Results: It was found that factory workers showed normal hearing, when calculated as average of 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz but they have started developing the early changes of NIHL in the form of notching at 4000 Hz frequency described as threshold shifts. It was seen that 198 right ears out of the total 341 studied showed threshold shifts >25 dB in 4 kHz frequency, even then 70 (35.35%) right ears showed hearing in normal range. In case of left ears 198 out of the total 341 studied showed threshold shifts >25 dB in 4 kHz frequency, even then 97 (48.99%) left ears showed hearing in normal range.
  9,090 343 -
EDITORIAL
Ossiculoplasty: A historical perspective
Narmaya Thapa
October-December 2015, 21(4):231-232
DOI:10.4103/0971-7749.167395  
  1,932 7,307 1
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