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Although Sensorineural hearing loss is only one of the three main causes of hearing impairments, close to 90 percent of all hearing loss cases are caused by it. Sensorineural hearing loss refers to cases in which the auditory nerve or the cochlea, located in the inner ear, are damaged.
The two sensorineural hearing impairment types are congenital hearing loss and acquired hearing loss. When the sensorineural damage happens because of the natural aging process it is called presbycusis.
Another common reason for sensorineural hearing loss is exposure to high decibel noises over a period of time.
It is well known that exposure to noise levels that exceed eighty five decibels may damage the inner ear air cells and even the auditory nerve itself. Other possible causes include various infections and diseases that can damage the inner ear, physical trauma and tumors. Like with all other types of hearing loss, awareness and early detection can help in avoiding further deterioration or experiencing unwanted side effects such as social isolation and depression. Tom Regev is a professional writer representing the Hearing Aids Edison NJ audiology center. Medical Disclaimer Statements on Get Holistic Health about health issues aren't meant to identify, treat, cure, or protect against illness. At the age of 9, I was diagnosed with severe to profound sensorineural hearing loss in both ears.
At 27 and as a first time mom, Shanna began loosing her hearing.  "Hearing aid wearing mom? I went back to the doctor. Gael Hannan is a writer, actor and public speaker who grew up with a progressive hearing loss that is now severe-to-profound. Read her blog.
Deafness Chronicles is a blog by Brazilian, Paula Pfeifer, who chronicles her hearing loss and how she is in the world of sounds after her cochlear implants. The blog, In My Head, is about a freelance journalist, mom, voracious reader, pop culture and sugar junkie who happens to be deaf. The author has a cochlear implant, reads lips, speaks, types fast, and has a lot to say. Ultra high frequency (UHF,10-20 kHz) and conventional audiometric thresholds (0,25-8 kHz) were obtainedft.om 42 stable CAPD patients. The Department of Logopaedics and the Renal Unit, Groote Schuur Hospital and University of Cape Town, South Africa. UHF (10-20kHz) testing is a sensitive early detector of sensorineural hearing loss and occurs prior to changes within the conventional frequency range (25-8000Hz).
Conventional and UHF threshold testing was done on all patients from the CAPD unit at Groote Schuur Hospital, all of whom had a negative history of noise exposure. In addition patients presenting with peritonitis in a4 month period, had pre and post-treatment audiograms. Hearing loss in the conventional frequency range was determined according to accepted clinical standards (11). The relationship between hearing threshold at 10, 12 and 14 kHz and duration of renal failure, urea and creatinine levels and number of treatments with vancomycin, erythromycin and aminoglycosides was examined for each age decade by means of the Pearson product moment correlation coefficient. Twenty patients had underlying CGN, 3 hypertensive renal disease, 6 polycystic kidney disease, 4 systemic lupus erythematosis, 2 diabetes, 1 Alport ' s and 6 miscellaneous conditions as a cause of their chronic renal failure. Twenty-one (25% ) and 42 (50% ) of the ears examined showed hearing loss in the conventional and UHF frequency range respectively. No significant relationship (Table II) was found between UHF thresholds and duration of end stage renal failure, number of treatments with ototoxic drugs and urea and creatinine levels except for the number of erythromycin treatments and creatinine levels at 10 kHZ in the 60-69 year old group.
This study confmned previous studies showing a high incidence of sensorineural hearing loss in chronic renal failure. In the second part of the study short term intraperitoneal vancomycin therapy did not cause a change in UHF hearing thresholds even if the patient had underlying hearing deficit.
This study was unable to address whether aminoglycoside therapy is safe in CAPD patients as previous reports suggest that the risk of hearing loss from the aminoglycosides is not inconsiderable (13,14). In conclusion there is high incidence of hearing loss in CAPD patients which is unexplained. AbstractBackground : Cisplatin-induced ototoxicity shows high interindividual variability and is often accompanied by transient or permanent tinnitus. Materials and Methods : Fifty-seven patients scheduled for cisplatin-based chemotherapy were included in the study.
Results : The subjective hearing loss was found in seven patients, while six patients had tinnitus during the chemotherapy. Conclusion : As use of high-frequency audiometry is still limited in research work only, we need a strict protocol of adding high-frequency audiometry in the cisplatin-based chemotherapy regimen.
IntroductionCisplatin contributed significantly in the early success of modern chemotherapy for solid tumors and today, cisplatin is a primary drug for testicular cancer, medulloblastoma, osteogenic sarcoma, cervix and ovarian cancers.
During follow-up, seven patients complained of subjective hearing loss and six had tinnitus at the time of first follow-up but none had both complaints. DiscussionCisplatin induced ototoxicity compromises, [11] development of language, cognitive functions, learning ability, communication and quality of life in terms of isolation and depression.
Obviously, old age is the main cause for sensorineural hearing loss, but there are also other elements that may influence it.
The cochlea, which contains three chambers that are filled with fluids, is responsible for translating and transmitting sounds to the auditory nerve. A healthy auditory nerve is composed of nerves that transfer electric information to the brain.
Annual checkups at an audiology center, especially for those over the age of fifty five, are recommended to ensure proper treatment is applied as soon as the first signs of hearing loss appear.
Hearing Sparks is a way for me to share my story of hearing loss, as well as news about accessibility, and other geeky stuff about deafness.When I was four years old I was diagnosed with a bilateral sensorineural hearing loss. Kirsteen is a working mum in Scotland writing about her cochlear implant and experiences of deafness. Twenty-one (50% ) and 11 (25% ) of the patients had UHF and conventional hearing loss respectively, when compared to age related control data.


Limitations in instrumentation confined UHF testing to laboratory research studies (1,2,3), but the recent availability of commercial UHF audiometers has resulted in renewed clinical and research interest. The onset of end stage chronic renal failure, the use of furosemide, and the number of treatments with vancomycin, erythromycin and aminoglycosides for peritonitis and exit site infection was documented from the case notes. UHF thresholds for each ear were compared to previously established age-related control data (I). Thirty-four (81% ), 26 (62% ) and 7 (17%) patients received 200,69 and 16 treatments with vancomycin, erythromcin and aminoglycosides respectively for exit site infections and peritonitis. The occurrence of hearing loss was distributed across the age range of subjects used in the study (Table I).
This suggests that intraperitoneal vancomycin is relatively safe even in high risk patients and would support the findings ofVaan der Hulst. However given the high frequency ofhearing loss in peritoneal dialysis patients UHF testing may identify patients at risk for aminoglycoside ototoxicity. Electrophysiologic analysis of auditory , vestibular and brain stem function in chronic renal failure.
Effects of experimental renal insufficiencyon the osmotic pressure and the biochemical composition of perilymph. It is not possible to identify the susceptible individuals before commencement of the treatment. All patients were divided into three groups depending on the dose of cisplatin infused in 3 weeks.
The hearing loss was sensorineural, dose dependent, symmetrical, bilateral and irreversible. Cisplatin is a cell cycle-nonspecific cytotoxic drug and has a toxic profile that is different from other important cytotoxic drugs. No patient had distant metastasis, and hence none underwent cranial radiation for treatment.
The tinnitus was present in one subject of Group 1 (50-year-old male) and group 3 (34-year-old male), while group 2 had 4 patients (mean age 50 years). Eight patients had significant hearing loss at Fisher′s scale and this loss was observed in 11 of 12 patients at 4 and 6 KHz.
In all three groups, hearing loss was sensorineural, irreversible and symmetrical, and there was no sex predilection. Predicting cisplatin ototoxicity in children: The influence of age and the cumulative dose. Ototoxicity of high-dose cisplatin by bolus administration in patients with advanced cancers and normal hearing. Evoked otoacoustic emissions--an approach for monitoring cisplatin induced ototoxicity in children.
Ototoxicity in children receiving platinum chemotherapy: Underestimating a commonly occurring toxicity that may influence academic and social development. Platinum compound-related ototoxicity in children: Long-term follow-up reveals continuous worsening of hearing loss. Left-right asymmetry in hearing loss following cisplatin therapy in children--the left ear is slightly but significantly more affected. Ototoxicity of cis-diamminedichloroplatinum (II): influence of dose, schedule and mode of administration. The role of hyperbaric oxygen therapy (hot) as an otoprotection agent against cisplatin ototoxicity. Ototoxicity in a randomized phase III trial of intra-arterial compared with intravenous cisplatin chemoradiation in patients with locally advanced head and neck cancer. Early changes in auditory function as a result of platinum chemotherapy: use of extended high-frequency audiometry and evoked distortion product otoacoustic emissions.
Detection of late ototoxic side effect of cisplatin by distortion otoacoustic emission (DPOAE). In severe cases sensorineural damage can even lead to deafness while moderate and mild conditions can be solved with the use of proper hearing aids or cochlear implants.
Material shown by Get Holistic Health is for educational purposes only and isn't meant to substitute for the recommendation of a doctor and other medical professional. In fact, for 22 years I often pretended to hear when I couldn't. This is my cochlear implant journey. This was unrelated to length of chronic renal failure and number of treatments with ototoxic drugs. Quick (1973) and Arnold (1975) demonstrated a shared antigenicity (5,6), and Bergstrom (7), Laitakari (8), and Urquiza (9) that common pathological mechanisms may cause renal and cochlear disorders.
A deviation of more than 15 dB across the frequency range, or of more than 20 dB at selected frequencies indicated hearing loss. Ototoxcity monitoring with ultra-high frequency audiometry in peritoneal dialysis patients treated with vancomycin or gentamycin.
We conducted a prospective, randomized and observational study in a tertiary care centre and evaluated the effects of different doses of cisplatin on hearing.
High doses of cisplatin cause nephrotoxicity, gastrointestinal toxicity, neurotoxicity and ototoxicity. During radiation for the head and neck cancers, ipsilateral temporal bone and ear of patients were protected by beam-modification devices (shielding block made up of lead) so as to avoid any affect of radiation on hearing. This list includes genetic disorders and chronic conditions linked to old age by the medical and science communities through research.
My left ear is my good ear - my right ear hears barely anything. There's more info right this way! Sixteen of these patients were monitored audiometrically using UHF during a course ofvancomycin therapy for peritonitis. Hutchinson and Klodd (4), and Kligerman and associates( 10), however, maintained that when factors such as age and ototoxic drug exposure are accounted for, chronic renal failure per se does not cause clinically significant hearing loss. A threshold change of more than 15 dB between the pre and post-treatment audiograms was considered to be a positive indication of ototoxic effects for the vancomycin subgroup.


It was unrelated to the number of treatments with potentially ototoxic drugs nor to the length of renal failure, or urea and creatinine levels (which were used as a crude index of adequacy of dialysis) except in an isolated subgroup of patients.
Ototoxicity is one of the dose-limiting side effects of cisplatin because it increases with increase in the dose. Of 9 patients, 6 had significant hearing loss at 8 and 12 KHz, while only 4 of 7 patients showed significant hearing loss at 16 KHz.
Cisplatin blocks transduction channels within the outer hair cells of the cochlea and causes progressive destruction of outer hair cells, inner hair cells and supporting cells within the organ of Corti. Because sensorineural damage caused by presbycusis is a gradual process that accompanies old age, many people fail to recognize it and treat it.
This observation is particularly striking as only 7 patients received aminoglycoside therapy for peritonitis.
It is important to realize that untreated hearing loss of any type may lead to severe side effects such as depression and even increase chances of Alzheimer, dementia and heart conditions. 1n conclusion there is high incidence of hearing loss in CAPD patients which is unrelated to ototoxic drugs. These observations strongly suggest that chronic renal failure and hearing impairment are in some way interconnected. Cisplatin-induced ototoxicity is often accompanied by transient or permanent tinnitus [4],[5] and shows high interindividual variability.
All included patients underwent a detailed history, clinical examination, hearing (tuning fork tests and pure tone audiometry) and vestibular functions assessment (bithermal caloric, positioning and positional tests), blood (complete hemogram, liver and renal function tests) and urine analysis. Cisplatin ototoxicity is also associated with the generation of reactive oxygen species, depletion of intracellular glutathione and interference with antioxidant enzymes within the cochlea.
It would be interesting to determine if there was progressive hearing loss in the affected patients after prolonged follow up. In this study, hearing assessment was done before starting cisplatin therapy and at one and three months after cisplatin infusion. Identification of susceptible individuals before commencement of the treatment is not possible; however, early ototoxic effects can be detected by high-frequency audiometry [7] and otoacoustic emission.
Materials and MethodsThis study was conducted in the Departments of Otolaryngology- Head and Neck Surgery, and Radiation-Oncology (Regional Cancer Centre).
Few studies [14],[15] involving follow-up to two years had also found irreversible hearing loss by cisplatin.
We found no correlation between age and hearing loss or between baseline hearing level and cisplatin-induced hearing loss. The hottest women in prison include a wide variety of young women who, for whatever reason, found themselves on the wrong side of the law and, ultimately, behind bars.
Group 2 comprised 35 patients (21 male and 14 female) of whom 23 had various head and neck cancer (excluding larynx) and the remaining 12 were suffering from carcinoma of the cervix. The maximum increase in the hearing threshold after cisplatin administration was 45 dB at 8 KHz in both ears of a 43-year-old patient. It's the perfect way to wash down a fancy dinner and it's some of the best social lubricant money can buy. In Group 2, cisplatin caused a maximum increase of 40 dB in the hearing threshold at 12 KHz in the hearing threshold of right ear in a 19-year-old patient. In the left ear, uniform increase of about 30 dB was observed in hearing threshold at all frequencies in all age groups. Few authors [20],[21] have found relationship between free circulating cisplatin in plasma with time.
They found that cisplatin infusion during afternoon and evening results in low plasma levels of free cisplatin, and hence cisplatin administrated during the early evening hours results in fewer side effects including ototoxicity. Measurement of correlation between time and plasma concentration was beyond the scope of this study. We found no correlation of tinnitus with the dose of cisplatin or age, which was comparable to the study by Moroso et al . The risk of permanent hearing damage from platinum chemotherapy is stimulating the development of otoprotectants for coadministration with platinum to reduce hearing damage without affecting the antitumor activity of the platinum agent. There are numerous otoprotectant agents under research, which include aspirin, antioxidants, [24] intratympanic dexamethasone [25] and hyperbaric oxygen therapy, [26] Ginkgo biloba extract, [27] diethyldithiocarbamate, [28] lipoic acid, [29] adenosine agonist, [30] vitamin E [31] and sodium thiosulfate. Although, the importance of high-frequency audiometry in cisplatin chemotherapy was established about 25 years earlier, [33] but in majority of the centers including our department, it is used only during research work. However, lack of infrastructure, non-availability of high-frequency audiometer and audiologist is a major problem in these centers, especially in our country. To conclude, we all know that cancer patients are living in physical and mental agony and cisplatin-induced ototoxicity further enhances this morbidity.
Audiological monitoring is an essential part of the management of adults and children receiving platinum-based chemotherapy.
Although few authors [12],[34],[35] found distortion product otoacoustic emission as a better method of detecting cisplatin-induced early ototoxicity but high-frequency pure-tone audiometry is the first choice due to its high sensitivity. High-frequency monitoring alerts the physician of early ototoxic effects, who has opportunity to change a patient′s course of treatment. Therefore, high-frequency audiometry should be included in the cisplatin-based chemotherapy regimen. Increase in the dose of cisplatin lead to increase in ototoxicity that warrants further research to find therapeutic efficacy of low-dose cisplatin or a better substitute of cisplatin. Otoprotective drugs are still at experimental level but may be beneficial in cisplatin ototoxicity.AcknowledgmentDr RS Minhas provided general help in this research work.



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