Is there a need for audiologic evaluation in patients with Behçet disease?

March 1, 2012     Saniye Cinar, MD, Fikret Cinar, MD, and Sibel Kiran, MD, PhD

Abstract. Behçet disease is known to be a multisystem condition. We conducted a study to determine the prevalence of hearing loss in patients with Behçet disease and to identify any associations between audiologic findings and other clinical manifestations and treatment. Our study group was made up of 41 adults with Behçet disease and 41 healthy sex- and age-matched controls. All patients and controls underwent a complete clinical otolaryngologic examination, which included pure-tone audiometry, acoustic impedance testing, and otoacoustic emissions testing. Audiology revealed that the prevalence of sensorineural hearing loss (SNHL) was significantly higher in the Behçet patients than in the controls-68.3 vs. 22.0% (p < 0.002). The duration of Behçet disease had no significant impact on whether patients did or did not experience hearing loss. Hearing loss was the fourth most common clinical finding in the Behçet group, after oral ulcers, genital ulcers, and skin lesions. We conclude that SNHL is present in a significant number of Behçet patients, and we suggest the need for an adequate investigation of hearing in the routine follow-up of these patients.

Middle ear encephalocele: Not just another chronic ear

February 18, 2012     John C. Goddard, MD and Jose N. Fayad, MD

The role of ultrahigh-frequency audiometry in the early detection of systemic drug-induced hearing loss

April 30, 2011     Rajeev Singh Chauhan, MS, Ravinder Kumar Saxena, MS, and Saurabh Varshey, MS


In monitoring patients for drug-induced hearing loss, most audiometric evaluations are limited to the range of frequencies from 0.25 to 8 kHz. However, such testing would fail to detect ototoxicity in patients who have already experienced hearing loss in the ultrahigh frequencies from 10 to 20 kHz. Awareness of ultrahigh-frequency ototoxicity could lead to changes in a drug regimen to prevent further damage. We conducted a prospective study of 105 patients who were receiving a potentially ototoxic drug-either gentamicin, amikacin, or cisplatin-to assess the value of ultrahigh-frequency audiometry in detecting systemic drug-induced hearing loss. We found that expanding audiometry into the ultrahigh-frequency range led to the detection of a substantial number of cases of hearing loss that would have otherwise been missed.

The effects of glutathione enhancement on sensorineural hearing loss

August 31, 2010     Robert T. Sataloff, MD, DMA, FACS, Therese Bittermann, MD, Linda Marks, RN, Deborah Lurie, PhD, and Mary Hawkshaw, BSN, RN, CORLN


Previous research has demonstrated the benefits of anti-oxidant treatment in the prevention of hearing loss in animals. Our study tested the effects of an undenatured whey protein supplement rich in glutathione on human patients with hearing loss. Over an average of 36 months, 30 patients with hearing loss and who had data sufficient for analysis were treated with a glutathione supplement and were compared with 30 retrospective controls selected from the same otologic patient population. Patients were followed using regular hearing tests. Linear regression analysis was used to determine whether study group, baseline audiometric score, time followed, and autoimmune etiology modified the rate of hearing loss. Treatment with the glutathione supplement failed to modify significantly the progression of hearing loss in the treated population. The baseline audiometric score was most predictive of the final audiometric score (p < 0.0005). Although glutathione supplementation was not shown to be helpful in slowing hearing loss in the patients studied, our research model proved valid as it demonstrated an overall decline in hearing in both the treated and control groups over time of sufficient magnitude to permit detection of a treatment effect if a substantial effect had occurred. We suggest that this model be applied to future studies investigating the effects of antioxidants on hearing loss.

How to eliminate air-bone gaps audiometrically: Use too much masking

April 30, 2008     Maurice H. Miller, PhD


The excessive, indiscriminate use of masking during measurements of pure-tone bone-conduction thresholds can reduce or eliminate air-bone gaps. This may result in an abnormal, audiometrically induced bone-conduction threshold shift and suggest to the otologist the need for auditory brainstem response testing and/or magnetic resonance imaging. A case is presented in which the inappropriate use of the masking plateau method resulted in a reduction of the air-bone gap in an ear with a mild conductive hearing loss. The audiometric Weber test should be used in these cases, and nonmasked bone thresholds should be used to determine the actual level of the cochlear reserve.

Audiometry: Masking

September 30, 2006     Mohamed A. Hamid, MD, PhD; Kenneth H. Brookler, MD

The 'normal' audiogram

July 31, 2006     Kenneth H. Brookler, MD; Mohamed A. Hamid, MD, PhD

Auditory steady-state response audiometry in profound SNHL: The impact of abnormal middle ear function

April 30, 2005     Ross Tonini, AuD; Charles Ballay, MD; Spiros Manolidis, MD
Auditory steady-state response (ASSR) audiometry is a commercially available tool that is used to predict behavioral auditory threshold levels. Its particular value stems from the technology's ability to measure frequency-specific responses in the background electroencephalogram to auditory stimuli presented across a broad range of frequencies and sound pressure levels. It is clearly of benefit when used to assess threshold levels in infants and children with severe-to-profound hearing impairment (i.e., cochlear implant candidates). Although numerous authors have provided evidence of the usefulness of ASSR testing, their reports have concerned patients whose middle ear impedance measures were normal. We report the cases of 2 patients who, following improvement of abnormal middle ear impedance values, experienced a marked improvement in measurable thresholds by ASSR testing.