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Á¢¼ö¹øÈ£ - 210107   OTPP-30 
Clinical Application of the Threshold Equalizing Noise Test in Patients with Meniere¡¯s disease: A Preliminary Study
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Objectives: Cochlear dead regions (DRs) are defined as regions with inner hair cells and/or related neurons, which may not function normally at a given frequency in patients with hearing loss. The threshold-equalizing noise (TEN) test is designed to detect the presence of DRs conveniently in a clinical setting. We aimed to make a preliminary assessment of the prevalence of cochlear dead regions in Meniere¡¯s disease and its relationship with hearing recovery. Methods:Between November 2010 and May 2015, 61 patients (65 ears) with Meniere¡¯s disease who visited our outpatient clinic were prospectively enrolled. Pure tone audiometry and TEN (HL) test were performed in every patient. DR at each frequency was indicated by masked thresholds of ¡Ã10dB above the TEN level and 10¡Ã dB above the absolute threshold. Result:DR was present in 14% (n=9) of 65 ears. According to audiometric configurations, DR was most common in moderately severe, flat hearing loss. The prevalence of DR was lower than that of SSNHL (sudden sensorineural hearing loss) in the previous study (26.5%). Mean hearing level and word recognition score were poorer in DR present ears (61.2¡¾9.7dB and 47.6¡¾31.6, respectively) compared to DR absent ears (56.7¡¾11.0dB and 67.9¡¾25.3, respectively). DRs in Meniere¡¯s disease were mainly distributed in the frequencies of 1k and 1.5k Hz. Among the DR present group, three patients recovered, two patients were aggravated, and three patients had no change of hearing. Most patients participated in TEN test more than one year after sudden hearing loss, it was difficult to show the relation between hearing outcome and the presence of DR. Conclusion:Although performance of the TEN test was limited in showing the relation with hearing prognosis in this study, the presence of DR showed poorer result of hearing compared to the absence of DR. The finding of different prevalence of DR according to causes and TEN test may have the potential to be used as a prognostic tool for hearing loss.


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