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. |