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Characteristics of hearing loss in patients with herpes zoster oticus

View Article: PubMed Central - PubMed

ABSTRACT

Patients with herpes zoster oticus (HZO) may commonly show symptoms associated with 7th and 8th cranial nerve (CN VII and CN VIII) dysfunction. The aim of this study is to investigate the characteristics of hearing loss in patients with HZO and discuss possible mechanisms.

Ninety-five HZO patients who showed at least one of the symptoms of CN VII and CN VIII dysfunction between January 2007 and October 2014 were included in this study. Hearing loss was defined when the mean thresholds of pure tone audiometry (PTA) in speech frequency (0.5 kHz + 1 kHz + 2 kHz/3) or isolated high frequency (4 kHz + 8 kHz/2) were greater than 10 dB in the affected ear compared with the healthy ear, and a total of 72 patients were classified as the hearing loss group.

The difference of mean PTA thresholds between affected and healthy ears was significantly greater in the high frequency range than in low range (20.0 ± 11.5 dB vs. 12.9 ± 15.7 dB, P = 0.0026) in patients with hearing loss (n = 72). The difference between affected and healthy ear was significantly greater in patients with vertigo (n = 34) than those without vertigo (n = 38) in both the high (P = 0.033) and low (P = 0.024) frequency ranges. In contrast, the differences between affected and healthy ears were not significantly different between patients with facial palsy (n = 50) and those without facial palsy (n = 22) in both the high (P = 0.921) and low (P = 0.382) frequency ranges.

In patients with HZO, hearing loss is more severe in the high frequency range than in the low frequency range. Hearing impairment is more severe in patients with vertigo than in those without vertigo in both the high and low frequency ranges, even though the degree of hearing impairment is not significantly different between patients with and without facial palsy. These findings indicate that the mechanisms of viral spread from CN VII to CN VIII may differ between vestibular and audiologic deficits.

No MeSH data available.


Comparison of pure tone averages between high frequency (3000, 4000, and 8000 Hz) and low frequency (250, 500, and 1000 Hz) ranges in patients with hearing loss (n = 72). Pure tone averages (means ± standard deviations) were presented in the panels. The difference in pure tone average between affected and healthy ears is significantly greater in the high frequency (20.0 ± 11.5 dB) than in the low frequency (12.9 ± 15.7 dB; P = 0.0026).
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Figure 2: Comparison of pure tone averages between high frequency (3000, 4000, and 8000 Hz) and low frequency (250, 500, and 1000 Hz) ranges in patients with hearing loss (n = 72). Pure tone averages (means ± standard deviations) were presented in the panels. The difference in pure tone average between affected and healthy ears is significantly greater in the high frequency (20.0 ± 11.5 dB) than in the low frequency (12.9 ± 15.7 dB; P = 0.0026).

Mentions: To assess cause-related hearing loss, the differences in PTA thresholds between affected and healthy ears were compared in HZO patients with hearing loss. Since hearing loss has been reported to be more apparent in the high frequency range in patients with HZO,[3,4] we compared the degree of hearing loss between PTA averages of high frequency (3, 4, and 8 kHz) and low frequency (250, 500 Hz, and 1 kHz) thresholds. In the affected ear (n = 72), mean pure tone average was 49.8 ± 25.0 dB and 33.4 ± 22.9 dB in the high frequency and low frequency range, respectively. Healthy ears exhibited pure tone averages of 29.8 ± 21.7 dB in the high frequency and 20.6 ± 13.1 dB in the low frequency range (Fig. 2). The difference in pure tone average between affected and healthy ears was significantly greater in the high frequency range than in the low frequency range (20.0 ± 11.5 dB vs. 12.9 ± 15.7 dB, P = 0.0026; Fig. 2). Among 72 patients of “hearing loss group,” 58 patients underwent speech discrimination test. Speech discrimination score (%) was significantly worse in the affected side than healthy side (83.9 ± 22.9 vs. 93.8 ± 7.6; P < 0.001).


Characteristics of hearing loss in patients with herpes zoster oticus
Comparison of pure tone averages between high frequency (3000, 4000, and 8000 Hz) and low frequency (250, 500, and 1000 Hz) ranges in patients with hearing loss (n = 72). Pure tone averages (means ± standard deviations) were presented in the panels. The difference in pure tone average between affected and healthy ears is significantly greater in the high frequency (20.0 ± 11.5 dB) than in the low frequency (12.9 ± 15.7 dB; P = 0.0026).
© Copyright Policy - open-access
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC5120946&req=5

Figure 2: Comparison of pure tone averages between high frequency (3000, 4000, and 8000 Hz) and low frequency (250, 500, and 1000 Hz) ranges in patients with hearing loss (n = 72). Pure tone averages (means ± standard deviations) were presented in the panels. The difference in pure tone average between affected and healthy ears is significantly greater in the high frequency (20.0 ± 11.5 dB) than in the low frequency (12.9 ± 15.7 dB; P = 0.0026).
Mentions: To assess cause-related hearing loss, the differences in PTA thresholds between affected and healthy ears were compared in HZO patients with hearing loss. Since hearing loss has been reported to be more apparent in the high frequency range in patients with HZO,[3,4] we compared the degree of hearing loss between PTA averages of high frequency (3, 4, and 8 kHz) and low frequency (250, 500 Hz, and 1 kHz) thresholds. In the affected ear (n = 72), mean pure tone average was 49.8 ± 25.0 dB and 33.4 ± 22.9 dB in the high frequency and low frequency range, respectively. Healthy ears exhibited pure tone averages of 29.8 ± 21.7 dB in the high frequency and 20.6 ± 13.1 dB in the low frequency range (Fig. 2). The difference in pure tone average between affected and healthy ears was significantly greater in the high frequency range than in the low frequency range (20.0 ± 11.5 dB vs. 12.9 ± 15.7 dB, P = 0.0026; Fig. 2). Among 72 patients of “hearing loss group,” 58 patients underwent speech discrimination test. Speech discrimination score (%) was significantly worse in the affected side than healthy side (83.9 ± 22.9 vs. 93.8 ± 7.6; P < 0.001).

View Article: PubMed Central - PubMed

ABSTRACT

Patients with herpes zoster oticus (HZO) may commonly show symptoms associated with 7th and 8th cranial nerve (CN VII and CN VIII) dysfunction. The aim of this study is to investigate the characteristics of hearing loss in patients with HZO and discuss possible mechanisms.

Ninety-five HZO patients who showed at least one of the symptoms of CN VII and CN VIII dysfunction between January 2007 and October 2014 were included in this study. Hearing loss was defined when the mean thresholds of pure tone audiometry (PTA) in speech frequency (0.5&#8202;kHz&#8202;+&#8202;1&#8202;kHz&#8202;+&#8202;2&#8202;kHz/3) or isolated high frequency (4&#8202;kHz&#8202;+&#8202;8&#8202;kHz/2) were greater than 10&#8202;dB in the affected ear compared with the healthy ear, and a total of 72 patients were classified as the hearing loss group.

The difference of mean PTA thresholds between affected and healthy ears was significantly greater in the high frequency range than in low range (20.0&#8202;&plusmn;&#8202;11.5&#8202;dB vs. 12.9&#8202;&plusmn;&#8202;15.7&#8202;dB, P&#8202;=&#8202;0.0026) in patients with hearing loss (n&#8202;=&#8202;72). The difference between affected and healthy ear was significantly greater in patients with vertigo (n&#8202;=&#8202;34) than those without vertigo (n&#8202;=&#8202;38) in both the high (P&#8202;=&#8202;0.033) and low (P&#8202;=&#8202;0.024) frequency ranges. In contrast, the differences between affected and healthy ears were not significantly different between patients with facial palsy (n&#8202;=&#8202;50) and those without facial palsy (n&#8202;=&#8202;22) in both the high (P&#8202;=&#8202;0.921) and low (P&#8202;=&#8202;0.382) frequency ranges.

In patients with HZO, hearing loss is more severe in the high frequency range than in the low frequency range. Hearing impairment is more severe in patients with vertigo than in those without vertigo in both the high and low frequency ranges, even though the degree of hearing impairment is not significantly different between patients with and without facial palsy. These findings indicate that the mechanisms of viral spread from CN VII to CN VIII may differ between vestibular and audiologic deficits.

No MeSH data available.