Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2006
Conductive hearing loss in patients with active acromegaly.
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Babic Borivoj B, Petakov Milan S, Djukic Vojko B, Ognjanovic Sanja I, Arsovic Nenad A, Isailovic Tatjana V, Milovanovic Jovica D, Macut Djuro, Damjanovic Svetozar S
Аннотация
OBJECTIVE: There have been rare conflicting results reported concerning possible higher frequency of hearing loss in acromegalic patients. Our goal was to determine whether there is higher frequency of conductive hearing loss in acromegalics and what may cause it if there is any.
STUDY DESIGN: Prospective study.
SETTING: Tertiary referral center.
PATIENTS: Thirty previously untreated patients with acromegaly were compared with 20 age- and sex-matched healthy control subjects.
INTERVENTIONS: In all subjects: Otomicroscopy, tuning fork tests, audiometry tympanometry, cochleostapedial reflex, otoacoustic emissions. In acromegalics: endocrinologic assessment, MRI and if necessary, epipharyngoscopy.
MAIN OUTCOME MEASURES: We searched for: 1) Signs of ossicle fixation: absence of stapedial reflex in the presence of normal tympanogram, conductive hearing loss, and absence of or grossly disturbed OAE; 2) Disturbances of middle ear ventilation: excessive negative pressure (tympanogram type C), or middle ear effusion (tympanogram type B).
RESULTS: The only statistically significant difference between untreated acromegalics and healthy subjects was the presence of middle ear ventilation problem: 7/30 acromegalics (23%) in comparison to none out of 20 healthy controls (0%), p = 0.033. The acromegalics with middle ear ventilation problem were significantly older, had longer duration of the disease, and lower mean growth hormone (GH) levels in comparison with acromegalics without this problem (51.6 +/- 1.7 vs. 44.4 +/- 2.5 years, 11.6 +/- 2.4 vs. 7.7 +/- 0.4 years, 21.68 +/- 4.89 vs. 49.98 +/- 12.54 microg/L respectively).
CONCLUSION: Patients with active acromegaly have more frequent middle ear ventilation problem than normal population, especially those with longer duration of the disease. Possible causes are discussed.
STUDY DESIGN: Prospective study.
SETTING: Tertiary referral center.
PATIENTS: Thirty previously untreated patients with acromegaly were compared with 20 age- and sex-matched healthy control subjects.
INTERVENTIONS: In all subjects: Otomicroscopy, tuning fork tests, audiometry tympanometry, cochleostapedial reflex, otoacoustic emissions. In acromegalics: endocrinologic assessment, MRI and if necessary, epipharyngoscopy.
MAIN OUTCOME MEASURES: We searched for: 1) Signs of ossicle fixation: absence of stapedial reflex in the presence of normal tympanogram, conductive hearing loss, and absence of or grossly disturbed OAE; 2) Disturbances of middle ear ventilation: excessive negative pressure (tympanogram type C), or middle ear effusion (tympanogram type B).
RESULTS: The only statistically significant difference between untreated acromegalics and healthy subjects was the presence of middle ear ventilation problem: 7/30 acromegalics (23%) in comparison to none out of 20 healthy controls (0%), p = 0.033. The acromegalics with middle ear ventilation problem were significantly older, had longer duration of the disease, and lower mean growth hormone (GH) levels in comparison with acromegalics without this problem (51.6 +/- 1.7 vs. 44.4 +/- 2.5 years, 11.6 +/- 2.4 vs. 7.7 +/- 0.4 years, 21.68 +/- 4.89 vs. 49.98 +/- 12.54 microg/L respectively).
CONCLUSION: Patients with active acromegaly have more frequent middle ear ventilation problem than normal population, especially those with longer duration of the disease. Possible causes are discussed.
Предметные рубрики MeSH
Acoustic Impedance TestsAcromegalyAdenomaAdultAgedAudiometry, Pure-ToneCase-Control StudiesChi-Square DistributionFemaleGrowth HormoneHearing Loss, ConductiveHumansInsulin-Like Growth Factor IMagnetic Resonance ImagingMaleMiddle AgedOtitis Media with EffusionOtoacoustic Emissions, SpontaneousPituitary NeoplasmsPrevalenceProspective Studies