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Published in: Indian Journal of Otolaryngology and Head & Neck Surgery 1/2019

01-10-2019 | Original Article

Audiological Evaluation in Hypothyroid Patients and Effect of Thyroxine Replacement Therapy

Authors: Ramsiya singh, Mohd Aftab, Sachin Jain, Dinesh kumar

Published in: Indian Journal of Otolaryngology and Head & Neck Surgery | Special Issue 1/2019

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Abstract

To do the audiological evaluation of patients with hypothyroidism and to assess status of hearing after thyroxin replacement therapy (TRT). Two groups were included: a hypothyroidism group (HG, n = 50), and a control group (CG, n = 50). Parameters studied: anominesic data, duration of hypothyroidism, comorbidities, cochleovestibular symptoms, biochemical and hormonal exams (TSH, FT4 and FT3), pure tone audiometry, impendence audiometry and BERA as where required. Mean age of the patients in HG was 26.5 ± 10.4 years. Male/Female ratio was 2.39. All HG patients had altered TSH values and 8% had diminished T4 values. Cochleovestibular symptoms were more common in hypothyroid patients (48%) than control (20%) p value. Pure Tone Audiometric threshold was found higher in 34% of cases. Sensorineural hearing loss was most common (76.46%) compared to conductive and mixed hearing loss. BERA showed significant prolonged absolute peak latency of wave III, inter peak latency (IPL) of wave I–III and reduced amplitude of wave Ia and Va. After thyroxine replacement therapy there was statistically significant improvement in hearing threshold in 46.42% ears (p  < 0.05), (if ≥ 5 dB hearing improvement consider as significant). The significant improvement was also found in BERA, in amplitude of wave Va. Site of involvement was at several levels, middle ear, cochlear or retro-cochlear. HG patients had more cochleovestibular symptoms, higher audiometric thresholds, increase in latency of wave III, IPL of I–III and reduced Ia and Va amplitude in the BERA. After TRT improvement in hearing threshold and BERA was found.
Literature
1.
go back to reference Hashemipour M, Hovsepian S, Hashemi M, Amini M, Kelishadi R, Sadeghi S (2012) Hearing impairment in congenitally hypothyroid patients. Iran J Pediatr 22(1):92–96PubMedPubMedCentral Hashemipour M, Hovsepian S, Hashemi M, Amini M, Kelishadi R, Sadeghi S (2012) Hearing impairment in congenitally hypothyroid patients. Iran J Pediatr 22(1):92–96PubMedPubMedCentral
2.
go back to reference Knipper M, Zinn C, Maier H, Praetorius M, Rohbock K, Kopschall I, Zimmermann U (2000) Thyroid hormone deficiency before the onset of hearing causes irreversible damage to peripheral and central auditory system. J Neurophysiol 83:3101–3112CrossRef Knipper M, Zinn C, Maier H, Praetorius M, Rohbock K, Kopschall I, Zimmermann U (2000) Thyroid hormone deficiency before the onset of hearing causes irreversible damage to peripheral and central auditory system. J Neurophysiol 83:3101–3112CrossRef
3.
go back to reference DeLong GR, Stanbury JB, Fierro-Benitez R (1985) Neurological signs in congenital iodinedeficiency disorder (endemic cretinism). Dev Med Child Neurol 27(3):317–324CrossRef DeLong GR, Stanbury JB, Fierro-Benitez R (1985) Neurological signs in congenital iodinedeficiency disorder (endemic cretinism). Dev Med Child Neurol 27(3):317–324CrossRef
4.
go back to reference Refetoff S, De Wind IT, De Groot IJ (1967) Familial syndrome combining deaf mutism, stippled epiphyses, goiter and abnormally high PBI: possible target organ refractoriness to thyroid hormone. J Clin Endocrinol 27(2):279–294CrossRef Refetoff S, De Wind IT, De Groot IJ (1967) Familial syndrome combining deaf mutism, stippled epiphyses, goiter and abnormally high PBI: possible target organ refractoriness to thyroid hormone. J Clin Endocrinol 27(2):279–294CrossRef
5.
go back to reference Brucker-Davis F, Skarulis MC, Pikes A (1996) Prevalence and mechanisms of hearing loss in patients with resistance to thyroid hormone. J Clin Endocrinol Metab 81(8):2768–2772PubMed Brucker-Davis F, Skarulis MC, Pikes A (1996) Prevalence and mechanisms of hearing loss in patients with resistance to thyroid hormone. J Clin Endocrinol Metab 81(8):2768–2772PubMed
6.
go back to reference Hilger JA (1956) Otolaryngologic aspects of hypometabolism. Ann Otol Rhinol Laryngol 65:395–413CrossRef Hilger JA (1956) Otolaryngologic aspects of hypometabolism. Ann Otol Rhinol Laryngol 65:395–413CrossRef
7.
go back to reference Parving A, Parving H, Lyngsoe J (1983) Hearing sensi tivity in patients with myxoedema before and after treatment with L-Thyroxine. Acta Otolaryngol 95:315–321CrossRef Parving A, Parving H, Lyngsoe J (1983) Hearing sensi tivity in patients with myxoedema before and after treatment with L-Thyroxine. Acta Otolaryngol 95:315–321CrossRef
8.
go back to reference Howarth AE, Llyod HED (1956) Perceptive deafness in hypothyroidism. Br Med J 1:431–433CrossRef Howarth AE, Llyod HED (1956) Perceptive deafness in hypothyroidism. Br Med J 1:431–433CrossRef
9.
go back to reference Crifo S, Lazzari R, Salabe GB et al (1980) A retrospective study of audiological function in a group of hypothyroid patients. Int J Pediatr Otorhinolarygeol 2(4):347–355CrossRef Crifo S, Lazzari R, Salabe GB et al (1980) A retrospective study of audiological function in a group of hypothyroid patients. Int J Pediatr Otorhinolarygeol 2(4):347–355CrossRef
10.
go back to reference Fracois M, Bonfils P, Leger J et al (1993) Audiological assessment of eleven congenital hypothyroidisms before and after treatment. Acta Otolaryngol 113(1):39–42CrossRef Fracois M, Bonfils P, Leger J et al (1993) Audiological assessment of eleven congenital hypothyroidisms before and after treatment. Acta Otolaryngol 113(1):39–42CrossRef
11.
go back to reference Unnikrishan AG, Kalra S, Sahay RK, Bantwal G, John M, Tewari N (2013) Prevalence of hypothyroidism in adults: an epidemiological study in eight cities of India. Indian J Endocrinol Metab 17(4):647–652CrossRef Unnikrishan AG, Kalra S, Sahay RK, Bantwal G, John M, Tewari N (2013) Prevalence of hypothyroidism in adults: an epidemiological study in eight cities of India. Indian J Endocrinol Metab 17(4):647–652CrossRef
12.
go back to reference Santos KTP, Dias NH, Mageto GMF, Carvalho LR, Lapate RL, Martins RSHG (2010) Audiologic evaluation in patients with acquired hypothyroidism. Braz J Otorhinolaryngol 76(4):478–484CrossRef Santos KTP, Dias NH, Mageto GMF, Carvalho LR, Lapate RL, Martins RSHG (2010) Audiologic evaluation in patients with acquired hypothyroidism. Braz J Otorhinolaryngol 76(4):478–484CrossRef
13.
go back to reference Malik V, Shukla GK, Bhastia N (2002) Hearing profile in hypothyroidism. Indian J Otolaryngol Head Neck Surg 54(4):285–290PubMedPubMedCentral Malik V, Shukla GK, Bhastia N (2002) Hearing profile in hypothyroidism. Indian J Otolaryngol Head Neck Surg 54(4):285–290PubMedPubMedCentral
14.
go back to reference Mordechai Z, Himelfarb MZ, Lakretz T, Gold S, Shanon E (1981) Auditory brainstem responses in thyroid dysfunction. J Laryngol Otol 95:679–686CrossRef Mordechai Z, Himelfarb MZ, Lakretz T, Gold S, Shanon E (1981) Auditory brainstem responses in thyroid dysfunction. J Laryngol Otol 95:679–686CrossRef
15.
go back to reference Anand VT, Mann SB, Dash RJ, Mehra YN (1989) Auditory investigations in hypothyroidism. Acta Oto-laryngol 108:83–87CrossRef Anand VT, Mann SB, Dash RJ, Mehra YN (1989) Auditory investigations in hypothyroidism. Acta Oto-laryngol 108:83–87CrossRef
16.
go back to reference Figueiredo LCMS, Lima MAMT, Vaisman M (2003) Alterações na audiometria de tronco encefálico em mulheres adultas com hipotireoidismo subclínico. Rev Bras Otorrinolaringol 69:542–547CrossRef Figueiredo LCMS, Lima MAMT, Vaisman M (2003) Alterações na audiometria de tronco encefálico em mulheres adultas com hipotireoidismo subclínico. Rev Bras Otorrinolaringol 69:542–547CrossRef
17.
go back to reference Anjana Y, Vaney N, Tandon OP, Madhu SV (2006) Functional status of auditory pathways in Hypothyroidism: evoked potential study. Indian J Physiol Pharmacol 50(4):341–349PubMed Anjana Y, Vaney N, Tandon OP, Madhu SV (2006) Functional status of auditory pathways in Hypothyroidism: evoked potential study. Indian J Physiol Pharmacol 50(4):341–349PubMed
Metadata
Title
Audiological Evaluation in Hypothyroid Patients and Effect of Thyroxine Replacement Therapy
Authors
Ramsiya singh
Mohd Aftab
Sachin Jain
Dinesh kumar
Publication date
01-10-2019
Publisher
Springer India
Published in
Indian Journal of Otolaryngology and Head & Neck Surgery / Issue Special Issue 1/2019
Print ISSN: 2231-3796
Electronic ISSN: 0973-7707
DOI
https://doi.org/10.1007/s12070-018-1395-3

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