No4-5(2) 2019
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DOI 10.37219/2528-8253-2019-4-47 |
Shydlovska Т.А., Navalkivska N.Y.
Distortion product otoacoustic emissions among the patients suffering
diabetes mellitus type II with hearing impairment
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Shidlovskaya Tetiana A.
State Institution “Institute of otolaryngology named after Prof. O.S.
Kolomiychenko of the National Academy of Medical Sciences of Ukraine”; Kyiv,
Ukraine.
Chief Laboratory for Occupational Voice and Hearing Disorders (with
phoniatrics group)
Doctor of Medical Sciences, Professor
E-mail: doctor_sh@ukr.net
Orchid ID: https://orcid.org/0000-0002-7894-359X
Navalkivska Nadiya Ya.
State Institution “Institute of otolaryngology named after Prof. O.S.
Kolomiychenko of the National Academy of Medical Sciences of Ukraine”; Kyiv,
Ukraine.
Graduate student
E-mail: navalkivska.nadia@gmail.com |
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Abstract
Topicality: Objective research methods of the auditory analyzer are
of great importance in diagnosis sensorineural disorders of auditory
function, treatment of such diseases and solving a number of expert
questions. While diagnosis the damage of auditory system, especially the
receptor part of the auditory analyzer the method of the caused OAE on the
frequency distortion product (DPOAE) plays a significant role. Quite often
at sensorineural hearing loss of different genesis is observed an affection
of cochlea structures of the inner ear. Diabetes mellitus (DM) is one of the
most acute medical and social problems. According to the latest data, there
are 463 million adults with diabetes mellitus in the world; accounting for
9.3% of the world's total population, meaning that 1 among 11 people suffers
from diabetes (IDF Diabetes Atlas 9th edition, 2019). Among patients with
diabetes, according to various authors, there are disorders in the auditory
analyzer.
Purpose: to determine changes in the condition of the receptor part
of auditory analyzer according to the OAE registration of the frequency of
distortion products among patients with diabetes mellitus type II with
impaired auditory function.
Materials and methods: 17 patients with diabetes mellitus type II
were examined, who, according to subjective audiometry, revealed impairments
of auditory function of the I-II degree. The control group consisted of 15
healthy normal-hearing persons who did not report hearing impairment, had no
elevated blood sugar levels. 32 persons were examined in total. The
registration of the caused OAE at frequency of distortion product (DPOAE)
was conducted on the analyzing system "Eclipse" "Interacoustics" (Denmark)
at frequencies 1-6 kHz. Statistical processing of the obtained results was
carried out according to the conventional methods of mathematical variation
statistics using the STATISTICA software package. The average value of
indicators was calculated - magnitude
(M) and its error (+- m). The probability of changes and differences between
the comparative values was estimated by the criterion for the reliability of
the difference (t) according to the Student's table.
Results and discussion: We have selected for the analysis patients
with diabetes mellitus type II, who according to subjective audiometry
revealed impaired auditory function. Patients also reported otologic
complaints of hearing loss, periodic or persistent subjective ear noise.
As a result of the OAE researches at frequency distortion products, the
following data were obtained. A full adequate response of the otoacoustic
emission across all frequency spectrums was reported in only 3 patients
(9.4% of cases) on the one hand. The majority of the observed patients in
whom the OAE was registered received a partially positive test (68.7%). In 7
patients (21.8%) the OAE response was not registered. The absence of OAE
response or a partially positive registration in 90.6% of the observed
patients indicated violation function of the cochlea in such patients. The
DPOAE (response intensity) emission amplitude at all tested frequencies (1-6
kHz) in patients with diabetes mellitus type II was significantly (P<0.01)
lower than the norm at all frequencies. Particularly pronounced such a
decrease is in the area of 4 kHz, where the amplitude of the OAE response
was 5.9±0.2 dB at a norm of 9.4±0.5 dB. Therefore, in patients with diabetes
mellitus type II with hearing impairment, there are changes in the receptor
part of the auditory analyzer, which is confirmed by the data of objective
examination methods.
The changes we have identified in the OAE indicators may express the
affection of the receptor structures of the auditory analyzer among patients
with diabetes mellitus type II with impaired auditory function. The
information obtained on the OAE indicators provides the detection of early
violations and the objective ascertainment of changes in the receptor part
of the hearing analyzer in diabetes mellitus type II.
Conclusions:
1. OAE data on the frequency of distortion products in patients with
diabetes mellitus type II objectively confirm the presence of violations in
the auditory receptor.
2. In patients with diabetes mellitus type II, the OAE amplitude at the
frequency of distortion products is significantly lower than normal at all
tested frequencies (1-6 kHz). Particularly pronounced such a decrease is in
the area of 4 kHz, where the amplitude of the OAE response was 5.9±0.2 dB at
a norm of 9.4±0.5 dB.
3. The conducted researches prove the expediency of examination by the
method of registration of OAE of patients with diabetes mellitus type II,
since it promotes the early detection of violation in the receptor
structures of the auditory analyzer in such patients.
4. The use of the method of recording otoacoustic emissions in the
examination of patients with type II diabetes is important for the
objectification of early signs of sensorineural hearing impairment in this
contingent. |
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Keywords
sensorineural hearing loss, Diabetes mellitus, hearing analyzer, otoacoustic
emission, DPOAE. |
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