Hearing impairment in patients of hypothyroidism in sub Himalayan region
Keywords:Audiometry, Hearing impairment, Hypothyroidism, Impedance, Thyroid gland
Background: The objective of the study was to assess the hearing impairment in patients of hypothyroidism.
Methods: A prospective clinical study has done at a referral centre included 33 diagnosed patients of hypothyroidism in the age group of 15 to 65 years, fulfilling the inclusion and exclusion criteria who attended the outpatient department. The diagnosis of hypothyroidism was confirmed by thyroid function tests i.e., serum T3, T4 and TSH levels while hearing assessment was done using tuning fork tests, pure tone audiometry, impedance audiometry and otoacoustic emissions. Hearing impairment was measured in decibels of hearing loss, or dB HL and graded as mild, moderate, moderately severe, severe, or profound.
Results: Percutaneous transluminal angioplasty showed 42.7% of the patients had high frequency sensorineural type of hearing loss. The air bone gap was not significant. On tympanometry, all the patients had type A graph and distortion product otoacoustic emissionss in all patients were pass.
Conclusions: Acquired hypothyroidism affects primarily high frequency hearing thresholds causing high frequency sensorineural hearing loss, with little or no effect on lower frequencies.
Cabello G, Wrutniak C. Thyroid hormone and growth: relationships with growth hormone effects and regulation. Reprod Nutr Dev. 1989;29:387-402.
Bernal J. Thyroid hormones and brain development. Vitam Horm. 2005;71:95-122.
Deol MS. The role of thyroxine in the differentiation of the organ of Corti. Acta Oto-laryngologica. 1976;81(5-6):429-35.
Mra Z, Wax MK. Effects of acute thyroxin depletion on hearing in humans. Laryngoscope. 1999;109(3):343-50.
Knipper M, Zinn C, Maier H, Praetorius M, Rohbock K, Köpschall I, et al. Thyroid hormone deficiency before the onset of hearing causes irreversible damage to peripheral and central auditory systems. J Neurophysiol. 2000;83(5):3101-12.
Uziel A, Gabrion J, Ohresser M, Legrand C. Effect of hypothyroidism on the structural development of the organ of Corti in the rat. ActaOtolaryngeol. 1981;92(5-6):469-80
Sohmer H, Freeman S. The importance of thyroid hormone for auditory development in the fetus and neonate. Audiol Neurootol. 1996;1:137-47.
DeLong GR, Stanbury JB, Fierro-Benitez R. Neurological signs in congenital iodine deficiency disorder (endemic cretinism). Dev Med Child Neurol. 1985;27(3):317-24
Refetoff S, De Wind IT, De Groot IJ. Familial syndrome combining deaf-mutism, stippled epiphyses, goiter and abnormally high PBI: possible target organ refractoriness to thyroid hormone. J Clin Endocrinol. 1967;27(2):279-94.
Brucker-Davis F, Skarulis MC, Pikus A, Ishizawar D, Mastroianni MA, Koby M, et al Prevalence and mechanisms of hearing loss in patients with resistance to thyroid hormone. J Clin Endocrinol Metab. 1996;81(8):2768-72.
Morgan JM McCaffrey T. Head and neck manifestations of endocrine diseases. In: Gleeson M, Clarke R. Scott-Brown's Otorhinolaryngology: Head and Neck Surgery 7Ed: 3 volume set. CRC Press; 2008:400.
Bircher HV. Der endemische Kropf und seine Beziehungen zur Taubstummheit und zur Kretinismus. Basel: Benno Schwabe. 1883.
Anand VT, Mann SB, Dash RJ, Mehra YN. Auditory investigations in hypothyroidism. Acta Oto-laryngologica. 1989;108(1-2):83-7.
Ritter FN. The effects of hypothyroidism upon the ear, nose, and throat. Laryngoscope. 1967;77:1427-79.
DeVos JA. Deafness in hypothyroidism. J Laryngol Otol.1963;77:390-414.
Hoff WV, Sturat D. Deafness in myxoedema. Quart J Med. 1979;48(2):361-7.
Meyerhoff WL. Hypothyroidism and the ear: Electrophysiological, morphological, and chemical considerations. Laryngoscope. 1979;89:1-25.
Debruyne F, Vanderschueren-Lodeweyckx M, Bastijns P. Hearing in congenital hypothyroidism. Audiology. 1983;22(4):404-9.
Parving A, Parving HH, Lyngsøe J. Hearing sensitivity in patients with myxoedema before and after treatment with L-thyroxine. Acta oto-laryngologica. 1983;95(1-4):315-21.
Parving A, Ostri B, Hansen JM, Bretlau P, Parving HH. Audiological and temporal bone findings in myxedema. Ann Otol Rhinol Laryngol. 1986;95(3):278-83.
Vikas M, Shukla GK, Naresh B. Hearing profile in hypothyroidism. Indian J Otolaryngol Head Neck Surg. 2002;54:285-90.
Ben-Tovim R, Zohar Y, Laurian N, Laurian L, Zohiar S. Auditory brain stem response in experimentally induced Hypothyroidism in albino rats. Laryngoscope. 1985;95:982-6
Khechinaschvili S, Metreveli D, Svanidze N, Knothe J, Kevanishvili Z. The hearing system under thyroid hypofunction. Georgia Med News. 2007;144:30-3
dos Santos KT, Dias NH, da Silva Mazeto GM, de Carvalho LR, Lapate RL, Martins RH. Audiologic evaluation in patients with acquired hypothyroidism. Brazilian J Otorhinolaryngol. 2010;76(4):478-84.
Vanasse M, Fisher C, Berthezene F, Roux Y, Volman G, Mornex R. Normal brainstem auditory evoked potentials in adult hypothyroidism. Laryngoscope. 1989;99:302-6.
Chandrasekhar M, Kowsalya V, Vijayalakshmi B. Electrophysiological changes on brainstem auditory evoked potentials in hypothyroid patients. J Pharm Res. 2011;4:2856-9.
Di Lorenzo L, Foggia L, Panza N, Calabrese MR, Motta G, Tranchino G, et al. Auditory brainstem responses in thyroid diseases before and after therapy. Hormone Res Paediatr. 1995;43(5):200-5.
Rubenstein M, Rubenstein C, Theodor R. Hearing dysfunction associated with congenital sporadic hypothyroidism. Ann Otol Rhinol Laryngol. 1974;83:814-9.
Rubinstein M, Perlstein TP, Hildesheimer M. Cochlear action potentials in experimentally induced Hypothyroidism in guinea pigs. Acta Otolaryngol. 1975;79(331):1-10.
Howarth F, Lloyd HE. Perceptive deafness in hypothyroidism. Br Med J. 1956;1:431-3.
Post JT. Hypothyroid deafness. Laryngoscope. 1964;74:221-32.
Clarke JG. Uses and abuses of Hearing loss classification. Asha. 1981;23:493-500.
Thornton AR, Jarvis SJ. Auditory brainstem response findings in hypothyroid and hyperthyroid disease. Clin Neurophysiol. 2008;119(4):786-90.