Title: A Study on Hearing Profile in Hypothyroidism and Comparative Evaluation of Hearing in Hypothyroid Subjects before and After Treatment with Thyroxine – A Study of 100 Cases
Authors: Dr Harpuneet Kaur Bakshi, Dr Dimple Sahni, Dr J.P. Goyal, Dr Raghuvansh Kumar, Dr B.S. Sohal, Dr Avnish Kumar
DOI: http://dx.doi.org/10.18535/jmscr/v4i9.52
Deafness is most common otolaryngological manifestation associated with thyroid dysfunction. So it was contemplated to study hearing profile in hypothyroid individuals and its response to thyroid hormone therapy. Material Method- This original research study included 100 subjects divided into 2 groups. Case group included clinically and biochemically confirmed hypothyroid patients before treatment (n=50) Control group- included Euthyroid subjects (n=50) Result: 41 out of 50 patients demonstrated hearing loss, 32 had Sensorineural hearing loss 9 had mixed hearing loss and 9 had normal hearing. Following treatment with levothyroxine hearing threshold improved by 5-10 db in 6 patients and more than 10 db in 33 patients while 2 patients had no improvement. BERA revealed reduced amplitude of wave I, II, III & V. After 6 months of treatment with levothyroxine wave V absolute amplitude improved significantly. Conclusion: Hypothyroid patient had significant degree of hearing impairment. An improvement in hearing parameters occurred following levothyroxine replacement therapy over a period of 6 months. Keywords – Hypothyroidism, BERA, thyroxine, Hearing loss, Audiometry. 1. Vanasse M, Fisher C, Roux Y, Volman G, Mornex R. Normal brainstem auditory evoked potential in adult hypothyroidism. Laryngoscope. 1989:99:302-6. 2. Freitas MC, Lima LHC. Diagnostico e treatmento do hipotireodismo. In Vilas L, editor. Endocrinologia Clinica. Guanabara koogan; 2006.p.219-30. 3. Jaime JC. Auto-immunidale endocrina. In: Greenspan FS & Gardner DG, editors. Endocrinologia Basica e Clinicia. 7 edicae. Rio de Janeiro: Mc Graw-Hill I nteramericana do Brasil;2006. p.71-87. 4. Oliveira JAA. Fisiologia de Audiocaco-Coclea ativa In: Figueiredo MS. Emissoes Otoacousticas e BERA Sao Jose dos Campos; Pulso Editirial; 2003 p.1-34. 5. Vant Hoff W, Stuard DW, Deafness in myxoedema. OJ Med.1979; 48:361-7. 6. Howarth AF, Lloyd HE. Perceptive deafness in hypothyroidism. British Medical Journal. 1956;1:431-33. 7. Higler JA. Otolaryngologic aspects of hypometabolism. Ann Otol Rhinol Laryngol. 1956; 65:395-413 8. Anand VT, Mann SB, Dash RJ, Mehta YN. Auditory investigations in hypothyro-idism. Acta Otolaryngol (Stockh). 1989; 108:83-87. 9. De Vos JA. Deafness in hypothyroidism journal of Laryngology and Otology 1963;77:390-414. 10. Malik V, Shukla GK, Bhatia N. Hearing profile in hypothyroidism. Indian Journal of Otolaryngology and Head and Neck Surgery. 2002 Dec;54:285-90. 11. Aggarwal Mk, Singh GB Nag RK, Singh SK, Kumar R, Yadav M. Audiological evaluation in goitrous hypothyroidism international journal of otolaryngology and Head & Neck Surgery. 2013 Sept;2(5): 201-206. 12. Berker D, Karabulut H, Isik S, Tutuncu Y, Ozuguz U, Erden G, et al. Evaluation of hearing loss in patients with Graves' disease. Endocrine 2012;41:116-21 13. Abbott RJ, O'Malley BP, Barnett DB, Timson L, Rosenthal FD. Central and peripheral nerve conduction in thyroid dysfunction: The influence of L-thyroxine therapy compared with warming upon the conduction abnormalities of primary hypothyroidism. Clinical Science. 1983 Jun; 64(6);617-22. 14. Huang TS, Chan YC, Lee SH, Chen FW, Chopra JJ. Visual, brainstem auditory and somatosensory evoked potential abnorm-alities in thyroid disease. Thyroidology. 1989 Dec; (3): 137-42. 15. Di Lorenzo L, Foggia L, Panza N, Calabrese MR, Motta G, Granchino G, Orio F Jr, Lombardi G. Auditory brainstem response in thyroid diseases before and after therapy. Horm Res. 1995;43(5):200-5 16. Khedr EM, EI Toony LF, Tarkhan MN, Abdella G. Peripheral and central nervous system alterations in hypothyroidism: electrophysiological findings. Neuropsych-obiology .2000 Jan;41(2):88-94. 17. Yumnan Anjana, Neelam Vaney, Tandon O P, Madhu S V. Functional status of auditory pathway in hypothyroidism, Evoked potential study. Indian Journal of Physiology and Pharmacology.2006;50: 341-349 18. Thornton A R D, Jarvis S J. Auditory brainstem response findings in hypothyroid and hyperthyroid 19. Chandershekhar M, Kowsalya V, Vijayalakshmi B. Electrophysiological changes on brainstem auditory evoked potentials in hypothyroid patients journal of pharmacy Research 2011;4(8):2856-2859. 20. Knipper M, Bandtlow C, Gestwa L, Kopschall I, Rohbock K, Wiechers B, Zenner HP, Zimmermann U. Thyroid hormone affects schwann cell and oligodendrocyte gene expression at the glial transition zone of the VIIIth never prior to cochlear function. Development. 1988 Sep; 125 (18): 3709-18. 21. Orhan I, Palit F, Aydin S, Soyle E, Sakalioglu O. Tympanometric changes and Eustachian tube function in patients with hypothyroidism. J craniofac Surg. 2014 May ; 25(3)e230-3. 22. Brucker-Davis F, Skarulis MC, Pikus A, Ishizawar D, Mastroianni MA, Koby M, Weintraub BD. Prevalence and mechanisms of hearing loss in patients with resistance to thyroid hormone. J Clin Endocrinol Metab. 1996 Aug;81(8): 2768-72Abstract
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