M. K. Aggarwal, Gautam Bir Singh^*, Ranjan K. Nag, S. K. Singh, Rajesh Kumar, Mayank Yadav

Show more
Institute of Medical Sciences, BHU, Varanasi, India.
Lady Hardinge Medical College & Associated Hospitals, New Delhi, India.
Show less

Abstract: Objective: To determine the incidence of deafness in patients suffering from goiterous hypothyroidism exclusively and to evaluate the role of L-thyroxine therapy in improving the hearing in this group of patients. Study Design: A prospective cohort study. Materials and Methods: Hearing status was evaluated in a sample size of 100 consecutive patients reporting to the ENT/Endocrinology department of Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP with the diagnosis of goitrous hypothyroidism. The study group included patients in the age group of 5 to 65 years belonging to either sex. Patients with detected hearing loss were categorized into group A, and all other patients were designated group B. L-Thyroxine treatment for goitrous hypothyroidism was initiated in all the cases. At the end of 6 months, a repeat audiogram was done in all the patients in order to evaluate the efficacy of the said treatment protocol on the hearing in these patients. The data were tabulated and statistically analysed using Paired Students “t” test. Results: An overall 39% hearing loss was observed in patients with goitrous hypothyroidism. 15% cases had sensorineural hearing loss, 13% had mixed hearing loss and 8% had a conductive hearing loss. A statistically significant hearing improvement was recorded in this study by L-thyroxine treatment in group-A, and no deterioration of hearing was recorded in group-B. Conclusions: The incidence of sensorineural hearing is less in patients with goitrous hypothyroidism (15%) as compared with the overall incidence of sensorineural hearing loss reported for hypothyroidism (30%-40%). Further, there is a definitive improvement in hearing with the use of L-thyroxine treatment of goitrous hypothyroidism.

Keywords: Hypothyroidism; Goitre; Hearing Loss; L-Thyroxine Treatment

Cite this paper: M. Aggarwal, G. Singh, R. Nag, S. Singh, R. Kumar and M. Yadav, "Audiological Evaluation in Goitrous Hypotyhroidism," International Journal of Otolaryngology and Head & Neck Surgery, Vol. 2 No. 5, 2013, pp. 201-206. doi: 10.4236/ijohns.2013.25042.

References

[1]   W. R. Kemp, “Deafness in Myxoedema,” British Medical Journal, Vol. 1, 1907, p. 375.

[2]   J. M. Morgan and T. McCaffrey, “Head and Neck Manifestations of Endocrine Disease,” In: M. Gleeson, Ed., Scott-Brown’s Otorhinolaryngology, Head and Neck Surgery, Hodder Arnold, London, 2008, p. 400.

[3]   A. Parving, H. Parving and J. Lyngsoe, “Hearing Sensitivity in Patients with Myxoedema before and after Treatment with L-Thyroxine,” Acta Oto-Laryngologica (Stockholm), Vol. 95, 1983, pp. 315-321. doi:10.3109/00016488309130948

[4]   A. Parving, B. Ostri, P. Bretlau, et al., “Audiological and Temporal Bone Findings in Myxoedema,” Annals of Otology, Rhinology, and Laryngology, Vol. 95, 1986, pp. 278-283.

[5]   M. Brenner, D. L. Hoistad and T. C. Hain, “Prevalence of Thyroid Dysfunction in Patients with Meniere’s Disease,” Archives of Otolaryngology—Head and Neck Surgery, Vol. 130, No. 2, 2004, pp. 226-228. doi:10.1001/archotol.130.2.226

[6]   R. Ben-Tovim, Y. Zohar, N. Laurian, et al., “Auditory Brainstem Response in Experimentally Induced Hypothyroidism in Albino Rats,” Laryngoscope, Vol. 95, 1985, pp. 982-986. doi:10.1288/00005537-198508000-00020

[7]   M. Vanasse, C. Fisher, F. Berthezene, et al., “Normal Auditory Evoked Potentials in Adult Hypothyroidism,” Laryngoscope, Vol. 99, No. 3, 1989, pp. 302-306. doi:10.1288/00005537-198903000-00012

[8]   Y. Sachdev and R. Hall, “Effusions into Body Cavities in Hypothyroidism,” Lancet, Vol. 1, 1975, pp. 564-565. doi:10.1016/S0140-6736(75)91571-8

[9]   W. Vant Hoff and D. W. Stuart, “Deafness in Myxoedema,” Quarterly Journal of Medicine, Vol. 48, 1979, pp. 361-367.

[10]   M. Rubenstein, C. Rubenstein and R. Theodor, “Hearing Dysfunction Associated with Congenital Sporadic Hypothyroidism,” Annals of Otology, Rhinology, and Laryngology, Vol. 83, 1974, pp. 814-819.

[11]   A. F. Howarth and H. E. Lloyd, “Perceptive Deafness in Hypothyroidism,” British Medical Journal, Vol. 1, 1956, pp. 431-433. doi:10.1136/bmj.1.4964.431

[12]   V. T. Anand, S. B. S. Mann, R. J. Dash, et al., “Auditory Investigation in Hypothyroidism,” Acta Oto-Laryngologica (Stockholm), Vol. 108, No. 1-2, 1989, pp. 83-87. doi:10.3109/00016488909107396

[13]   J. T. Post, “Hypothyroid Deafness,” Laryngoscope, Vol. 74, 1964, pp. 221-232.

[14]   J. A. DeVos, “Deafness in Hypothyroidism,” Journal of Laryngology & Otology, Vol. 77, 1963, pp. 390-414. doi:10.1017/S0022215100060795

[15]   N. Umapathy and P. J. Dekker, “Myringoplasty Is It Worth Performing in Children,” Archives of Otolaryngology—Head and Neck Surgery, Vol. 129, No. 10, 2003, pp. 1053-1055. doi:10.1001/archotol.129.10.1053

[16]   G. B. Singh, S. Sharma and N. Singh, “Role of Transtympanic Myringoplasty in Modern Otology,” Journal of Otolaryngology, Vol. 35, No. 6, 2006, pp. 408-412. doi:10.2310/7070.2005.0033

[17]   J. L. Jameson and A. P. Weetman, “Disorders of Thyroid Gland,” In: A. S. Fauci, E. Braunwald, D. L. kasper, et al., Eds., Harrison’s Principles of Internal Medicine, Mcgraw Hill, New York, 2008, pp. 2240-2242

[18]   J. A. A. Oliveira, “Fisiologia da Audicao-Coclea Ativa,” In: M. S. Figueiredo, Eds., Emissoes Otoacusticas e BERA, Pulso Editorial, Sao Jose dos Campos, 2003, pp. 1-34.

[19]   K. T. P. Dos Santos, N. H. Dias and G. M. F. Da Silva, “Mazeto Audiologic Evaluation in Patients with Acquired Hypothyroidism,” Brazilian Journal of Otorhinolaryngology, Vol. 76, No. 4, 2010, pp. 478-484.

[20]   L. Di lorenza, L. Foggio, N. Panza, et al., “Auditory Brainstem Response in Thyroid Diseases before and after Therapy,” Hormone Research, Vol. 43, 1995, pp. 200-205. doi:10.1159/000184278

[21]   J. Hald, C. M. Milroy, K. Damkjaer-Jansen, et al., “Human Temporal Bone Findings in Acquired Hypothyroidism,” Journal of Laryngology & Otology, Vol. 105, No. 11, 1991, pp. 886-889. doi:10.1017/S0022215100117748

[22]   Z. Mra and M. K. Wax, “Effects of Acute Thyroxin Depletion on Hearing in Humans,” Laryngoscope, Vol. 109, No. 3, 1999, pp. 343-350. doi:10.1097/00005537-199903000-00001

[23]   F. Debruyne, M. Vanderschueren-Lodeweyckx, P. Bastijns, et al., “Hearing in Congenital Hypothyroidism,” Audiology, Vol. 22, 1983, pp. 404-409. doi:10.3109/00206098309072800

[24]   A. Parving, “Hearing Problems and Hormonal Disturbances in the Elderly,” Acta Oto-Laryngologica (Stockholm), Vol. 476, 1991, pp. 44-53. doi:10.3109/00016489109127255