Selected complex auditory disorders

Abstract

This article provides an overview of four auditory disorders relevant generally to adults and especially to veterans. The disorders are noise-induced hearing loss, idiopathic sudden sensorineural hearing loss, otosclerosis, and Ménière's disease. Sensorineural hearing loss characterizes each, but additional aspects vary with each of the four conditions. This article describes the conditions, discusses their diagnoses and treatments, and outlines current and suggested rehabilitation. The emphasis is on recent advances, some of which await confirmation prior to possible acceptance as standard practice.

A mass-spring model of the auditory system in otosclerosis

“…The discrete mass-spring model of the ear contributed to an enhanced understanding of how the structures affected by otosclerosis influence hearing, and how they relate to the different grades of the disease. When investigating the altered parameters in otosclerosis, it was possible to predict both quantitatively and qualitatively, based on the discrete mass-spring model, the influence of stapedial annular ligament stiffness (Dai et al, 2009;Feng and Gan, 2004;Huber et al, 2003;Min et al, 2010) at the early stages and the influence of increased stapedial mass (Beales, 1987;Brookler, 2008;Frost, 1962;Hungria, 1988;Iyer and Gristwood, 1984;Miller and Schein et al, 2005;Min et al, 2010;Vicente et al, 2004) at the advanced stages, thereby corroborating the qualitative data already reported in the literature.…”

“…In our discrete mass-spring model of the auditory system, simulating increased stapedial mass resulted in reduced displacement of the stapes only at the higher frequencies (above 2000 Hz), as expected for the late stages of the disease. The overgrowth of bony tissue is probably associated with the more advanced stages of the disease, as reported qualitatively in the literature (Frost, 1962;Hungria, 1988;Miller and Schein, 2005;Min et al, 2010;Palacius and Valvassori, 2001;Vicente et al, 2004). Speech audiometry shows a marked decline in speech discrimination (Hungria, 1988); consequently, the individual complains of difficulties in understanding what is spoken, even with great intensity, particularly in the case of losses around 90 dB (Albernaz, 2008).…”

“…In addition to increased stapedial annular ligament stiffness, abnormal bony tissue formation is known to occur in otosclerosis (Brookler, 2008;Frost, 1962;Hungria, 1988;Miller and Schein, 2005;Min et al, 2010;Vicente et al, 2004). It is also known that the second most commonly affected site is the oval window area and the stapes footplate (Beales, 1987).…”

“…The second most frequently involved site is the area of the oval window and the stapedial footplate (Beales, 1987). The characteristic changes of otosclerosis in the auditory system are increased stiffness of the stapedial annular ligament (Dai et al, 2009;Feng and Gan, 2004;Huber et al, 2003;Min et al, 2010) and abnormal bone growth (Brookler, 2008;Frost, 1962;Hungria, 1988;Miller and Schein, 2005;Min et al, 2010;Vicente et al, 2004).…”