Agarwal M K, Jha A K, Singh S K
Institute of Medical Sciences, Banaras Hindu University, Varanasi.
Indian J Otolaryngol Head Neck Surg. 1998 Apr;50(2):116-21. doi: 10.1007/BF02991673.
A total of 50 patients with diabetes mellitus were the subject matter of this study. Of these, 13 patients had diabetic neuropathy on clinical evaluation. Amongst the group of patients without diabetic neuropathy, 64.86% had sensorineural hearing loss and 21.6% patients had conductive deafness as compared to patients with diabetic neuropathy having sensorineural hearing loss in 69.2% and conductive deafness in 23% cases. The hearing threshold were found to be within normal limits in deabetics with or without neuropathy at lower frequencies but it was significantly incressed at higher frequencies (4000 Hz and 8000 Hz) in patients with diabetic neuropathy when compared with diabetic patients without neuropathy. The hearing threshold were increased at higher frequencies in uncontrolled diabetics. This was significant when compared with diabetics with normal fasting plasma glucose. The values of these tests as diagnostic and prognostic tools presently remains of no avail. However, it is hoped that with better precision and sophistication they may be utilised to detect finer sensorineural loss in diabetics, much before the development of long term complication inflicting the nervous system. This study also underlies the importance of looking for the hearing defects in diabetics which may be insignificant to the patient in face of apprehension for the disease itself.
本研究共纳入50例糖尿病患者。其中，13例经临床评估患有糖尿病性神经病变。在无糖尿病性神经病变的患者组中，64.86%患有感音神经性听力损失，21.6%患有传导性耳聋；相比之下，患有糖尿病性神经病变的患者中，69.2%患有感音神经性听力损失，23%患有传导性耳聋。在低频时，无论有无神经病变的糖尿病患者听力阈值均在正常范围内，但与无神经病变的糖尿病患者相比，糖尿病性神经病变患者在高频（4000Hz和8000Hz）时听力阈值显著升高。血糖控制不佳的糖尿病患者在高频时听力阈值升高。与空腹血糖正常的糖尿病患者相比，这一差异具有统计学意义。目前，这些检查作为诊断和预后工具尚无用处。然而，人们希望随着检测精度和复杂性的提高，它们可用于在糖尿病患者出现累及神经系统的长期并发症之前更早地检测出细微的感音神经性听力损失。本研究还强调了在糖尿病患者中寻找听力缺陷的重要性，尽管这些缺陷对于患者自身可能并不明显，但鉴于患者对疾病本身的担忧，仍需加以关注。
