Sharma Suktara, Prajapati Vipul, Sharma Arvind, Tan Benjamin Y Q, Sharma Vijay K
Department of ENT, GCS Medical College, Ahmedabad, Gujarat India.
Department of Internal Medicine, GCS Medical College, Ahmedabad, India.
Indian J Otolaryngol Head Neck Surg. 2022 Aug;74(Suppl 1):651-657. doi: 10.1007/s12070-021-02474-3. Epub 2021 Feb 26.
Auditory processing difficulties and hearing loss have been reported among stroke survivors, but is largely neglected. Post-stroke hearing impairment may affect communication between stroke survivors and healthcare professionals, thereby restricting rehabilitation and long-term patient outcome. In this prospective pilot study, we sought to determine the prevalence and pattern of hearing loss in stroke patients when compared to age and sex matched controls. 50 consecutive patients with first-ever stroke, both hemorrhagic and ischemic, and a comparison cohort of 50 age and sex matched controls were assessed. Pure Tone Audiogram was performed in all patients within 15 days of stroke onset and mean hearing loss was determined. Mean audiometric threshold was significantly higher in both ears in stroke patients (mean 44.0 ± 12.1 dB) when compared to the control subjects (36.1 ± 11.4 dB; = 0.001). After adjusting for Diabetes mellitus and hypertension, sensorineural hearing loss was more common and severe in stroke compared to controls ( < 0.005). Most of the strokes were ischemic and involved middle cerebral artery territory. A modest correlation between hearing threshold and stroke severity in both ears was seen (mean B 0.775, R 0.54, CI 0.122-1.427, = 0.020). Our pilot study shows significant hearing impairment in patients with stroke, compared to age and sex matched controls with similar prevalence of cardiovascular risk factors, interestingly seen in a predominantly anterior circulation stroke population. Undetected hearing loss may impact post stroke functional recovery. Hence, current rehabilitation guidelines should include auditory screening in all patients of stroke for detection of hearing loss.
据报道，中风幸存者中存在听觉处理困难和听力损失的情况，但这在很大程度上被忽视了。中风后听力障碍可能会影响中风幸存者与医护人员之间的沟通，从而限制康复进程和患者的长期预后。在这项前瞻性试点研究中，我们试图确定与年龄和性别匹配的对照组相比，中风患者听力损失的患病率和模式。对50例首次发生中风（包括出血性和缺血性）的连续患者以及50例年龄和性别匹配的对照组进行了评估。在中风发作后15天内对所有患者进行纯音听力图检查，并确定平均听力损失。与对照组（36.1±11.4dB；P = 0.001）相比，中风患者双耳的平均听力阈值显著更高（平均44.0±12.1dB）。在调整糖尿病和高血压因素后，与对照组相比，中风患者的感音神经性听力损失更为常见且严重（P < 0.005）。大多数中风为缺血性，累及大脑中动脉区域。双耳听力阈值与中风严重程度之间存在适度相关性（平均B 0.775，R 0.54，CI 0.122 - 1.427，P = 0.020）。我们的试点研究表明，与心血管危险因素患病率相似的年龄和性别匹配的对照组相比，中风患者存在显著的听力障碍，有趣的是，这在主要为前循环中风的人群中可见。未被检测到的听力损失可能会影响中风后的功能恢复。因此，当前的康复指南应包括对所有中风患者进行听力筛查，以检测听力损失。
