Coronary artery bypass grafting and sensorineural hearing loss, a cohort study

BMC Ear, Nose and Throat Disorders - Tập 5 Số 1 - 2005
Omer Ashraf1
1Aga Khan University, Stadium Road, Karachi, 74800, Pakistan

Tóm tắt

AbstractBackgroundSudden sensorineural hearing loss is routinely encountered by the otologist. The etiology is varied and often identifiable. One of the relatively less frequent causes is surgery. Apart from being an established entity with otological surgeries, sensorineural hearing loss has also been known to occur after non-otological procedures under general anesthesia. Commonest amongst these procedures is cardiopulmonary bypass, an association that has long been recognized. However, despite the proposition of diverse hypotheses in the past, the pathophysiology remains unclear.MethodsThe study is a prospective matched cohort study that will be carried out in Aga Khan University Hospital, Karachi, Pakistan. Participants among exposed would include all those patients who would be undergoing coronary artery bypass surgery in the hospital who fall under the criteria for inclusion. Unexposed group would comprise of patients undergoing a non-bypass procedure of similar duration under the same type of anesthesia who meet the selection criteria. Both these groups will undergo audiometric testing at our hospital on three different occasions during the course of this study. Initially before the procedure to test the baseline hearing capacity; then one week after the procedure to assess any changes in hearing ability following the surgery; and finally a third audiogram at six weeks follow-up to assess further changes in any hearing deficits noted during the second phase of testing. Certain variables including the subjects' demographics and those concerning the procedure itself will be noted and used later for risk factors analysis. A detailed past medical and surgical history will also be obtained. Data analysis would include calculation of relative risk and significance of the results, by running the chi-square test. Other statistical tests like Fisher exact test may then be employed to facilitate data interpretation. Continuous scale may then be employed and multivariate linear regression used.DiscussionThis study is planned to obtain a better understanding of the correlation between sudden sensorineural hearing loss and cardiopulmonary bypass. Being the first major cohort trial in this line of investigation, the project is designed to identify the existence of any significant relationship between cardiopulmonary bypass and sensorineural hearing deficit.

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Tài liệu tham khảo

Byl FM: Sudden hearing loss: eight years' experience and suggested prognostic table. Laryngoscope. 1984, 94: 647-661.

Arenberg IK, Allen GW, DeBoer A: Sudden deafness immediately following cardiopulmonary bypass. J Laryngol Otol. 1972, 86: 73-77.

Brownson RJ, Stroud MH, Carver WF: Extracorporeal cardiopulmonary bypass and hearing. Arch Otolaryngol. 1971, 93: 179-182.

Plasse HM, Spencer FC, Mittleman M, Frost JO: Unilateral sudden loss of hearing: an unusual complication of cardiac operation. J Thorac Cardiovasc Surg. 1980, 79: 822-826.

Plasse HM, Mittleman M, Frost JO: Unilateral sudden hearing loss after open heart surgery: a detailed study of seven cases. Laryngoscope. 1981, 91: 101-109.

Shapiro MJ, Purn JM, Raskin C: A study of the effects of cardiopulmonary bypass surgery on auditory function. Laryngoscope. 1981, 91: 2046-2052.

Millen SJ, Toohill RJ, Lehman RH: Sudden sensorineural hearing loss: operative complication in non-otologic surgery. Laryngoscope. 1982, 92: 613-617.

Ness JA, Stankiewicz , Kaniff T, Piffar R, Allegretti J: Sensorineural hearing loss associated with aortocoronary bypass surgery: a prospective analysis. Laryngoscope. 1993, 103: 589-593.

Report from the national center for health care technology, coronary bypass surgery. JAMA. 1981, 246: 1645-1649. 10.1001/jama.246.15.1645.

Wright JL, Saunders SH: Clinical records: sudden deafness following cardiopulmonary bypass surgery. J Laryngol Otol. 1975, 89: 757-759.

Cox AJ, Sargent EW: Sudden sensorineural hearing loss following non-otologic non cardiopulmonary bypass surgery. Archives of Otolaryngology-Head and Neck Surgery. 1997, 123: 994-998.

Goodhill V, Harris L, Brockman SJ, Hantz O: Sudden deafness and labyrinthic window ruptures. Annals of Otology. 1973, 82: 2-12.

Thomsen KA, Terkildsen K, Arnfed I: Middle ear pressure variations during anesthesia. Archives of Otolaryngology. 1965, 82: 609-611.

Patterson ME, Bartlett PC: Hearing impairment caused by intratympanic pressure changes during general anesthesia. Laryngoscope. 1976, 86: 399-404.

Keane J: Locked In Syndrome With Deafness. Neurology. 1985, 35: 1395-1396.

Egan CA, Davies L, Halmagyi GM: Bilateral total deafness due to pontine hematoma. Journal of Neurology and Neurosurgical Psychiatry. 1996, 61: 628-631.