JOURNAL OF EVIDENCE BASED MEDICINE AND HEALTHCARE

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2020 Month : May Volume : 7 Issue : 20 Page : 1001-1008

A Comparative Clinical Study on Treatment of Noise Induced Hearing Loss

Sudeep Madisetty1

 Corresponding Author:
Dr. Sudeep Madisetty,
Associate Professor,
Department of ENT,
RVM Institute of Medical Sciences and Research, Siddipet, Telangana.
E-mail: sudeepent@gmail.com

ABSTRACT
BACKGROUND
Noise-Induced Hearing Loss (NIHL) is one of the most common forms of sensorineural hearing loss. It is a major preventable problem related to hearing and is probably more widespread than revealed by conventional pure tone threshold testing. NIHL resulting from damage to the cochlea usually is associated with symmetrical mild to moderate hearing loss with associated tinnitus. But in a significant number of patients, NIHL is associated with asymmetrical thresholds and, depending on the exposure, severe to profound hearing loss as well. We wanted to evaluate audiological values and compare two oral antioxidant regimens in the treatment and prevention of NIHL.

METHODS
87 patients with noise induced hearing losses were included. They were divided into two groups A (44 patients) and group B (43 patients). Audiological examination was done with air conduction audiometry, PTA, observing notches in audiogram and DPOAE values. Both the groups were administered fixed medical regimens for a period of 6 months followed by audiological evaluation with same tests. Data was analysed using standard statistical methods.

RESULTS
In group A there were 32 males (72.72%) and 12 females (27.27%) and in group B there were 31 males (72.09%) and 12 females (27.90%) with a male to female ratio of 2.52:1. The mean ages in both groups were 47.23 ± 2.70 years and 46.25 ± 3.10 years respectively. More than 50 dB thresholds observed in 38/44 (86.36%) of group A and 35/43 (81.39%) of group B patients. PTA with above 50 dB in 27/44 (61.36%) of group A and 25/43 (58.13%) of group B patients. DPOAE values were absent in 31/44 (70.45%) of group A and 32/43 (74.41%) of group B patients. There was no significant statistical difference between the two groups and they were identical (p significant at <0.05).

CONCLUSIONS
The ideal agents for common clinical use are an oral agent with a known safety profile which is of the antioxidant category, with vasodilator properties and vitamins and steroids. There were affirmative effects of these agents improving audiological evaluation in patients with NIHL after 6 months. While there is not yet an effective medication to treat and prevent a multifactorial and complex pathological condition such as NIHL, a treatment based on the synergistic effects of natural micronutrients such as the antioxidants vitamins A, C, and E and the vasodilator magnesium all with good safety profiles, seems to be an excellent and promising efficacious therapeutic alternative for the treatment of this sensory impairment associated with NIHL.

KEYWORDS
Hearing, Noise, Cochlea, Thresholds of Hearing and Antioxidants