Comparison Betweem Pure Tone Audiometry And Auditory Brain-stem Response Thresholds In Patient With Presbycusis In Co-morbid With Arterial Hypertension And Diabetes Mellitus

Background:Presbycusis known as age-related bilateral sensorineural hearing loss is a complex phenomenon resulting from an elevation hearing loss as well as changes in the auditory processing,with course acceleration highly influenced by comorbidities including arterial hypertension(AH)and diabetes mellitus(DM).Two major diagnostic approaches used include pure tone audiometry(PTA)and audiometry brain-stem response(ABR).PTA is a standard test for hearing evaluation and the most frequently used,but when PTA cannot be performed ABR test can be recorded.Comparative studies regarding the change in PTA and ABR threshold without an age limit and co-morbidities,consideration have been published.However,literature has no reports regarding the aforementioned concerns.Objective:In this prospective study,we aimed to compare the relationship between PTA and ABR thresholds in patients with presbycusis in co-morbid with arterial hypertension and diabetes mellitus,either alone or combined and evaluate the influence of arterial hypertension and diabetes mellitus on the relationship between PTA and ABR thresholds in patients with presbycusis.Methods:This study was approved by the institutional review board of the second hospital of Shandong University,and was carried out in the audiology center of the second hospital of Shandong University.In this prospective study,we investigated 56 patients comprised of 35 females and 21 males,with mean age 64.71± 9.3(50-83)who met the study criteria.Depending on associated co-morbidities,the cohort was divided into 4groups,thus:group ?(presbycusis alone,n=21),group ?(presbycusis and DM,n=12),group ?(presbycusis and AH,n=14)group ?(presbycusis and DM/AH,n=9)respectively.PTA and ABR thresholds were obtained and analyzed.The statistical data analysis was performed using ANOVA-ONEWAY(SPSS-IBM),and p-value(<0.05)was considered significant.Results:In this study,ABR and PTA threshold difference between ears was not statistically significant.The comparison between the mean threshold difference of ABR and PTA in group? and ? was significant at each frequency,while group ? exhibited a significant difference at high frequency only.However,group IV showed no significant difference between ABR and PTA thresholds.We also found that the mean difference in decibel was different in each group.In group I,the mean difference decibel was<20dB at high frequency and>20dB at 0.5 and 1 kHz.Group ? showed a mean difference<20dB at all frequency range.In group ?we found a mean difference between the two tests<20dB at 4,8 and 2-4 kHz and>20dB at 0.5,1,and 2 kHz.Finally,in group IV the mean threshold difference was>20dB at each frequency.Conclusion:There was a positive relationship between the ABR and PTA threshold,which appear to be insignificant in presbycusis patients with both AH and DM;this finding may be related to synergic effects of the two chronic illnesses on the cochlea.