İbrahim ALADAĞ, Semiha KURT, Ahmet EYİBİLEN, Mehmet GÜVEN, Ünal ERKORKMAZ

Tip 2 diyabetli hastalarda işitsel fonksiyon bozukluklarının erken dönemde değerlendirilmesi

Amaç: Normal işiten tip 2 diyabetli hastalarda ortaya çıkabilecek işitsel fonksiyon bozuklukları araştırıldı. Hastalar ve Yöntemler: Tip 2 diyabet tanılı 40 hasta distorsiyon ürünü otoakustik emisyonlar DPOAE ve işitsel beyin sapı yanıtları ABR ile araştırıldı. Tüm olgular hastalık süresi, mikroanjiyopati ve periferik nöropati varlığı ve metabolik kontrol açısından değerlendirildi. Sonuçlar, işitmesi normal ve diyabeti olmayan 22 kişilik kontrol grubuyla karşılaştırıldı.Bulgular: Kontrol grubuyla karşılaştırıldığında, diyabetli olgularda DPOAE düzeyleri, 4 KHz’de anlamlı olmak üzere p=0.011 , tüm frekanslarda daha zayıf bulundu; ABR’de ise, III-V dalgalar arası latans farklı idi p=0.042 . Metabolik kontrolü kötü olan olgularda DPOAE düzeylerinde 4 kHz için p=0.046; 8 kHz için p=0.020 anlamlı azalma, mikroanjiyopatisi olan olgularda ABR I-V dalgalar arası latansta uzama p=0.039 , nöropatisi olan olgularda ise hem DPOAE seviyelerinde 0.75 kHz için p=0.022; 1 kHz için p=0.019; 3 kHz için p=0.049 hem de ABR III dalga mutlak latansı p=0.007 ve I-III dalgalar arası latansta p=0.023 anlamlı farklılık görüldü. Hastalık süresi işitsel fonksiyon bozukluğu üzerine etkili bulunmadı p>0.05 .Sonuç: Bulgularımız, tip 2 diyabetin, koklear ve retrokoklear seviyede işitsel fonksiyonlarda bozulmaya yol açtığını; ayrıca, mikroanjiyopati, nöropati ve hastalığın metabolik kontrol derecesinin de bu bozulmada etkili olabileceğini göstermektedir

Anahtar Kelimeler:

İşitsel yollar, diabetes mellitus, tip 2, uyarılmış potansiyel, işitsel, beyinsapı, işitme kaybı, sensorinöral, otoakustik emisyon, spontan

Early evaluation of auditory dysfunction in patients with type 2 diabetes mellitus

Objectives: We investigated auditory dysfunction in type 2 diabetic patients with normal hearing. Patients and Methods: Forty patients 22 females; 18 males; mean age 55 years; range 32 to 76 years with type 2 diabetes were examined by distortion product otoacoustic emissions DPOAE and auditory brainstem responses ABR . The patients were evaluated with respect to disease duration, microangiopathy, peripheral neuropathy, and metabolic control. The results were compared with those of 22 healthy controls. Results: Compared to controls, diabetic subjects had decreased DPOAE amplitudes at all frequencies, being significant at 4 kHz p=0.011 ; ABR recordings showed a significant difference only in the III-V interwave interval latency p=0.042 . In the diabetic group, poor metabolic control was associated with significantly decreased DPOAE amplitudes at 4 kHz p=0.046 and 8 kHz p=0.020 ; the presence of microangiopathy was associated with prolonged ABR I-V interwave latency p=0.039 ; and neuropathy was associated with decreased DPOAE amplitudes at 0.75 kHz p=0.022 , 1 kHz p=0.019 , and 3 kHz p=0.049 , and ABR differences in the absolute latency of wave III p=0.007 and the I-III interwave latency p=0.023 . The duration of disease did not affect auditory function p>0.05 . Conclusion: Our results suggest that type 2 diabetes mellitus may lead to auditory dysfunction of cochlear and retrocochlear origin, and that microangiopathy, neuropathy, and poor metabolic control have adverse effects on auditory function.

Keywords:

Auditory pathways, diabetes mellitus, type 2, evoked potentials, auditory, brain stem, hearing loss, sensorineural, otoacoustic emissions, spontaneous,

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