Tuba BAYINDIR, Tamer ERDEM, Elmas UZER, Yüksel TOPLU, Ramazan SARI, Orhan ÖZTURAN

Kontrollü ve Kontrolsüz Tip 2 Diabetes Mellitusun İşitme Üzerine Etkisinin Otoakustik Emisyon İle Değerlendirilmesi

İnsülin bağımlı (Tip 1 DM) ya da bağımsız (Tip 2 DM) diabetes mellitusta görülebilen işitme kaybı, bilateral, progresif sensörinöral tip işitme kaybı olarak tanımlanmıştır. Bu işitme kaybı mikroanjiopati, nöronal dejenerasyon ya da diabetik ensefalopati ile ilişkili olabilir. Bu çalışmanın amacı Tip 2 DM'da metabolik kontrolün subklinik işitme fonksiyonları üzerine etkisini otoakustik emisyon ölçümleri ile değerlendirmekti. Diabetes mellitusun metabolik kontrolü glikolize hemoglobin (HgA1c) ile değerlendirildi. İşitmesi normal olan (işitme eşiği ≥30dB), metabolik kontrol sağlanmış ve sağlanamamış diabetik hastalarda distorsiyon ürünü (DPOAE) ve geçici uyarılmış (TEOAE) otoakustik emisyon ölçümleri yapıldı. Bu kriterleri taşıyan 25 hasta çalışmaya dahil edildi ve hastalar HgA1c seviyelerine göre iki gruba ayrıldı. Grup 1'de metabolik kontrolü sağlanmış (HgA1c<%6) hastalar, grup 2'de ise metabolik kontrolü sağlanamamış hastalar (HgA1c>%6) yer aldı. Bu sayede Tip 2 DM'da gliseminin metabolik kontrolünün dış tüylü hücreler üzerindeki etkisinin araştırılması hedeflendi. Bu çalışmada otoakustik emisyon ölçümleri ile insülin bağımlı olmayan diabetes mellitusta metabolik kontrolün sağlanmamış olması ya da olmamasının, dış tüylü hücre fonksiyonunu etkilemediği istatistiksel olarak gösterilmiştir. Her ne kadar çalışmamızda diabetik hastalarda metabolik kontrolün işitme kaybı üzerine etkisi olmadığı otoakustik emisyon ölçümleri ile gösterilmiş olsa da, bu konuda daha geniş çalışmaların yapılmasına ihtiyaç vardır. Anahtar kelimeler: İşitme Kaybı; İnsülin Bağımlı Olmayan Diabetes Mellitus; Metabolik Kontrol; Otoakustik Emisyon.

Anahtar Kelimeler:

İşitme Kaybı; İnsülin Bağımlı Olmayan Diabetes Mellitus; Metabolik Kontrol; Otoakustik Emisyon.

Evaluation of the Auditory Effects in Controlled and Uncontrolled Type 2 Diabetes Mellitus Using Otoacoustic Emissions

The hearing loss associated with both insulin dependent (Type 1 DM) or non-insulin dependent diabetes mellitus (Type 2 DM) is described as a bilateral and progressive sensorineural type hearing loss. The hearing loss in diabetic patients may be related to microangiopathy, neuronal degenerations or diabetic encephalopathy. The purpose of this study was to establish the effect of metabolic control on the subclinical auditory disfunction related with Type 2 DM by utilizing otoacoustic emission. The metabolic control of the DM was measured by using HbA1c. Distortion product otoacoustic emissions (DPOAE) and transient evoked otoacoustic emissions (TEOAE) measurements were accomplished in metabolicolly controlled and uncontrolled diabetic patients with hearing levels better than 30 dB in both groups. Twenty-five patients with Type 2 DM were eligible to participate in the study. The patients were seperated into two groups according to the HgA1c levels. Group 1 and Group 2 consisted controlled Type 2 DM cases having HgA1c<6% and uncontrolled Type 2 DM cases with HgA1c>6%. Therefore; the effects of metabolic control of glycemia on the outer hair cells (OHCs) functions were evaluated in the Type 2 DM patients. We aimed to investigate the possible role of metabolic control in diabetic patients on the outer hair cells (OHCs) functions.No statistically significant differences were found in the otoacoustic emission measurements of the patients who have metabolicolly controlled diabetes and uncontrolled group. In this study, by using DPOAE (DPgram and DPOAE I/O) and TEOAE measurements. There was no statistically significant effect of metabolic control on hearing loss in diabetic patients. Further comprehensive clinical investigations shoud be done to reveal the effects of metabolic control in diabetes mellitus on hearing. Key words: Hearing Loss; Non-Insulin Dependent Diabetes Mellitus; Metabolic Control; Otoacoustic Emission.

Keywords:

Hearing Loss; Non-Insulin Dependent Diabetes Mellitus; Metabolic Control; Otoacoustic Emission.,

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Corresponding Author: Tuba BAYINDIR, MD
Inonu University, Medical Faculty,
Department of Otorhinolaryngology, MALATYA, 44069,
Fax: 0090 422 341 12 20
Phone: 0090 422 341 06 60 ext. 4604
e-mail: tbayindir@inonu.edu.tr