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The influence of botulinum toxin on auditory disturbances in hemifacial spasm
- Katedra i Klinika Neurologii w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach
- Klinika Otolaryngologii Uniwersytet Medyczny w Białymstoku, ul. Skłodowskiej 24A, 15-276 Białystok, Poland
- Medyczne Centra Diagnostyczne Voxel, Zabrze
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Abstract
Hemifacial spasm (HFS) is frequently accompanied by other symptoms, such as visual and auditory disturbances or pain. The aim of the study was to assess the occurrence of auditory symptoms accompanying HFS using subjective and objective methods, their relation with other HFS symptoms, and their resolution after botulinum toxin (BTX-A) treatment.
Material and methodsThe occurrence of hypoacusis, ear clicks and tinnitus was assessed by questionnaire in 126 HFS patients from an electronic database which included medical data such as severity of HFS rated by clinical scale and magnetic resonance imaging focused on the presence of vascular nerve VII and VIII conflict. Forty consecutive patients treated with BTX-A and 24 controls matched by sex and age underwent laryngological examination including audiometry, tympanometry and acoustic middle ear reflex before injection and two weeks later.
ResultsAbout 45.2% of patients complained of auditory disturbances (31.7% hypoacusis, 30.2% ear clicks and 7.1% tinnitus) on the side of HFS. Auditory disturbances correlated with severity of HFS symptoms but not with age, disease duration, or neurovascular conflict with nerves VII and VIII. We did not find abnormalities in audiometric and tympanometric assessment in patients in comparison with controls. No abnormalities were detected in brainstem evoked potentials comparing the sides with and without HFS symptoms. Tinnitus and absence of ipsilateral acoustic middle ear reflex occurred more often in patients with auditory symptoms than those without them. BTX-A treatment caused resolution of subjective acoustic symptoms without any improvement in audiometric assessment.
ConclusionsAuditory disturbances accompanying HFS are probably caused by dysfunction of the Eustachian tube, which improves after BTX-A treatment.
Abstract
Hemifacial spasm (HFS) is frequently accompanied by other symptoms, such as visual and auditory disturbances or pain. The aim of the study was to assess the occurrence of auditory symptoms accompanying HFS using subjective and objective methods, their relation with other HFS symptoms, and their resolution after botulinum toxin (BTX-A) treatment.
Material and methodsThe occurrence of hypoacusis, ear clicks and tinnitus was assessed by questionnaire in 126 HFS patients from an electronic database which included medical data such as severity of HFS rated by clinical scale and magnetic resonance imaging focused on the presence of vascular nerve VII and VIII conflict. Forty consecutive patients treated with BTX-A and 24 controls matched by sex and age underwent laryngological examination including audiometry, tympanometry and acoustic middle ear reflex before injection and two weeks later.
ResultsAbout 45.2% of patients complained of auditory disturbances (31.7% hypoacusis, 30.2% ear clicks and 7.1% tinnitus) on the side of HFS. Auditory disturbances correlated with severity of HFS symptoms but not with age, disease duration, or neurovascular conflict with nerves VII and VIII. We did not find abnormalities in audiometric and tympanometric assessment in patients in comparison with controls. No abnormalities were detected in brainstem evoked potentials comparing the sides with and without HFS symptoms. Tinnitus and absence of ipsilateral acoustic middle ear reflex occurred more often in patients with auditory symptoms than those without them. BTX-A treatment caused resolution of subjective acoustic symptoms without any improvement in audiometric assessment.
ConclusionsAuditory disturbances accompanying HFS are probably caused by dysfunction of the Eustachian tube, which improves after BTX-A treatment.
Keywords
hemifacial spasm, auditory symptoms, botulinum toxin
Title
The influence of botulinum toxin on auditory disturbances in hemifacial spasm
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
29-36
Page views
234
Article views/downloads
794
DOI
10.5114/ninp.2012.27451
Bibliographic record
Neurol Neurochir Pol 2012;46(1):29-36.
Keywords
hemifacial spasm
auditory symptoms
botulinum toxin
Authors
Monika Rudzińska
Magdalena Wójcik
Katarzyna Zajdel
Karolina Hydzik-Sobocińska
Michalina Malec
Marcin Hartel
Jacek Składzień
Andrzej Szczudlik