HST 721 Lecture 12: Sensorineural Hearing Loss

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1 HST 721 Lecture 12: Sensorineural Hearing Loss 1

2 SNHL: Perceptual Correlates 2

3 SNHL: Perceptual Correlates 1. Threshold shifts 2. Problems in Noisy Environments 3. Loudness Recruitment 3

4 SNHL: Perceptual Correlates 4. Pitch anomalies 4

5 SNHL: Perceptual Correlates 5. Tinnitus 5

6 Normal SNHL: Histopathology Hair cells and supporting cells particularly vulnerable. OHCs most vulnerable 6 khz 105 db, 2 hrs 6 khz 108 db, 2 hrs Acoustic trauma in cats 6

7 SNHL: Histopathology Stereocilia damage on remaining IHCs and OHCs 1st Row OHC Disarray Acoustic trauma in cats and guinea pigs 7

8 SNHL: Histopathology Spiral ligament fibrocytes can also be involved A C57BL/6 1.5 month B C57BL/6 14 month 100 µm Aging in the C57BL/6 mouse 8

9 Nerve loss is usually secondary to IHC loss SNHL: Histopathology A B Can progress for years after injury C D 1 yr survival E F Kanamycin-treated cats 3 yr survival 9

10 SNHL: Histopathology Nerve fiber loss is more complete when both IHCs and supporting cells degenerate Kanamycin-treated cats 10

11 SNHL: Histopathology A Normal chinchilla B C D Carboplatin-treated chinchilla E F Selective IHC loss is extremely rare 11

12 SNHL: Basal-apical gradient Human: Workplace Exposures 12

13 SNHL: Basal-apical gradient Mouse: Aging in the C57BL/6 strain ABR Threshold Shift (db) ABR Threshold (db SPL) A. Absolute Thresholds 1.5 month 3.0 month 7.0 month 15 month B. Threshold Shifts Test Frequency (khz) % Present % Present % Present A. Inner Hair Cells 1.5 month 3.0 month 7.0 month 15 month B. Outer Hair Cells C. Spiral Ganglion Cells Cochlear Frequency (khz) 13

14 Effects of OHC loss: tuning and threshold Furosemide 14

15 Effects of IHC damage: tuning and threshold 15

16 Effects of OHC loss: tuning and threshold 16

17 Effects of HC loss: tuning and threshold 12 khz 110 db, 2 hrs Auditory Nerve Thresholds OHC loss raises thresholds IHC loss makes nonresponsive regions Hair Cell Loss Patterns 17

18 Effects of OHC loss: tuning and threshold 3 khz 115 db, 2 hrs Auditory Nerve Thresholds OHC loss raises thresholds Hair Cell Loss Patterns 18

19 Stereocilia damage: tuning and threshold 3 khz 110 db, 2 hrs Auditory Nerve Thresholds Hair Cell Loss Patterns Note damage focus in extreme base 19

20 Stereocilia damage: tuning and threshold 3 khz 103 db, 2 hrs 20

21 OHC loss: SR and dynamic range Normal Ear dynamic range ~ 30 db Dynamic range = SPLs over which discharge rate increases CF 21

22 OHC loss: SR and dynamic range After OHC loss, the neural response shows: 40 db decrease in sensitivity & loss of sharp tuning No change in spontaneous discharge rate No change in maximum discharge rate No change in dynamic range 22

23 Response IHC loss areas : SR with and vs. dynamic without range IHCs After IHC loss, the neural response area shows: No response to sound No spontaneous activity 23

24 OHC loss and the Audiogram Produces notched audiogram Response loss only for mid frequency OHC loss restricted to middle of cochlea 24

25 IHC loss and the Audiogram Produces notched audiogram, as for OHC loss Response loss only for mid frequency OHC & IHC loss restricted to middle of cochlea 25

26 HC loss and loudness recruitment: Normal Ear 0 db 30 db 60 db 90 db 26

27 HC loss and loudness recruitment: Normal Ear 0 db 30 db 60 db 90 db 27

28 HC loss and loudness recruitment: OHC loss 0 db No response in either ear 30 db No response in damaged ear 60 db 90 db Less response in damaged ear Identical response in both ears 28

29 HC loss and pitch shift: IHC loss 0 db 30 db 60 db 90 db Response to 2500 Hz is carried by wrong fibers Response pattern is never normal 29

30 IHC loss: SR and tinnitus? IHC loss eliminates spontaneous discharge in auditory nerve fibers This silent band produces an abnormal response gradient in quiet This gradient may be interpreted as a sound: TINNITUS 30

31 OHC loss and two-tone suppression Two-tone suppression in BM response Arises from OHC transducer nonlinearity and its control of the OHC motors 31

32 Two-tone suppression in normal ear Two-Tone Suppression Contours * * 20 Dynamic db Dynamic Range Range Shift: 3 db/db 32

33 OHC loss - Loss of two-tone suppression * * 33

34 Suppressive effects are a form of anti-masking 10 db With suppression, noise can increase to > 20 db re threshold without saturation 40 db 70 db 34

35 OHC loss - Loss of Dynamic Range Shift in Noise 10 db Without suppression, fiber saturates as noise level grows re noise threshold. 40 db 35

36 Threshold shifts SNHL: Perceptual Correlates Loudness Recruitment Tinnitus Pitch Shifts Problems in Noise 36

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