Effect of cerumen impaction on hearing and cognitive functions in Japanese older adults with cognitive impairment

Abstract

Aim:To assess the effect of cerumen impaction and its removal on hearing ability and cognitive function in elderly patients with memory disorders in Japan.Methods: Pure tone audiometry (PTA) and the Mini-Mental State Examination (MMSE) were administered to participants before and after cerumen removal. Participants who had cerumen impaction in the better-hearing ear comprised the case group; the control group consisted of participants who either did not have cerumen impaction or had it in the worse hearing ear. Hearing and cognition changes were compared between the groups after cerumen removal.Results: A total of 55 patients who completed all examinations were assigned to the case group (29 patients) or the control group (26 patients). The average hearing change was 4.6 ± 7.4 in the case group and 0.9 ± 0.9 in the control group (P = 0.029). The average change in MMSE score was 0.7 ± 2.5 in the case group and −1.0 ± 4.1 in the control group (P = 0.068). The case group showed a significant improvement in MMSE scores after age adjustment compared with the control group (P = 0.049). Conclusion:Hearing improved significantly in the case group relative to controls after cerumen removal. A significant cognitive improvement in the case group relative to controls was additionally observed after cerumen removal with age adjustment. Thus, the present results suggest routine ear canal examinations might benefit elderly individuals with memory disorders. Geriatr Gerontol Int 2014; 14 (Suppl. 2): 56-61.

Hearing and dementia

“…While effects on specific aspects of cognitive function are difficult to predict, correction of reversible hearing deficits has been shown to benefit global functioning in daily life [ 20 , 21 , 23 , 78 , 79 ]. Simple interventions such as earwax removal can be highly effective [ 79 ]. In addition, prescription of hearing aids and other assistive listening devices where appropriate, environmental modification strategies may be useful in managing altered hearing in patients with dementia.…”

Cerumen impaction shown by brain magnetic resonance imaging in patients with cognitive impairment

“…If cerumen impaction can be recognized on brain MRI, we can specify patients with cerumen impaction and remove the cerumen impaction for them. Removal of the cerumen impaction might result in a significant improvement of cognitive function . A Web of Science search that included the terms “MRI” and “dementia” revealed more than 5300 papers.…”

“…Removal of the cerumen impaction might result in a significant improvement of cognitive function. 1,6 A Web of Science search that included the terms "MRI" and "dementia" revealed more than 5300 papers. There were none for a search with "MRI" and "cerumen."…”

“…The participants were six patients whose hearing level improved 15 dB or more unilaterally or bilaterally after the removal of cerumen impaction, from a larger study of 55 patients described previously. 1 The study was approved by the Committee for the Ethics of Human Research for the National Center for Geriatrics and Gerontology. Age, sex, results of Mini-Mental State Examination, otoscopic findings, and hearing levels before and after cerumen impaction removal are shown in Table 1.…”

Anodal transcranial direct current stimulation over the auditory cortex improved hearing impairment in a patient with brainstem encephalitis

“…Pure tone audiometry materials were used to define the average hearing threshold, as in previous studies. 7 , 8 Japanese monosyllabic word lists, which have been used in previous studies, 9 , 10 were used for the speech discrimination tests. Maximum speech discrimination was assessed using analysis of variance (ANOVA) with repeated measures.…”