The evaluation of hearing functions and serum prestin level in patients with sheehan syndrome

THE EVALUATION OF HEARING FUNCTIONS AND SERUM PRESTIN LEVEL IN PATIENTS WITH SHEEHAN SYNDROME Dr Yusuf Geylani, Thesis, VAN, 2019. Objective: The pituitary gland is an organ that plays important roles in the endocrine system.The endocrine system of the whole body is adjusted here. Pituitary insufficiency can occur as a result of loss of hypothalamic stimulation or direct loss of pituitary functions. Hypopituitarism that occurs in postpartum women with severe bleeding is called Sheehan's Syndrome (SS). Sensorineural hearing loss is responsible for most hearing losses. The main causes of sensorineural hearing loss are advanced age, use of ototoxic drugs, exposure to noise, hereditary and autoimmune diseases. In this study; We aimed to evaluate the hearing test results in SS patients followed up at the Endocrinology Outpatient Clinic of Yüzüncü Yıl University Medical Faculty Hospital. Material and Methods: In this study, 24 female patients aged 33-81 years with the diagnosis of Sheehan Syndrome who were followed up in the outpatient clinic of the Endocrinology Department of Dursun Odabaş Medical Center, Faculty of Medicine, Yüzüncü Yıl University (YYU) between June 2018 and May 2019 were prospectively evaluated. Twenty-four healthy women aged 34-79 years without any inherited, acquired or systemic disease and without Sheehan's Syndrome were included as the control group. Growth hormone, thyroid stimulated hormone (TSH), sT3, sT4, prolactin, somatomedin-C, cortisol, FSH, LH, progesterone, Estradiol, ACTH, DHEA-SO4 and serum prestin levels were studied. Pure tone audiometry and tympanometer measurements were also evaluated for hearing loss. Results: In our study, all cases and control groups were female. The mean age of the cases was 55.13 years and the mean age at the time of diagnosis was 47.09 years. The mean age of the hemorrhagic birth cases which cause disease was 32.48 years and the mean duration of the disease was 22.74 years. In the case group, The mean values of ACTH 14.42 pg / ml, growth hormone 0.14 ng / ml, DHEA-SO4 34 μg / dl, estradiol V 21.58 pg / ml, FSH 5.05 mIU / ml, LH 2.34 mIU / ml, prolactin 5.30 ng / ml, free T3 2.24 pg / ml, free T4 0.79 ng / dl and somatomedin-c 50.9 ng / ml were significantly lower than the control group. The pure tone audiometer results were significantly higher in the PTA case group, which is the average of pure sounds, compared to the control group. moderately positive correlation between the mean duration of the left ear high frequency and disease duration in the case group; a moderate negative correlation was found between the mean high frequency of the left ear and the mother's age at birth. Moderate negative correlation between serum prestin level and free T3 and free T4 was observed in the case group. Conclusion: There was a statistically significant difference in hearing loss in patients with Sheehan syndrome when compared with the control group. Sheehan syndrome (SS) may lead to hearing loss. Audiometry may be recommended for auditory follow-up during SS follow-up, and if high-frequency hearing loss occurs, treatment of these patients can be prevented from worsening. Keywords: Pituitary insufficiency, Sheehan syndrome, hearing loss, serum prestin.