E-ISSN:2456-3110

Case Report

Neural Hearing Loss

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 12 DECEMBER
Publisherwww.maharshicharaka.in

Ayurvedic management of Badhirya w.s.r. to Sensory Neural Hearing Loss - A Single Case Report

Sahoo D1*, Pawar DK2
DOI:10.21760/jaims.9.12.44

1* Diptidipanita Sahoo, Post Graduate Scholar, Department of Shalakya Tantra, Institute of Teaching and Research in Ayurveda, Jamnagar, Gujarat, India.

2 Deepak K Pawar, Assistant Professor, Department of Shalakya Tantra, Institute of Teaching and Research in Ayurveda, Jamnagar, Gujarat, India.

Introduction: Sensorineural hearing loss (SNHL) is a type of hearing loss or deafness in which the root cause lies in the inner ear or sensory organ (cochlea and associated structures) or the vestibulocochlear nerve (cranial nerve VIII). According to ancient Acharyas, Badhirya is caused by the vitiated Vata Dosha or Vata-Kapha Doshas obstructing the Shabdavaha Srotas (pathway of hearing) or Shabdavaha Sira (auditory nerve) or by the negligence of Karnanada (tinnitus), etc., and gives rise to diminished hearing or incapability of hearing. In Vataja Badhirya patient is unable to differentiate the sound. So on the basis of sign and symptom it can be correlated with Sensory neural hearing loss.

Aim: To evaluate the effect of Marsha Nasya with Anu Taila, Karnapurana with Bilwadi Taila and Sarivadi Vati (orally) in the management of Badhirya (SNHL).

Materials and Methods: The subject approached Shalakya Tantra OPD with complaints like decreased hearing along with trouble in understanding speech since 1 years. Marsha Nasya with Anu Taila, Karnapurana with Bilwadi Taila, and Sarivadi Vati (orally) were prescribed for the treatment of the mentioned complaints for 6 months.

Discussion: Vata Vyadhi Chikitsa Siddhant can be implemented as the management of Badhirya. The disease is Vata and Kapha predominant. Karnapurana and Nasya are the most prescribed procedures in the management of Badhirya, and thus attempts are made to bring about excellent results.

Results: This case study indicates the significance of Ayurvedic management in Badhirya, which was confirmed by subjective improvement and by audiometric findings.

Keywords: Badhirya, Karnapurana, Nasya, Rasayana, Sensory neural hearing loss

Corresponding Author How to Cite this Article To Browse
Diptidipanita Sahoo, Post Graduate Scholar, Department of Shalakya Tantra, Institute of Teaching and Research in Ayurveda, Jamnagar, Gujarat, India.
Email: 		Sahoo D, Pawar DK, Ayurvedic management of Badhirya w.s.r. to Sensory Neural Hearing Loss - A Single Case Report. J Ayu Int Med Sci. 2024;9(12):330-334.
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https://jaims.in/jaims/article/view/4123/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-11-15 2024-11-25 2024-12-05 2024-12-14 2024-12-26
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
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© 2024by Sahoo D, Pawar DKand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

J Ayu Int Med Sci 2024;9(12)330
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Diptidipanita S et al. Ayurvedic management of Badhirya w.s.r. to Sensory Neural Hearing Loss

Introduction

The World Health Organization (WHO) has defined hearing loss as “a person who is not able to hear as well as someone with normal hearing - a hearing threshold of 20 dB or better in both ears.”

Sensorineural hearing loss (SNHL) is a type of hearing loss or deafness in which the root cause lies in the inner ear or sensory organ (cochlea and associated structures) or the vestibulocochlear nerve (cranial nerve VIII).

SNHL occurs when there is a problem in the sensory apparatus of the cochlea (sensory) or in the pathways of conduction of nerve impulses to the brain. SNHL can be peripheral and central (auditory pathway or cortex).

Acharya Sushruta has mentioned 28 types of Karna Rogas (diseases of the ear) in Uttara Tantra Chapter 20, and Badhirya (HL) is one of them.[1] According to Acharya Sushruta, vitiated Vata and Kapha Doshas reside in Shabdanuvaha Siras and cause Badhirya.[2]

Acharya Dalhana states that not only Vata Dosha but also Rakta, Pitta, and Kapha Doshas get involved to cause Badhirya.[3]

According to Acharya Vagbhatta, Vata associated with Kapha and getting increased or by neglect of Karnanada (Tinnitus) results in hearing only loud sounds, hearing with difficulty, and gradually leading to deafness.[4]

Acharya Sushruta has mentioned in Urdhvjatrugata Marmas (supra clavicular region) that when Aghata (trauma) on Vidhura Marma occurs, it will lead to Badhirya.[5]

In Ayurveda, Vataghna and Vatakaphaghna are the treatments mentioned in context with Badhirya, which include Vatashamaka Snehana, Swedana, Nasya, Karnapoorana, oral administration of Rasayana Sevana, Ghritapana, and other Vatahara procedures.[10]

The Following are some tests that may be recommended for babies and children to diagnose hearing loss: Auditory brainstem response, central auditory evoked potential,Otoacoustic emissions, Middle ear muscle reflex, Tympanometry, B.E.R.A.Audiometry.[11]

Case Report

Patient information

A 17-year old girl child came to Shalakya OPD of ABC hospital on December 30, 2023, with complaints of decreased hearing in both ears since 1 year. Even she is facing trouble in understanding speech. she hadn’t taken any allopathic treatment. So, she came here for further Ayurvedic management.

History of past illness

The subject has no systemic illness.

Family history

No any history found related to sensory neural hearing loss.

Personal history

Table 1: Personal History of the Patient

1.BowelRegular, once a day
2.AppetiteGood
3.Micturition5-6 times per day
4.Sleep8 hr in night and day sleep for 1 hour
5.DietMixed

Pareeksha (Examination)

Table 2: Ashta Sthana Pareeksha

1.NadiVata Pradhan Kapha Anubandha, 72/min
2.MalaPrakruta, regular, once a day
3.MutraPrakruta, 5 to 6 times/day, once at night
4.JihwaLipta
5.ShabdaPrakruta
6.SparshaPrakruta
7.DrukAawila
8.AkrutiMahyama

Table 3: Dashavidha Pareeksha

1.PrakritiVata-Pittaja
2.VikritiMadhyama
3.SaraTavakasara
4.SamhananaMadhyama
5.SatmyaMadhyama
6.Satva Pravara
7.Ahara Shakti Madhyama
8.Vyayama ShaktiMadhyama
9.VayaBala
10.PramanaMadhyama

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On Examination of Ear

Table 4: On Examination of Ear before treatment (30/12/2023)

Otoscopic examinationRt. EarLt. Ear
EACClearClear
Tympanic membraneIntact and Mild retractedIntact and Normal
Tunnic Fork Test
a.  Rinne’s test
b.  Weber’s test		AC>BC
midline		AC>BC
midline
Audiometry - PTASevere mixed hearing lossModerately severe sensory neural hearing loss

Treatment

Table 5: Treatment advised from (1/01/2024 to 1/06/2024), follow up for 6 months at the interval of 15 days.

Treatment 1/01/2024 to 1/06/2024MedicineMode of administrationDuration
Oral administrationSarivadi Vati1 Vati of 250 mg thrice a day with lukewarm water or milk after a meal.6 months
KarnapuranaBilwadi TailaApprox. 24-26 drops (1ml). For 15 days with a 3-day interval6 months (2 sittings in 1 month).
Nasya KarmaAnuTaila6-6 drops each nostril for 7 days with a 3- days interval6 months (3 sittings in 1 month).

Pathya - Apathya (do’s and don’ts)

The patient was advised to follow Pathya Apathya during the whole treatment duration.

Pathya Vihara

Avyayama (avoidance of exercise), Ashirahsnana (Avoid head bath), Brahmacharya (celibacy), Abhashana (avoid excessive talking), Agni Santapa

Pathya Ahara

Godhuma (wheat), Shali (rice), Mudga (green gram), Yava (barley), Puranaghrita (ghee), Patola (bottle gourd), Shigru (drum stick), Lava, Mayura (peacock), Harina, Kukkuta

Apathya Vihara

Danta Kastha (brushing teeth with a hard brush made out of tender branches), Sirahsnaana (head bath), Vyayama (heavy exercise), Shoka, Shrama (Physical exertion)

Apathya Ahara

Ruksha Kashaaya Bhojana, Pravata (windstorm) and Shitodaka (drinking cold water)

Discussion

According to the Acharyas, Shrotrendriya originates from Akasha Mahabhoota. Shabda (sound) travels through Vata while in the presence of Akasha Mahabhuta (space). Through Shrottendriya Adhishthana (Karna), Shrottendriya transmits the sound to Shravana Buddhi, which is responsible for the perception of sound. Thus, Vata plays an important role in normal hearing procedures. According to Aacharya Sushruta, vitiated Vata and Kapha Doshas reside in Shabdanuvaha Srotasa or Sira and cause Badhirya (SNHL).

The “Vata Vyadhi Chikitsa[7]” andRasayana Chikitsa(rejuvenation therapy) can be implemented as the management of Badhirya. These principles probably help in the regeneration and repair of damaged hair cells, which have improved hearing. As Acharyas has mentioned, different kinds of treatments are used in the management of Badhirya (SNHL), like Ghritapana, Rasayana Sevana, Nasya, Snehana, Swedana, Snehavirechana, Sirobasti, Karnapurana, Jalaukavacharana, etc., but Karnapurana and Nasya are the most prescribed procedures in the management of Badhirya (SNHL).

As mentioned earlier, the signs and symptoms of hearing loss can be correlated with Badhirya in Ayurveda. Badhirya is due to the vitiation of Vata and Kapha Dosha. Anu Taila Nasya scratches out the Kapha Dosha from Shira and improves the function of Indriyas (Karna Indriya), thereby clearing the Srotorodha. Anu Taila was planned, which pacifies the aggravated Vata Dosha in the head and helps to normalize the function of the central nervous system by nourishing the nervous system and balancing the circulation of blood in the sense organs, including the ear. Shringataka Marma in Shira is the junction of all sense organs like the eye, ear, nose, and tongue, and any medicine applied over this area targets the vitiated doshas related to all sense organs and helps in the nourishment of nerves connecting to these areas. Karnapurana is one of the treatments mentioned for all Karnarogas. Karnapurana with Bilwadi Taila has the Vatashamaka property and maintains normal hearing capacity, as quoted by Acharya Charaka.


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“Na Karnaroga Vatothaha Nochchav Shrutihi, Na Badiryam Syannityam Karna Tarpanaat.”[12] Sarivadi Vati removes Shrotorodha and does Vatanulomana also It is the best Rasayana Dravya for Shravnendriya Vikara.

Results

Before the start of the treatment on December 30, 2023, the audiometry report was done, which showed severe mixed hearing loss in the right ear and moderately severe sensory neural hearing loss in the left ear. After six months of treatment protocol, the patient got excellent results in subjective criteria. Now she was able to hear from one room to another, feeling relieved in her complaints and repeated Audiometry was done after treatment on June 1, 2024, which showed moderate sensory neural hearing loss in both ears.

Table 6: On Examination of Ear After Treatment (1/06/2024)

Otoscopic examinationRt. EarLt. Ear
EACClearClear
Tympanic membraneIntact and NormalIntact and Normal
Tunnic Fork Test
a.  Rinne’s test
b.  Weber’s test		AC>BC
The sound lateralized towards right ear.		AC>BC
-
Audiometry Moderate sensory neural hearing lossModerate sensory neural hearing loss

Conclusion

Audiometry Report of Patient

jaims_4123_01.JPG
Before Treatment (30/12/23)

jaims_4123_02.JPG
After Treatment (1/06/24)

In sensory neural hearing loss, “Vata Vyadhi Chikitsa” andRasayana therapy can be implemented as a management method. Anu Taila Nasya, Bilwadi Taila Karnapurana, and Sarivadi Vati orally have provided excellent improvement in the present case. Thus, this case study indicates effective management of Ayurvedic oral medicine and procedures to treat Badhirya (sensory neural hearing loss).

References

1. https://pdfs.semanticscholar.org

2. Kaviraja Ambikadutta Shastri; Sushruta Samhita of Maharsi Susruta with the Ayurveda tattva Sandipika hindi Commentary; Chaukhambha Sanskrit Sansthan Varanasi, reprint 2013; Uttartantra 20/3-6, pg. No. 111.

3. Kaviraja Ambikadutta Shastri; Sushruta Samhita of Maharsi Susruta with the Ayurveda tattva Sandipika hindi Commentary; Chaukhambha Sanskrit Sansthan Varanasi, reprint 2013; Uttartantra 20/3-6, pg. No. 111.

4. Kaviraja Ambikadutta Shastri; Sushruta Samhita of Maharsi Susruta with the Ayurveda tattva Sandipika hindi Commentary; Chaukhambha Sanskrit Sansthan Varanasi, reprint 2013; Uttartantra 20/8, pg. No. 116.

5. Sushruta Samhita with the Nibandha Sangrah Comm. - Dalhana Chaukhambha Sanskrit sansthan Varanasi, reprint 2013; Nidana sthana 1/83, pg. No. 269.


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6. Brahmanand tripathi; astanga hrdayam of srimadvagbhata with the nirmala hindi commentary; Chaukhambha Sanskrit pratishthan delhi, reprint 2014; Uttartantra 17/10, pg. No. 1000.

7. Sushutra, Ambika Dutta Shastri, Sushutra Samhita with Elaborated Ayurveda Tatva Sandipika Hindi Commentary, Reprint. Varanasi: Choukhambha Sanskrit Sansthan, SharirSthan 6/46, 2011

8. https://www.who.int

9. Https://En.Wikipedia.Org/Wiki/Sensorineural_Hearing_Loss 10-03-2023 09:45am

10. Sushruta Samhita, Edited by Vaidya Jadavji Trikamji Acharya, Reprint Edition. Varanasi: Chaukhambha Surbharti Prakashan; 2008. Uttara Tantra 21/3.

11. Deboshree Bhattacharjee https://parenting.firstcry. com/articles/hearing-loss-in-children

12. Shastri KN, Chaturvedi GN. Charaka Samhita of Agnivesha, Sutra Sthana. Ch. 5., Ver. 84 2009 Varanasi Chaukhamba Sanskrit Sansthana:128

13. YT Karnaroga rogadhikara Uttar tantra 1-4

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