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Biomedical subjects

A Parving

Publications and source records attributed to A Parving.

At least 91 records · Page 5Linked to original sources
PubMed1988

In-the-ear hearing aids. The use and benefit in the elderly hearing-impaired.

Preliminary clinical experiences with in-the-ear hearing aids (ITE-HAs) have been promising, and a beneficial effect has been demonstrated in younger hearing-impaired subjects. However, the subjects applying for audiological examination and rehabilitation are predominantly elderly people (i.e. greater than or equal to 70 years). The present questionnaire examination was performed in order to evaluate the use and benefit of ITE-HAs also in the elderly hearing-impaired, and compare with the effect in younger subjects. An extensive questionnaire was sent 6 months after hearing aid fitting to all patients fitted with ITE-HAs. A total number of 693 subjects corresponding to 80% responded to the questionnaire. 70% of the patients are greater than or equal to 70 years and 23% are above the age of 80 years. The results demonstrate that the elderly hearing-impaired use the hearing aids predominantly in situations when listening to television and in small groups; 64% use their hearing aids the whole day and only 6% never use the aids; with increasing age were indicated increasing handling problems, both concerning change of battery, handling of volume control, and insertion of the aid into the ear canal. Only 8% of the patients were dissatisfied with the cosmetic appearance of the hearing aids, the dissatisfaction being more frequent in the young age group below 70 years (16%) than above the age of 70 years (9%). It is concluded that also the elderly hearing-impaired use and benefit from ITE-HAs.

Adolescent↗
PubMed1988

Clinical application of brain-stem audiometry.

Based on the examination of 249 consecutive patients, the usefulness of brain-stem response audiometry in a major audiological clinic was evaluated. Auditory brain-stem responses were performed either for hearing threshold determination (67 patients) or for assessment of retrocochlear hearing loss (182 patients). The results demonstrate that ABR is a reliable method for the estimation of hearing thresholds in non-cooperative subjects. The rate of false positives was 5% and no false negatives were found. In combination with caloric testing, ABR is considered a valuable testing procedure in the audiological clinic and it may form the basis for submission to brain imaging examination when a suspicion of retrocochlear hearing disorder is raised. Concerning the diagnosis of retrocochlear hearing disorder, no false negatives have yet been found, while a rate of 13% of false positives has been indicated.

Adolescent↗
PubMed1988

Hearing disabled children--epidemiology and identification.

An investigation of hearing disabled children was performed in the Copenhagen City and County in order to: evaluate the prevalence and incidence of congenital/early acquired hearing disability and delineate any change in these parameters compared to the 1970'ies; evaluate the time of identification of the hearing impaired child; indicate who first suspects the child's hearing disability. It was demonstrated that the prevalence of hearing aid treated children had been reduced with 40-42%, however, the incidence was unchanged 0.13%. An annual variance of 0.06-0.20% was present. No significant difference in the incidence was found between the two geografical areas. The median age at identification was 15-18 months, and only 32-48% of the hearing disabled children had been identified at the age of 1 year, showing an improvement in comparison to the 15-16% identified at the same age in the 1970'ies. Children, who could be registered as auditory at-risk were not identified earlier than the non-at-risk children. In 57-67% of the children the parents were the first to suspect the hearing disability. On the basis of the investigation it is concluded that the incidence of congenital/early acquired hearing disability in children is unchanged over a 10 year period, and that a delayed identification of these children is present although an improvement in the early identification has taken place.

Child, Preschool↗
PubMed1987

Detection of hearing impairment in early childhood.

The parents of 21 hearing-impaired children (hearing loss greater than or equal to dB HL for the average of 500, 1,000, and 2,000 Hz) volunteered to participate in the present investigation. This was performed in order to clarify who first suspects the hearing impairment; to describe some of the signs arousing suspicion of hearing dysfunction; describe some of the psychological problems encountered by parents of hearing-impaired children. An extensive questionnaire formed the basis for a personal follow-up interview, which was tape-recorded for further evaluation. In 57%, family members were the first to suspect the hearing impairment. In only 29% did systematic hearing screening by the BOEL-test detect the children. The signs and signals from the child arousing parental suspicion of hearing impairment are related to the child's behaviour patterns. It was found that most parents are acquainted with children's motoric and language development, but have a superficial knowledge of normal perceptual development. In order to improve the early detection, it is proposed to strengthen the non-professional screening resources present in the general population. In order to reduce the parents feeling of grief and anxiety, it is proposed that psychologists cooperate with physicians within the audiological units and support the parents in their recognition and acceptance of their child's handicap. Thereby can be obtained an improved treatment of the 'hearing-impaired family'.

Adaptation, Psychological↗
PubMed1987

In-the-ear hearing aids. A comparative investigation of the use of custom-made versus modular type aids.

The present investigation was performed in order to evaluate and describe the benefit of a CITE-HA and compare its use with that of a modular type ITE-HA. Thirty-five patients at a median age of 70 (range 27-84) years, were fitted with CITE-HAs. As a reference group, we selected 37 patients at a median age of 74 (range 27-85) years, fitted with various types of modular in-the-ear-HAs. Based on an extensive questionnaire and an objective evaluation using insertion gain measurements and discrimination score in background noise, it was demonstrated that hearing disabled patients--even when elderly--benefit from in-the-ear-HAs; that the discrimination score measured with CITE-HAs was lower than that with the modular in-the-ear-HA; and that custom-made in-the-ear-HAs in general offer no major advantages when compared with the modular in-the-ear-HA types. In addition it was shown that the hearing aid amplification used by the majority of patients was considerably less than the amplification described by the POGO formula.

Adult↗
PubMed1987

Choroideremia, congenital deafness and mental retardation in a family with an X chromosomal deletion.

An interstitial deletion of the proximal part of the long arm of the X chromosome was found in two brothers both suffering from choroideremia, congenital deafness and mental retardation. The mother was subsequently found to be heterozygous for the deletion, and to have the typical ophthalmological phenotype of a choroideremia carrier together with an elevated stapedial reflex threshold. Syndromes including choroideremia seem to be composed of characteristics which, independent of each other, occur as X-linked traits. Since this deletion covers part of the region Xq21.1-Xq21.31 it is postulated that besides the locus for choroideremia this region harbors a locus for X-linked congenital deafness and possibly a locus for X-linked mental retardation.

Adult↗
PubMed1986

On prediction of hearing disability.

The present investigation was performed in order to evaluate the pure-tone frequency and/or averages of frequencies best correlated with speech intelligibility measured by the discrimination score (DS) in quiet and in background noise, and, in addition, indicate a valid low fence of the DS when correlated to a self-assessment procedure. The material comprises 158 male subjects with a median age of 60 years, range 52-72 years, drawn from an ongoing longitudinal epidemiological investigation. By self-assessment 36% indicated hearing disability in noisy backgrounds, while 64% had no hearing problems. The pure-tone frequency that correlated best with the speech intelligibility in quiet was the 2-kHz pure-tone frequency. In background noise the best correlation was found with the 3-kHz pure-tone frequency. In the group of subjects with complaints of hearing problems, the median discrimination score in background noise was 84% (IQR 72-92), while in the group of subjects with no complaints the median discrimination score in noise was 92% (IQR 88-96). Based on the results it is concluded that DS in background noise is a valuable measure in the assessment of hearing disability, but no low fence value can be indicated on the basis of the present results.

Aged↗
PubMed1986

Epidemiology of hearing impairment in male subjects: a follow-up investigation.

As part of a longitudinal study 158 male subjects, with a median age of 60 years, range 52-72 years, were re-examined after a 3-year interval. No significant deterioration in their hearing sensitivity was demonstrated when measured by pure-tone or speech audiometry. The prevalence of hearing impairment is 39% based on the criterion greater than or equal to 20 dB HL averaged over 0.5, 1, 2, 3, and 4 kHz. This is similar to the prevalence of 36% experiencing hearing problems in daily listening situations.

Aged↗
PubMed1985

Hearing disorders in childhood, some procedures for detection, identification and diagnostic evaluation.

Hearing disability in childhood is a sign/symptom which should be detected, in order to avoid developmental disorders in language, speech, psychological and mental behavior. For proper treatment the hearing thresholds should be identified and the site of lesion evaluated in order to obtain a classification of the hearing loss. The causative factor(s) of the hearing disorder should be evaluated by means of an interdisciplinary cooperation. This review summarizes the results obtained in a series of investigations dealing with some procedures for detection, identification and nosological classification of hearing impairment in childhood. Based on these investigations a model for an examination program is proposed. This model requires interdisciplinary cooperation, preferably established at assessment centers. Prospective studies performed at these centers may offer precise data on the epidemiology of hearing disorders. Consequently preventive measures may be applied in order to reduce the number of children suffering from the symptom of hearing loss.

Acoustic Impedance Tests↗
PubMed1985

Aetiology of hearing disorders in children at the schools for the deaf.

Ninety-three children attending the schools for the deaf in Copenhagen were examined in order to assess the aetiology of the hearing disorder and to compare the causing factors to those indicated in a previous investigation from 1953. Based on pre-existing investigations including both audiological and non-audiological procedures, the aetiology of the hearing impairment was known in 63% while in 37% the cause of the hearing disorder was unknown. A thorough examination programme was performed in 71 of the attending children whereby a reduction of 'unknown cause' of the hearing disorder could be obtained in half of these children. Compared to the previous investigation from 1953 the incidence of acquired hearing impairment had decreased in contrast to congenital severe hearing impairment. Based on the results of the present investigation it is concluded that an improved nosological classification can be obtained by re-evaluation of both the children and the parents; the physical examination is a long-standing dynamic process running over years; the increased incidence of congenital hearing impairment can be ascribed to prenatal infections, predominantly foetal rubella which is a preventative disease.

Adolescent↗
PubMed1985

Hearing disability and communication handicap for compensation purposes based on self-assessment and audiometric testing.

It is reasoned that for compensation or epidemiological studies an evaluation of hearing disability and the concomitant handicap must include the ability to perceive visual cues. A scaling procedure for hearing- and audiovisual communication handicap is presented. The procedure deviates in two ways from previous handicap assessments: (1) It is based on individual self-assessment of semantic speech perception but can be implemented by means of professional audiological test procedures. (2) The system does not make use of pure-tone auditory thresholds as a predominant audiological principle, but is based on speech perception. The interrelationship between auditory and audiovisual handicap is evaluated. A total score including audio- and audiovisual perception handicap is proposed and a suggestion for disability percentages is presented.

Audiometry↗
PubMed1984

Early detection and identification of congenital/early acquired hearing disability. Who takes the initiative?

Questionnaires were distributed to parents of hearing-impaired children (average of the hearing thresholds greater than or equal to 35 dB at 500, 1000 and 2000 Hz) in order to perform an evaluation concerning the initiators of the detection and identification of congenital/early acquired hearing impairment. In 59% (23/39) the parents were the first to suspect the hearing loss. In 13% (5/39) the child failed the auditory screening test. In 16% (6/39) the child was registered as at risk and in 13% (5/39) the suspicion was raised by trained personnel in nurseries. In 43% (17/39) more than 4 weeks passed from the time the first suspicion was raised until a valid hearing threshold determination was performed. This delay was caused by health personnel in 59% (10/17). The median age at the hearing threshold assessment was 20 months (range 4-48 months) in this group of children. Only 33% (13/39) were diagnosed at the age of 1 year, despite the fact that the hearing loss was either congenital or acquired during the neonatal period. It is concluded that the parents are the first initiators of the identification of their hearing-impaired child, but the point of time at which the hearing loss is identified is still unacceptably late in most cases. Proposals for an improved early detection and identification of hearing-impaired children are made in order to prevent developmental disorders in speech, language, psychological and mental behaviour.

Age Factors↗
PubMed1984

Aetiological diagnosis in hearing-impaired children--clinical value and application of a modern examination programme.

The clinical value and applicability of an examination programme aimed at identification and diagnosis of hearing loss was investigated. A total of 32 children born during the period 1970-1980 with a permanent hearing loss greater than or equal to 35 dB HL was subjected to both audiological and non-audiological test procedures, included in the examination programme. The criterion for selection of the children was hearing impairment of unknown aetiology. Based on the examination procedures, an aetiological/nosological classification could be obtained in 63% (20/32) of the children, while the aetiology remained unknown in 37% (12/32). When incorporating these data in the data of a previous epidemiological investigation an aetiological classification could be established in 89% (105/117). The present investigation demonstrates that extensive interdisciplinary cooperation with physicians outside the field of audiology is necessary for the aetiological diagnosis of hearing impairment in childhood. However, extensive interdisciplinary cooperation meets with severe practical problems. These may be overcome by the establishment of assessment centres at which trained physicians can examine and discuss the individual hearing-impaired child, and in addition exchange information from their own disciplines. Thus, more precise and valid data on the aetiological factors of hearing impairment may be obtained and in addition preventative methods taken into account. In this way a reduced prevalence of hearing impairment in childhood may be achieved.

Audiometry, Pure-Tone↗