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Biomedical subjects

D B Hawkins

Publications and source records attributed to D B Hawkins.

At least 73 records · Page 4Linked to original sources
PubMed1980

Loudness discomfort levels: a clinical procedure for hearing aid evaluations.

Before any amplification system is evaluated, prescribed, or recommended, the audiologist must determine that the limits of its output across frequency are not greater than the levels at which clients experience discomfort, that is, their Loudness Discomfort Levels (LDL). After reviewing terminology, reasons for obtaining LDLs, and several sources of variability in LDL measurements, a new clinical LDL measurement procedure for hearing aid evaluations is suggested. The main aspects of this procedure are the instructions (from Morgan, Wilson and Dirks, 1974), the stimuli (sweep-frequency pulsed pure tones), the psychophysical method (tracking procedure), the calibration of the stimuli (by a hearing aid receiver attached to a 2 cm3 coupler), and the presentation of the stimuli (through the hearing aid receiver coupled to the client's earmold). This technique is suggested as clinically feasible and as a defensible procedure for obtaining LDLs for the purpose of more closely specifying an appropriate SSPL90 curve.

Correction of Hearing Impairment↗
PubMed1980

Caustic ingestion: controversies in management. A review of 214 cases.

Two hundred fourteen patients admitted with a history of caustic ingestion are reviewed. Sixty-five had mucosal penetrating burns. Children five years of age and under accounted for 39% of admissions, but only 8% of burns requiring treatment. Adults accounted for 48% of admissions and 81% of burns requiring treatment. Complications associated with mucosal penetrating burns occurred in 31 patients; all but one were due to lye or acids. A three year prospective study evaluating methylprednisolone in the management of caustic burns is reported. This included 24 patients with mucosal penetrating burns due to lye or acids. The results of this study, and this review as a whole, indicate that methylprednisolone is beneficial in moderately severe burns due to lye, but is not indicated for severe burns from liquid lye, or for acid burns.

Accidents, Home↗
PubMed1980

Schwannomas of the head and neck in children.

Schwannomas are relatively rare tumors that arise from Schwann cells of the sheaths of peripheral nerves. They may be found in any portion of the body. In reported series of schwannomas, the percentage of tumors in the head and neck varies from 16% to 45%. Usually demonstrating slow growth, they often have a history of long duration, and are most often diagnosed in adults. Approximately 10% of schwannomas are diagnosed in patients under 21 years of age. In this paper two children with large schwannomas of the head and neck are reported. In both, the symptoms were of relatively short duration, but physical findings suggested that the tumors had been present much longer. One patient was a 10-year-old female with a schwannoma filling the anterior and posterior triangles of the left side of her neck and extending superiorly to the base of the skull. The tumor intimately involved the vagus, spinal accessory, and hypoglossal nerves. The other patient was a 12-year-old female with a nasal tumor filling the right naris and nasopharynx. Our management of these patients is discussed.

Age Factors↗
PubMed1980

Interaural time discrimination ability of listeners with sensorineural hearing loss.

Interaural time just noticeable differences (JNDs) were obtained with a low-frequency (450-550 Hz) and high-frequency (3 750-4 250 Hz) narrow-band noise for 3 normally hearing subjects and 8 subjects with sensorineural hearing loss. Results for the hearing-impaired subjects were compared to those of the subjects with normal hearing at the same sound pressure level (85 dB SPL) and sensation level (30 dB SL). Although large individual differences were present, when considered as a group, interaural time discrimination for the subjects with sensorineural hearing loss was significantly poorer than that of the normal subjects for both signals at both intensity levels. There was no apparent relationship between configuration of hearing loss and time discrimination, but correlations of +0.8 were found between degree of hearing loss and time JNDs. Normal interaural intensity JNDs were obtained from 2 subjects with sensorineural hearing loss whose time JNDs were very poor, thus providing further evidence against the latency hypothesis.

Adult↗
PubMed1977

Orbital involvement in acute sinusitis. Lessons from 24 childhood patients.

The possibility of acute bacterial sinusitis should be considered in any child with sudden swelling about the orbit. Management is determined by the stage of the disease as well as by the sinus predominantly involved. Extraocular movements and proptosis are the best guidelines for therapy. When there is no proptosis and extraocular mobility is normal, conservative therapy with intravenous antibiotics and nasal decongestants is usually effective. When ocular mobility is impaired or proptosis develops, intranasal or external surgical drainage are usually required. Of 24 patients summarized in this paper, the ethmoid was the predominantly involved sinus in 12, the frontal in 7, the maxillary in 5. Only 4 of the 12 with predominant ethmoiditis required surgery. All 7 were predominant frontal involvement needed surgical drainage.

Abscess↗
PubMed1977

Glottic and subglottic stenosis from endotracheal intubation.

As a result of increased use of prolonged endotracheal intubation, complications of intubation are now being seen more often. Stenosis of the airway may develop at the level of the glottic or subglottic larynx, or in the trachea. Discussions of management do not always distinguish clearly between laryngeal stenosis and tracheal stenosis. Yet, these are two separate entities. Discussions of laryngeal stenosis usually deal with subglottic stenosis, with less emphasis on obstruction at the glottic level. Of 20 patients, 14 adults and six children, with stenosis of the larynx secondary to intubation, we were successful in establishing adequate airways in 16. An analysis of these 20 patients leads to the following conclusions: 1. Scarring in the glottic posterior commissure between the arytenoid cartilages is a frequent cause of laryngeal stenosis after intubation. 2. Endoscopic management can be successful in many cases if it is started early enough, and repeated as often as is necessary. The earlier it is begun, the better the results will be. 3. Indwelling stents which are extremely valuable in laryngeal stenosis from external trauma, may not be as useful in stenosis from endotracheal tube trauma.

Adolescent↗
PubMed1976

A needle holder for vascular and plastic surgery.

A needle holder is described that can be oriented to both the long and transverse axes of the hand, can be used with equal facility in either hand, and because of its narrow configuration is less apt to obscure the operative field.

Surgery, Plastic↗
PubMed1976

Tracheostomy in infants and young children.

Seventy-three tracheostomies performed in children three years of age and under in a 52-month period are discussed. Thirty-six were under one year of age. Forty-one were performed for upper airway obstruction, 23 for ventilation or suction, and nine for a combination of upper airway obstruction and lower bronchopulmonary disease. Operative complications developed in 10 patients, and postoperative complications in 16. The most common complication was interstitial air; the most deadly was obstruction of the cannula. There were 20 deaths. Sixteen were due to the patients' diseases; four were due to complications of tracheostomy. If serious operative and postoperative complications are avoided, the important factors determining prognosis are the patient's age and the condition for which the tracheostomy was done. The long term results in these patients show this to be true for both survival and duration of tracheostomy.

Age Factors↗
PubMed1974

Endotracheal tube perforation of the hypopharynx.

Perforation of the hypopharynx or esophagus is a serious though not often reported complication of endotracheal intubation. Only 12 cases had been reported before the eight which are presented here to emphasize this hazard of intubation. The early symptoms of perforation, which occurred during insertion of the tube, were: subcutaneous emphysema (seven patients), mediastinal emphysema (six), pneumothorax (two), cardiac arrest (one). One patient had no recognized early signs of perforation, but presented with an abscess of the mediastinum six weeks later. The site of perforation, determined by endoscopy in six patients, was the lateral hypopharynx in four, and the vallecula in two. The outcome of the eight perforations was as follows: two patients recovered on conservative management; in two, abscesses of the neck and in one an abscess of the mediastinum developed. All three recovered after drainage of the abscesses. Three patients died. Two outstanding characteristics of these eight cases were that in all of them intubation was attempted by physicians relatively inexperienced in the technique, and in all but one it was done in emergency. Since the use of intubation in emergency situations is increasing, all physicians in training should receive formal instruction in technique.

Adult↗