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Biomedical subjects

J C Cooper

Publications and source records attributed to J C Cooper.

89 records · Page 5Linked to original sources
PubMed1976

Audiologic profile of noise-induced hearing loss.

Audiologic results for 450 ears presumed to have uncomplicated noise induced hearing loss were analyzed to describe their typical profile and to quantify the characteristic audiometric notch. Data consisted of tonal and speech thresholds, speech discrimination scores, Bekesy tracings, and short increment sensitivity index scores, and tone decay at 4,000 hertz. In each case, the pattern of results indicated a cochlear site of lesion, although the only uniformly cochlear sign was the absence of a pattern of abnormal adaptation in Bekesy tracings. In each case, the audiogram could be approximated by a quartic equation. The mean difference between actual thresholds and those predicted by the best-fit quartic did not exceed 7.72 dB and was less than 5 dB for eight of the 11 frequencies for which comparisons were made. We propose the application of this characteristic to clinical practice and to automated hearing conservation programs.

Adult↗
PubMed1976

In defense of SISIs. The short increment sensitivity index.

We review the Short Increment Sensitivity Index (SISI) in terms of its performance with a variety of sites of lesion and its likely physiologic basis. We conclude that its original schema can be broadened to extend its clinical application if changes are made in the parameters of its routine use. The two major changes involve (1) a presentation level of no less than 90 dB hearing threshold level (HTL) and (2) a bimodal interpretation of results based on the premise that high scores indicate normal cochlear function and low scores indicate extensive cochlear damage or neural dysfunction. We suggest that routine use of the modifications suggested here can provide useful diagnostic information and bring to light a group of neurally impaired patients that has been relatively ignored.

Audiometry↗
PubMed1976

Oral swelling in Sjögren's syndrome.

A case is reported of a 69-year-old female with Sjögren's syndrome who presented with a problem of interest to the oral surgeon. The clinical features and cryosurgical management of a rare cause of palatal swelling are described. The confusion that exists in the literature concerning the nomenclature of chronic inflammatory salivary gland lesions is discussed.

Aged↗
PubMedDate not supplied

Current status of laryngectomee rehabilitation: I. Results of therapy.

Of 103 people with the clinical diagnosis of laryngeal cancer studied by the authors, 53 eventually were treated by total laryngectomy and, in some cases, radical neck dissection (43), preoperative radiation therapy (15), postoperative radiation therapy (29), and post-operative chemotherapy (7). All were entered into a comprehensive rehabilitation program. Six months following completion of their cancer therapy 47 were re-evaluated. Of these, 12 (26 per cent) used esophageal speech as the dominant mode of communication, 16 (34 per cent) the electrolarynx, and the remainder either wrote (16 [34 per cent]) or signed (3 [6 per cent]). Twenty-six (55 per cen) were considered to be successfully) rehabilitated overall and 21 (45 per cent) were not. These data indicate that the rehabilitative needs of today's laryngectomee are not being met successfully with traditional methods.

Adult↗
PubMedDate not supplied

Normal tympanometric shape.

Computer-assisted curve-fitting techniques were used to describe quantitative and qualitative characteristics of normal tympanometric shape. The data base consisted of set of triplicate tympanograms, obtained at 2-week intervals, from 72 ears of children with normal middle ears enrolled in the first through the fifth grades. A nonlinear equation produced significantly better prediction of normal tympanograms (R2 = 0.70) than did linear equations (R2 less than 0.44), bringing into question the use of the latter in determining normality. The complexity of applying curve fitting in clinical practice led to the development of a qualitative technique to determine normality. An initial application of the technique as a screen in 76 ears subjected to myringotomy produced a sensitivity of 96% and a specificity of 83% with respect to identification of the presence of middle ear fluid.

Acoustic Impedance Tests↗
PubMedDate not supplied

Effect of anesthetic gases on middle ear pressure in the presence of effusion.

Halothane, randomly with or without nitrous oxide (N2O), was administered by face mask to 69 children (selected by tympanometric and otoscopic evidence of chronic otitis media with effusion) for pressure equalization (PE) tube insertion in one or both ears. Tympanograms were obtained from 127 ears prior to and soon after the induction of a satisfactory level of anesthesia. The effect of anesthesia was identical whether N2O was used or not: 85% (75/88) of ears with flat tympanograms (B) remained B (all contained fluid); 15% (13/88) became peaked and 62% (8/13) of those contained fluid. All but two ears with peaked tympanograms showed substantial increases in middle ear pressure (mean: 179 mm H2O, range: -70 to +550 mm H2O) regardless of the presence of fluid. We conclude the N2O is not responsible for aerating the middle ear in the usual surgical setting, and that assisted ventilation used in mask inhalation anesthetic techniques will inflate all normal middle ears, most ears with a peaked tympanogram regardless of fluid, and 15% of ears with a nonpeaked tympanogram. It is unlikely that inhalation of anesthetic gases is responsible for displacement of middle ear fluid down the eustachian tube within the time constraints of the usual operating room setting.

Anesthesia, Inhalation↗
PubMedDate not supplied

Predictive value of tympanometry in middle ear effusion.

The presence of middle ear effusion may be inferred from a tympanogram by the configuration of the pressure compliance curve. Not infrequently, however, effusion is absent at the time of surgery when strongly indicated by preoperative tympanometry. We evaluated this discrepancy by contrasting preoperative tympanograms with the findings at surgery in 462 children, aged 4 to 8 years, with clinical evidence of persistent effusion in 909 ears. Based on these results we can classify tympanograms as to high risk for effusion, intermediate, and low risk. The proportion of ears with effusion was 83%, 47%, and 34%, respectively. The proportion of ears with fluid in the high risk tympanogram group did not change appreciably over a 1- to 8-week period, ie, no trend toward spontaneous resolution occurred. The high incidence of effusion at surgery in our low risk group is far higher than expected and is presumably due to reinfection of these ears during the time between examination and operation.

Acoustic Impedance Tests↗
PubMedDate not supplied

Isolated duodenal varices as a cause of massive gastrointestinal bleeding.

Portal hypertension and the development of varices in areas of portosystemic venous anastomoses can lead to dramatic and life-threatening haemorrhage. Varices most commonly occur in the gastro-oesophageal region but ectopic varices can arise at other sites in the gastrointestinal tract. This report describes a patient with massive haemorrhage from duodenal varices. We believe the case highlights the importance of considering ectopic varices as a cause of gastro-intestinal haemorrhage especially when oesophageal varices are absent.

Duodenal Diseases↗