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Biomedical subjects

J Holmquist

Publications and source records attributed to J Holmquist.

At least 55 records · Page 3Linked to original sources
PubMedDate not supplied

Middle ear ventilation in secretory otitis media.

The Eustachian tube function was determined repeatedly in 42 patients during as well as after the course of secretory otitis media. Air pressure equalization technique and impedance audiometry were used. Also the size of the mastoid air cell system was determined. It was found that poor tubal function and a small mastoid air cell system are signficance findings in these ears.

Adult↗
PubMedDate not supplied

Tympanometry revealing middle ear pathology.

In order to evaluate the usefulness of impedance audiometry as a screening method for school children, two different pilot studies were performed. The results indicated that impedance audiometry (tympanometry and stapedius reflex test) was more efficient than otoscopy and pure tone screening in the detection of ears with secretory otitis media (SOM). In order to gain some more experience, an extended study of 800 7-year-olds was performed. The results from this investigation showed 6.5% pathological values with pure tone screening, 13.5% pathological values with tympanometry and 32% elevated or nonelicitable stapedius reflexes. Analysis of our observations indicates that the stapedius reflex may be too sensitive a test to be used as a screening method. Tympanometry, however, is recommended as a complement to pure tone screening in screening of children. A 6-12 months follow-up was also performed on 357 ears in which an initial study had shown a middle ear pressure of less than or equal to -100 mm H2O. At the repeated test 20% had pathological pure tone screening, 40% had a middle ear pressure of less than or equal to -100 mm H2O, 57% had elevated or nonelicitable stapedius reflexes, and 14% had middle ear effusion. The high frequency of persisting abnormal middle ear pressure and effusion in these 357 ears suggests that a middle ear pressure of less than or equal to -100 mm H2O can be a predisposing factor for SOM. In an experimental study on human temporal bones it was demonstrated that the tympanogram preserves its original appearance when the water level is low in the middle ear, while a higher level gives rise to a pathological tympanogram. It is also demonstrated that there is a discrepancy between the tympanometrically, indirectly recorded middle ear pressure and the middle ear pressure as measured manometrically, directly from the middle ear.

Acoustic Stimulation↗
PubMedDate not supplied

Frequency of pathologic changes in the middle ear.

One third of a total of 2,783 60-year-old males living in Gothenburg were examined to establish the frequency of pathologic changes in the middle ear. During 1973 to 1975, 767 men were examined. The eardrums were studied with otomicroscopy. Audiometric tests and x-ray of the mastoid cell system were performed. Pathologic changes were found in 37% of which 5% had chronic otitis. Hearing impairment was found in 95% of patients with chronic otitis. This group showed a significant reduction in mastoid cell area compared to males with normal tympanic membranes. There was a distinct relationship between low social class and small mastoid cell area and high frequency of noise injury.

Ear, Middle↗
PubMedDate not supplied

Eustachian tube function and retraction of the tympanic membrane.

The medial displacement of the tympanic membrane or the retracted tympanic membrane is a common clinical finding. Also, retractions are looked upon as the precursor of middle ear cholesteatoma. In current otologic literature there seems to be some dispute whether the retractions of the tympanic membrane are caused by negative intratympanic air pressure or by shrinkage of middle ear adhesions pulling the tympanic membrane or part of it medially. In this study only ears with posterior/superior retractions of the tympanic membrane were investigated. Tympanometry revealed that only 33% of the ears did have middle ear pressure within +/- 100 mm H2O. After insertion of a polyethylene tube through the tympanic membrane, the eustachian tube function was tested using the air pressure equalization technique. None of the ears could change the negative air pressure upon swallowing. Planometric measurements on the x-ray of the mastoid air cell system of the present material deviate from those of a normal material, indicating a significantly smaller air volume in the present material. It may be concluded that dysfunction of the eustachian tube and a small air volume of the mastoid are characteristic features of an ear with posterior/superior retraction of the tympanic membrane.

Adult↗
PubMedDate not supplied

Surgery of the mastoid in ears with middle ear effusion.

It has been demonstrated that in most ears with middle ear effusion the mastoid air cells may be involved as well. The mucosal changes and the secretion extends into all cavities of the ear including the mastoid air cells. In most ears insertin of a ventilating tube through the tympanic membrane is adequate for proper aeration of the middle ear as well as of the mastoid air cell system. The draining usually stops and the mucosa gradually changes into its normal condition. In a small percentage of these, the ear will continue to drain and the mastoid will not clear up. Antibiotics and decongestants fail to cure the ear. Surgical intervention of the mastoid may be indicated in the rare cases where conventional treatment fails to control the condition. The aim of this report is to 1) focus attention to the fact that the mastoid is an integral part of the middle ear cavity; 2) discuss the pathogenesis in stubborn ears with middle ear effusion; and 3) demonstrate the surgical procedure commonly used in our department in order to reestablish aeration of the mastoid air cell system. Early recognition and proper treatment of ears with middle ear effusion will hopefully reduce the incidence of stubborn cases and also decrease the number of those cases which end up with chronic otitis media and cholesteatoma. It is hoped that the screening programs involving school and even preschool children, as well as new preventative programs, will diminish the frequency of cases which need extensive surgery as discussed in this paper.

Ear, Middle↗