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Biomedical subjects

Q C Beery

Publications and source records attributed to Q C Beery.

At least 19 recordsLinked to original sources

Acoustical and physical dynamics of the diatonic harmonica.

The harmonica is arguably the most widely played instrument in the world, yet there is a surprising paucity of published studies of its acoustics or physical dynamics. The typical diatonic harmonica and the physical forces involved in its natural function are described, and simple observations of the harp's functions are reported. The speaking of the reeds, naturally, when producing a bend, and when speaking as an overblow or overdraw is discussed and investigated by simple stopping of the reeds, by videostroboscopic analysis, and by recording vibration of the reeds with displacement gauges. The reeds of the ten hole harmonica can be made to vibrate at varying frequencies depending on the size and shape of the player's vocal tract. Three different modes of speaking from each hole and its pair of reeds are revealed and studied: first, naturally in a closing mode, either blown or drawn; second, as a bend, either blown or drawn, with pitch in the interval between the two notes in the hole; and third, as an overblow or overdraw in an opening mode with a pitch outside the interval between the two natural notes of the hole. This dynamic interaction allows the player to speak with the instrument perhaps as with no other.

Acoustic Stimulation

Microwave-cured tracheostoma vents.

This article describes a technique of making custom flexible and combined flexible/rigid tracheostoma vents. The combined flexible rigid tracheostoma vent provides a flexible material that is nonirritating in the peristomial region and maintains a patent tracheostoma by the rigidity of the hard acrylic resin section. The flexible tracheostoma vent can be easily inserted and is more comfortable than the rigid commercially available tracheostomy tube. The use of microwave-cured materials permits fabrication during a single visit. The steps involved in the fabrication of the tracheostoma vents are simple and require no elaborate laboratory equipment.

Acrylic Resins

Discovering the voice in the children's museum.

The authors report on a special section of a Children's Museum which is designed to involve the child and parent in actively learning about vocal function. This approach is recommended as an excellent way to promote interest in healthy vocal function.

Audiovisual Aids

Oral endoscopy in prosthodontic management of the soft palate defect.

Telescopic oral endoscopy is an effective aid in the construction and modification of a speech aid prosthesis. The method is noninvasive and easy to perform, permits the prosthodontist to achieve the goal of functional effectiveness in prosthesis construction while keeping the weight and size of the pharyngeal extension at a minimum, decreases the number and length of patient visits required for modification, and when coupled to a fiberoptic teaching arm or a video camera and recording system, it becomes an excellent aid in teaching, patient education and orientation, and record keeping.

Adult

Speech considerations in prosthodontic rehabilitation of the glossectomy patient.

A knowledge of normal articulation is needed before the prosthodontist can assess the compensatory articulation used by glossectomy patients. The amount and portion of tongue resected is directly correlated with speech intelligibility. The loss of the tip of the tongue is more critical to intelligibility than a hemiglossectomy. Partial glossectomy speakers can often use the residual tongue stump to perform adaptive movements that approximate normal movements and should be treated as an articulation problem. The compensatory articulation used by the total glossectomy patient was reviewed. The prosthodontic management of patients with partial tongue resection often includes lowering the palatal vault, while the management of the total glossectomy patient usually requires a mandibular tongue prosthesis. These prostheses can be refined with the use of multiview videofluoroscopy, videotaping, and spectrographic analysis.

Dentures

The influence of perennial allergic rhinitis on facial type and a pilot study of the effect of allergy management on facial growth patterns.

Perennial rhinitis with an allergic component (PRAC) in association with chronic mouthbreathing has been thought to cause skeletal open-bite facial type and narrow transverse facial dimensions. The object of this study was to supply data for this theory and to determine if allergy management would alter the course of facial growth. When a group of children, aged 5 to 10 years, with PRAC was compared with a matched control sample, a significantly larger palatomandibular angle and lower anterior facial height were found for the PRAC group. Transverse cephalometric measurements showed significantly narrower bilateral orbital breadth, bizygomatic, and binasal dimensions (narrower face) of the PRAC patients compared with the control sample. A pilot study of twelve PRAC patients who received 2 1/2 years of allergy management revealed no significant dento-facial dimensional change. This study suggests that PRAC with chronic mouthbreathing can alter the development of the midface. Whether allergy therapy can prevent or change this is as yet uncertain.

Cephalometry

Pharyngeal wall motion in prosthetically managed cleft palate adults.

Fiberoptic nasoendoscopy was used to evaluate the activity in the lateral and posterior pharyngeal walls of five adults with cleft palate, each of whom had worn a prosthetic speech appliance for more than 20 years. Activity during speech was greatest in the area of the levator veli palatini muscle and Passavant's ridge, while no gross activity was observed in the area of the auditory tube superiorly. Activity was variable within and between subjects. Apparent medial movement of the auditory tube seemed to be secondary to the influence of the levator muscle on the pharyngeal wall soft tissues.

Adult

Prosthodontic rehabilitation for glossectomy patients.

Patients with oral carcinomas often have resection of the tongue, the floor of the mouth, or the bone of the mandible. Postoperatively, these patients encounter chewing, swallowing, and speech problems. Oral rehabilitation through prosthetic management can aid in alleviating these problems. Designs of the prosthesis vary according to patient needs. A "snap-on" tongue prosthesis or palatal augmentation prosthesis can be constructed. Total glossectomy patients require prosthetic intervention on a mandibular framework. Partial glossectomy patients require prosthetic augmentation on a maxillary framework. Through prosthetic management of this type, articulation and resonance are improved, food is more easily directed into the esophagus, tissues are protected and socialization is enhanced through improved appearance.

Deglutition

A comparative study of four methods of evaluating velopharyngeal adequacy.

Forty-eight subjects with repaired palatal clefts were divided into three major groups on the basis of speech symptoms and were examined for velopharyngeal valving integrity by means of the R-D nasal manometer, pressure-flow techniques, the Hunter oral manometer, and videofluoroscopy. Videofluoroscopy appeared to provide data that most nearly agreed with predictions of valving made from speech. The Hunter oral manometer was the least useful of the four techniques.

Adolescent

Longitudinal assessment of Eustachian tube function in children.

Eustachian tube function was evaluated in 27 children (32 ears) with tympanostomy tubes at 6-week intervals for 12 to 30 months. Using a modified inflation-deflation test of passive and active ventilatory function, it was found that the ears had persistent functional obstruction. Most ears exhibited no significant change in tubal function throughout the observation period. There was no difference in the ventilatory function when the nasal airway was congested (other than due to purulent upper respiratory tract infection) and not congested. However, significant seasonal effects on Eustachian tube ventilatory function were recorded: function was poorer in the winter than in the summer. No relationship was found between Eustachian tube ventilatory function and the age of the child.

Adolescent

Cefaclor compared with amoxycillin acute otitis media with effusion: a preliminary report.

A double-blind, randomized clinical trial comparing cefaclor with amoxycillin in the treatment of acute otitis media with effusion (OME) in infants and children is being conducted at Children's Hospital of Pittsburgh. Although the randomization code has not yet been broken, the results of treating the first 55 children are reported, since they appear to be of interest. Of the 62 ears with acute OME on which an initial tympanocentesis was performed, 41 positive cultures were isolated from the middle ear aspirates. Of the 10 ears from which Haemophilus influenzae was isolated, one had a type b strain, and of the remaining unencapsulated strains, one was resistant to both penicillin G and ampicillin. In the one ear from which Staphylococcus aureus was isolated, the organism was found to be resistant to ampicillin. However, all of the organisms were sensitive in vitro to cefaclor. In 88% of all subjects observed for the first 2 weeks, the initial symptomatic response was excellent. Six children had persistent signs and symptoms of acute OME and received a second tympanocentesis; however, none of the effusions from the repeat aspiration revealed an organism. An effusion was still present in 97% of the ears after 3 days, in 69% after 2 weeks, and in 48% 6 weeks after initiation of the study. Tympanocentesis did not appear to affect either the initial clinical response or the persistence of effusion. There were no adverse reactions to either drug in this study. Because an apparent increase in the incidence of ampicillin-resistant strains of H. influenzae is being reported, and because of the presence of ampicillin-resistant S. aureus in some ears with acute OME, a new antimicrobial effective against all the common pathogens causing acute middle ear disease would be desirable. In this respect, the preliminary findings of treatment with cefaclor from this study appear promising.

Acoustic Impedance Tests

Function of the Eustachian tube related to surgical management of acquired aural cholesteatoma in children.

A group of 12 children with acquired cholesteatoma had the ventilatory function of the Eustachian tube assessed by the inflation-deflation technique. All had varying degrees of functional rather than mechanical obstruction of the Eustachian tube. In these children, the pathogenesis of acquired cholesteatoma appeared to be the result of the following sequence of events: functional Eustachian tube obstruction, high negative middle ear pressure, atelectasis of the tympanic membrane-middle ear, a retraction pocket in either the posterosuperior or attic portion of the tympanic membrane, and adhesive otitis media. Tympanoplasty in these children was not successful. It is suggested that when the middle ear-mastoidectomy cavity is allowed to remain open, then the bony portion of the Eustachian tube should be surgically closed to prevent postoperative reflux of nasopharyngeal secretions.

Adolescent

Effect of inflammation of the ventilatory function of the eustachian tube.

In an attempt to determine the effect of an upper respiratory tract infection on the ventilatory function of the Eustachian tube, 20 children who had recurrent acute or chronic middle ear effusions were studied. Baseline Eustachian tube function testing was obtained when there were no signs or symptoms of upper respiratory infection. These tests were repeated at six-week intervals and whenever an upper respiratory tract infection supervened.

Adolescent

Certain effects of adenoidectomy of Eustachian tube ventilatory function.

In an effort to develop a simple and accurate method to identify children in whom adenoidectomy might prevent otitis media, the ventilatory function of the Eustachian tube was assessed by a manometric technique. Nasal pressures during swallowing were also determined in some. The study group consisted of 23 children with otitis media in whom tympanostomy tubes had been inserted. All were judged clinically and roentgenographically to have prominent adenoids. Inflation-deflation Eustachian tube ventilation studies were obtained in 36 ears that remained intubated, aerated and dry both before and eight weeks after adenoidectomy. Fifteen of the 36 (42 percent) ears had improvement in Eustachian tube ventilatory function postadenoidectomy which was attributed to relief of extrinsic mechanical obstruction of the tube. In the remaining 21 (58 percent) ears in which Eustachian tube function was not improved, mechanical obstruction was not apparent preoperatively. The effect of nasopharyngeal pressures on a pliant Eustachian tube (Toynbee phenomenon) due to obstruction of the posterior nasal choanae by the adenoid mass was suggested as a possible cause of functional Eustachian tube obstruction. In several instances in which preadenoidectomy mechanical obstruction of the Eustachian tube was not demonstrated, the tube appeared to have been made more pliant by the operation. This increase in compliance of the Eustachian tube was attributed to loss of adenoid support of the tube in the fossa of Rosenmuller. From this study, preliminary recommendations for selection of patients for adenoidectomy are the following: 1. Eustachian tube ventilation function tests in a dry, intubated middle ear; 2. if extrinsic mechanical obstruction of the Eustachian tube is present and chronic inflammation is absent, adenoidectomy will probably improve Eustachian tube function. The surgical technique should include adequate removal of the adenoid tissue in the fossa of Rosenmuller; 3. if the Eustachian tube does not appear to be mechanically obstructed, the adenoids should not be removed unless functional obstruction is suspected due to obstruction of the posterior nasal choanae. Adenoid tissue within the fossa of Rosenmuller should not be removed when such circumstances exist; and 4. in the abscence of obstructive adenoids to the nasal choanae or Eustachian tube, adenoidectomy probably will not improve Eustachian tube function and could make it worse. A more rational and effective approach to adenoidectomy for the prevention of otitis media in children may be possible through this type of preoperative evaluation.

Adenoidectomy

Otologic history, audiometry and tympanometry as a case finding procedure for school screening.

An algorithm for identification of hearing loss and middle ear effusion based on otologic history, audiometry and tympanometry was designed and tested on 771 first grade school children. Each ear was profiled as being normal, at risk, or in need of otologic referral based on test-retest screening. In addition, each child was categorized on the basis of the worse ear. Results showed 57 percent of the children as being normal; otologic referral was indicated in 14 percent. The remaining children (29 percent) were at risk or at high risk. The combination of medical history, audiometry and tympanometry constitutes an excellent case finding procedure for screening the otologic status of young school children. Through the utilization of specific criteria, optimal referrals can be made, thereby providing better health care.

Audiometry