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Biomedical subjects

R G Matschke

Publications and source records attributed to R G Matschke.

At least 19 recordsLinked to original sources
PubMed2003

[Subjective assessment of acute tinnitus and proposal of a tinnitus score].

BACKGROUND: Frequency, loudness and the level for masking of tinnitus of many patients can be measured. The measured parameters and the subjective feelings of the patients often do not correlate. METHODS: In a prospective study the subjective experiences of symptoms of 34 in-patients with acute tinnitus without hearing loss were analysed. The patients were asked before, during, immediately after and 3 years after therapy to fill in a form each. 4 questions allowed to assume the complaints to categories, 4 times the patients were asked to mark the intensity of their complaints on horizontal visual analogue scales. Each question scored from 0 to 5 points, a total score from 0 to 40 is possible. RESULTS: The therapy improved all parameters, the score improved from 23.0 to 14.7. The introduced questionnaire and the score allow a detailed documentation of the success of the treatment and with it the possibility to compare various approaches of therapy.

Acute Disease↗
PubMed2000

[Distortion products of otoacoustic emissions (DPOAE) in acute tinnitus aurium].

BACKGROUND: The origin of subjective tinnitus is not really known yet. It is possible to investigate the function of outer hair cells by means of the distortion products of otoacoustic emissions (DPOAE). METHODS: DPOAE of 56 patients were analysed in a prospective study (tinnitus without any loss of hearing n = 34; hearing loss with a maximum of 35 dB and tinnitus n = 22). There was always a normal tympanogram and in no case a conductive hearing loss. The relation of the primary tones f2/f1 was 1.22, the levels of the primary tones were 70 dB. RESULTS: DPOAE-amplitudes were reduced distinctly in both groups of patients. But there was no general difference and no difference at the frequency of tinnitus between the ear with tinnitus and the contralateral ear (no hearing loss) or there was a small reduction related to the normal ear (distinct hearing loss). DPOAE-amplitudes did not change in patients without hearing loss after a treatment with Pentoxifylline i.v., also not at the frequency of tinnitus, although there was a subjective reduction of tinnitus. In patients with hearing loss DPOAE-amplitudes enhanced like the improvement of hearing threshold at the frequency of tinnitus. CONCLUSIONS: The low DPOAE-amplitudes are a sign of damaged outer hair cells of the patients. But there is a symmetry of the DPOAE-amplitudes and there is no change of DPOAE after a therapy with Pentoxifylline i.v. in patients without hearing loss.

Adolescent↗
PubMed1998

[Is there a correlation between sudden deafness and smoking?].

BACKGROUND: The etiology of sudden hearing loss is not yet known. The most common mechanism of sudden hearing loss would appear to be impaired cochlear blood circulation. Tobacco smoking causes changes in hemostasis and raises the body's need for oxygen because of carbon monoxide, one component of the smoke which blocks a part of the hemoglobin. PATIENTS AND METHODS: 297 patients (76 smokers, 99 former smokers, and 122 non smokers) who were treated because of sudden hearing loss in the hospital in the last 5 years were queried about their smoking habits. We asked the patients to complete a questionnaire in order to get more reliable answers. We explored the kind of tobacco, the number of cigarettes or cigars per day, the age at onset of smoking, the number and rate of recurrence of sudden hearing loss, the result of the treatment of a former sudden hearing loss (if there was one), the characteristics of tinnitus, the possibility of stopping smoking, and the significance of tobacco smoking as reflected in health policy. RESULTS: Tobacco smoking does not increase the overall risk of sudden hearing loss. The incidence of smokers in the population of the region and the incidence of smokers among patients with sudden hearing loss is equal. But the average age of the smoking patients is significantly lower than the average age of non smokers and former smokers. Smokers have a higher rate of recurrence of a sudden hearing loss. The result of treatment of former sudden hearing loss is worse in smoking patients. CONCLUSIONS: There is no obvious relation between the risk of sudden hearing loss and tobacco smoking.

Adult↗
PubMed1997

[Implantable bone conduction hearing aids].

Conventional extern bone conduction hearing aids often cause retroauricular pain by compression of the skin, distortion is enhanced by the vibrational pattern and feedback can be a problem and, last but not least, do not fit into cosmetic schemes. We report about experiences with 2 different systems of partly implantable bone conduction hearing aids which were designed to overcome the technical, audiological and cosmetical problems of conventional bone conduction hearing aids. There is a transcutaneous and a percutaneous system discussed. Clinical experiences demonstrate that the percutaneous system is superior in both objective hearing gain and patient acceptance.

Bone Conduction↗
PubMed1994

[Communication and noise. Speech intelligibility of airplane pilots with and without active noise compensation].

Noise exposure measurements were performed with pilots of the German Federal Navy during flight situations. The ambient noise levels during regular flight were maintained at levels above a 90 dB A-weighted level. This noise intensity requires wearing ear protection to avoid sound-induced hearing loss. To be able to understand radio communication (ATC) in spite of a noisy environment, headphone volume must be raised above the noise of the engines. The use of ear plugs in addition to the headsets and flight helmets is only of limited value because personal ear protection affects the intelligibility of ATC. Whereas speech intelligibility of pilots with normal hearing is affected to only a smaller degree, pilots with pre-existing high-frequency hearing losses show substantial impairments of speech intelligibility that vary in proportion to the hearing deficit present. Communication abilities can be reduced drastically, which in turn can affect air traffic security. The development of active noise compensation devices (ANC) that make use of the "anti-noise" principle may be a solution to this dilemma. To evaluate the effectiveness of an ANC-system and its influence on speech intelligibility, speech audiometry was performed with a German standardized test during simulated flight conditions with helicopter pilots. Results demonstrate the helpful effect on speech understanding especially for pilots with noise-induced hearing losses. This may help to avoid pre-retirement professional disability.

Adult↗
PubMed1994

[A laryngeal cancer in pregnancy].

The case of a 33-year-old pregnant female with a large tumor of the larynx is presented. At initial clinical examination the patient presented with a history of painful swelling of her left neck and hoarseness that had persisted for more than 6-months. The pregnancy was in its 28th week. A large squamous cell carcinoma of the left vocal cord was found that had spread into the left pyriform sinus and infiltrated soft tissues of the thyroid cartilage. The simultaneous occurrence of laryngeal cancer and pregnancy was associated with much concern, since decisions regarding treatment of the mother had possible direct consequences for the foetus. In particular, close interdisciplinary cooperation was required between the otorhinolaryngologist, obstetrician and anesthesiologist. This resulted in the birth of a healthy child and a happy mother after laryngectomy. However, the size of the tumor allowed no disease-free survival for more than one year.

Adult↗
PubMed1993

[Early detection of hearing disorders. 10 years experience with screening more than 8,000 infants].

Prevention and early detection of deficits of the developing human being demand more and more complex solutions. Screening programmes have been developed to detect deficits and diseases before they cause symptoms. A well-organised and accurately performed screening programme can detect preliminary signs of diseases and may prevent irreversible damage. Early detection of deficits only makes sense if it is followed by consequences. Not only early detection of impairment or of children which are threatened by impairment is a very important medical task, but also the interdisciplinary cooperation in therapy. The most serious impact of hearing deficits in newborn is on the lack of speech-acquisition. It is an indisputable fact that the early detection of hearing impairment in newborn markedly improves the prognosis for further language development if early medical and/or rehabilitative therapy takes place. The following description of 10 years of experience with a newborn hearing screening programme that is effected in cooperation with the maternity ward and the ENT-clinic since 1981, can supply further arguments in favour of the need for early detection, the discussion on reflex audiometry, and to emphasise the need for cooperation of all relevant specialists.

Acoustic Stimulation↗
PubMed1992

[Long-term results of stapedectomy and stapedotomy].

We have followed up 91 patients for 3 or more years after stapes surgery for otosclerosis, 59 by stapedectomy and 32 by stapedotomy. The surgical technique was chosen randomly. Both surgical techniques achieved significant hearing improvement, but in the higher frequencies (3 kHz) the results of stapedotomy are better and more stable than those after stapedectomy. Surgical revision was necessary in 5 patients--1 after stapedotomy, 4 after stapedectomy.

Audiometry, Pure-Tone↗
PubMed1991

[Protection for noise-induced hearing loss using active hearing protection systems].

Though noise induced hearing loss is no longer the most frequent occupational disease in the Federal Republic of Germany, the environmental pollution by the product "noise" in our technical and industrialized world has not been reduced. On the contrary, the situation is worsened by the rising influence of leisure noise. To avoid occupational hearing loss, the "Noise Injury Prevention Code" issued by the insurers would demand wearing personal ear protection, e.g. ear plugs, if ambient noise levels are above 85 dB(A). But there are working places in which such equipment would have precisely the adverse effect, because one of the reasons for possible damage to hearing is radio communication. In military aircraft cockpits for example noise exposure measurements showed ambient noise levels above 90 dB(A) during regular flight service nearly all the time. To be able to understand radio traffic in spite of the noisy environment, the headphone volume must be raised above the noise of the engines. The use of ear plugs can only be of limited value. Whereas pilots with normal hearing show only little impairment of speech intelligibility, those with noise-induced hearing losses show substantial impairment that varies in proportion to their hearing loss. Communication abilities may be drastically reduced which may compromise the reliability of radio traffic. To avoid compromising air security one has to demand a noise protection system which allows to reduce ambient noise levels without disturbing speech intelligibility in the inevitable radio communication. Nowadays active noise cancelling (ANC) systems by electronic compensation in different ways provide effective protection against noise induced hearing loss.(ABSTRACT TRUNCATED AT 250 WORDS)

Acoustic Stimulation↗
PubMed1991

[Experience with surgical therapy in snoring and sleep apnea].

Knowledge of the connection between habitual snoring diseases and obstructive sleep apnoea has stimulated research into sleep disturbance in patients at high risk of cardiovascular disease. Any disturbance of nasal ventilation leads to a higher resistance to breathing and may cause cardiovascular complications in the long run. Anatomical and functional conditions that lead to intermittent incomplete blockage or complete occlusion of the upper respiratory tract must be detected and surgically eliminated, if possible. Surgical procedures for treating snoring and obstructive sleep apnoea may be successful and fill the gap between conservative treatment and continuous nasal positive airway pressure therapy. Our experience in 24 patients in presented.

Adult↗
PubMed1990

Smoking habits in patients with sudden hearing loss. Preliminary results.

Tobacco, especially its content of nicotine, is a drug that has a powerful seductive effect and a dangerous risk of dependence. It is well known that smoking of cigarettes in the industrialized countries of Europe neutralizes an essential part of medical success in that tobacco-induced shortening of life is estimated to equal the possible medical extension of life. Nicotine is the best explored component of tobacco and its effects on heart circulation have been investigated by many research groups. Cigarette smoking raises the body's need for oxygen, because the carbon monoxide that is always inhaled with the smoke partially blocks the haemoglobin. Though acute and combined effects of nicotine and carbon monoxide have been established chronic diseases of the smoker cannot fully be declared. An attempt was made to define some correlation between smoking habits and the risk of a sudden hearing loss. All the patients who were treated in our clinic because of sudden hearing loss were asked to complete a questionnaire anonymously in order to get more reliable answers. However, the outcome was not very encouraging. Only three quarters of our patients responded to the questions, of these only 29% were smokers. However, half of the non-smokers were former smokers. The data are discussed in relation to other investigations.

Adult↗
PubMed1990

Frequency selectivity and psychoacoustic tuning curves in old age.

Frequency selectivity represents an important contributory factor in the understanding of human speech. It refers to the ability of the ear to discriminate between two simultaneously occurring sounds of different spectral composition. The capabilities of frequency selection, time pattern analysis, and information processing can be determined generally only by speech audiometry. Schorn and co-workers (1977) published a simplified method for audiological investigations whereby results obtained at two different frequency values are sufficient. The test tone frequencies of 0.5 and 4 kHz were selected because they are representative of the frequency range of normal speech. To determine the influence of ageing on frequency selectivity we investigated three groups of patients between the ages of 20-30, 40-50 and 60-70 years. All of the subjects had normal hearing according to ISO 7029 standards. The measurements of pure-tone audiometry, speech audiometry, and the psychoacoustic tuning curves were performed sequentially on the same day. The influence of ageing on frequency selectivity mainly concerns frequencies above 2 kHz. This is related to the progressive loss of outer hair cells in the basal parts of the cochlea in old age. Our investigations show that particular attention must be paid to a loss of frequency selectivity in old age. This becomes evident mainly after the 60th year. Frequency selectivity is not significantly disturbed before that age, although pure tone audiograms show high frequency inner ear hearing loss earlier in life.

Adult↗
PubMed1989

[Electronic noise compensation for improving speech discrimination in airplane pilots].

Noise exposure measurements were performed in pilots of the Federal Navy during realistic flight situations. The ambient noise levels during regular flight service were maintained at levels nearly all the time above 90 dB. To avoid occupational hearing loss, the "Noise Injury Prevention Code" issued by the insurers would demand wearing personal ear protection, e.g. ear plugs. But such equipment in the aircraft cockpit would have precisely the opposite effect, because one of the reasons for possible damage to hearing is radio communication. To be able to understand radio traffic in spite of the noisy environment, headphone volume must be raised above the noise of the engines. The use of ear plugs can be of only limited value. Whereas pilots with normal hearing show only little impairment of speech intelligibility, those with noise-induced hearing loss show substantial impairment that varies in proportion to their hearing loss. Communication abilities may be drastically reduced which may compromise the reliability of radio traffic. Cockpit noise has its maximum intensity around 125 Hz and flight helmets and ear defenders are not very effective in low frequency ranges. Sennheiser electronic KG developed an active noise compensation circuit, which makes use of the "anti noise" principle. Here the outside noises picked up by two microphones integrated into the headset are processed electronically in such a way that they largely neutralise the original noise. It had to be made sure that the radio traffic signal was not also compensated and that the signal to noise ratio was clearly increased.(ABSTRACT TRUNCATED AT 250 WORDS)

Aircraft↗
PubMed1988

[Cochlear implant for children? Possibilities--risks--prerequisites].

The development of scientific, technical, medical and psychological knowledge of human hearing and communication has reached a point where it seems possible to liberate totally deaf patients from their acoustic isolation. For some of them there is now reasonable hope that, to a certain degree, hearing and speech may be restored by the use of a cochlear implant. The cochlear implant is a device which directly stimulates the auditory nerve via electrical stimuli and in doing so mimics the function of the auditory system transmitting sound information to the central hearing pathways. It is expected that the human brain is able to "read" this message and, for example, to understand speech. But there are very special risks regarding implantation in children which are reviewed and discussed. Preconditions that have to be met to ethically, justify this experiment are stated, aiming at achieving maximum benefit for the child.

Audiometry, Evoked Response↗
PubMed1987

[Clinical, histologic and bacteriologic findings in peritonsillar abscess].

Peritonsillar abscesses are the main complication of chronic inflammation of the tonsils. They should be considered as emergency cases and require quick and adequate treatment. Although abscess tonsillectomy has been reported since 1932, there is still a vivid discussion about this method of choice. We report on our experiences and findings in 284 cases of peritonsillar abscess. Our experiences show that theoretical considerations against this method of surgical treatment are smaller than the advantages for the patient. The authors recommend abscess tonsillectomy at one time and on both tonsils as treatment of choice in peritonsillar abscess without restriction.

Adolescent↗
PubMed1987

[Risk of noise-induced hearing loss caused by radio communication? Audiologic findings in helicopter crews and pilots of propeller airplanes].

The affects of noise on the human inner ear have been well known for a long time, and measures to prevent occupational noise-induced hearing loss show a clear reduction in the statistics of morbidity. Nevertheless, there are working environments in which the use of ear protection seems to be inapplicable, because communication by speech is indispensable, for example in the cockpit of aircraft. Noise exposure measurements were performed on pilots of helicopters and propeller-machines of the German Federal Navy during realistic flight situations. The ambient noise levels during regular flight service were maintained at levels between 89 dB and 120 dB. Sound protection by flight-helmets and headphones is not only neutralised while using radio and intercom, but the noise during radio-communication is even louder than the noise of the engines. The use of ear protection to avoid excessive noise exposure is only of limited effectiveness. While pilots with normal hearing show only little impairment of speech intelligibility, those with noise-induced hearing loss show substantial impairment that varies in proportion to their hearing loss. Communication abilities may be drastically reduced which may compromise the reliability of radio-communication. The problem may be possibly solved in future by an electronic compensation system for noise.

Aircraft↗