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At least 937 records · Page 52Linked to original sources
PubMed2004

Behavioral audiometry: protocols for measuring hearing thresholds in babies aged 4-18 months.

OBJECTIVE: This paper provides the first report in English of original behavioral audiometry protocols for measuring hearing thresholds in very young children, including the multiply handicapped. METHODS: Based on reactions to one or two well-calibrated acoustic stimulations delivered in the sound field, the protocol first involves the use of a vibrator to measure hearing levels by bone conduction. This measurement technique, which is not affected by middle ear infections, is the key diagnostic step. Moreover, in profoundly hearing loss children, it triggers reactions through vibratory stimulation and sets the scene for the conditioning of responses. Next, hearing levels are assessed by air conduction with the aid of headphones, in order to measure hearing levels in each ear as early as possible. A unique set-up is used to facilitate the emergence of reliable "surprise reactions", which may be interpreted by a sole examiner. Classical visual reinforcement is replaced by a highly interactive, dynamic and playful exchange between child and examiner, which gives meaning to the perception of stimuli and heralds the learning of hearing. RESULTS: The results concern 105 babies suffering from bilateral sensorineural hearing loss and aged 4-18 months at the first behavioral test. Group 1 comprised 91 babies with no other handicap, in whom full bilateral air conduction was obtained in 82.4% before 12 months and in 98.9% before 18 months. In this group, air conduction in each ear was obtained in 47.0% before 12 months and in 70.3% before 18 months. In Group 2, which included 14 multiply handicapped babies, full bilateral air conduction was obtained in 37.5% before 12 months and in 78.6% before 18 months. Air conduction in both ears was obtained in 28.6% before 18 months. CONCLUSION: The protocols described make it possible, in a minimum number of sessions, to measure hearing thresholds early over the whole range of hearing frequencies, even in multiply handicapped babies and those suffering from developmental retardation.

Acoustic Impedance Tests↗
PubMed1991

[On infantile audiometry: the Bordeaux strategy].

Infantile "subjective" or behavioural audiometry requires highly skilled pediatric audiologists. It is indeed often said in the majority of centres that any subjective examination is impossible under the age of 3, whereas in our clinic we successfully complete extremely precise tests, including in bone conduction, as from the age of 6 months. The strategy and techniques employed to obtain audiometric curves with headphones as from such an age are described. Subsequently, the statistical studies covering over 600 cases are presented, evidencing the earliness, accuracy and reliability of the curves obtained over nearly 15 years in Bordeaux by the method described.

Audiometry↗
PubMedDate not supplied

[Functional state of the human hearing analyzer exposed to +Gx acceleration].

The functional state of the acoustic analyzer of man was investigated during an exposure to +Gx acceleration of 4-14 g applied at an angle of 78 degrees to the long axis of the body. During an exposure to 8-10 g the hearing state began to deteriorate. This included an increase in the tonic thresholds of hearing sensitivity with respect to the aerial and bone conduction, and an increase in the differential thresholds of hearing with respect to the strength and pitch. With an increase of the acceleration value these changes grew, reaching maximum at 14 g. It is suggested that possible mechanisms of changes in the hearing sensitivity are associated with disorders in the systems of sound conveyance and perception.

Acceleration↗
PubMedDate not supplied

Clinical assessment of ossicular mobility by a ceramic vibrator designed for implantable hearing aids.

Ossicular mobility was assessed by direct coupling of a piezoelectric ceramic vibrator to the ossicles during middle ear surgery. The sites excited were body of the incus, head of the stapes, and footplate of the stapes through a hydroxyapatite ceramic strut. The threshold of the vibratory hearing was determined by the patient's response as a minimum audition, and the vibration threshold was obtained by subtracting the preoperative bone conduction threshold from the vibratory hearing threshold. The results were analyzed by the state of hearing after the operation, which revealed that a patient with a good vibration threshold during the operation had a tendency to get good postoperative hearing. This may mean that postoperative hearing can be predicted to some extent during the operation by the measurement of ossicular mobility.

Adolescent↗
PubMed1979

[Surgical results of stapedectomy or stapedotomy (author's transl)].

468 stapes operations have been performed at the ENT-Department of the University of Zurich between 1970 and 1978. In one half of the cases, a total or partial removal of the footplate with introduction of a wire connective tissue prosthesis has been used. In the other half, the operation consisted in a limited fenestration of the footplate, which was large enough to accept a wire teflon piston of 0.6 mm diameter. Statistical analysis of the results of both methods shows a better bone conduction threshold for the speech frequencies (500, 1,000 and 2,000 Hz) as well as for air conduction at 4,000 cps after stapedotomy. Complete postoperative deafness occurred in one case following stapedectomy (0.3% of patients with primary operation). The advantages of stapedotomy over stapedectomy are the following: 1. Less trauma to the inner ear, 2. better stability of the position of the prosthesis and 3. better adaptation of the length of the prosthesis. The surgical steps used for stapedotomy are described.

Bone Conduction↗
PubMed1982

[Functional effect of the argon laser on the hearing organ of the guinea pig].

While numerous histological findings point towards a possible destruction of inner-ear structures by the Argon-Laser we still miss a satisfactory statement concerning functional impact of stapedectomy or stapedotomy using laser beams. To investigate this we irradiated the promontorium of each of 10 guinea-pigs with laser powers between 0.6 W and 2.2 W ten times for 0.5 s. Then, and on the first, fifth and tenth postoperative day we recorded the brainstem potential evoked by bone-conducted clicks. We found that after the application of laser power up to 1.2 W a reversible threshold shift of up to 20 dB took place. Above powers of 1.2 W a permanent threshold shift was found (Fig. 1). Before sacrificing the animals we recorded the course of temperature in the perilymph during laser irradiation (Fig. 2 and 3). In order to set application limits of power within we consider laser impact functionally critical we compared the temperature increment during single shots and permanent elevation of the temperature above body temperature with values we have found earlier at the human petrous bone (Fig. 2 and 3). This led us to the conclusion that the temperature increment during the shot might be the limiting factor as far as the deterioration of inner-ear function is concerned. This may very well coincide with our hypothesis (Thoma and coworkers, 1981) that the vaporization of endocochlear fluid during the shot is a possible cause of cochlear malfunction after stapedectomy by laser.

Animals↗
PubMed2006

[Analysis of results of stapedotomy in patients with obliterative otosclerosis].

INTRODUCTION: In obliterative type of otosclerosis the stapes footplate is greatly thickened and diffusely replaced by a massive otosclerotic masses that fill in the oval window niche, often annular ligament cannot be visualized. In the case of obliterative otosclerosis the only effective way of treatment is surgery. MATERIAL AND METHODS: The analysed group consisted of 53 patients with primary obliterative otosclerosis. In the control group there were 30 consecutive patients treated for otosclerosis. The auditory organ was assessed on the ground of the following criteria for the frequencies 0.5, 1, 2 and 4 kHz.: 1. Change of pure tone thresholds of air conduction (AC) 2. Change of pure tone thresholds of bone conduction (BC) 3. Change of pure tone thresholds of air-bone gap (ABG) as the difference between the mean AC and BC thresholds before the operation (AC0 and BC0) and 12 months after the operation (AC1 and BC1). RESULTS: Postoperatively mean value of change of AC thresholds in the analysed group was about 24 +/- 2 dBHL and in the control group about 25 +/- 2 dBHL (no significant difference). In the analysed group the mean value of BC thresholds varied about 8 dBHL and in the control group about 11 dBHL (no significant difference). The average values of ABG after the operation varied about 14 +/- 1 dBHL in both--the analysed and the control group. Postoperatively the mean value ABG was amounted to 20 +/- 1 dBHL in the analysed group and in the control group to 18 +/- 1 dBHL (no significant difference). On the basis of the subjective assessment completely subsidence of aural tinnitus reported 70% patients in the analysed group and 80% patients in the control group. CONCLUSION: 1. The incidence of obliterative otosclerosis represents 9,6% of all otosclerotic patients treated surgically. 2. Stapedotomy is the treatment of choice in patients with obliterative otosclerosis, because significant improvement of AC, BC and ABG 12 months after the operation was reported, mean values did not differ between the above and control group. 3. Complete subsidence of aural tinnitus was reported in 70% patients with obliterative otosclerosis.

Adult↗
PubMed1988

[Evoked response audiometry in pediatric audiology].

Since we know that maturation of the hearing system occurs within the first few weeks after birth, audiologic testing should be performed as soon as possible whenever there is the slightest suspicion of a hearing disorder. The only reliable test method in this early period of life is the electric response audiometry. To use the advantages of this objective test method, several criteria must be observed. The most important of these are: 1. good sedation, 2. sufficient test routine comprising not only clicks but also 500 Hz pulses and bone-conducted stimuli, and 3. sufficient experience in the interpretation of the various recorded response patterns. Comparing subjective and objective results in 533 children, the ERA proves to be the more reliable and effective method giving extensive information on the hearing threshold and the dynamic response of audition and allowing an exact control and correction of the hearing aid adjustment.

Audiometry, Evoked Response↗
PubMed1991

[Bone anchored hearing aid. Results of bilateral applications].

In our experience B.A.H.A. (Bone Anchored Hearing Aid) with its direct bone conduction brings a better hearing rehabilitation for patients with draining ear and further more with major aplasia. 23 patients were tested, 12 have got a bilateral hearing aid, 5 unilateral. They reported a better comfort, a more natural sound and a better discrimination in noise. A bilateral application brought them a stereoacousy with a special directivity, we also note improvement of hearing by different hearing tests.

Audiometry↗
PubMed1980

Effectiveness of the CO2 laser in experimental tympanic neurectomy.

As one of a series of investigations to evaluate the efficacy and safety of CO2 lasers in otologic microsurgery, squirrel monkeys were subjected to tympanic neurectomies by means of vaporizing Jacobson's nerve in the promontory region. Air and bone conduction hearing acuity was measured by computer-averaged pure tone evoked responses and behavioral audiometry before and after laser surgery. A moderate (avoidable) conductive loss was found as a consequence of the surgical approach selected, but no significant sensorineural loss was apparent. Thus, there would appear to be no adverse cochlear side effects as a result of using this instrument in the middle ear. The laser neurectomy procedure, however, was no more effective for the clinical purposes for which it was proposed than those techniques reported by several other investigators.

Animals↗
PubMed1995

The bone-anchored hearing aid. Design principles, indications, and long-term clinical results.

This article presents a summary of design principles, indications, and clinical results obtained with the bone-anchored hearing aid (BAHA). Hearing through bone conduction and mechanical stimulation of the skull with percutaneous versus transcutaneous excitation and the functional capability of the ear level BAHA sound processor is presented. Moreover, the surgical procedure is described and the success rate to establish and maintain osseointegration is presented together with the frequency of skin reactions at the implant site. The audiologic and questionnaire results achieved with the BAHA is also presented and discussed.

Adult↗
PubMed1983

Myringoplasty: hearing gain in relation to perforation site.

One hundred perforations of the tympanic membrane with successful myringoplasties have been reviewed. A partially reversible impairment of bone conduction was noted, being more obvious in posterior and subtotal perforations. It was also shown that the site of perforation affects the degree of hearing loss and the degree of subsequent improvement after myringoplasty; marginal and malleolar perforations had a greater hearing loss and less post-operative hearing improvement than central and non-malleolar perforations. It was also shown that posterior perforations had a greater hearing loss than anterior perforations.

Adult↗
PubMed2006

Patient satisfaction with the bone-anchored hearing aid: a 14-year experience.

OBJECTIVES: To evaluate the self-rated quality of life (QoL) and benefits associated with the use of bone-anchored hearing aids (BAHAs) and to identify potential improvements in comparison to the previous conventional hearing aids. STUDY DESIGN: Cross-sectional. SETTING: BAHA program in tertiary referral center. PATIENTS: One hundred fifty-two adults who underwent BAHA procedure for more than 6 months. INTERVENTION: Rehabilitative. MAIN OUTCOME MEASURE: Results of the Entific Medical Systems questionnaire. RESULTS: One hundred seventeen responses (77%) were obtained. Overall satisfaction was excellent (median = 9). BAHA was rated very good/excellent in single-person conversation (85%), but fared less well in group situation (45%). BAHA was reported as better than the previous aid by more than 50% of patients within each subcategory where applicable (handling, 64%; comfort, 56%; cosmetic, 60%; sound, 68%; infections, 75%). Of those who reported improvement of ear infections, one quarter remained unsatisfied of improvement in QoL. Patients who used BAHA for 3 years or less (n = 45) had a similar rating to sound quality and conversation as those who used it longer (n = 72). Surprisingly, a subset of patients (n = 8) with poor bone-conduction thresholds (> 45 dB) remained satisfied with the device (median = 8). CONCLUSIONS: The BAHA can improve QoL and hearing outcome with full acclimatization to the device being achievable within a reasonable amount of time. As with conventional aids, sound quality in group situations remains poor with the BAHA. Our results provide a predictive value during preoperative counseling of patients.

Adolescent↗
PubMed1976

Sensorineural hearing after removal of cholesteatoma from labyrinthine fistulae.

An investigation was undertaken to determine what factors improve or worsen bone conduction thresholds following treatment of labyrinthine fistula produced by cholesteatoma. It is suggested that closure of the fistula and reconstruction of normal sound transmitting pathways by ossicular reconstruction produce a favorable mechanical situation to produce this response. In addition there remains the possibility that removal of cholesteatoma matrix may prevent a toxic degeneration of the cochlea at the site of the fistula. Therapy advocated is a two stage combined approach tympanoplasty.

Audiometry↗
PubMed1999

Early complications of surgery for chronic otitis media.

This audit report details early post-operative complications following surgery for chronic otitis media. One hundred and forty-five cases were assessed. There were no facial nerve palsies, a bone conduction threshold elevation occurred in 4.6 per cent of cases. A wound infection occurred in six per cent of cases as did BIPP allergy. Twenty-six per cent of patients reported symptoms consistent with chorda tympani trauma. Short-lived symptoms of jaw discomfort were reported by 46 per cent of patients and imbalance or vertigo by 10 per cent of patients. The findings are compared with other published reports of complications following ear surgery.

Arthralgia↗
PubMed2003

Dehiscence of bone overlying the superior semicircular canal as a cause of an air-bone gap on audiometry: a case study.

Dehiscence of bone overlying the superior semicircular canal can result in a syndrome of vertigo and oscillopsia induced by loud noises or by maneuvers that change middle ear or intracranial pressure. Patients with this disorder can also experience a heightened sensitivity to bone-conducted sounds in the presence of normal middle ear function. High-resolution CT scans of the temporal bones demonstrate the dehiscence. The authors describe a patient with bilateral superior canal dehiscence who had bilateral low-frequency conductive hearing loss, normal middle ear function, intact acoustic reflexes, and intact vestibular-evoked myogenic potentials. These findings would not be expected on the basis of a middle ear cause of the conductive hearing loss. A high-resolution CT scan of the temporal bones in this patient revealed bilateral superior canal dehiscence. Normal acoustic immittance findings in the presence of conductive hearing loss should alert clinicians to the possibility of inner ear cause of an air-bone gap due to superior canal dehiscence.

Audiometry↗
PubMed2002

[The evaluation of results of the surgical treatment in patients with otosclerosis].

The authors presents hearing results in 216 patients with otosclerosis surgical treated. Averaged cochlear reserve in relation to the bone conduction determined before operation was used in this study. The follow-up was 2 months-10 years. Good results was proved in more than 93%, no change in 5% and deterioration in less than 2%. The cochlear reserve up to 10 dB obtained in 59% of all patients. The cases when no changes (and deterioration) after surgical treatment correlated to large anomaly evolution in the structure of the hole drum and extensive focus with otosclerosis.

Bone Conduction↗
PubMed1996

Hearing results following modified radical versus canal-up mastoidectomy.

Modified radical mastoidectomy (MRM) provides relatively safe surgical access for the removal of chronic middle ear and mastoid disease and gives reproducible results. However, it had been suggested that hearing may not be as good as that after "intact canal wall mastoidectomy" (ICWM). This paper reviews 153 tertiary referrals suffering from extensive disease who underwent MRM and compares their hearing results with those obtained by other authors using ICWM and MRM and a variety of reconstructive techniques. In this study there were no dead ears and no significant changes in bone conduction despite prolonged drilling and extensive disease. Hearing results after MRM were found to be better after primary surgery than after revision and better in the presence of an intact stapes. No rigid prostheses were used at first-stage surgery. There were no significant differences found between hearing results obtained by MRM in this series and other published results of canal wall down mastoidectomy and ICWM, irrespective of the use of ossicular replacement prostheses.

Adolescent↗