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PubMed1996

Acoustic trauma caused by lightning.

Lesions produced by exposure to noise are frequent in everyday life. Injuries may be found in all systems of the human body, from the digestive to the endocrine, from the cardiovascular to the nervous system. Many organs may be damaged, the ear being one of them. It is known that noise produced by factories, airports, musical instruments and even toys can cause auditory loss. Noises in nature can also cause acoustic trauma. This report is the case history of acoustic trauma caused by lightning. The patient was studied with CAT scan, electroencephalogram, and brain mapping, impedance audiometry with tympanogram and acoustic reflex, audiometry and evoked otoacoustics emissions: distortion products and transients.

Acoustic Impedance Tests↗
PubMed1993

Gamma knife radiosurgery for acoustic tumors: multivariate analysis of four year results.

In order to evaluate the results of radiosurgery for acoustic tumors and to identify optimum treatment parameters, an analysis of tumor control, as well as incidences of hearing loss, facial and trigeminal neuropathies was undertaken. Between August 1987 and August 1991, 134 patients with 136 acoustic tumors received stereotactic gamma knife radiosurgery at the University of Pittsburgh. Median follow-up was 24 months (range: 6-56 months). Tumor volumes ranged from 0.10 to 17.00 cm3 (median = 2.75 cm3). From one to ten isocenters were utilized per tumor treated (median = 3). Minimum tumor doses varied from 12 to 20 Gy (median = 17 Gy). The 4-year actuarial tumor control rate was 89.2 +/- 6.0%. Some degree of hearing (by pure tone audiometry) was preserved in 71.0 +/- 4.4% of patients. The actuarial rates for preservation of either pretreatment hearing level or useful hearing were 34.4 +/- 6.6% and 35.1 +/- 97% respectively. Respectively, the actuarial incidences of postradiosurgery facial and trigeminal neuropathies were 29.0 +/- 4.4% and 32.9 +/- 4.5%, respectively. No significant factors affecting tumor control were identified. Multivariate analysis identified a significantly increased risk of hearing loss in patients with neurofibromatosis (p = 0.0003) as well as decreased risks of facial and trigeminal neuropathies with both decreasing tumor diameter (p = 0.001) and increasing number of isocenters treated (p = 0.003). Radiosurgery is a safe and effective treatment for acoustic neuromas with acceptable morbidity that may be lowered by the use of multiple isocenter treatment techniques and by earlier treatment of small tumors.

Adolescent↗
PubMed1993

Acoustic properties of lesions generated with an ultrasound therapy system.

Methods for quantitative imaging of ultrasound propagation properties were applied to the examination of the acoustic appearance of lesions generated by high intensity focused ultrasound in excised pig livers. Single lesions, about 10 mm maximum diameter by 30 mm long, were created in each of six liver specimens. Two dimensional images (32 by 32 points) of sound speed, mean attenuation coefficient (as a function of frequency in the range 3 to 8.5 MHz) and mean backscattering coefficient (5 to 8 MHz) were obtained in 7 mm thick sections of tissue, cut to include a cross-section through the lesion. Images of these properties, presented alongside surface photographs of the samples, provided a qualitative demonstration that attenuation coefficient was the most useful and backscattering coefficient was the least useful acoustic parameter for visualizing such lesions. Quantitatively the data demonstrated significant increases in attenuation coefficient and sound speed in lesioned liver relative to normal, whereas backscattering was shown not to change in a significant manner except when undissolved gas is the mechanism for increased acoustic scattering. Samples where gas was not fully removed following lesion production gave significant increases in backscattering at the lesion centre, but the shape and size of regions of high backscattering coefficient corresponded poorly with the shape and size of the lesions, unlike attenuation and sound speed for which such correspondence was good.

Acoustics↗
PubMed1995

Acoustic energy determines haemoglobin release from erythrocytes by extracorporeal shock waves in vitro.

Haemoglobin release from erythrocytes by extracorporeal shock waves from an electrohydraulic lithotripter was quantified and correlated with the acoustic energy administered to the cell container. Cells were exposed in 2-, 5.9-, and 10.5-mL vials to 100 shock waves delivered at a low, medium and high lithotripter output setting, both with and without covering of the central ellipsoidal axis by a metal cage. Using the identical set-up, previous experiments had shown that the fragmentation efficiency was linearly correlated with the delivered acoustic energy. As a result, shock waves generated from 0.83 microgram mJ-1 (in 2-mL vials) to 1.53 micrograms mJ-1 (in 10.5-mL vials) haemoglobin. At all vial types, the amount of haemoglobin correlated linearly with the delivered acoustic energy (r = 0.96 in 2-mL, r = 0.97 in 5.9-mL and r = 0.98 in 10.5-mL vials). It was independent of the presence of the cage.

Acoustics↗
PubMed1994

Effect of acoustic streaming on ultrasonic heating.

It was found in in vitro experiments performed on tissue phantoms that acoustic streaming in low attenuating fluid may dramatically reduce the temperature rise generated by ultrasound at the surface of bone, if the ultrasound path contains a low-attenuating-fluid/thin-soft-tissue/bone structure. The temperature rise at the surface of bone generated by a 3.5 MHz focused ultrasound beam of 180 mW source acoustic power and an average acoustic intensity at the focus of 5.8 W/cm2 was measured to be only 18% of the value predicted by an existing model, when the bone was in contact with the low attenuating fluid. When a bone surface that is covered by 1 mm thick soft tissue is exposed to the same ultrasound beam, the measured temperature rise at the tissue-bone surface is only 60% of the calculated value.

Acoustics↗
PubMed1995

Stereotactic radiosurgery using the gamma knife for acoustic neuromas.

PURPOSE: To assess the efficacy and toxicity of stereotactic radiosurgery using the gamma knife for acoustic neuromas. METHODS AND MATERIALS: Between January 1990 and January 1993, 36 patients with acoustic neuromas were treated with stereotactic radiosurgery using the gamma knife. The median maximum tumor diameter was 21 mm (range: 6-32 mm). Tumor volumes encompassed within the prescribed isodose line varied from 266 to 8,667 mm3 (median: 3,135 mm3). Tumors < or = 20 mm in maximum diameter received a dose of 20 Gy to the margin, tumors between 21 and 30 mm received 18 Gy, and tumors > 30 mm received 16 Gy. The dose was prescribed to the 50% isodose line in 31 patients and to the 45%, 55%, 60%, 70%, and 80% isodose line in one patient each. The median number of isocenters per tumor was 5 (range: 1-12). RESULTS: At a median follow-up of 16 months (range: 2.5-36 months), all patients were alive. Thirty-five patients had follow-up imaging studies. Nine tumors (26%) were smaller, and 26 tumors (74%) were unchanged. No tumor had progressed. The 1- and 2-year actuarial incidences of facial neuropathy were 52.2% and 66.5%, respectively. The 1- and 2-year actuarial incidences of trigeminal neuropathy were 33.7% and 58.9%, respectively. The 1- and 2-year actuarial incidence of facial or trigeminal neuropathy (or both) was 60.8% and 81.7%, respectively. Multivariate analysis revealed that the following were associated with the time of onset or worsening of facial weakness or trigeminal neuropathy: (a) patients < age 65 years, (b) dose to the tumor margin, (c) maximum tumor diameter > or = 21 mm, (d) use of the 18 mm collimator, and (e) use of > five isocenters. The 1- and 2-year actuarial rates of preservation of useful hearing (Gardner-Robertson class I or II) were 100% and 41.7% +/- 17.3, respectively. CONCLUSION: Stereotactic radiosurgery using the gamma knife provides short-term control of acoustic neuromas when a dose of 16 to 20 Gy to the tumor margin is used. Preservation of useful hearing can be accomplished in a significant proportion of patients.

Adult↗
PubMed1994

Linear accelerator-based stereotactic radiosurgery for acoustic schwannomas.

PURPOSE: Stereotactic radiosurgery (SRS) is currently being investigated for treatment of acoustic schwannomas in patients who are not good surgical candidates. The vast majority of the available data is based on gamma knife-treated patients. We present the largest series of patients treated with linear accelerator-based SRS. METHODS AND MATERIALS: Thirty-two patients with acoustic schwannomas were treated with SRS between July 1988 and February 1993; follow-up ranged from 4-59 months. Age ranged from 34-88 years (mean, 62 years). The primary presenting symptom was hearing loss in 30 patients and dementia in two patients. Indications for SRS were age > 65 years (17 patients); recurrence after surgery (13 patients); and medical infirmity (two patients). Dose to the periphery of the lesion ranged from 10-22.5 Gy (mean, 15.5 Gy) specified at the 68-90% isodose line (mean, 80%). Collimator size ranged from 12-35 mm (mean, 23 mm), indicating that the sizes of the tumors were significantly larger than those reported in most gamma knife series. RESULTS: Follow-up magnetic resonance imaging (MRI) and/or computed tomography (CT) scans revealed the following at 1 year: tumor regression, 12 patients (63%); and no change, seven patients (37%). At 2 years, 11 tumors (73%) were smaller and four tumors (27%) were unchanged. At 3 years, seven patients (78%) had experienced tumor regression and two (22%) had no change. No patient experienced tumor progression after SRS. Seven patients (22%) suffered one or more treatment complications: new onset of 5th and/or 7th cranial nerve deficit (six patients), ataxia (two patients), and/or hydrocephalus necessitating VP shunt (two patients). CONCLUSION: Linear accelerator-based SRS provides excellent short-term local control and a relatively low incidence of complications for acoustic schwannomas. Our data compare favorably with results obtained with gamma knife-based SRS. Additional follow-up will be necessary to evaluate the long-term results of treatment.

Adult↗
PubMed1989

Vibratory acoustic stimulation and the flow velocity waveform in the fetal internal carotid artery.

Eleven healthy fetuses between 36 and 39 weeks of gestation were studied during the active sleep state to examine effects of a 5-s vibratory acoustic stimulus on the baseline fetal heart rate and flow velocity waveform in the fetal internal carotid artery. There was an immediate marked rise in baseline fetal heart rate with concomitant drop in pulsatility index in the flow velocity waveform of the fetal internal carotid artery, which persisted for at least 15 min after the stimulus. However, when the pulsatility index was standardized for a fetal heart rate of 140 beats/min this index remained virtually unaltered. These data suggest that in the healthy term fetus during active sleep state, a vibratory acoustic stimulus has no measurable effect on cerebral vascular resistance. Since virtually all reported studies on vibratory acoustic stimulation of the fetus were carried-out during the quiet sleep state, the data from the present study do not provide any information on the safety of this device when employed as a means of assessing of fetal well-being.

Acoustic Stimulation↗
PubMed1980

Evidence for a cochlear origin for acoustic re-emissions, threshold fine-structure and tonal tinnitus.

Delayed acoustic waves have been measured in the sealed ear canal in response to click and tone-burst stimuli. The response shows compressive nonlinearity, evidence for 'active' processing, and frequency tuning. At low sound levels group and phase delays correspond, and represent about 15 waves delay for the mid-frequency region. Frequency positions of pressure peaks and dips for continous tone stimulation can be predicted from the phase delays and persist well below threshold. Fine-structure in the audiogram is also related to these irregularities. Hydrostatic pressure, induced by body tilt, can eliminate audiogram fine-structure and reve rse the positions of peaks and dips for inverted body positions. This is interpreted as due to changes of internal reflection from the middle ear caused by acoustic impedance changes. Tinnitus can be induced by this inverted body posture, can be measured objectively in certain cases, and demonstrates properties such as synchronisation and beating with an external signal. These findings support the view of Kemp that the phenomena of acoustic re-emission, threshold fine-structure, and tinnitus are interrelated and originate within the cochlea.

Acoustic Stimulation↗
PubMed1981

Masking-period patterns and cochlear acoustical responses.

A suppression-period pattern' for acoustical responses has been measured in a similar way to the masking-period pattern. A triggered low-frequency masker decreases the acoustical response to a short test signal differently at different presentations within the period of the masker. The two patterns show such close relationships that a masking-period pattern can be developed out of a set of suppression-period patterns: masked threshold is reached with the same parameter conditions under which the acoustic responses diminish. The rules elaborated for masking-period patterns seem to hold for suppression-period patterns as well.

Acoustics↗
PubMed1981

Acoustical responses and suppression-period patterns in guinea pigs.

Acoustic responses to short sound stimuli have been measured in the external ear canal of guinea pigs. Unequivocal responses had frequencies between 1.8 and 3.2 kHz, latencies (to their peak pressures) of 2.8 to 4.5 ms and sound pressures up to -10 dB SPL. A set of criteria was developed to clearly distinguish acoustical responses from after-resonances of the stimuli. Added phase-locked, very-low-frequency tones were able under some conditions to totally suppress the acoustical responses. The suppression-period pattern thus produced strongly resemble those obtained for man and the masking-period patterns obtained with human subjects.

Acoustic Stimulation↗
PubMed1991

Involvement of GABA in acoustically-evoked inhibition in inferior colliculus neurons.

Most criteria for establishing GABA as an inhibitory neurotransmitter in the central nucleus of inferior colliculus (ICc) have been satisfied, but the role of GABA in acoustic coding in ICc is not established. The present study examined this issue by evaluating the effects of iontophoretic application of agents that alter activity at GABA receptors on potential forms of acoustically-evoked inhibition in ICc neurons. Application of the GABAA antagonist, bicuculline, selectively blocked the firing reduction at high intensities observed during non-monotonic rate-intensity functions in ICc neurons. Binaural inhibition was selectively blocked by bicuculline and increased by nipecotic acid. Application of GABA, nipecotic acid (GABA uptake inhibitor) and a benzodiazepine (flurazepam), which enhances the action of GABA, increased the duration and intensity of ipsilateral inhibition and response pause, while bicuculline blocked these acoustically-evoked inhibitory events. Offset inhibition was increased by nipecotic acid application and reduced by bicuculline with the appearance of an offset peak. The present data support an important role for GABA as a neurotransmitter, mediating, in part, non-monotonicity, binaural inhibition, response pause and offset inhibition in ICc neurons. Alterations of these GABA-mediated inhibitory phenomena may occur in auditory dysfunctions observed with aging and audiogenic seizures.

Acoustic Stimulation↗
PubMed1992

Loudness balance between electric and acoustic stimulation.

Binaural loudness balance between electric and acoustic stimulation is obtained in auditory brainstem implant listeners who had substantial acoustic hearing in one ear. The data are well described by a linear relationship between acoustic decibels and electric microamps. Based upon this linear relationship, we propose an exponential model of loudness growth in electric stimulation. The exponential model predicts that the loudness growth function can be determined solely by the threshold and the uncomfortable loudness level in electric stimulation. This prediction is consistent with previous psychophysical data on loudness functions. Implications of this finding for speech processor designs are discussed.

Acoustic Stimulation↗
PubMed1993

Distortion in the cochlea: acoustic f2-f1 at low stimulus levels.

The stimulus level and frequency dependence of the quadratic difference tone (QDT) measured as an otoacoustic emission in the ear canal has been investigated in the guinea pig and compared with simultaneously measured cubic difference tone (CDT) and with the round window electrical response. Acoustic QDT level tended to be highly labile. Growth of the ear canal response with covaried stimuli was very gradual (slope < 0.5). Acoustic and CM responses showed similar behaviour when f2 alone was incremented. The QDT was strongly dependent on stimulus frequency separation for high frequency stimuli. It is suggested that, at low stimulus levels and high frequencies, the acoustic QDT may originate in the 'tonic' motile responses of outer hair cells as they follow the envelope of the two-tone stimulus.

Acoustic Stimulation↗
PubMed1994

Modulation of thresholds to acoustical and electrical stimulation of the intact ear in guinea pig by furosemide and noise.

Middle latency responses (MLR) to acoustical stimulation (AS) and to electrical stimulation (ES) of the intact inner ear were recorded in guinea pigs. ES threshold curve decreased in the frequency range 2-16 kHz with a slope 5.4 dB/octave. Immediately after 50 mg/kg intravenous injection of the furosemide, which resulted in a temporary suppression of the cochlear function, the ES thresholds increased and resembled thresholds found in gentamicin-treated animals. Whereas temporary threshold shift (TTS) at 1 kHz ES was negligible at this time, maximum TTS at 8 kHz and 20 kHz ES was limited to 27 dB and 37 dB resp. TTS to acoustical stimulation was larger than TTS to ES (in some cases exceeded 50 dB) and it was similar at all frequencies. Amplitude-intensity functions (AIF) to high-frequency ES stimuli (20 kHz) consisted of two parts--a flat part at low intensities and a steep part at high intensities of the ES. High-frequency noise exposure (third-octave band noise, centered at 16 kHz, intensity 105 dB for 1 h) reduced or abolished only the flat part of the AIF, the steep part, as well as the responses to low-frequency ES, were not substantially changed. TTS at high frequencies, elicited by the noise exposure, were similar for ES and AS. However, amplitudes of acoustically evoked MLR significantly increased after the noise exposure while MLR amplitudes to ES did not change. The results characterize the frequency-intensity domain of the electrophonic effect in the guinea pig and its changes after influencing the inner ear function by furosemide and noise.

Acoustic Stimulation↗
PubMed1994

Return of auditory function following structural regeneration after acoustic trauma: behavioral measures from quail.

After measuring baseline behavioral audiograms, three of four behaviorally trained quail and fifteen untrained cohorts were exposed to a 1.5-kHz octave-band noise at 116-dB SPL for 4 h. The trained birds were tested daily following the exposure and showed a steady recovery of absolute sensitivity with a return to normal absolute thresholds by post-exposure days 8-10. Thirteen untrained cohorts were sacrificed after various survival times to evaluate the structural condition of the ear. The cohorts all showed regeneration of sensory cells similar to that seen in chicks. The effects of repeated acoustic trauma on recovery of sensitivity were evaluated by re-exposing the three trained birds and two untrained cohorts 106 days after the first exposure. One of the trained birds was exposed a third time, 113 days following the second exposure. The findings demonstrate that, following acoustic trauma, normal sensitivity returns prior to complete structural regeneration of the sensory epithelium and that repeated acoustic trauma may increase the time course of recovery of normal hearing sensitivity.

Acoustic Stimulation↗
PubMed1994

Discharge pattern in the auditory nerve evoked by vowel stimuli: a comparison between acoustical and electrical stimulation.

Single channel cochlear implants only transmit the time structure of the electrically coded input signal. All nerve fibres show similar thresholds for monopolar round window stimulation, i.e., activation does not depend on their site of origin. To investigate the fine structure of the firing pattern elicited by stimulation with an analogue coded speech processing system (VIENNA 1-channel implant), cats were electrically stimulated with German steady-state vowels at the round window. Single fibre activity was recorded from primary auditory fibres and period histograms were calculated. The electrically evoked impulse patterns were compared with those from acoustic stimulation with the same vowels. With acoustic stimulation, the response of a fibre depends on the individual characteristic frequency (CF) with regard to the fundamental F0 and the formants F1, F2 and F3 of the vowels, the spontaneous activity of the fibre and the sound level. The evoked firing pattern was used to calculate period histograms, the frequency content of which was analysed by Fourier transformation. With electrical stimulation in the threshold range, an action potential is strongly synchronized to a cathodic peak of the current within one period of F0. With increasing current level 3-5 impulses can be locked to the same period. The timing of the short intervals is determined by the relative refractory period and current peaks (negative or positive) caused by the dominant higher formant F2 or F3. The acoustically evoked patterns are specific for the CF of the neuron and represent the spectral information of the different vowels.(ABSTRACT TRUNCATED AT 250 WORDS)

Acoustic Stimulation↗
PubMed1994

Role of acoustic striae in hearing: mechanism for enhancement of sound detection in cats.

We report the results of behavioral studies in cats conducted first, to demonstrate the presence of a monaural mechanism for the enhancement of signal to noise; and then to examine the necessity or sufficiency of the acoustic striae for this mechanism. The results show that cats do indeed have a monaural mechanism for enhancing the detection of tones in co-located background noise for noise levels at least as high as 60 dB SPL. The ablation-behavior results show that surgical section of the dorsal (DAS) and most of the intermediate (IAS) striae has no measurable effect on this mechanism. In sharp contrast, even partial section of the trapezoid body results in a profound and permanent deficit and this deficit is not accounted for by hearing loss alone. It is concluded that the ascending and descending fibers in the dorsal and intermediate acoustic striae are neither necessary nor sufficient for enhancing the detection of salient sounds in a noisy environment while the ascending or descending fibers in the ventral acoustic stria are sufficient and probably necessary.

Acoustic Stimulation↗