摘要:

Studies documenting subjective changes in quality of life of pediatric cochlear implant recipients are limited. In this study, parents of cochlear implant recipients completed a questionnaire requesting them to list advantages and disadvantages associated with their children's cochlear implant use. Preimplantation, benefits expected by parents included awareness of environmental sounds (89% of parents), improved speech perception (50%), and improved speech production (36%). Disadvantages expected included equipment maintenance and repair (21% of parents), slow progression of auditory and speech skills (21%), and resistance to wearing the device (18%). One year postimplantation, benefits reported by parents included environmental sound perception (76% of parents), speech perception (64%), and speech production (52%). Two years postimplantation, benefits reported by parents included perception of environmental sounds (76% of parents), speech perception (67%), and speech production (57%). Three years postimplantation, benefits reported included perception of environmental sounds (61% of parents), speech perception (78%), and speech production (74%). Postimplantation, 36%, 24%, and 52% of the parents had no disadvantages to report at the 1, 2, and 3-year intervals, respectively. At all postimplant intervals, disadvantages associated with the size and maintenance of equipment were listed most frequently (36%, 48%, and 22% of parents, respectively). Open-ended questionnaires may be useful when evaluating a child before or after cochlear implantation.

ISSN:0192-9763    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

This study examined the relationship between objective changes in electrocochleographic (ECochG) parameters and subjective changes in symptoms in a group of patients with Meniere's disease/endolymphatic hydrops (MD/ELH) after application of positive and negative atmospheric pressure changes to the sealed ear canal. Our goals were to further examine the therapeutic effects of atmospheric pressure change on the treatment of MD/ELH, as reported by a series of Swedish studies, and to examine the utility of ECochG for monitoring these effects. By combining a clinical immittance unit and an evoked potential unit, ECochG responses were obtained from the tympanic membrane while different atmospheric pressures were applied indirectly to the middle ear via the external ear canal. For comparison, ECochG responses at various atmospheric pressures also were obtained for otologically normal subjects. For the MD/ELH group, there was a significant (p<0.01) reduction in the abnormal summating potential/action potential (SP/AP) amplitude ratio, although the amplitude ratios did not become “normal.” There was no significant effect of ear canal pressure change on ECochG components for the normative subjects. Although these findings were encouraging regarding the therapeutic effects of overpressure, they were not accompanied with changes in MD/ELH symptoms.

ISSN:0192-9763    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

To characterize otologic causes for vertigo, data on 564 patients with the six most common diseases involving vertigo were retrieved from the database of a computer-aided diagnostic system for neurotologic diseases. The diseases were Meniere's disease, vestibular schwannoma, benign paroxysmal positional vertigo, vestibular neuritis, sudden deafness, and traumatic vertigo. The prevalence of tinnitus in the study population was 76%. The most severe forms of vertigo and nausea were found in vestibular neuritis, whereas the most severe case of tinnitus appeared in Meniere's disease. Of the patients with vestibular schwannoma, 49% had had vertigo. A linear discrimination analysis using case history classified 90% of the patients into correct groups. The key questions discriminating between the diseases concerned the frequency and duration of vertigo attacks, the duration of hearing loss and vertigo, and the occurrence of head injury. Making a correct diagnosis during the first office visit can be difficult, especially for sudden deafness, vestibular schwannoma, and Meniere's disease. Neurotologic and audiometric information was of minor value in distinguishing between these six diseases. Vestibular schwannoma had significantly greater asymmetry in electronystagmography and smaller gains in smooth pursuit in comparison with the other diseases. Factorial analysis did not aid the clustering of these diseases.

ISSN:0192-9763    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

A case of episodic facial paralysis resulting from a pneumocoele of the temporal bone is presented. The patient had undergone facial nerve exploration and blind sac closure after a transverse fracture of the petrous temporal bone.

ISSN:0192-9763    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

ObjectiveTo determine the effectiveness of baclofen in ameliorating tinnitus in adult patients.Study DesignRandomized double-blind placebo-controlled trial.Setting:California Ear Institute at Stanford, California, a tertiary otology/neurotology referral center.PatientsRestricted to adults receiving otologic evaluation at the California Ear Institute at Stanford. Some patients had a primary complaint of tinnitus, whereas others with tinnitus were recruited during treatment for another condition. The study population was felt to be representative of the general population with tinnitus.InterventionsThree weeks of baclofen (10 mg orally twice daily for 1 week, 20 mg orally twice daily for the second week, and 30 mg orally twice daily for the third week) or placebo designed to mimic baclofen capsules in route, schedule, appearance, and taste were given to patients.Main Outcome MeasuresTinnitus handicap inventory, pitch and loudness matching, and maskability of tinnitus.ResultsSubjective and objective evaluation failed to demonstrate any clinical or statistical advantage of baclofen over placebo. Reports of subjective improvement occurred in only 9.7% of the baclofen versus 3.4% of the placebo groups, a nonsignificant difference. Withdrawal from the baclofen arm of the study occurred in 26% due to side effects, which could be attributed to the medication.ConclusionsBaclofen is no more effective than placebo in ameliorating tinnitus in adult patients.

ISSN:0192-9763    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

ObjectiveTo demonstrate a causal relationship between bone dust and the development of headache after retrosigmoid removal of acoustic neuromas.Study DesignThe study design was both retrospective (group 1) and prospective (groups 2 and 3).SettingTertiary Care Referral Center/Outpatient Data Collection.PatientsEighty-four consecutive patients underwent surgery at the Mount Sinai Medical Center in New York by the same surgical team.InterventionAll patients underwent retrosigmoid removal of acoustic neuromas via the following methods: group 1, standard excision; group 2, excision and cranioplasty; group 3, excision, cranioplasty, and residue trapping.Main Outcome MeasurePresence or absence of postoperative headache.ResultsIn all, 43 patients (51%) reported postoperative headache. By groups, headache incidence was 64% for group 1 (43% grade 3–4), 81% for group 2 (37% grade 3–4), and 10% (all grade 1) for group 3. Differences with respect to headache incidence and severity were statistically significant between groups 1 and 3, and between groups 2 and 3 (p < 0.001).ConclusionsFree circulation of bone dust into the posterior fossa during intradural drilling of the internal auditory canal may be the most important factor in the development of headache after this surgical procedure.

ISSN:0192-9763    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The single-photon-emission computed tomography (SPECT) scan enables clinicians to probe dynamic and metabolic changes in brain tissue through measurement of regional cerebral blood flow (rCBF). Diagnostic benefits of the SPECT scan in clinical neurology have been demonstrated. SPECT scanning has been shown to be more sensitive than morphologic imaging techniques [magnetic resonance imaging (MRI) and computed tomography (CT)] in many conditions. However, the use of the scan in assessing neurotologic complaints remains inadequately investigated. Few studies have explored the value of SPECT in establishing the causes of dizziness, hearing loss, and tinnitus. We studied SPECT along with MRI, CT scan, electroencephalogram (EEG), and other evaluations in patients with these neurotologic complaints. SPECT abnormalities were more frequent and prominent than those visualized by other imaging modalities. Overall, 78% of SPECT scans revealed abnormalities. Abnormalities were found in 46% of MRIs, 40% of CTs, and 29% of EEGs. The disparity between SPECT scanning and other procedures was also seen once patients were divided by their chief complaints. This study illustrates the sensitivity of SPECT scanning in evaluating neurotologic complaints and highlights the need for additional research into the importance of SPECT scanning in comprehensive neurotologic evaluation.

ISSN:0192-9763    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0192-9763    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0192-9763    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0192-9763    

出版商:OVID    

年代:1996

数据来源: OVID