摘要:

AbstractUtilizing audiometry, acoustic reflex threshold and reflex decay testing, electronystagmography and the brain stem auditory evoked response, cochlear‐vestibular and brain stem function in chronic renal failure has been investigated. After elimination of the etiologic factors known to affect — or possibly affect — such function, a clinically significant abnormality of auditory, vestibular and brain stem function was not

ISSN:0023-852X    

DOI:10.1288/00005537-198208000-00001

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractTuning forks have been used as clinical pure tone generators since the middle of the nineteenth century. The development of electronic signal sources has fostered innumerable advances in audiologic diagnosis, yet the tuning fork remains in daily use by thousands of physicians, for rapid and reliable screening of auditory acuity.This study examines tuning forks as oscillators, determining harmonic distortion with real‐time spectral analysis. Various methods of striking the instrument are compared, with regard to harmonic distortion and sound pressure level generated. Tuning forks are, thus, compared to their electronic counterparts for the first time in the literature.Gentle striking of a steel, 256 Hz. fork on the thenar eminence produces tones comparable in purity to those generated by ANSI‐calibrated audiometers.Similar results were obtained with forks of higher frequency; however, careful use of light aluminum alloy forks may produce equally satisfactory resu

ISSN:0023-852X    

DOI:10.1288/00005537-198208000-00002

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractBrain stem auditory evoked potentials (BSEP) were elicited and recorded from the spasm side and from the non‐spasm side of 39 patients operated upon to relieve hemifacial spasm. Thirty‐seven patients were studied before the microvascular decompression surgery at the root entry zone of the facial nerve was performed. Thirty‐one patients were studied 4 to 10 days postoperatively, and 7 were evaluated a second time, 6 weeks to 6 months after surgery. The latencies of peaks III and V of the ipsilaterally recorded BSEP were statistically significantly (p<0.05) larger on the spasm side than were those recorded on the non‐spasm side. The I to III interwove latencies did not show any statistically significant difference. This implies that the effects of hemifacial spasm are not limited to the facial nerve but extend to other cranial nerves and other parts of the brain stem than those involved in facial motor function. The pure tone thresholds recorded before and after the operations were essentially the same in the majority of the patients, were 10 to 15 dB lower in 13% of the patients postoperatively, and were 10 to 15 dB higher in 13% of the patients postoperatively. One patient suffered a moderate sensorineural low‐frequency hearing loss postop

ISSN:0023-852X    

DOI:10.1288/00005537-198208000-00003

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractA series of 51 patients with intractable vertigo from Meniere's disease were treated by a surgical procedure termed cochleosacculotomy. In this operation a right‐angled pick is introduced through the round window membrane and advanced 3 mm in the direction of the oval window. This passage carries the pick through the cochlear partition causing a fracture‐disruption of the osseous spiral lamina and cochlear duct. Within the time limits of this study (mean 4.32 months) 88% were relieved of disabling vertigo. Hearing losses of more than 20 dB occurred in 23% of the patients. Profound hearing losses occurred in two patients, one of which was associated with postoperative otitis me

ISSN:0023-852X    

DOI:10.1288/00005537-198208000-00004

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractAlthough otosclerosis in childhood is not common in the United States, we have done 62 stapes procedures in 43 patients who were under age 20 at the time of their initial surgery. There were 16 males and 27 females who developed a conductive hearing loss due to otosclerosis between age 6 and 17. The most common age at onset was 12 and 13 years, perhaps suggesting a relationship to puberty. Of these children and teenagers, 42% had severe oval window otosclerosis. Teflon wire prostheses were used in 33% of the operations and wire loop prostheses in most of the remainder; 27% had preoperative bone conduction of 25 dB or worse, indicating the presence of cochlear otosclerosis. The results of stapedectomy were good and approximately equal to that of adult patients.

ISSN:0023-852X    

DOI:10.1288/00005537-198208000-00005

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractThe establishment of a cochlear implant team and the implementation of the Oklahoma City project was for the purpose of monitoring techniques and results reported by other investigators as well as perhaps contributing to the improvement of this method of restoring sound to profoundly deafened individuals. Years of planning and 3 years of actual experience with over 25 patients who have been implanted will be documented. Technical advances in prosthetic attachments and new transformer circuitry as well as better methods of evaluating results will be presented. Our assessment of the value of the cochlear implant and its future will be discussed.

ISSN:0023-852X    

DOI:10.1288/00005537-198208000-00006

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractPatients with hemostatic disorders about to undergo surgery present a special challenge for the otolaryngologist. The most common coagulation disorders constituting more than 90% of all patients seen with severe inherited bleeding defects are hemophilia and von Willebrand's disease (pseudohemophilia). Neither of these is an absolute contraindication for surgery. Hemophilia, a sex‐linked disorder, can be divided into two distinct classes: hemophilia A (classic hemophilia), a deficiency of factor VIII production, and hemophilia B (Christmas disease), a deficiency of factor IX production. Von Willebrand's disease is an autosomal dominant disorder consisting of a decrease in factor VIII activity plus a prolonged bleeding time and abnormal platelet aggregation with ristocetin.Careful preoperative evaluation and early hospitalization are important for these patients. The close cooperation of a hematologist, monitoring availability and proper replacement of these factors, is essential. Careful postoperative attention should be directed at the maintenance of sufficient therapeutic levels of replacement therapy for a minimum of 7–10 days. We shall present cases of patients with inherited bleeding diatheses who underwent successful surgery at our institution. The use of Amicar® and Avitene® will also be pres

ISSN:0023-852X    

DOI:10.1288/00005537-198208000-00007

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractEncephaloceles of the temporal bone are encountered infrequently by the otolaryngologist and, therefore, may be misdiagnosed. Serious sequelae and central nervous system infections may result with inadequate management. A series of 15 recent cases are presented and discussed in relationship to etiology and surgical management. Transmastoid and middle cranial fossa approaches will be delineated along with the rationale and techniques for each. The use of pedicle and free tissue flaps, as well as autogenous bone and synthetics will be outlined.

ISSN:0023-852X    

DOI:10.1288/00005537-198208000-00008

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractThere are few clinical neuro‐otologic investigations of acute head injury. We obtained impedance and auditory brain stem response measures for 25 acute head‐injured patients, usually within 76 hours following injury. All patients were comatose at the time of assessment. Impedance abnormalities were found for over three‐fourths of the patients. Generally, they were associated with transient, reversible dysfunction, such as high negative middle ear pressure. The acoustic stapedius reflex, however, was seldom observed, even in patients with apparently normal middle ear function.Auditory brain stem response measures showed evidence of CNS dysfunction in 80% of the patients. Abnormalities ranged from prolonged latency and reduced amplitude of the wave V auditory brain stem response component to total absence of brain stem auditory activity. There was a relationship between auditory brain stem response findings and neurologic outcome at 1 month post assessment. Electrophysiologic auditory measures are clinically valuable in neuro‐otologic diagnosis and neurologic prognosis of acute, severe head

ISSN:0023-852X    

DOI:10.1288/00005537-198208000-00009

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractBasic audiologic data, as well as five selected measures of the auditory brain stem response, and results from seven central auditory tests were obtained from ten adult subjects with a variety of brain stem lesions. The ABSR measures included latency, waveform morphology, amplitude ratio, presentation rate and intensity function. The central tests administered were competing sentences, rapidly alternating speech, binaural fusion, staggered spondaic words, dichotic digits, frequency patterns and low pass filtered speech. Both procedures (ABSR and C.A.T. battery) were highly sensitive to brain stem lesions in the study group as a whole, but showed some limitations for individual subjects. The data also indicated the value of employing a test battery and multiple electrophysiologic measures as opposed to single indices of auditory performance. Findings on individual central tests and ABSR measures are reported, as well as data on laterality effects.

ISSN:0023-852X    

DOI:10.1288/00005537-198208000-00010

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY