ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01071.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Over the last 5 years, detailed air pressure, flow and voice measurements have been made on indwelling tracheo‐oesophageal speaking valves whilst inserted in patients, using specially designed apparatus. This study was set up to investigate the relationship between speech andin vivoparameters.In vivopressure measurements were generaly lower for Groningen low resistance than Groningen high resistance, while flow and voice measurements were higher. A plot of opening pressure against pressure at maximum flow for all valves suggested a straight line relationship. A graph of maximum voice agaist composite parameter score for all valves showed a cluster of points between the composite score of 0–15. The advances in knowledge about these valves should be of use in the design of improved val

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01072.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

This study was designed to determine the acceptance and effectiveness of a hearing aid in the management of children with persistent hearing loss due to glue ear (otitis media with effusion [OME]). Forty‐eight children with OME, in whom the main symptom was deafness, were treated with a hearing aid instead of surgery and reviewed at 3‐monthly intervals over 6–12 months. Seventy‐one per cent reported unequivocal satisfaction with the aid. Sixty‐five per cent used the aid continuously throughout the day whilst 35% used it only at specific times of need. Ninety‐eight per cent noticed a definite improvement in their hearing whilst using the aid and this was confirmed audiometrically in 100%. Disability was considered in terms of speech development and educational achievement. In 66% there had been a subjective decline in these parameters prior to aid prescription. In all but one child significant improvement was made sufficient to alleviate parental and teachers’ concern. No children reported significant symptoms due to OME other than deafness and there were no complications of hearing aid usage. At follow‐up, however, 13% of children continued to use a hearing aid in an ear in which the OME had resolved. This study has shown that in this preselected group of children with persistent OME and the predominant symptom of deafness, a hearing aid was an effective treatment for their deafness with high acceptance

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01073.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Magnetic resonance imaging (MRI) is the definitive investigation in the detection of an acoustic neuroma and its use is becoming increasingly widespread for this purpose. In the Oxford region, this facility has been available for 3 years, resulting in the scanning of the internal auditory meati and cerebellopontine angeles of 892 patients and the detection of 38 acoustic neuromas. Based on our use of this investigation over this time period, we have attempted to rationalize our entry protocol for screening by limiting the availability of the test to those patients up to 70 years of age presenting with unilateral audiovestibular symptoms in the absence of significant neurological symptoms or signs, with an average difference in hearing threshold of 15 dB between normal and symptomatic ears or unilateral tinnitus with normal hearing. By following these entry criteria, we would hope to maximize the available resources.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01074.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Swallowing function was measured using a simple timed test in 20 healthy subjects with a sore throat (16 women, median age [range] 27.5 years [19.3–44.5]) and the test was repeated following recovery. All three indices from the test average volume per swallow (ml). average time per swallow (s) and swallowing capacity (ml s−1) were significantly improved following recovery (P= 0.0001, 0.041 and 0.0001 respectively). There was no significant change in respiratory function between the two visits. The indices from a timed test of swallowing are sensitive enough to detect changes occurring due to a sore throat; the test provides a simple bedside technique for quantifying swallowing and may be useful in measuring the rate of recovery from swallowing problems and in assessing the effect of different treatments on swallowing funct

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01075.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Examination of the larynx with a flexible endoscope has been a standard procedure for over 20 years. Although excellent images have been obtained there has not been a method for achieving any objective measurements and there are clearly both research and clinical applications for this. The reason for this is firstly because of the inherent distortion of the lens and secondly because of an absence of a reliable method of assessing the relative position of the endoscope within the larynx. This paper illustrates the theory of how these problems have been overcome and describes the equipment used in the clinical situation. The first clinical trial of the Vocim system is detailed, demonstrating an error of only 4%.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01076.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Improvements in MR imaging techniques allow visualisation of the anatomy of the cerebellopontine angle (CPA) in increasingly accurate detail, revealing the complex interrelationship of the neurovascular structures in this region. We wished to assess whether vessels and vascular loops intimately associated with cranial nerves VII and VIII, corresponded to any abnormality or symptom pattern, and thus had any clinical significance. The MR scans of 108 patients were retrospectively reviewed and the imaging status of VII, VIII, the vessels, presence of vascular loops and their relationship to the nerves, coded and recorded. The patients’ records were independently reviewed and the presence and ‘sidedness’ of asymmetrical hearing loss, tinnitus, vertigo, and the results of caloric and brain stem evoked responses recorded. The vessels were closely associated with VII and VIII in over 30% of this sample with vascular loops imaged in 21% of patients, and clearly imaged entering the IAM in 7% of both right and left CPAs studied. There was no statistically significant relationship demostrated between the proximity of the vessels, or vascular loops, to the nerves and a symptom, or symptom pattern. These findings should be considered a normal variant on MR sca

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01077.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

This study assessed the effect of needle electrode position on the human cochlear summating potential (SP) obtained by transtympanic electrocochleography (ECochG). Electrocochleography was performed on 10 subjects with large central tympanic membrane performations with good cochlear function, and in whom a needle electrode could be accurately placed in a series of five pre‐determined positions in the middle ear. A comparison of the electrocochleograms revealed a wide scatter of results between different positions in the same patient and between similar positions in different patients. Only when the needle was repositioned at an almost identical recording site in the same subject, was good reproducibility achieved. Such a wide and unpredictable variation in results would suggest great caution is needed when comparing traces obtained using a transtympanic technique which precludes a view of the electrode ti

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01078.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The degree of glottal closure during phonation has an influence on voice quality and it is related to the robustness of the voice source. To quantify glottal closure a frame of reference was created by investigating 47 healthy men and 92 healthy women with no vocal complaints using videolaryngostroboscopy. Observing recorded images the degree of glottal closure was rated with a percentage. Results indicate that men have better glottal closure than women (P<0.001). An increase in vocal intensity is related to improved glottal closure (P<0.001), and in women a negative relationship was established between pitch and glottal closure (P<0.001). Normal glottal closure in men is a complete closure, whereas in women a closure of at least 90% should be attained. If these percentages cannot be established during loud phonation, it suggests the presence of a less robust larynx. To evaluate and quantify the function of the voice source, in clinical practice the larynx should not be observed at only one intensity level, but at a variety of intensity and frequency levels.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01079.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Emergency tracheostomy prior to laryngectomy for laryngeal carcinoma has been associated with peristomal recurrence. Is the peristomal recurrence caused by the tracheostomyper se, or is it due to the association of tracheostomy with subglottic tumours and locally advanced tumours? This study examines the association between tracheostomy. as an independent variable, and peristomal recurrence. Forty‐three patients with T3glottic carcinomas and treated by a combinationof total laryngectomy and radiotherapy were studied. The difference in peristomal recurrence between the tracheostomy and non‐tracheostomy patients was not statistically significant. Nor was there a correlation between the time interval between tracheostomy and laryngectomy, and the incidence of peristomal recurrence. It is concluded that tracheostomy, as an independent variable, does not cause peristomal recurre

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01080.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY