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Biomedical subjects

A F Josey

Publications and source records attributed to A F Josey.

3 recordsLinked to original sources

Brain stem evoked response audiometry in a clinical practice.

Brain stem evoked response audiometry (BERA) is an effective method of evaluating the auditory pathway from the peripheral endorgan through the brain stem. The authors have found this test to be a valuable adjunct to the neurotologic evaluation and have applied the study to over 500 patients (639 ears) in a 22 month time span. BERA has an excellent success rate (98%) in determining the presence of cerebellopontine angle lesions and is helpful in establishing whether a hearing loss is of cochlear or retrocochlear type. The authors have found BERA of use in the diagnosis of multiple sclerosis as well as other neurologic diseases affecting the brain stem. It is a valid method of dealing with suspected malingerers and those who cannot respond to standard audiometric techniques. BERA has been helpful in determining the threshold of hearing in these patients. The authors conclude that BERA is a clinical study of practical significance and that more otolaryngologists should consider adding it to their diagnostic protocol.

Adolescent

Performance intensity functions in cochlear and eighth nerve disorders.

In this report, performance intensity functions for monosyllabic materials (PI-PB) were obtained on two groups of subject: 20 patients with eighth nerve pathology and 15 individuals with Meniere's disease. The subjects with retrocochlear involvement exhibited marked deterioration in word recognition as the speech intensity was increased beyond the level required for a maximum discrimination score. Such a dramatic breakdown, referred to as the "rollover effect," was not seen to occur among the subjects with cochlear disorders. Hence, the PI-PB function appears to be a valuable tool for use in the special test battery.

Adolescent

Acoustic neuroma: results of brain stem evoked response audiometry.

Brain stem evoked response (BER) audiometry presents abnormal findings in patients with acoustic neuromas. The test involves averaging of recordings at the vertex as sound-triggered nerve impulses travel from the cochlea to the brain stem. From the time the sound stimulus arrives at the cochlea until it reaches the first major brain stem synapse (within 10 milliseconds), five major waves have been identified as typical of normal averaged responses. Abnormality in the cochlea or eighth nerve causes specific changes in pattern, primarily in wave latency. These latency shifts can be used to predict the site of the lesion. In evaluating 17 lesions of the cerebellopontine angle, BER audiometry was accurate in the diagnosis of all of the tumors. This diagnostic tool should play a prominent role when acoustic tumor is suspected.

Adolescent