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Biomedical subjects

A Hildmann

Publications and source records attributed to A Hildmann.

6 recordsLinked to original sources
PubMed1999

[Ototoxicity of cisplatin in children].

BACKGROUND: The ototoxicity of cisplatin has long been well known for its damage to hair cells. However, the results of published studies vary widely with respect to the intensity and frequency of auditory damage. METHODS: We analyzed the data of 13 young children that have been treated with cisplatin for varying tumor diseases in established combination chemotherapy. The study focused on these major questions: How high is the rate of cisplatin-related incidents of hearing loss in relation to age, sex, nature of tumor, and total dosage of the administered cisplatin? How much does the supplementary application of further ototoxic medications affect the ototoxicity itself? RESULTS: Eight of 13 children examined showed regular hearing capacities in conformity with their age-group, 3 showed a bilateral, and one child showed an one-sided loss of auditory capacity. Deterioration of preexisting auditory damage was observed in one child. No relation to age, sex, nature of tumor, or dosage of administered cisplatin was established. Bilateral hearing loss occurred in three of these children, which indicates that possible synergy of aminoglycoside antibiotics and cisplatin should be investigated with respect to ototoxicity. CONCLUSION: The results indicate that cisplatin, especially in combination with other ototoxic drugs, can lead to severe hearing loss in young children. Since factors other than the possible synergy discusses above favorable to the development of auditory damage cannot be specified, every child under cisplatin therapy should undergo auditory checkups at brief intervals.

Child↗
PubMed1999

Neonatal screening for hearing disorders in infants at risk: incidence, risk factors, and follow-up.

OBJECTIVE: To determine the incidence and risk factors for hearing disorders in a selected group of neonates and the feasibility of selective hearing screening. SETTINGS: Multicenter prospective trial at five centers in Germany. METHODS: Enrollment criteria: in addition to previously defined risk factors by the Joint Committee on Infant Hearing (family history of hearing loss, in utero infections, craniofacial anomalies, birth weight <1500 g, critical hyperbilirubinemia, ototoxic medications, bacterial meningitis, postnatal asphyxia, mechanical ventilation >5 days, stigmata, or syndromes associated with hearing loss), the impact of maternal drug abuse, birth weight <10th percentile, persistent pulmonary hypertension, and intracranial hemorrhage more than or equal to grade III or periventricular leukomalacia on infant hearing were evaluated. The screening procedure was performed by automated auditory brainstem response (A-ABR; ALGO 1-plus; Natus Med Inc, San Carlos, CA). STATISTICS: univariate analyses of risk factors versus A-ABR results and a multivariate regression analysis were used; additionally, the total test time was recorded. RESULTS: Seven hundred seventy recordings from 777 infants enrolled consecutively constitute the basis of this analysis. Mean gestational age was 33.8 +/- 4.3 weeks, birth weight 2141 +/- 968 g; 431 infants being male and 339 female; 41 (5.3%) infants exhibited pathologic A-ABR results (16 bilateral and 25 unilateral). Meningitis or sepsis, craniofacial malformations, and familial hearing loss were independent significant risk factors. Median total test time was 25 minutes. Follow-up examinations in 31 infants revealed persistent hearing loss in 18 infants (13 infants sensorineural, 5 from mixed disorders), 7 requiring amplification. CONCLUSION: Hearing screening in high-risk neonates revealed a total of 5% of infants with pathologic A-ABR (bilateral 2%). Significant risk factors were familial hearing loss, bacterial infections, and craniofacial abnormalities. Other perinatal complications did not significantly influence screening results indicating improved perinatal handling in a neonatal population at risk for hearing disorders.

Analysis of Variance↗
PubMed1993

[Tympanic effusion].

Since epidemiologic studies have shown, that the majority of middle ear effusions disappear spontaneously and sequelae a less frequent than expected, a more conservative treatment strategy is advisable. In this review pathogenetic factors are discussed and a treatment policy is recommended as it appears logic to the authors. It is stressed that exact audiologic data are difficult to obtain in children. If an effusion persists at least for 3 months, adenoidectomy, paracentesis and aspiration of the middle ear fluid has to be considered. The insertion of middle ear ventilation tubes is not the first step in our treatment. Special strategies for treatment have to be applied in some groups such as children with Francheschetti or Down Syndrome and children with cleft palates as well as in children with retardation in speech development.

Child↗
PubMed1992

[Indications and surgical treatment of large middle ear abnormality].

Children with atresia of the external auditory canal should undergo hearing assessment and fitting of a bone conduction hearing aid as early as possible to allow speech to develop normally. Surgery is done between 5 and 6 years of age, guided by high-resolution computed tomography, which provides a more precise diagnosis based on the abnormalities seen. The temporomandibular joint lies more posteriorly than normal due to aplasia or hypoplasia of the tympanic bone, so that the middle ear must be approached through the mastoid, resulting in a less favourable coupling to the middle ear structures. In unfavourable cases bone anchored hearing aids, creation of a meatus for fitting a hearing aid or a bone conduction hearing aid must be considered.

Adolescent↗
PubMed1986

An autoradiographic study of bone grafts in small animals.

Bone remodelling was studied in allografts and isografts by means of autoradiography. Collagen and proteoglycans of the organic bone matrix were labelled with H-3 amino acids and S-35 sodium sulphate. The principles of primary bone formation are followed in graft remodelling as well. Matrix breakdown and reformation are carried out by mononuclear cells. Components of the original matrix can be seen in osteoclasts, perivascular cells, osteoblasts, young osteocytes, and in new bone. The label allows tracing of these components and proves their reuse.

Amino Acids↗