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Biomedical subjects

B D Forquer

Publications and source records attributed to B D Forquer.

11 recordsLinked to original sources

Cochlear otosclerosis: a review of audiometric findings in 150 cases.

Audiometric findings and histories were reviewed for 150 patients diagnosed by polytomography as probable cochlear otosclerosis cases. Most patients were under 65 and had a relatively short duration of hearing impairment. Most had a mild to moderate loss with excellent speech discrimination. Seventy-five percent of the ears had acoustic reflex findings indicative of minimal stapes fixation. We recommend the acoustic reflex test for identification of patients with probable cochlear otosclerosis.

Adult

Sodium fluoride: effectiveness of treatment for cochlear otosclerosis.

We examined the effectiveness of sodium fluoride in treatment of cochlear otospongiosis in ninety-four patients with cochlear otosclerosis and ninety-eight patients with stapedial otosclerosis and sensorineural hearing loss. The drug halted or slowed the progression of sensorineural hearing impairment in 63% of the patients with cochlear otosclerosis and 46% of the patients with stapedial otosclerosis. The single factor that best predicted which patients would respond most favorably to treatment was rate of progression before treatment. Sodium fluoride therapy was successful for 79% of the patients losing their hearing at a rate of 5 dB or more per year at one or more of the speech frequencies. The finding that patients with more rapid rates of progression responded most favorably to sodium fluoride therapy suggests that patients with the most active otospongiotic processes will be the most responsive to treatment.

Cochlea

Middle ear effusion in children: a report of treatment in 500 cases.

Records were studied of 500 children younger than 9 years of age with middle ear effusion who had received one of three treatment strategies: (1) administration of medication, including decongestants, antihistamines or antibiotics (or a combination), (2) administration of medication for a limited time and then surgical therapy if effusion did not resolve or (3) myringotomy done immediately with insertion of ventilation tubes and, in some cases, removal of adenoids. Early surgical intervention resulted in significantly shorter delay in hearing restoration. It did not result in a lower recurrence rate and it did not reduce the number of occasions when thick fluid, as compared with thin fluid, was found at operation. Four children for whom medical and surgical treatment failed were considered candidates for mild gain, low maximum-power-output hearing aids. All other children had normal hearing after treatment. Medication was successful in achieving this goal in 48 percent of the cases.

Child

Cochlear otosclerosis: acoustic reflex findings.

Progressive cochlear impairment develops in a small percentage of patients with clinical otosclerosis, apparently owing to involvement of the cochlea by the otosclerotic bone. In recent years it has been postulated that otosclerosis frequently produces a pure sensorineural hearing impairment without stapedial involvement. We investigated the acoustic reflex responses in a group of patients diagnosed as sensorineural otosclerosis and compared these reflex findings with the findings in patients with confirmed otosclerosis but with a minimal conductive impairment. In the minimal conductive hearing impairment group we substantiated the findings of others that the negative on-off reflex is common in otosclerotic patients whose conductive impairment is 10dB or less. In the group with cochlear otosclerosis we found abnormal reflexes in 58 percent of the patients. These findings indicate that stapedial involvement is common in patients thought to have pure sensorineural otosclerosis.

Adolescent

Eustachian tube dysfunction and Meniere's disease: a report of 341 cases.

Tympanometric results were reviewed for 341 cases of Meniere's disease and 200 cases of sensorineural hearing loss of unknown causes. The results indicate that the incidence of Eustachian tube dysfunction in patients with Meniere's disease is nearly the same as in a control group of patients with sensorineural hearing loss of unknown causes: The percentage of patients with Meniere's disease having Eustachian tube dysfunction was similar to the percentage of normal-hearing listeners with Eustachian tube dysfunction reported by Jerger.

Acoustic Impedance Tests

The negative on/off effect in cochlear and early stapedial otosclerosis.

Acoustic reflex patterns were reviewed for 100 patients suspected of having cochlear otosclerosis (group 1) and 73 patients with confirmed stapedial otosclerosis and conductive hearing losses of less than 5 years duration (group 2). Three abnormal reflex patterns were exhibited by these patients--"negative on/off," "no response when the probe was in the affected ear," and "no response when the stimulus was in affected ear." Results showed that the negative on/off pattern was equally as common for the two subject groups. The "no response" patterns were more common for the early stapedial otosclerosis group. The presence of acoustic reflex patterns classically associated with stapedial otosclerosis in patients with cochlear otosclerosis leads us to predict that some degree of stapedial fixation is common in many cases of cochlear otosclerosis. Based upon these findings, the presence of the negative on/off pattern in patients with mild sensorineural hearing loss, excellent speech discrimination, and a family history of hearing loss, is now considered indicative of cochlear otosclerosis.

Adolescent

Evaluation of the auditory system: an update.

The purpose of this paper is to describe the audiologic techniques currently used at the Otologic Medical Group, Inc. Auditory threshold in children is determined by a combination of behavioral and objective audiometric techniques. When behavioral techniques fail, auditory brainstem response audiometry combined with impedance audiometry gives a good estimate of hearing thresholds. Impedance audiometry is a valuable addition to the diagnosis of cochlear otosclerosis. This technique is also of benefit in the neurotologic evaluation. Auditory brainstem response audiometry is the most accurate method of detecting an acoustic tumor. We no longer use SISI, tone decay, or Bekesy tests. The newer audiometric studies have greatly improved our evaluation of the auditory system.

Acoustic Impedance Tests

The stability of and the relation between the acoustic reflex and uncomfortable loudness levels.

Acoustic reflexes and uncomfortable loudness levels were recorded for eight normal-hearing listeners on eight separate occasions and eight listeners with sensorineural hearing impairments on three to four occasions. Frequencies tested were 500, 1000, 2000, and 4000 Hz for both measures. Neither acoustic reflexes nor uncomfortable loudness levels was found to vary significantly across sessions for either the normal or hearing impaired listeners. However, significant intensity differences were noted between acoustic reflexes and uncomfortable loudness levels, for both subject groups, and these differences were dependent upon subject and frequency.

Adult

Middle ear effusion: relationship of tympanometry and air-bone gap to viscosity.

Sixty cases comprising 95 ears were reviewed in which myringotomy with ventilation tube insertion had been performed for alleviation of middle ear effusion and for which tympanometric and pure-tone audiometric data had been collected within five days of surgery (mean = 1.0 days). Results suggest that types B and C tympanograms in combination with greater than 15 dB air-bone gaps are good indicants of thick fluid in children less than nine years old. No tympanometric patterns in combination with air-bone gap data systemactically predicted thin fluid. For all subjects, type C tympanograms with less than 15 dB air-bone gaps indicated an absence of significant fluid at surgery.

Acoustic Impedance Tests