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B Kimberley

Publications and source records attributed to B Kimberley.

7 recordsLinked to original sources

Age and the human cochlear traveling wave delay.

OBJECTIVE: Cochlear physiologic changes that occur with aging also may affect the mechanics and filtering properties of the cochlea. In studying aging effects, it is also necessary to consider the effects of hearing threshold losses because thresholds generally increase with age, and threshold losses also affect the filtering properties of the cochlea. A distortion product emission (DPE)-based measurement of human cochlear traveling wave delays allows an indirect assessment of the mechanics of the traveling wave and how it might change with age. DESIGN: The cochlear traveling wave delay has been derived from DPE phase measurements using an f1 sweep paradigm (Kimberley, Brown, & Eggermont, 1993). In the present study, traveling wave delay was estimated from DPE phase measurements taken from the left ears of 91 subjects (22 to 78 yr) with auditory thresholds ranging from normal hearing (< or = 25 dB SPL, ANSI 1969) to mild cochlear hearing damage. No one under the age of 65 had hearing losses exceeding 40 dB SPL to 8 kHz. Pure-tone thresholds were determined at eight frequencies through a 4-interval, forced-choice, adaptive-level psychophysical test. DPE phase and amplitude measurements were made at these eight frequencies using CUBeDIS-related software (AT&T Bell Labs). Round-trip traveling wave estimates were calculated from the DPE phase measurements for each of the eight f2 frequencies (places). RESULTS: Traveling wave delays estimated using DPE phase were not significantly affected by mild hearing losses. Traveling wave delay, however, does increase slightly with age. Optimal f2/f1 ratio and associated DPE amplitude also were tested for age or threshold effects. The optimal f2/f1 ratio remained unaffected by age or hearing loss but decreased with increasing frequency. The maximum DPE amplitude decreased with both advancing age and increasing pure-tone threshold, so it was impossible to isolate the contribution of each individual factor. CONCLUSIONS: Mild hearing losses do not affect the round-trip traveling wave delay. There is a slight age dependence, however. This may suggest that there are age-related but threshold-independent factors that may alter such properties as basilar membrane stiffness or cochlear fluid composition. The relationship between maximum DPE amplitude and threshold, at the frequencies tested, is a better predictor of hearing thresholds than the DPE amplitude as obtained from a fixed ratio DPE amplitude measurement.

Adult↗

Cochlear traveling-wave delays estimated by distortion-product emissions in normal hearing adults and term-born neonates.

Functional aspects of human cochlear maturation were studied with distortion-product otoacoustic emissions (DPE). Cochlear travel times were measured on basis of the phase-frequency relationship for DPEs in 54 term-born babies (36 to 42 weeks conceptional age [CA]) for f2 frequencies from 1.7 to 10 kHz, and the results were compared with a normaltive data set based on 36 adult ears. At the two extremes of the f2 frequency range used, 1.7 kHz and 2.4 kHz on the low end and 7 kHz and 10 kHz on the high end, the travel times for neonates were similar to those in adult ears. In the mid-frequency range (3.4 kHz and 4.8 kHz) the mean values were significantly smaller than those for adults. We attempt to explain these findings on the basis of the maturation of two partially compensating (i.e., with cochlear travel time) cochlear mechanisms: the maturation of the characteristic frequency (CF)-place relationship in the cochlea (the "shifting place" principle) and the maturation of the cochlear amplifier.

Adult↗

Use of the labial artery for replantation of the lip and chin.

A 12-year-old boy suffered from a full-thickness traumatic amputation of his lower lip and chin following a horse bite. Microsurgical technique was used to reanastomose the inferior labial artery and a vein of the chin. The replanted flap remained viable, and the patient has done well despite some early problems with eating and drooling. The patient is now able to purse his lips and has regained sensation and the use of his orbicularis oris and musculus mentalis, even though no attempt was made to repair the motor nerves or sensory nerves. Because of the potential superior cosmetic and functional results following replantation, we recommend aggressive microsurgical attempts at arterial and venous anastomosis not previously described following traumatic amputation. The inferior labial artery may be considered for use as a nutrient artery for replantation and in future elective maxillofacial reconstruction and free-flap transfer.

Amputation, Traumatic↗