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Biomedical subjects

B Welleschik

Publications and source records attributed to B Welleschik.

At least 19 recordsLinked to original sources
PubMed1991

[The development of endogenous inner ear hearing loss due to occupational noise exposure].

Pure tone audiograms of 80 workmen with preexisting endogenous cochlear hearing loss were investigated over an average of 16 years (range 10 to 26) of occupational exposure to noise. Further hearing deterioration was moderate in the majority of cases more severe hearing losses more often affected the low tone range. The pure tone threshold 0.25 to 8 kHz remained unaltered in at least one ear in 24% of cases, in the high tone range 3 to 6 kHz in 51%. The average hearing loss was least at 3 kHz, followed by 4 kHz. The average hearing loss was somewhat greater in the initially better hearing ear. Differences between the two sides mostly developed in the high and the low tone region of trough-shaped thresholds, and in the low tone region of sloping thresholds. Hearing losses were greater when preexisting impairment did not exceed 30 dB HL than in preexisting damage over 30 dB HL. The average hearing losses for 0.5, 1, 2, 3 and 4 kHz were all lower than the respective average values for noise-induced hearing loss. Thus there was no evidence of increased noise susceptibility in endogenous cochlear hearing loss, either in comparison with controls or in a comparison of the sides or frequency ranges.

Adolescent↗
PubMed1991

[Frequency dependence of the SISI test.(short increment sensitivity index). Clinical examples].

Experimental data on the influence of test frequency on the SISI-score are controversial. Comparability is limited by the diversity of experimental conditions. In a series of cases of pancochlear sudden hearing loss SISI-scores at 0.5 kHz and 3 kHz were compared. Some examples show that the sensitivity of the SISI-test at 0.5 kHz is much lower to that at 3 kHz. Low SISI-scores, of little evidence per se, have to be considered very critically in the low pitch range.

Audiometry, Pure-Tone↗
PubMed1988

[A severe late tonsillar hemorrhage 2 months postoperatively].

Tonsilloadenoidectomy performed on an 8-year old girl, in the course of which heavy bleeding from the left niche was staunched by suture ligation, was complicated from the 7th day onwards by severe haemorrhages at intervals from 5 to 25 days, causing life-threatening hypovolaemia. Haemorrhages started mostly in the early morning hours and ceased spontaneously. Revision of the left niche was undertaken shortly after the 5th bleeding two months postoperatively. After removal of the almost completely restituted mucosal covering, spreading of a haemosiderinstained canal released a massive pulsating haemorrhage which was controlled by ligation of the external carotid artery and suturing of the tonsillar bed. As the origin of the haemorrhage, an arterial lesion either by tonsil enucleation or by suture ligation is discussed. Attention is drawn to the possibility that certain branches of the external carotid artery may be positioned very close to the inferior half of the tonsil.

Adenoidectomy↗
PubMed1987

[Does pure-tone audiometry provide inferences for a vascular cause of sudden deafness?].

The theory that sudden hearing loss is caused by some form of vascular catastrophe has not been confirmed by pathological evidence, but it agrees with a number of clinical observations. But there are several pieces of experimental and clinical evidence that cast serious doubt upon a vascular hypothesis, especially the considerable variability in site and degree of cochlear and vestibular impairment. A review of the vascular anatomy of the inner ear makes it clear that many clinically observed audiometric patterns and associated partial vestibular deficits in idiopathic sudden hearing loss cannot be explained by assigning a site of presumed vascular occlusion. We investigated 166 pure tone audiograms of patients with idiopathic sudden hearing loss by using the statistical method of cluster analysis, which allow an explanation based on the vascular anatomy. Three types of audiograms could be found which differed not in shape but in the degree of hearing loss. None of them can be explained by the vascular anatomy. The three groups of audiograms with different degrees of hearing loss allowed investigations of the influence of age, sex, vestibular disturbance and vascular disease. Men are more often affected, the degree of the hearing loss is not dependent on age, vestibular disturbance, vascular disease, diabetes or smoking. The prognosis for sudden hearing loss is independent of all the investigated parameters. Our findings support the conclusion that a vascular hypothesis cannot adequately explain the clinical findings in idiopathic sudden hearing loss.

Audiometry↗
PubMed1986

[Calculation of percentage hearing loss with pocket computers].

The computation of percentage hearing loss usually uses tables giving the values. Using such tables an incorrect reading off or a miscalculation is not infrequent. A computerprogram for pocket computers in BASIC is presented, which allows to compute the percentage hearing loss according the tables for speech audiometry by Boenninghaus und Röser introduced 1958 and 1973. Additionally the computation of percentage hearing loss using the method for pure tone audiometry by Röser (1973) is possible. Some peculiarities of the diverse tables are discussed.

Audiometry, Pure-Tone↗
PubMed1986

[Malformation of the inner ear. Cerebrospinal otorrhea in stapedectomy].

Otoliquorrhoea occurred during stapedectomy (gusher) and signified a case of inner ear malformation which was not apparent on preoperative tomograms but could be demonstrated on postoperative CT scans. There was no bony separation between the irregularly dilated inner auditory canal and the vestibulum. The cochlea was not fully rotated. Intraoperative problems in such malformations may lead to further postoperative hearing impairment. Hence, we report on the clinical, operative and CT findings in order to avoid an operation in patients with similar signs and symptoms.

Adolescent↗
PubMed1983

[Functional results of tympanum drainage in chronic seromuco-tympanum--Clinical course up to 2 years following the operation].

The hearing capacity of 95 children with chronic seromuco-tympanum (SMT) treated with middle-ear ventilation tubes was studied preoperatively and for a period of up to two years after the operation. A total of 510 audiograms with the threshold of air conduction and bone conduction were evaluated. The pre-surgery audiogram shows on the average an air-bone gap of 30 dB. In the first post-surgery audiogram the air-bone gap was improved on the average by 15-20 dB. The observation carried out over a period of two years shows that in general this improvement of the hearing capacity is preserved. The treatment of SMT by middle-ear ventilation tubes and the resulting improvement of the hearing capacity prevents the negative effects on children's acquisition of speech and on their intellectual development.

Adolescent↗
PubMed1981

[Otosclerosis: surgical improvement of hearing and primary labyrinthine efficiency (author's transl)].

The result of stapedectomy in which the stapes were replaced by a Schuknecht prosthesis is examined on the basis of 156 audiograms. Of particular interest is the connection between the degree of restored hearing through surgery and the preoperative bone-conduction hearing loss. The degree of restored hearing can be proved to be independent of the preoperative performance of the inner ear, which means that in patients with a higher degree of inner-ear involvement the raising of the air-conduction hearing threshold is achieved in the same way as in patients without inner-ear involvement.

Adult↗
PubMed1981

[Air conduction or bone conduction hearing aids? Comments on hearing aids for sound conduction deafness (author's transl)].

Measuring curves and psycho-acoustical measurements are used for an investigation of the extent to which the bone-conduction hearing aid is equivalent to the air-conduction hearing aid. It can be shown that basically there is no objection against the use of a bone-conduction hearing aid (ear-level aid) for patients suffering only from sound-conduction hearing defects. The air-conduction hearing aid significantly superior in those cases where the requirements to be met by the hearing aid with respect to the frequency range (music) are higher. If the sound conduction disorder is accompanied by a sound paralgia, this means that the essentially reduced dynamic range of the bone-conduction hearing aid significantly restricts the possible applications of the bone-conduction hearing aid.

Bone Conduction↗
PubMed1980

[Audiological supervision of workers exposed to noise in Austria (author's transl)].

The recent Worker's Protection Law entails an extension of the local precautions in industries with a high noise level. In order that the necessary duties can be better accomplished the Federal Ministry for Social Administration has appointed "authorized doctors". A large proportion of these colleagues are not ENT specialists. It was therefore necessary to work out guiding principles which permit as exact and uniform an assessment of the worker as possible both at the medical examination on taking up work and at the routine audiometric checks. These guide-lines are discussed in greater detail with reference to practical examples.

Audiometry↗
PubMed1980

[Occupational hearing loss as probability diagnosis (author's transl)].

The paper discusses the question of which factors that are to be taken into consideration are of relevance to the expert in making his differential diagnosis in cases of occupational hearing loss. On the basis of the medical literature and earlier investigations the discussion is concerned with the proof of recruitment as well as with the effects of the exposure level and the exposure duration. Special reference is made to the "typical" hearing-threshold curve. The result of the examination with factor-analysis of 14,684 pure tone audiograms suggests that a small involvement of low and medium frequencies in the hearing loss is especially typical of occupational hearing losses. Not even this method permits delineating the effects of age on hearing from those of exposure to noise. The varying (pathogenetic) exposure level has a strikingly low influence on the extent of the occupational hearing loss. The entire data resulting from 25.544 pure tone audiograms are furthermore used for the computation of hearing-loss curves of different tail probability (supposing a normal distribution). The expert has thus a means available to estimate the probability of whether or not a concrete case is still a typical example of occupational hearing loss.

Aging↗
PubMed1980

[Is the risk of noise-induced hearing damage higher for men than for women? (author's transl)].

Out of data on 25,544 workers exposed to noise three groups of the same age and of equally high exposure are selected, which serve to study the effects of the varying periods of noise exposure. A regression-analysis is made for both men and women in each group. Due to the method of analysis chosen the ascent of the regression-line (regression-coefficient) represents exclusively the effects of noise-exposure on the loss of hearing. The regression-coefficients for men and women turn out to be the same. Thus, contrary to previous studies, there is no difference between men and women in the effects of occupational noise-exposure on the ability to hear. The fact that male workers exposed to noise suffer usually from a more deteriorated sense of hearing than female workers can be explained by the increased effects of presbyacusis.

Adult↗
PubMed1979

[On the audiology of multiple sclerosis (author's transl)].

The paper reports about a female patient who developed an uncommon, unilateral, reversible hearing defect while suffering from multiple sclerosis. The tone audiogram showed a break in the hearing threshold curve down to values no longer measurable, progressing from the high to the low frequencies. There were all symptoms of a retrocochlear hearing defect. After about a month a restitutio ad integrum was achieved. The paper continues with discussions on the seat of the focus of demyelinisation with particular reference to the central part of the N. acusticus, whose myelin sheaths are formed by glia cells.

Adult↗
PubMed1979

[The effect of the noise level on the occupational hearing loss. Observations carried cut in 25,544 industrial workers (author's transl)].

The paper deals with the investigations carried out into the effects of the exposure level on the hearing thresholds in the range of 0.5--4 kHz. The investigations are based on the data of 25,544 workers exposed to noise at their working places ("noise workers"). The hearing thresholds at 0.5 and 1 kHz practically do not differ in any level class nor do they differ from the thresholds of the persons exposed to under 85 dB(A). Starting with 2 kHz the hearing loss is intensified with an increase in frequency and exposure level. The effects of the exposure levels of 85 dB(A) to 96.9 dB(A) are dependent linearly on the level; with an exposure of 85 dB(A) to 90 dB(A) to 96.9 dB(A) are dependent linearly on the level; with an exposure of 85 dB(A) to 90 dB(A) the risk of a noise-induced damages to be paid to the person concerned, is nearly as high as with exposures of 90 dB(A) to 96.9 dB(A). At exposures of under 85 dB(A) the hearing losses are significantly smaller. These data suggest that 85 dB(A) must be regarded as the critical intensity. A difference in the development of noise-induced hearing losses dependent on the exposure level was not discovered; in all level classes examined the hearing loss develops linearly to the number of noise-years.

Adult↗
PubMed1978

[Sudden deafness: the audiometric profile (author's transl)].

34 cases of unilateral idiopathic sudden deafness were subjected to an intensive audiometrical examination programme. The average hearing loss in percent (calculated on the basis of the pure tone audiogram according to D. Röser, 1973) amounted to 71.6% prior to treatment, the average sound audiogram corresponding to a pantonal hearing defect. The percent gain in audition due to the treatment averaged 24.3%. The pretherapy hearing defect is greater in older patients, and therapy is much less successful in older than in younger patients. If treatment is started within 7 days, it is considerably more successful than in those cases where it is started a long time after the beginning of the disease. This, however, is no proof of the effectiveness of early treatment, but might also be due to the high rate of spontaneous remissions. The final stage of healing or partial recovery is reached, on the average, 20 days after the onset of the illness. In nearly all patients a recruitment was proved to exist; this means that most cases were cochlear hearing defects. The results are compared with the statements contained in medical literature, and an attempt is made to interpret diverging results.

Age Factors↗
PubMed1978

[Noise-induced hearing loss and the sisi test. on the assessment of noise-induced hearing loss (author's transl)].

In the assessment of noise-induced hearing loss problems arise mainly in those cases where the middle frequencies are involved in the hearing defects at a proportionally high degree, because this strongly impairs the speech discrimination and because such a hearing defect cannot be regarded as a typical case of noise-induced hearing loss. A recruitment test must be carried out in the middle or lower frequency range in order to diagnose any possible multifactorial genesis of the hearing defect. As concerns the widely used SISI test the result is shown to depend not only on the test intensity but also on the test frequency. Since the hearing threshold in the middle under discussion is usually better in the middle and lower frequency ranges than in the higher ones and since, as a consequence, the test intensity in the SISI test is lower, frequently lower SISI values can be observed here than in the case of higher frequencies. Since the test of the lower frequencies results in lower SISI values than for higher frequencies also in those cases where the hearing threshold in the lower frequency range is the same or even worse, we must assume that the results of the SISI test depend on the frequency. In the examination of patients with a hearing defect where the hearing threshold curve flattens obliquely, intensity dependence and frequency dependence are added in the lower frequency range; negative SISI values are not infrequent. It is not admissible to conclude from that a retrocochlear defect in the middle and lower frequency ranges in cases of noise-induced hearing loss in the high-tone range.

Audiometry↗
PubMed1977

[Speech discrimination and dynamic compression. A comparative study with hearing aids (author's transl)].

A hearing aid with dynamic compression and the very same one without dynamic compression were used for an examination of 13 patients with recruitment who were hard of hearing with respect to sound perception. The maximum degree of speech discrimination possible to be reached was determined. Although in general the hearing aid with dynamic compression yielded better results, the differences between the two aids were, however, small and showed a high scattering range. Thus, we have to draw the conclusion that the lacking 100% speech discrimination in the case of recruitment-positive disorders with respect to sound perception is not due to distorted sound volume dynamics.

Hearing Aids↗