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D Mrowinski

Publications and source records attributed to D Mrowinski.

At least 19 recordsLinked to original sources
PubMed1992

[Effect of decreased and lost high frequency hearing on latency of acoustically evoked brain stem reaction].

The diagnosis of retrocochlear damage is supported by an increased latency difference between peak I and peak V. In case of high frequency hearing loss peak I is often hard to determine, and peak V latency may be shifted not only by neural delay, but also by missing basal hair cells. The amount of cochlear delay can be estimated by a procedure presented here. High frequency decay was simulated by steep high-pass noise masking. Peak V latency turned out to be established by the highest unaffected frequency components of the click stimulus. Thus, in case of a high frequency gap (with normalization towards higher frequencies) latency may be almost normal. In case of prolonged latency the amount ascribable to the cochlea may be rather precisely be estimated. If the whole lag is explained this way, unnecessary further diagnostics can be avoided.

Audiometry, Evoked Response↗
PubMed1991

Low-frequency masking of brainstem potentials.

The phase and intensity dependence of masking a click by a loud low-frequency tone was examined with brainstem potentials. Wave V latency is practically unaffected; its amplitude, however, is maximally suppressed at a phase of 270 degrees, i.e. rarefaction in the ear canal and basilar membrane displacement towards the scala tympani. Corresponding to subjective threshold, a minor suppression is also observed for the opposite deflection. In the phase of maximal suppression, wave V can be cancelled by a 30 Hz tone of 115 dB SPL up to click intensities of 40 dB HL. With cochlear damage, total suppression can be achieved at even higher click intensities as long as they are close to the subjective threshold. Low-frequency suppression is discussed as a tool applicable for early diagnosis of endolymphatic hydrops.

Acoustic Stimulation↗
PubMed1989

[Brain stem evoked response audiometry study with a bone conduction receiver in atresia of the auditory canal and microtia].

Conductive hearing loss may be determined from the latency delay of the brainstem auditory evoked response Jewett V, if other reasons that may prolong latency are ruled out. Therefore it is important to determine the bone conduction threshold when examining infants. Two bone vibrators have been chosen, which, with the help of "inverse filtering", provide the possibility of a good sound conduction of the click stimulus and thus a measurement near the hearing threshold. When applying bone vibrators to infants it must be borne in mind, that the sound transfer is reduced because the cranial sutures are not yet closed. The measurement of bone conduction is suitable for securing the result of high-grade combined hearing defects. In two cases of atresia of the external auditory canal and microtia brainstem evoked response audiometry is presented with evaluation of both air and bone conduction.

Adult↗
PubMed1989

Auditory brain stem response monitoring during middle ear surgery.

Conductive hearing loss can be determined in the course of middle ear surgery by sound probe stimulation and simultaneous recording of auditory brain stem responses. Mechanical properties of the ossicular chain, usually judged subjectively by the surgeon's visual and tactile senses, can be quantified objectively. Thus, disarticulation of ossicles can be localized precisely, and fixation of the head of the malleus can be differentiated from stapes fixation. Moreover, the function of the reconstructed ossicular chain or prosthesis may be ascertained.

Audiometry, Evoked Response↗
PubMed1988

[Is measuring impedance following ear operations an aid in the analysis of postoperative sequelae?].

While the diagnostic value of pre-operative tympanometry is undisputed, there are very few publications on its application in postoperative control of sound conduction development. We measured otoadmittance several times after middle ear surgery in 42 cases. A significant increase of maximal admittance is found over a period of up to 24 months in case of tympanoplasty type I (16 cases, Fig. 1), and after stapedectomy (8 cases, Fig. 3). After a tympanoplasty of type III (Wullsteins classification) many tympanograms were flat, even in the follow-up examination, but a tendency to improvement can also be observed (Fig. 2). In none of the groups was hearing loss correlated with otoadmittance. Thus, tympanometry is not suitable for postoperative evaluation of conductive hearing loss. Nevertheless, our results indicate that the healing process after tympanoplasty modifies middle ear sound transmission for quite a long time.

Acoustic Impedance Tests↗
PubMed1987

Auditory brainstem responses to single-slope stimuli. The influence of steepness and polarity.

Click polarity has little influence on brainstem potentials. We applied an auditory stimulus similar to a step function generated in a closed acoustic system. The influence of stimulus onset steepness (comprising rise time and intensity) on wave V latency and amplitude was investigated. A remarkable latency prolongation was observed for condensation (C) compared with rarefaction (R), if a sharp bend at the foot of the slope was avoided. The C latency lag was nearly the amount of rise time. The effect can be explained by cochlear travel time. Wave V amplitude for R slopes was significantly enhanced. At high intensity and short rise time, it reached twice the values found with C slopes, or with clicks of either polarity. Although the explanations found are not yet satisfactory, a clinical application in cochlear diagnosis is predictable.

Adult↗
PubMed1986

A long-term study of hearing in children following neonatal hyperbilirubinemia.

We conducted a long-term study of 85 children with known transient neonatal hyperbilirubinemia to determine if their hearing had been affected. None of the children had neural symptoms such as kernicterus. The children ranged in age from birth to 9 months and were studied by means of brainstem evoked response audiometry (BERA). Thirty-four of the children were studied sequentially between 15 and 80 months after the initial examination. Our results showed that there was no significant correlation between serum bilirubin concentrations and BERA thresholds or latencies. These findings indicate that, unlike manifest cases of kernicterus, neonatal hyperbilirubinemia does not affect neonatal hearing when treated promptly.

Audiometry, Evoked Response↗
PubMed1985

Brainstem and cochlea potentials evoked by rarefaction and condensation single-slope stimuli. A preliminary report.

Influences of stimulus polarity on Jewett wave V are rather small when using clicks which produce two or more polarity changes within a short time interval. In order to separate pressure changes towards rarefaction (R) and towards condensation (C) we applied steep single-slope stimuli returning very slowly to baseline. Brainstem responses recorded from 8 human subjects differed markedly for R and C onset. Amplitudes were much higher for R than for C onset. The main C response was double-peaked with the first peak appearing about 0.5 ms earlier and the second, higher one, 1 ms later than the predominant R wave. The transition from single-slope to click stimulation was investigated by combining R and C slopes. For large time intervals, independent responses to either slope were observed. Down to an on/off interval of 1 ms, the on-response predominated. For still shorter intervals an equalization of R and C responses and a graduation towards click responses was found. Using the same stimuli, cochlear microphonics (CM) and compound action potentials (CAP) were recorded from 7 guinea pigs. The CM did not replicate the slow off-motion of the single-slope stimulus, but returned back to baseline after 0.6 ms. The C compared with R latency of the CAP (peak N1) was also delayed by 0.6 ms. This delay, and that of human peak V, may be explained by CAP initiation only by one direction of basilar membrane motion.

Acoustic Stimulation↗
PubMed1985

[Latency behavior of early acoustic evoked potentials in inner ear hearing loss].

In 101 patients suffering from sensory hearing loss the latency of the auditory evoked brain stem potentials was investigated. In case of minor and moderate pancochlear deafness latency is found to be within normal range. In severe pancochlear hearing loss above 80 dB latency is significantly delayed. In basocochlear hearing disorders the latency-delay is depending on the extent of the frequency loss and on the degree of pure tone threshold shift. If the patient is suffering from a high frequency hearing loss, normal latency will be found in the higher stimulus levels whereas within low levels latency tends to be delayed depending on the cut-off frequency. A general prolongation of latency across all sound pressure levels will take place in cases with steep forms of high frequency hearing loss. For the purpose of investigating the wave-I-latency we used an earcanal electrode in some patients. It can be shown, that in cochlear hearing disorders the latency of wave V is delayed to the same extent as the latency of wave V. After discussing model studies reference values of wave-V-delay as a function of the degree of high frequency disorders are listed

Audiometry, Pure-Tone↗
PubMed1979

Chronic and acute transtentorial herniation with tumours of the posterior cranial fossa.

In patients with expanding lesions of the posterior fossa general hyper-reflexia (and bilateral latency shifts of auditory evoked brain stem potentials) have been noted as possible symptoms of chronic ascending transtentorial herniation. After ventricular tap, this chronic herniation may evolve into acute herniation with progressive reduction of consciousness which in our experience can only be survived by decompression of the compressed brain stem. The chronic transtentorial herniation is related morphologically to demyelination of the pyramidal tracts and the auditory pathways, whereas the acute transtentorial herniation is related to microcirculatory disturbances in the reticular formation of the mesencephalo-pontine junction.

Auditory Pathways↗
PubMed1979

[Objective diagnosis of recruitment by brainstem audiometry (author's transl)].

The differential diagnosis in cochlear damage with brainstem potentials is easily done by looking for normal latencies that coincide with substantial hearing loss. Further validation can now be achieved with methods representing Fowler and SISI test equivalents. Amplitudes of brainstem potential were compared in 28 patients with marked differences of hearing loss in either ear. Amplitudes are balanced at the stimulus intensity corresponding to subjective loudness balance (Fig. 3). Intersubject comparison of input/output function steepness is not advisable because of the greater interindividual variation of amplitudes (Fig. 2). Amplitude modulation by short Gauss-shaped increments (Fig. 1) or by decrements of a continuous tone evokes clear brainstem potentials at thresholds of about 5dB above subjective detection, but it also depends upon stimulus duration or steepness (Fib. 4), frequency (Fig. 5) and the degree of modulation (Fig. 6). With a cochlear hearing loss of more than 40dB, a 1 dB increment evokes potentials for continuous tone intensities higher than 20 dB above subjective thresholds (Fig. 7). This test is mainly useful for children with retarded language development and lacking a stapedius reflex, for adults, who cannot sufficiently cooperate, and where there is a prolonged latency due to middle ear damage or a steep high frequency loss.

Audiometry↗
PubMed1979

[The complex tympanic membrane impedance in various middle ear disturbances (author's transl)].

Clinical experience with two-component registration (Susceptance and Conductance) of the tympanic membrane impedance at two frequencies (220 and 660 Hz) is reported. More than 1000 results of the last 6 years have been evaluated. The normal tympanometric shape is confirmed by computer simulation. More information about mass and elasticity relations of the middle ear is obtained by the complex registration at 660 Hz. Clinical examples are presented to demonstrate the influence of scars on the ear drum and of a disruption of the ossicular chain. In 77 cases of otosclerosis with stapes fixation, as confirmed by operation, the shape of the pressure-dependent admittance is significantly narrower than in normal hearing ears. For a glomus tumor a pulsation of the oto-admittance following the electro-cardiogram can be shown. In a classification of the tympanometric types the different shapes correspond well to the set of functional finding (normal) ears, otosclerosis, Eustachian tube malfunction, processes of the middle ear cavity, post operation state). The extreme sensitivity of the method, however, produces a small group of unpredictable results for each type. So differential diagnosis is to be done by usual audiometric methods or microscopy of the ear drum.

Acoustic Impedance Tests↗
PubMed1978

[Quantitative results of the brainstem audiometry in middle ear, cochlear, and retrocochlear hearing damage (author's transl)].

After a discussion of the technique and validity of the objective audiometry using acoustically evoked brainstem potentials, we demonstrate the shape of potentials at various locations of the scalp. We compare the objective findings for middle and inner ear hearing losses with the subjective audiogram. Disturbances in the middle ear are marked through a letency shift corresponding to the hearing loss with normal bone conducted reaction. When the cochlea is damaged we notice a quick decrease in amplitude from the loudnesscompensation to the threshold with normal latencies. As examples for retro-cochlear damages we give the cases of a child, retarded after encephalitis, of an infant and of a patient with stato-acoustic neurinoma, whereby also the cochlear, subcortical and cortical potentials are evaluated.

Acoustic Stimulation↗
PubMed1978

[Examination of patients with normal and abnormal voice by pneumotachography (author's transl)].

22 patients with normal vocal function and 33 with voice disorders were examined by pneumotachography. The degree of air-flow speed during phonation, the volume of air during phonation, and the duration of phonation were studied in 17 dysphonic patients with complete closure of the glottis, 16 patients with incomplete glottic closure, and 19 euphonic (control) patients. The following results were obtained: 1. The parameters of the study are dependent upon the intensity of phonation. 2. The values of the normal group and the dysphonic patients with complete closure of the glottis during phonation are approximately the same. 3. The values of dysphonic patients with incomplete closure of the glottis are significantly different from the other two groups. According to the results obtained, pneumotachography appears to be a useful method in the evaluation of laryngeal function. Its advantage consists of determining measurable values which are particularly important for followup examinations during treatment. However, the procedure should be used only as part of the complete phoniatric examination.

Air↗
PubMed1977

[Damages of the auditory pathway at brain stem level investigated by acoustically evoked potentials (author's transl)].

In 57 patients with operated expansive tumors in the postcranial fossa auditory evoked brain stem potentials were investigated. A group of 36 with neurological evidence for the brain stem compression showed significantly prolonged latencies (Fig. 1), whereas the evoked potentials were nearly normal in the preceding state of CSF circulatory disturbances (21 cases). For one patient with a neurinoma of the right trigeminal root the post-operative reduction of the pathological latency shift is demonstrated (Fig. 2). Latency evaluation of evoked brain stem potentials are used in our clinical routine for differential diagnosis of retrocochlear hearing damages.

Acoustic Stimulation↗
PubMed1977

[The investigation of different types of vocal disorder by statistical frequency analysis (author's transl)].

Common disorders of the vocal cords were assessed by indirect and direct laryngoscopy and by stroboscopy, and they were compared over the frequency range of "a". Amplitude and frequency variations from the normal are illustrated in recurrent laryngeal nerve paralysis, intubation granuloma, chronic oedema, the hyperkeratosis of chronic laryngitis, hypokinesia and hypokinetic dysphonia. In several cases, the effects of exercise or previous surgery are demonstrated. The described technique gives a useful aid to the management of vocal cord disease.

Aged↗