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D T Ries

Publications and source records attributed to D T Ries.

9 recordsLinked to original sources
PubMed1999

The peaked audiometric configuration in Meniere's disease: disease related?

A retrospective analysis of audiograms was completed for persons from 3 different patient groups. These 3 groups were (1) persons with unilateral Meniere's disease, (2) persons with unilateral acoustic tumor, and (3) persons from the general clinical population of an audiology clinic in a major medical center. As Paparella, McDermott, Luiz, and de Sousa (1982) also report, the most common audiometric configuration in the Meniere's disease group was peaked, a condition in which poorer hearing is reported in the low and high frequencies, and an island of better hearing sensitivity occurs at either 1.0 or 2.0 kHz. Some of the peaked audiograms from persons in our Meniere's disease group could be a result of a low-frequency hearing loss caused by Meniere's disease combined with a high-frequency hearing loss due to aging or other environmental factors. However, 27% (13/48) of the peaked audiograms in ears with Meniere's disease were found in persons with no hearing loss in the high frequencies of their nondiseased ear. Thus, the peaked audiometric configuration is associated with Meniere's disease, as suggested by research results from animals with experimentally induced endolymphatic hydrops. Peaked audiometric configurations were also observed in roughly 9% of the general clinical population and in 12.5% of ears of persons with acoustic tumors. A rule--based on the audiometric configurations that maximized identification of patients with Meniere's disease--using the general clinical population as a control did not fare as well when the tumor group was used as a control. This finding provides further evidence that peaked audiograms, although common to Meniere's disease, are not pathognomonic of this disease. Furthermore, these results indicate that the diagnosis of Meniere's disease from audiometric profiles is risky, at best.

Adult↗
PubMed1999

Safety and clinical performance of acoustic reflex tests.

OBJECTIVE: Safety and effectiveness of acoustic reflex tests are important issues because these tests are widely applied to screen for retrocochlear pathology. Previous studies have reported moderately high sensitivity and specificity for detection of acoustic neuroma. However, there have been reports of possible iatrogenic hearing loss resulting from acoustic reflex threshold (ART) and decay (ARD) tests. This study assessed safety and clinical performance of ART tests for detection of acoustic neuroma. DESIGN: We report a case in which ARD testing resulted in a significant bilateral permanent threshold shift. This case was the impetus for us to investigate the clinical utility of ART and ARD tests. We analyzed sensitivity and specificity of ART, as well as asymmetry in pure-tone thresholds (PTT) for detection of acoustic neuroma in 56 tumor and 108 non-tumor ears. RESULTS AND CONCLUSIONS: Sensitivity and specificity were higher for PTT asymmetry than for ART. Ipsilateral ART at 1000 Hz had poor sensitivity and specificity for detection of acoustic neuroma, and involves some potential risk to residual hearing for presentation levels higher than 115 dB SPL. Approximately half of the acoustic neuroma group had ipsilateral ARTs that would require administration of ARD tests at levels exceeding 115 dB SPL. Therefore, we conclude that PTT asymmetry is a more effective test for detection of acoustic neuroma, and involves no risk to residual hearing. Future studies of contralateral reflex threshold and ARD in combination with PTT asymmetry are recommended.

Adult↗
PubMed1999

Masker laterality and cueing in forward-masked intensity discrimination.

Forward-masked intensity discrimination was measured as a function of level in experiments designed to reveal insights into the mechanism(s) underlying the midlevel elevation of the Weber fraction. The standard and maskers were 1.0-kHz tones that were separated by 100 ms. Performance was measured for listeners with normal hearing using an adaptive procedure. In experiment 1, intensity discrimination was measured in the presence of an ipsilateral masker (80 dB SPL), a contralateral masker (93 dB SPL), and a binaural (dichotic) masker produced by combining the ipsilateral and contralateral maskers. Listeners perceived only the contralateral masker in the binaural-masker condition. The contralateral masker produced a small midlevel elevation of the Weber fraction. The ipsilateral masker and the binaural masker produced a large, midlevel elevation of the Weber fraction. Experiment 2 found that a two-tone masker resulted in a reduction (improvement) in the Weber fraction for some conditions, but the midlevel elevation remained for all subjects in this cue-tone condition. Experiment 3 demonstrated that cross talk could not account for all of the masking observed with contralateral maskers. Taken together, the results suggest that a single complex mechanism or multiple mechanisms may be responsible for the masking seen in these experiments. On the basis of the cueing results, it is concluded that a portion of the masking is due to cognitive factors; however, a sensory mechanism cannot be ruled out for the remaining portion, based on the results of these experiments. Finally, a small but significant amount of masking due to contralateral maskers places the mechanism for this outcome central to the cochlear nucleus.

Adult↗
PubMed1998

Basilar membrane nonlinearity and loudness.

Loudness matching functions for tones for persons with one shifted-threshold ear (hearing loss and noise-shifted thresholds) and one ear within normal limits were used to derive the presumed basilar membrane (BM) input-output (I/O) function in a normal ear. The comparison was made by assuming that the BM I/O function for the ear with the cochlear threshold shift has a slope of one (a linearized cochlea). The function for the normal ear was derived from the loudness matching function based on this assumption. Comparisons were made for archival basilar membrane data [M. A. Ruggero, N. C. Rich, A. Recio, S. S. Narayan, and L. Robles, J. Acoust. Soc. Am. 101, 2151-2163 (1997)] for chinchilla and archival loudness matches for long-duration tones for persons with various degrees of cochlear hearing loss [F. Miskolczy-Fodor, J. Acoust Soc. Am. 32, 486-492 (1960)]. Comparisons were made also between BM I/O functions and ones derived from loudness matches for persons with unilateral hearing loss simulated by broadband noise. The results show a close resemblance between the basilar membrane I/O function and the function derived from loudness matches for long-duration tones, even though the comparison was between human and chinchilla data. As the degree of threshold shift increases from 40 to 80 dB, the derived BM I/O functions become shallower, with slopes for losses of 60 dB or more falling in the range of values reported for physiological data. Additional measures with short-duration tones in noise show that the slope of the loudness function and the slope of the derived basilar membrane I/O function are associated with the behavioral threshold for the tone. The results for long-duration tones suggest a correspondence between BM displacement and loudness perception in cases of recruitment, but the relation between the degree of loss and the amount of BM compression and the relation between signal duration and compression suggests that other factors, such as the neural population response, may play a role.

Adult↗
PubMed1992

Episodic crises: does dementia make a difference?

Preventing episodic crises in residents with and without dementia is possible when staff learns how to identify "signaling events": changes in behavior or life status, physiological symptoms, or other complaints.

Aged↗