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Biomedical subjects

E Arslan

Publications and source records attributed to E Arslan.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Neonatal screening: risk factors and outcome in 4400 children].

The aim of this study was to determine the incidence of neonatal deafness and how effective screening could be in a cohort of infants under the national health service in Mestre Venice. The criteria used in the screening of a population at risk were those established by the JCIH (1990). All the children born between September 1992 and August 1995 (4408 infants) were examined in an attempt to identify risk factors. The children presenting one or more risk factors and those admitted to neonatal intensive care for any reason were submitted to ABR testing. The results were considered negative if the wave V was perceived at an intensity < or = 40 dB nHL. Of the 4408 children screened, a total of 5 were found with a degree of deafness in excess of 50 dB HL. Three children were found to be at risk while two had a silent history. In terms of etiology, 2 children showed genetic transmission, one there had a 21 trisomia while it proved impossible to determine the cause of deafness in the remaining two. As indicated in other studies, application of a risk register makes it possible to identify congenital deafness in 50-60% of the cases. For this reason the authors consider mass screening through the use of oto-acoustic emissions to be quite useful.

Acoustic Stimulation↗
PubMed1995

[Speech perception test in Italian language for profoundly deaf children].

Speech perception tests are an important part of procedures for diagnosing pre-verbal hearing loss. Merely establishing a child's hearing threshold with and without a hearing aid is not sufficient to ensure an adequate evaluation with a view to selecting cases suitable for cochlear implants because it fails to indicate the real benefit obtained from using a conventional hearing aid reliably. Speech perception tests have proved useful not only for patient selection, but also for subsequent evaluation of the efficacy of new hearing aids, such as tactile devices and cochlear implants. In clinical practice, the tests most commonly adopted with small children are: The Auditory Comprehension Test (ACT), Discrimination after Training (DAT), Monosyllable, Trochee, Spondee tests (MTS), Glendonald Auditory Screening Priocedure (GASP), Early Speech Perception Test (ESP), Rather than considering specific results achieved in individual cases, reference is generally made to the four speech perception classes proposed by Moog and Geers of the CID of St. Louis. The purpose of this classification, made on the results obtained with suitably differentiated tests according to the child's age and language ability, is to detect differences in perception of a spoken message in ideal listening conditions. To date, no italian language speech perception test has been designed to establish the assessment of speech perception level in children with profound hearing impairment. We attempted, therefore, to adapt the existing English tests to the Italian language taking into consideration the differences between the two languages. Our attention focused on the ESP test since it can be applied to even very small children (2 years old). The ESP is proposed in a standard version for hearing-impaired children over the age of 6 years and in a simplified version for younger children. The rationale we used for selecting Italian words reflect the rationale established for the original version, but the choice of single words follows different criteria from the original version. In fact, the two languages differ in important linguistic features so that the test can not be not adapted to the Italian language by simply translating the words involved. As currently there is no children's language dictionary in Italian arranged according to age bracket, we chose words used in children and in pre-school reading material.

Child↗
PubMed1992

Cochlear and neural dysfunction in acoustic neuroma: can they be separately revealed by auditory brain-stem wave V latency?

Cochlear and retrocochlear lesions may be differentiated by a diagnostic index (D5), which is derived from the patient's auditory brain-stem wave V latency and pure-tone hearing threshold at 2 to 4 kHz. The D5 values obtained from 49 cases of acoustic neuroma (AN) have been shown to share some properties with D5 values of patients with cochlear hearing loss (280 cases), indicating a lesser prolongation of wave V latency in cases with pronounced hearing loss. Assuming this finding is indicative of some degree of cochlear impairment concomitant to the neural dysfunction, AN data were corrected in an attempt to remove the effects of cochlear impairment. The resulting D5 values could reflect the delay in wave V solely due to the neural dysfunction. A significant relationship between these D5 values and tumour size seems to support this hypothesis.

Adult↗
PubMed1990

Effects of different noises on speech discrimination by the elderly.

Elderly people often complain of difficulty in speech discrimination, especially in noise environments. The effects of 4 competing noises on sentence intelligibility were evaluated: speech noise, cocktail party noise, traffic noise and continuous discourse. A comparison was made between young and old normally hearing subjects and young and old hearing-impaired subjects with similar audiograms. The old people with normal hearing had slightly reduced discrimination compared to the young during competing speech noise and cocktail noise. Discrimination in the hearing-impaired elderly was also significantly worse than in the young people with normals hearing, during competing cocktail party noise, traffic noise and continuous discourse. The young hearing-impaired had results between young normal-hearing subjects and old hearing-impaired, except for continuous discourse. Thus the effects of age on speech discrimination in noise are subtle, becoming more pronounced in the presence of hearing loss. Age-related changes in primary speech discrimination were particularly evident during competing continuous discourse.

Adult↗
PubMed1988

Hearing loss in sports hunters exposed to occupational noise.

The hearing level of 133 railway workers who also hunted for sport was evaluated and compared with that of 82 non-hunting colleagues. Both groups were affected by hearing loss, mostly involving the high-frequency range. Hunters were found to differ from non-hunters by having significantly worse hearing threshold in the ear contralateral to the shoulder supporting the firearm. The interaural threshold difference at 4 kHz was related to the number of rounds fired and exposure duration, thus providing an estimate of the adverse effect of gunfire noise to which the hunters had been exposed.

Adult↗
PubMed1987

Prediction of auditory brainstem wave V latency as a diagnostic tool of sensorineural hearing loss.

The lesion location (cochlear vs. retrocochlear) of sensorineural hearing loss may be differentiated with a diagnostic index (delta V), which is calculated from the wave V latency of the monaurally evoked auditory brainstem response (ABR), and from the pure-tone hearing threshold at 2 and 4 kHz. The delta V values obtained from 80 recruiting ears have proven to correlate linearly to the amount of the hearing loss, hence allowing to define appropriate confidence boundaries for cochlear hearing losses. In contrast, the delta V values obtained from 32 ears of patients with retrocochlear lesions--cerebellopontine angle (CPA) tumors--were all found to exceed the 95% upper confidence limits projected for cochlear lesions, thus giving a 100% rate of true results in the detection of retrocochlear pathology. These results, providing an ABR parametric model for the cochlear hearing loss, suggest a diagnostic strategy for the early detection of CPA tumors based on the exclusion of a cochlear hearing loss.

Brain Stem↗
PubMed1985

Does general anaesthesia affect the child's auditory middle latency response (MLR)?

Auditory MLR and ABR were recorded simultaneously in 9 children under general anaesthesia, after electrocochleography had demonstrated a normal hearing threshold. In contrast to the ABR components which in all cases appeared to be clearly recognizable, and with latencies within the normal range, MLR revealed gross abnormalities represented by instability of the components and abnormal latency of the detectable peaks. Since such variations in the MLR pattern may be thought of as a direct consequence of general anaesthesia, it seems likely that these potentials reflect a neural activity which, in children, is affected by CNS drugs.

Anesthesia, General↗
PubMed1985

Quantitative analysis of vestibular response in cerebello-pontine angle tumors.

The results obtained by vestibular examination are reported for 20 patients with cerebellopontine angle tumours. Eye pursuits, spontaneous, positional and caloric induced nystagmus (lateral and directional preponderance for duration, frequency and speed of slow phase) were evaluated in order to identify the most sensitive parameter. Half cases showed abnormalities in eye tracking test, one third a spontaneous nystagmus, 5% only a positional nystagmus. A lateral preponderance of the healthy side was found in 95% of the cases when calculated on the slow phase velocity of the caloric nystagmus, while lower rates were obtained with duration (79%) and frequency (74%). These results suggest that an asymmetry in the speed of slow phase of the caloric nystagmus is the most relevant sign to proceed to X-ray examination, especially if found in cases where the residual hearing does not allow reliable audiometric results.

Adult↗
PubMed1984

Auditory brain-stem response and hearing threshold in cerebellopontine angle tumours.

The auditory brain-stem responses (ABR) in 19 patients with confirmed cerebellopontine angle tumours are evaluated in relation to the hearing threshold as obtained by pure-tone audiometry. ABR pathological alterations, in terms of either absence or presence of components, appear to relate to the suprathreshold stimulus intensity and to match the changes which can be observed in subjects with normal hearing, when stimulated at the equivalent suprathreshold intensity. Of the diagnostic indexes considered (I-V interval, IT5, delta V), IT5 and delta V could be evaluated in the largest patient population. They may be used in combination to enhance their sensitivity in retrocochlear lesion detection.

Audiometry↗
PubMed1984

Simultaneous recording of auditory evoked potentials. Relationships among the fast, middle and long latency components.

The whole pattern of the fast, middle and long latency auditory evoked potentials (AEP) was recorded simultaneously from the scalp surface of 13 normal-hearing adults. The individual responses were displayed on a nonlinear time axis in order to improve identification of the components. Stimulation consisted of 2048 unfiltered clicks, delivered monaurally at 80, 60, 40 dB HL with an ISI of 750 ms. Changes in mean latency and amplitude of each AEP component were statistically evaluated in relation to intensity and electrode montage (vertex-mastoid ipsi- and contralateral to the stimulated ear). The latencies of fast components I-VI and the slow P1 increase significantly with declining stimulus intensity. The amplitudes of the fast, I, II, III, V and the slow P1-N1, P2-N2 decrease significantly with intensity. As regards differences due to the electrode montage the contralateral recording causes significant changes in latency of the fast potentials up to wave IV, and changes in amplitude of the fast up to wave V, and of the slow P1-N1 and P2-N2. Therefore, as their latency and amplitude seem to be less closely related to the stimulus and electrode placement, the middle components behave differently, compared with the preceding and following components. Based on parametric comparisons of potentials ranging widely in latency, but each one evoked by an equal sensory input, this kind of AEP evaluation may be useful both for neurophysiological and clinical studies of the whole auditory pathway function.

Adult↗
PubMed1983

Electrocochleography and brainstem potentials in the diagnosis of the deaf child.

The deaf child must receive sound amplification before he reaches the age of two years. At this age the hearing threshold is best measured objectively by electrocochleography (ECochG) and auditory brainstem response (ABR) audiometry. When used correctly, both methods allow an exact threshold estimation which is informative enough for adequate hearing aid prescription. Both methods have advantages and disadvantages when used in children. The advantages of ECochG are: (a) a more exact threshold estimation and (b) strictly monaural evaluation. The advantages of ABR are: (a) ease of performance; it is not invasive and does not require general anaesthesia and (b) allows for exploration of higher levels in the auditory pathway up to the midbrain. We believe that ECochG and ABR are compatible and complementary in the diagnosis of childhood deafness. ABR could be used in first instance, while ECochG could be reserved for doubtful cases and for those who cannot be adequately sedated. Extra-audiological factors such as the availability of anaesthetists and varying hospital facilities, play a further role in determining the choice of electric response technique.

Audiometry↗
PubMed1983

Evaluation of the monaurally evoked brainstem response in the diagnosis of sensorineural hearing loss.

The auditory brainstem responses (ABRs) obtained in 47 subjects with asymmetric hearing loss (12 with surgically confirmed cerebello-pontine angle tumours, 35 without otoneurologic and/or neuroradiologic evidence of tumour) were evaluated by means of an index named delta V. The calculation of this index was based upon the patient's wave V absolute latency obtained at a fixed intensity of 90 dB HL and the value of latency predictable by means of the normative data. The index clearly separates retrocochlear from cochlear sites of lesion. Moreover delta V values obtained in defined cochlear lesions show a linear relation with the patient's pure tone hearing loss at 2 and 4 kHz; this behaviour is probably due to a reduction of the auditory dynamic range in the recruiting ears. delta V appears to have clinical usefulness because of two main points: first it is based upon an evaluation of the monaurally evoked ABR; second, it improves the diagnostic specificity of the responses. The rate of false positive results can be further reduced by combining delta V and IT5 values.

Audiometry, Evoked Response↗
PubMed1982

Clinical and audiological findings in a case of auditory agnosia.

A case is reported of severe agnosia for verbal and non-verbal sounds without associated aphasic disorder. A CT scan revealed bilateral, temporal lobe lesions from two ischaemic accidents that had occurred 9 months apart. The search for subtle deficits in the patient showed normal sensitivity to changes in the intensity and frequency of simple sounds; in contrast, his ability to discriminate sound duration and musical note sequences was severely impaired. The simultaneous recording of the whole auditory-evoked response pattern revealed no abnormality in the early components, which reflect the activation of the auditory nuclei and pathways of the brain stem. However, the middle and late components were delayed and slowed. These results and others in the literature suggest that the neocortex in man, as in other mammals, plays an essential role in the temporal aspects of hearing. Also, the two main ingredients commonly recognized in auditory agnosia, i.e. word deafness and the inability to interpret non-verbal sounds, are caused by the disruption of elementary, bilaterally represented cortical functions which start the processing of every kind of auditory information.

Agnosia↗
PubMed1982

Logarithmic display of auditory evoked potentials.

Auditory evoked potentials (AEP) can be simultaneously recorded on-line as a succession of 11 waves, through a single input channel of a mini-computer. Since the response waves differ widely in frequency, a computing routine has been developed to display the whole response pattern in a single picture. Based upon a non-linear samples reduction of the digitized response, this routine allows a logarithmic transformation of the time axis. The method improves the identification of the AEP components and provides an objective estimate of the central auditory pathway for both neurophysiological and neuroclinical studies.

Computers↗
PubMed1982

Phonometric study of the human first heart sound.

The first heart sound was studied in 20 normal subjects. The phonocardiogram (PCG) was recorded from apical and mid-precordial areas using microphone with a flat response curve from 0.2 to 8,000 Hz. It was stored, together with a simultaneous electrocardiogram, on an FM analog tape recorder (linear frequency response from 0 to 4,000 Hz), fitted with a filter with weighting curve B according to the American National Standard Institute. A linear (SPL) recording was also made. The signal was fed through a digital converter into a minicomputer and the frequency distribution of the first heart sound was analyzed using Fast Fourier Transform. These data were stored and the average spectra were calculated for both B and SPL. The SPL spectra from both apex and mid-precordium showed a maximum intensity of about 80 dB between 12-20 Hz, decreasing progressively to a constant level of 35 dB between 110-120 Hz. The spectra obtained from both areas using filter B showed a maximum intensity of 40-50 dB between 20-60 thereafter. It is important to emphasize that the dB values in B and SPL are absolute, since they refer to a standard reference weighting. It appears that the SPL recording is more valuable in that it allows the study of all components of the PCG signal. The spectra obtained in this study will be used as a standard for future research in various pathological conditions.

Adolescent↗