Biomedical subjects

Emmanuel A M Mylanus

Publications and source records attributed to Emmanuel A M Mylanus.

21 records · Page 2Linked to original sources

PubMed2002

The bone-anchored hearing aid in patients with a unilateral air-bone gap.

OBJECTIVES: To study the benefit of the application of a bone-anchored hearing aid in patients with a unilateral air-bone gap. STUDY DESIGN: Prospective evaluation in eight patients. METHODS: Binaural hearing was assessed in the sound field by comparing aided and unaided scores obtained with a sound localization test and a speech recognition in noise test with spatially separated sound and noise sources. SETTING: Tertiary referral center. PATIENTS: The patients had subnormal hearing and unilateral conductive hearing loss. RESULTS: Sound localization improved significantly in the six patients with acquired hearing loss. The binaural advantage, studied with speech-in-noise tests with spatially separated speech and noise sources, proved to be comparable with that in a control group of subjects with normal hearing when they were listening monaurally versus binaurally. For one of the two patients with unilateral congenital conductive hearing loss, the results were ambiguous. This patient's age at the time of surgery was high: 40 years (the other patient was 19 years old at the time of surgery). This might have played a role. CONCLUSION: If reconstructive surgery is not possible (e.g., in a patient with a chronically draining ear or a severe congenital malformation), a bone-anchored hearing aid is an option to reestablish binaural hearing. The results reported herein suggest that, at least for patients with acquired hearing loss, the bone-anchored hearing aid is an effective treatment of unilateral conductive hearing loss.

Acoustic Stimulation↗

PubMed2002

Craniofacial titanium implants and chronic pain: histologic findings.

OBJECTIVE: To determine whether histologic features or histomorphometric outcomes of retrieved craniofacial percutaneous titanium implants could be found that could be related to chronic pain at the implant site in the temporal bone. STUDY DESIGN: Histologic investigation and histomorphometric measurements of seven retrieved titanium implants with surrounding bone tissue. SETTING: Tertiairy referral center. PATIENTS AND METHODS: Four patients who had previously received percutaneous titanium implants for auricular prostheses (1 patient) and a bone anchored hearing aid (three patients) had chronic pain at the implant site despite conservative treatment. The implants were retrieved, sectioned, and ground for qualitative light microscopic inspection and quantitative measurement of the bone-to-metal contact and bone area. RESULTS: Qualitative inspection of the sections of the implants demonstrated soft tissue zones at the interface, especially under the flange. Inflammatory cells were seen in the interface in all seven implants. In the implants with good bone-to-metal contact, the percentage of bone-to-metal contact rose with time. In the two implants with poor bone-to-metal contact, the soft tissue zones were more extensive, and slightly more skin reactions were observed than in the other implants while still in situ. CONCLUSION: A clear explanation for the chronic pain is not at hand. The only common histologic findings were the inflammatory cells present in the interface, but with varying density, and the presence of soft tissue zones. A variety of bone-to-metal was found among the retrieved implants.

Adolescent↗

PubMedDate not supplied

Candidacy for the bone-anchored hearing aid.

The BAHA (bone-anchored hearing aid) is a bone conduction hearing aid with percutaneous transmission of sound vibrations to the skull. The device has been thoroughly evaluated by various implant groups. These studies showed that, in audiological terms, the BAHA is superior to conventional bone conduction devices. In comparison with air conduction devices, the results are ambiguous. However, a positive effect is found with respect to aural discharge. The most powerful BAHA can be applied to patients with a sensorineural hearing loss component of up to 60 dB HL. It was shown that bilateral BAHA application leads to binaural sound processing. Preliminary results on the application of the BAHA in patients with unilateral conductive hearing loss suggest that stereophonic hearing can be re-established. The application of the BAHA as a transcranial CROS (contralateral routing of signal) device in unilateral deafness minimizes head shadow effects.

Auditory Threshold↗