PubMed HealthSearch

Biomedical subjects

F H Bess

Publications and source records attributed to F H Bess.

At least 19 recordsLinked to original sources

Identification and management of children with minimal hearing loss.

Throughout the last two decades, we have witnessed a gradual change in the audiological profile of the hearing-impaired child. The number of children with severe to profound hearing losses seems to be declining, while those with minimal losses seems to be increasing. Such losses include unilateral sensorineural, mild bilateral sensorineural, and bilateral conductive hearing loss. Historically, children with minimal hearing loss have received limited attention from physicians, audiologists, or educators. It has been assumed that minimally hearing-impaired children will exhibit few, if any, handicaps and require no special assistance in the academic setting. Recent evidence challenges that assumption, however, and suggests that, in fact, children with minimal hearing loss can demonstrate significant academic and communicative difficulties. It is recommended that children with minimal hearing impairment be considered at high risk for communication and educational difficulties and that assessments be made early in order to identify problems and implement management programs.

Child

Deriving criteria for hearing impairment in the elderly: a functional approach.

We describe a method for deriving criteria for hearing impairment in the elderly based on self-reported handicap. Using the Sickness Impact Profile (SIP) and Hearing Handicap Inventory for the Elderly - Screening (HHIE-S) version as functional measures of handicap, the analysis proceeded in five steps: 1. Audiometric thresholds at various frequencies were inter-correlated. This was done both within and between ears. 2. Better and poorer ear thresholds were determined for each frequency, and these were correlated with the HHIE-S and SIP scores. 3. Using the HHIE-S and SIP scores as dependent variables, stepwise multiple linear regressions were used to select the frequencies that explained the most variance in the functional scales. 4. Using the HHIE-S and SIP as standards, receiver operating curves were constructed for each frequency to select the threshold level that provided the best test accuracy. 5. The newly-derived criteria were then compared against four other "traditional" criteria of hearing impairment. In general, the newly-derived criteria combined a relatively low frequency with a relatively high frequency, with the low frequency being functionally more important. Depending on the functional scale used, the threshold level was in the 25 to 35-dB range for the lower frequencies and 40 to 45-dB for the higher frequencies. These features provide a suitable compromise to the current debate over which threshold levels comprise the best discrimination of aged persons who are hearing-impaired. Future research should focus on developing consensus standards for functional hearing impairment and handicap in the elderly.

Age Factors

Glomus tumor of the middle ear: origin, symptomatology, and treatment.

The glomus tumor is considered to be the most common of all tumors that involve the middle ear. This report defines the glomus tumor and discusses the symptomatology of the tumor with respect to the various developmental courses it may follow. Forty clinical cases of glomus tumor are reviewed, with emphasis upon the incidence of the tumor and its symptoms, including the audiological manifestations noted in this series of cases. Current medical management of the glomus tumor recommends surgical removal of the lesion when possible; however, irradiation and embolization of the tumor may also be considered when its invasion into surrounding structures has been extensive. The pathology and its treatment may have marked temporary or permanent effects upon the hearing of the patient, and the importance of ongoing audiological management is therefore emphasized.

Acoustic Impedance Tests

Further observations on noise levels in infant incubators.

The purpose of this study was to conduct an acoustic analysis of incubator noise under two conditions: when the incubator was associated with different types of life-support equipment; and when impulse noise was created by striking the side of the incubator or by opening and closing the doors of the storage unit. It was found that the life-support equipment increased the overall noise levels of incubators by as much as 15 to 20 dB. Much of this increased energy was in the high frequency region. Impulse signals created by striking the side of the incubator ranged from 130 to 140 dB. A representative impulse for opening the incubator was 92.8 dB, whereas closing the door produced a peak amplitude of 114 dB.

Hearing Loss, Noise-Induced

Two experiments on subtle mid-frequency hearing loss and its influence on word discrimination in noise-exposed listeners.

The present study consisted of two experiments. Experiment I was directed toward the detection of subtle mid-frequency cochlear dysfunction and the determination of word discrimination in noise for persons with noise-induced hearing loss. The presence of significantly elevated aural-overload thresholds, consistent with the presence of cochlear pathology in regions of normal pure-tone sensitivity, confirmed previous findings obtained with this subject population by other investigators. In addition, a marked reduction in word discrimination was observed in the presence of a background of competing noise. For experiment II, normal hearers listened to consonant-nucleus-consonant monosyllables filtered to match the mean audiometric configuration of the noise-exposed subjects in experiment I. Results showed significantly better performance with these filtered words by the normally hearing subjects than that by the noise-exposed group for unfiltered materials. The results of the second experiment were interpreted as providing further support for the presence of subtle auditory dysfunction in the mid-frequencies despite normal threshold sensitivity in this same frequency region.

Acoustic Stimulation

Performance intensity functions in cochlear and eighth nerve disorders.

In this report, performance intensity functions for monosyllabic materials (PI-PB) were obtained on two groups of subject: 20 patients with eighth nerve pathology and 15 individuals with Meniere's disease. The subjects with retrocochlear involvement exhibited marked deterioration in word recognition as the speech intensity was increased beyond the level required for a maximum discrimination score. Such a dramatic breakdown, referred to as the "rollover effect," was not seen to occur among the subjects with cochlear disorders. Hence, the PI-PB function appears to be a valuable tool for use in the special test battery.

Adolescent

Word discrimination for listeners with flat sensorineural hearing losses.

This study examined discrimination scores among listeners (742 ears) with flat sensorineural hearing losses. The discrimination data were analyzed in terms of degree of hearing impairment and subject age. Contrary to previous findings, the results showed that the average subject exhibited a discriminative ability of 70% or better for hearing levels less than 60 dB. A 10 to 20% decline in intelligibility, however, was found for losses 60 dB and greater. Listeners' performance decreased somewhat as a function of age especially for subjects with the greatest hearing losses. Finally, a subject's word discrimination was similar whether hearing loss was based on a three- or a five-frequency average.

Adolescent

Split-half reliability of two word discrimination tests as a function of primary-to-secondary ratio.

Two clinical word discrimination tests, the Northwestern University Auditory Test No. 6 (NU-6) and the Modified Rhyme Test (MRT), were examined for internal consistency and for split-half reliability under varying primary-to-secondary ratios (P:S) in normal hearers. Although the statistical analysis indicated that half-lists could be used reliably for both discrimination tests at most P:S conditions, the wide variability found among individual listeners does not support the clinical practice of half-list testing in noise--at least not for normal-hearing listeners.

Adult

Intelligibility of time-altered speech in relation to chronological aging.

The Northwestern University Auditory Test Number 6 (NU-6) measure of speech discrimination was time compressed and presented to four age groups ranging from 54 to 84 years of age. Experimental stimuli were presented at sensation levels of 24, 32, and 40 dB to an equal number of right and left ears and male and female subjects. Results indicated that intelligibility decreased as a function of increasing time compression and age and decreasing sensation level. Changes in speech intelligibility associated with the aging process appear to be closely allied to changes in the temporal resolving power of the central auditory processing system.

Adult

Audiometric, impedance, and otoscopic findings in children with cleft palates.

We examined the prevalence of hearing loss and/or middle ear disease among 34 children with cleft palates, using pure-tone audiometry, acoustic impedance, and pneumatic otoscopy. The overall incidence of hearing loss and otitic complications varied from 57% to 68%, depending on the procedure used. Of the three clinical procedures used in this study, pure-tone audiometry exhibited the poorest diagnostic efficiency. Close predictive agreement was found between impedance and otoscopy.

Adolescent

Acoustic reflex relaxation in sensorineural hearing loss.

This study examined stapedial reflex recordings of pulsed pure tones (500, 1,000, 2,000, and 4,000 Hz) in 26 subjects with normal hearing and 18 with sensorineural impairment. The stapedial reflex tracings clearly differentiated the two groups of subjects. Like many of our special audiometric procedures, this test was least effective in those with mild hearing loss. The test also appeared to be useful in identifying high-frequency hearing losses. Although this reflex measurement appears to have potential as a clinical tool, additional field study appears necessary.

Acoustic Stimulation

Acoustic impedance measurements in cleft-palate children.

Clinical acoustic impedance findings in a group of 40 children with cleft lip or palate and a group of 20 noncleft children are presented. The cleft subjects exhibited a high incidence of hearing loss and aural pathology. The data suggest that impedance measurements lend pertinent supportive information to routine puretone audiometric testing in the detection and management of middle-ear disease in the cleft-palate population.

Adolescent

Hearing sensitivity in rural Michigan.

In a survey of the hearing sensitivity of a rural mid-Michigan population, 1,325 adults over 15 years of age received pure tone air conduction tests in a "mini" IAC room housed in a small trailer. In addition, a detailed questionnaire was administered to each person to obtain information about his exposure to noise vocationally and avocationally, family history of hearing loss, etc. Results indicated that, on the average, individuals displayed hearing losses considerably greater than was predicted on the basis of presbycusis alone. Also, people who had never had any industrial noise exposure had thresholds almost as poor as those who had worked in factories. These findings are discussed in view of the subject's exposure to various types of nonoccupational noise such as snowmobiles and motorcycles.

Adolescent

Acupuncture and transdermal electrostimulation in the treatment of deafness.

A review and critique of the research on acupuncture and transdermal electrostimulation therapy in treating sensorineural hearing loss is presented. Of 111 subjects in these studies were noted to exhibit a decrease in hearing sensitivity. Additional data collected at our clinics on four preschool hearing-impaired children failed to provide evidence of improvement following acupuncture. Similar results are reported with transdermal therapy, suggesting that both procedures are inappropriate for the treatment of sensorineural hearing loss.

Acupuncture Therapy

A test battery approach to the investigation of susceptibility to temporary threshold shift.

This study examined individual differences among various psychophysical measures that have been suggested previously as predictors of susceptibility to noise-induced temporary threshold shift (TTS). The test battery was administered to a group of five normal-hearing young adults and consisted of the following procedures: (1) critical intensity (CI) at 2 kHz; (2) loudness discomfort level (LDL) at 0.5, 1, 2 and 4 kHz; (3) aural overload thresholds at 0.5, 1 and 2 kHz. Three measures of TTS, one employing a broad-band noise as the exposure stimulus and two others using tonal fatiguers, were utilized to assess susceptibility to TTS. Results revealed that the test battery delineated tough from tender ears. Furthermore, the aural overload test was found to be a highly accurate predictor of TTS.

Acoustic Impedance Tests