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Biomedical subjects

H Feiglin

Publications and source records attributed to H Feiglin.

7 recordsLinked to original sources

Cochlear implantation in healthy and otitis-prone children: a prospective study.

OBJECTIVE: To evaluate and compare the timing of surgery, intraoperative findings, and otitis media-related outcome of cochlear implantation in children who are otitis-prone with their counterparts who are not otitis-prone. STUDY DESIGN: Prospective. METHODS: Children referred for cochlear implantation were assigned to a non-otitis-prone group (group A: normal otoscopy on their first visit after referral) or an otitis-prone group (group B: current or a recent history of otitis media at referral). Group B patients were managed using a structured protocol aimed at preimplantation otitis media control. The study reviewed pre-, intra-, and postoperative data. RESULTS: Of the 18 children studied, 8 were assigned to group A (mean age at referral, 40.6 mo) and 10 to group B (mean age at referral, 31.6 mo). For otitis media control, all otitis-prone children underwent ventilating tube insertion (various numbers of procedures before implantation). Only one otitis-prone child required cortical mastoidectomy also. Time from referral to implantation was similar in the two groups (mean, 6.6 mo). High-resolution computed tomography data showed mastoid pneumatization to be significantly smaller in the otitis-prone group, but the facial recess was not smaller in this group. During implantation, 10 children had inflamed middle ear mucosa. Seven of these belonged to group B. All of these seven children had a round window niche obliterated by the inflamed mucosa, which had to be removed for round window membrane identification. After implantation, only one child had drainage through the ventilating tube for more than 1 week. Two children in group B developed otitis media (1 year postimplantation) that was overcome within 1 week. There were no otitis media-related complications. CONCLUSIONS: If a structured protocol is used for the control of otitis media before cochlear implantation, otitis media should not require a delay in implantation. In otitis media-prone children, the round window niche is often obscured by inflamed mucosa. Its removal is mandatory for identification of the round window membrane. After cochlear implantation, otitis media is not a frequent occurrence.

Acute Disease↗

Correlations between audiogram and objective hearing tests in sensorineural hearing loss.

Owing to its subjective nature, behavioral pure-tone audiometry often is an unreliable testing method in uncooperative subjects, and assessing the true hearing threshold becomes difficult. In such cases, objective tests are used for hearing-threshold determination (i.e., auditory brainstem evoked potentials [ABEP] and frequency-specific auditory evoked potentials: slow negative response at 10 msec [SN-10]). The purpose of this study was to evaluate the correlation between pure-tone audiogram shape and the predictive accuracy of SN-10 and ABEP in normal controls and in patients suffering from sensorineural hearing loss (SNHL). One-hundred-and-fifty subjects aged 15 to 70, some with normal hearing and the remainder with SNHL, were tested prospectively in a double-blind design. The battery of tests included pure-tone audiometry (air and bone conduction), speech reception threshold, ABEP, and SN-10. Patients with SNHL were divided into four categories according to audiogram shape (i.e., flat, ascending, descending, and all other shapes). The results showed that ABEP predicts behavioral thresholds at 3 kHz and 4 kHz in cases of high-frequency hearing loss. Also demonstrated was that ABEP threshold estimation at 3 kHz was not affected significantly by audiogram contour. A good correlation was observed between SN-10 and psychoacoustic thresholds at 1 kHz, the only exception being the group of subjects with ascending audiogram, in which SN-10 overestimated the hearing threshold.

Acoustic Stimulation↗

The precision level of the objective hearing tests.

A comparative study was performed with 51 patients, using the stapedial reflex (ART), early auditory brain-stem responses (ABR), later auditory evoked potentials (SN10) and the audiogram, to assess the value of objective tests in the evaluation of the auditory level. The ABR and the SN10 are valid to determine the level of hearing. The ART s of limited value.

Audiometry↗

Perilymphatic fistula--the value of diagnostic tests.

Perilymphatic fistula (PLF) remains one of the most challenging problems in otological practice. Fifty-two consecutive patients (53 ears) who underwent explorative tympanotomy for suspected PLF between 1985-1992 were included in this study. The clinical picture, history, patients' complaints and laboratory tests were analysed and compared with the operative findings. The conclusions of our work are that the diagnosis of PLF is based mostly on the clinical picture and a battery of laboratory diagnostic tests, but no one test is truly diagnostic for PLF.

Adult↗

Noninvasive recordings of cochlear evoked potentials in Meniere's disease.

Noninvasive meatal electrocochleography simultaneously recorded with brain stem auditory evoked potentials were performed on 24 adult patients with unilateral Meniere's disease. Data from the affected ear were compared with those of the nonaffected ear and with those of ten healthy normally hearing adults. The most striking finding was the significant deviation from the norm of the nonaffected ears' action potential duration. The combination of simultaneously recorded surface meatal electrocochleography and brain stem auditory evoked potentials complement the diagnostic battery of Meniere's disease in ruling out retrocochlear involvement, indicating cochlear involvement of the affected ear, and revealing subclinical changes in the contralateral ears.

Adult↗

Effect of hearing aids on hearing.

We examined 114 patients aged 10 to 91 years with different kinds of hearing aids fitted in one ear only, the unaided ear acting as a control. They were re-examined several times during a period of follow-up from 1 to 9 years comparing the relative change in hearing due to hearing aid usage with various degrees of amplification of the aid. We compared the degree of hearing loss in the aided and unaided ear looking for evidence of a possible change in hearing related to the frequency of hearing aid usage in hours per day and in years, the maximum power output (MPO) and the gain of the aid. According to our findings there is no change in hearing between the aided and the unaided ear at the alpha = 0.05 probability level at least for 8 years. There is no effect of the long-term amplification of the hearing aid on deterioration of hearing comparing the aided ear and the unaided ear, but with high MPO of the aid, the patient should be followed up more frequently than with low MPO amplification.

Adolescent↗

Oral contraceptive pills and clinical otosclerosis.

Clinical otosclerosis is a familial disease which is more frequent among women in their reproductive years. The condition usuallly is aggravated by pregnancy. Endocrinologic variables may influence the time of onset and the course of the disease. It is suspected that oral contraceptives (OCs) might stimulate the onset of the disease. Six hundred nulliparous women between the ages of 16 and 30, who used a variety of OCs for 12-36 months, were examined. The hearing of these women was thoroughly investigated. The first audiometric examination of the 600 women revealed three cases (0.5%) of clinical otosclerosis. This incidence is equal to that of the population as a whole, but lower than the incidence found in previously parous women. Audiometric examinations were normal in the remaining 597 women, and repeated examinations revealed no new cases of clinical otosclerosis, despite continuous OC use.

Adolescent↗