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Biomedical subjects

H S Johannsen

Publications and source records attributed to H S Johannsen.

At least 19 recordsLinked to original sources
PubMed2005

[Quality control of audiologic results in a university phoniatric/pediatric institution. An example of expert assessment of occupational noise induced hearing loss].

AIM: An investigation was made to reveal whether suspicion of occupational hearing loss can be satisfactorily determined by an otolaryngologist or workplace audiological measurement. These were compared with a formal audiometrical assessment at a university clinic. METHODS AND RESULTS: A retrospective study was made of 95 cases of noise induced hearing loss. A total of 78 individuals were investigated by an otolaryngologist and 70 by workplace audiometry. Using workplace audiometry, 27% of the tests showed a reduction in working capacity of at least 20%. In only five of these was a specialist opinion sought within a year. In 50%, this took longer than 5 years. A comparison of audiometric data from expert opinion revealed that there was conformity in only 47% with workplace audiometry and 48% with otolaryngologist testing. In some cases (27% workplace and 33% ENT practice), the measured hearing loss and calculation of disability exceeded that determined by the experts. CONCLUSIONS: The results of workplace audiometry demonstrated that hearing loss was frequently reported only after the workers had received a disability of at least 20%. Possible reasons for discrepancies in audiological testing might be the exaggeration of hearing loss by the worker, insufficient recovery time after noise exposure, or inexperienced audiologists. Our data show that audiometric testing in workplace audiometry, as well as in ENT practice, often reveal a higher disability rating compared to formal audiological (university) assessment, even if these discrepancies do not reach statistical significance.

Adult↗
PubMed2003

[Myoclonus of the middle ear. A rare, differential diagnosis for objective tinnitus].

UNLABELLED: PRESENT STATE OF KNOWLEDGE: Myoclonus of the musculature of the soft palate, as well as middle ear myoclonus resulting from abnormal contraction of the stapedius and/or tensor tympani muscles, are two of the rarer causes in the differential diagnose of objective tinnitus. AIM: Here we describe a childhood case. To our knowledge, no case has previously been described in a child. METHODS AND RESULTS: Our patient isa six year old girl with a bilateral 40 dB sensorineural hearing loss and a high frequency objective tinnitus. The methods of clinical investigation, possible differential diagnoses and therapeutic options are discussed. CONCLUSION: Both intracerebral changes and systemic disorders have been described in some adult patients with palatal myoclonus. Whereas these cases are unlikely to respond to therapy, there is the chance that in some patients with objective tinnitus middle ear myoclonus may be the cause. This should be excluded by appropriate otoneurological investigations.

Acoustic Impedance Tests↗
PubMed2001

[Value of acoustic speech analysis for prognostic assessment of stuttering in children. Partial results of a prospective longitudinal study].

UNLABELLED: PRESENT STATE OF KNOWLEDGE: There are currently no known acoustic parameters by which stuttering children can be appraised which will predict their subsequent speech fluency. AIM: To explain the significance of factors which perpetuate stuttering by using computer-based speech analysis of fluent speech for a 1 1/2 year period and to relate acoustic analysis with clinical measurements of stuttering. Special attention was given to motor-oral and/or linguistic deficits. METHOD AND RESULTS: A prospective study of 58 pre-school children who stutter. Correlations were sought between acoustic variables in the severity and course of the stuttering with the influence of motor-oral and linguistic disturbances. 19 age-matched, normal-speaking children served as controls. A subdivision of the study group into different subgroups with particular motor-oral and/or linguistic problems showed that children whose stuttering coincides with a delayed speech development have a distinctly better prognosis for early remission. In most of these children the stuttering remitted to such a degree as the deficits causing the stuttering could be reappraised, which means simultaneous improvement of the linguistic competence. CONCLUSION: It was apparent that remission rate was much higher in those children who showed linguistic disturbances at the same time with stuttering. Within the stuttering group, subgroups showed a few correlations in several acoustic parameters, but these could not, as yet, be shown to give any prognostic markers in the routine diagnosis of children who stutter. If a child shows any danger-signs of acquiring stuttering on a more permanent basis, a careful diagnosis is necessary in order to find the individually underlying factors before any therapeutical procedure.

Child↗
PubMed2001

[Phoniatric aspects in microsurgical removal of benign vocal cord changes].

INTRODUCTION: Microsurgery of benign vocal cord lesions is usually done to improve, to restore or to preserve patients' voice. Solid anatomical and physiological knowledge concerning the voice are basic requirements of any surgeon operating in this field. PREOPERATIVE DIAGNOSTICS AND DOCUMENTATION: The significance of patients' history as well as phoniatric investigation, laryngoscopic and stroboscopic findings and their proper documentation are presented. INDICATIONS: The surgical procedure must be part of an extensive therapeutical concept that also takes into consideration drug therapy as well as voice therapy procedures to improve voice quality. POSTOPERATIVE REGIMEN: The care for the patient's voice usually goes beyond surgery. To gain the best possible postoperative results, several steps are necessary in addition to surgical procedures. These steps will be pointed out.

Humans↗
PubMed1999

Stuttering children and the probability of remission--the role of cerebral dominance and speech production.

OBJECTIVE: The identification of critical characteristics which might predict whether childhood stuttering will become chronic. Part of the study investigates the relationship between hearing and central processing of acoustic stimuli, cerebral dominance and the clinical course of the stuttering. METHODS: A prospective study of 79 stuttering children aged 3-9 years. The subjects were examined with regard to their cerebral dominance in various tests of laterality, their peripheral hearing and their ability to discriminate sound using the dichotic discrimination test according to Uttenweiler (V. Uttenweiler, Dichotischer Diskriminationstest für Kinder, Sprache Stimme Gehör 4 (1980) 107-111). Results were correlated with the probability of remission of stuttering. Comparisons were made with a control group of 18 children of kindergarten age with normal speech. The period of investigation was 18 months. RESULTS: Seventy-two children underwent follow-up examinations. Of these, 36 achieved fluency of speech. The results of the dichotic discrimination test showed no relation to the rate of remission. When the relationship between handedness and stuttering was investigated, it was found that left-handed children had a significantly poorer chance of attaining speech fluency. CONCLUSIONS: The Uttenweiler test allowed no prognostic evaluation of the future course of stuttering in the age group studied, though auditory dominance was not completely developed in a majority of the 3-6 year-old children. Handedness, however, appears to be related to the probability that stuttering will become chronic.

Case-Control Studies↗
PubMed1999

[Medication-induced vocal cord paralysis as an uncommon cause of cord paralysis].

A case is reported of a 57-year-old man who was found to have a right vocal cord paralysis that most likely followed prolonged treatment with the anti-arrythmic medication Amiodaron-HCl (Cordarex). Phoniatric treatment was given for 5 1/2 months, during which time microlaryngoscopy and stroboscopy were performed. With the help of speech therapy, mobility of the paralyzed cord was seen to begin to return 3 1/2 months after discontinuing the Amiodaron-HCl. Full cord mobility has not returned to date.

Amiodarone↗
PubMed1999

Clinical course of acute laryngeal trauma and associated effects on phonation.

We report the clinical course of blunt laryngeal trauma in three young patients. All three patients underwent several phoniatric examinations as well as indirect microlaryngoscopy and microstroboscopy. The follow-up period ranged from three to eight months. In the first case, there was isolated haemorrhage of the left vocal fold; in the second, dislocation of the arytenoid cartilage with formation of an adhesion in the area of the anterior commissure; and, in the third, non-dislocated fracture of the thyroid cartilage with development of haematoma in the right hemilarynx and transient vocal fold paralysis. One patient required surgical treatment; however, repositioning of the arytenoid cartilage, attempted seven weeks following the injury, proved unsuccessful. In conclusion, all three patients showed significant limitation of vocal fold vibration many months after trauma which was unrelated to the extent of resulting tissue damage. In all three cases, patients developed secondary posttraumatic functional dysphonia requiring treatment.

Accidental Falls↗
PubMed1995

[Apraxia of the larynx].

Disturbances of vocal function in patients with apraxia of speech are well known in the literature and have often been described. Although apraxia of phonation is presumed, only 1 case is mentioned in the literature. We present a 51-year-old man (with missing signs of dysarthria and aphasia after spontaneous right temproparietal hemorrhagia) who had aphonia and missing respiration during speaking, whereas articulation was nearly undisturbed. After differential diagnostic exclusion of other central disorders of phonation we classify this patient as having apraxia of phonation or laryngeal apraxia.

Aphonia↗
PubMed1994

Stuttering in childhood: a five-year longitudinal study in progress.

The actual state of research in childhood stuttering is presented and certain points open to criticism are discussed. We want to find answers to some of the open questions by means of a longitudinal study that starts at an early stage. In this study the prognostic validity of various dimensions of behaviour can be determined with regard to the development of stuttering. Thus, the conditions for the development of a valid and reliable instrument for early diagnosis are created that enable the specialist to estimate the probability of chronicity and to determine whether to treat or not to treat childhood stuttering. Furthermore, the study aims to develop a screening procedure which is easy to use for the persons in the child's surroundings (parents, teachers, physicians) so that stuttering children can be referred to a specialist at an earlier stage.

Age of Onset↗
PubMed1994

[Stuttering in childhood: etiology and follow-up. Initial results of a 5-year longitudinal study].

For about 15 months a multifactorial longitudinal study on the development of stuttering in preschool children has been conducted at the Phoniatric Outpatient Department of the University of Ulm. The main subject of the study is to determine valid indicators to estimate the risk of future chronicity or remission of stuttering and to find out whether and how it is possible to differentiate normal developmental dysfluencies from chronic abnormal dysfluencies. Preliminary results are presented and discussed.

Child↗
PubMed1994

Use of tiapride on stuttering in children and adolescents.

Reported here is the therapeutic efficacy of Tiapride with 10 10- to 17-yr.-old patients afflicted with severe stuttering problems. During the 20-wk. open, controlled study (baseline, low dose of Tiapride, high dose of Tiapride, follow-up observation without medication) the stuttering in various speech situations decreased markedly. No substantial change in different parameters of acoustic analysis and psychopathological characteristics accompanied the reduction in stuttering when group data were compared although positive effects concerning these variables could be seen in some cases. Several conclusions based on these results are presented. One assumed effect of the medication is improvement of central nervous regulatory mechanisms of speech motor coordination. Further, the value of the medication Tiapride in comprehensive stuttering therapy is discussed.

Adolescent↗
PubMed1993

Spontaneous reposition of a dislocated arytenoid cartilage.

We report a patient suffering from arytenoid cartilage dislocation after difficult tracheal intubation and the abrupt spontaneous reposition in the course of severe vomiting 1 month after the operation. Predisposing factors for the unusual reposition are discussed.

Arytenoid Cartilage↗
PubMed1992

[Contact granuloma: symptoms, etiology, diagnosis, therapy].

Contact ulcer granuloma has a multifactorial etiology but vocal abuse is considered the most important etiological factor. Some other possible factors are well-known: tuberculosis, allergies, hormonal or autonomic imbalance, psychosomatic influences, reflux-esophagitis, pathological conditions of the nose, nasal accessory sinus, tonsils. Constitutional factors play also an important role. The symptoms range from mild huskiness to severe hoarseness with pain extending to the ear, dysphagia, sometimes hemoptysis and chronic cough. Failure to recognize the pathological features of this frequently overlooked lesion leads to diagnosis of larynx cancer, angiosarcoma or hemangioma. Indication for microsurgical removal is only severe dyspnea by size of mass or if the dignity is not clear, because any surgical procedure has only temporary value and does not eliminate the etiological factors. The dignity can normally be proved by stroboscope. Vocal rehabilitation and re-education are an essential appropriate means of treatment for this disease if other causative factors are excluded.

Diagnosis, Differential↗
PubMed1991

[The value of indirect microlaryngo-stroboscopy in the follow-up care of patients with vocal cord carcinoma treated with primary irradiation].

On the value of indirect Microlaryngo-stroboscopy in the follow-up of patients with vocal cord tumors having had primary radiotherapy: The technique of stroboscopy is explained, its weight in the evaluation of vocal cords vibration is discussed. Arrest of vibration may be a hint for a malignoma, particularly if this state develops again after radiotherapy.

Humans↗
PubMed1991

[Dysphagia as initial symptom in tetanus. A case report].

A 69-year-old woman was examined because of progressive dysphagie. A barium esophagogram showed no obstruction but a swallowing in trachea suggested a neuromuscular disorder. ENT examination showed no specific signs of infection. The clinical diagnosis of tetanus was confirmed by electromyography. This case demonstrates an uncommon cause of dysphagia where the classical signs of tetanus in the early stages of this disease were absent and dysphagia was the initial and sole presenting symptom.

Aged↗
PubMed1989

[Etiology of sulcus glottidis].

Sulcus glottidis means a notch in the medial edge of the vocal fold. Its histological basis is a loss of vocal fold substance caused by laryngitis. The site of defect is the connective tissue layer between vocal muscle and epithelium. The elastic fibres found there are damaged. This malformation occurs during childhood quite frequently. Heredity cannot be proven.

Adult↗