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Biomedical subjects

J J Wazen

Publications and source records attributed to J J Wazen.

5 recordsLinked to original sources

Clinical results with a percutaneous bone-anchored hearing aid.

During a 2-year period ending in July 1987, nine patients were implanted with a percutaneous bone-anchored hearing aid developed at the University of Gothenburg and Chalmers University of Technology, Sweden. Patients selection was based on the presence of conductive or mixed hearing loss in patients who are unable to wear a conventional hearing aid because of infection or ear canal problems. Patients had speech discrimination scores of at least 60% for phonetically balanced monosyllables (CID lists) at 40 dB above threshold, and a pure tone bone conduction average of 45 dB hearing loss or better. Patients were evaluated in sound field, preoperatively and postoperatively using warble tones, speech reception threshold, speech discrimination, and synthetic speech identification. The patient's unaided hearing and hearing with a bone-anchored hearing aid were compared with the patient's hearing with a standard bone conduction hearing aid. Signal to noise ratio testing with the synthetic speech identification test demonstrated that the bone-anchored hearing aid was comparable to a standard bone conduction aid. There were no complications in our series. Five patients who reported otorrhea with conventional hearing aids experienced no otorrhea after implantation. Patient satisfaction, as assessed by questionnaire, revealed that all patients preferred the bone-anchored hearing aid to previously worn hearing aids.

Adult

Referred otalgia.

The diagnosis and management of otalgia may be a very simple task or a very complex and frustrating experience for both physician and patient. A thorough understanding of the anatomy of the head and neck is required. A basic knowledge of neuroanatomy, with emphasis on the cranial nerves, their course, distribution, and function, is also necessary. The complexity of this field may sometimes require the treating physician to call for consultations from colleagues in the fields of oral surgery, neurology, or neurosurgery. It is often through the collaboration of different specialists that patients are provided with the appropriate medical care they deserve. This has never been more true than in the area of the head and neck.

Ear

Intraoperative BAER monitoring and hearing preservation in the treatment of acoustic neuromas.

We treated 20 cases of acoustic neuromas in the last 2 1/2 years using the suboccipital approach with intraoperative monitoring of eighth nerve function in an attempt to preserve hearing. Total tumor removal was accomplished in 18 cases. Three tumors were small (less than 2 cm in size); 3 tumors were moderate sized (2 to 3 cm) and 14 tumors were large (greater than 3 cm). In 15 cases, all BAER components were lost during surgery. These patients had no postoperative hearing. In five patients there was intraoperative preservation of some or all BAER components. These included the three patients with small tumors and two other patients with moderate sized tumors. One patient with a moderate size tumor had preservation of wave 1 only, and had no postoperative speech discrimination. One patient with a small tumor retained all 5 BAER components, but had no postoperative hearing. Three patients in our series retained functional hearing after surgery, including 3 of 5 patients with tumors 2 cm or smaller. Intraoperative BAER monitoring appears to be useful in predicting postoperative hearing. Tumor size seems to be the primary factor in preservation of hearing following acoustic neuroma surgery.

Adult