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Biomedical subjects

K I Berliner

Publications and source records attributed to K I Berliner.

15 recordsLinked to original sources
PubMed1992

Acoustic tumors: effect of surgical removal on tinnitus.

Tinnitus is common in patients with acoustic tumors and may be the initial symptom leading to diagnosis. We might anticipate that tumor removal would alleviate preoperative tinnitus. However, few have studied this systematically. Further, the effect of tumor removal in those with no preoperative tinnitus has rarely been examined. In this study, a questionnaire was sent retrospectively to patients who had undergone surgical removal of an acoustic tumor, addressing the characteristics of tinnitus, and asking whether surgery had directly affected tinnitus. A total of 134 questionnaires were returned. Those who indicated preoperative tinnitus tended to show small but statistically significant improvements in the perceived severity of the tinnitus after surgery, although the symptom rarely resolved entirely. Those with no preoperative tinnitus have an approximately 50 percent chance of developing it following surgery.

Adult↗
PubMed1990

Investigator differences in the cochlear implantation of children.

Eight investigational sites are involved in clinical trials of the 3M/House cochlear implant for children. Statistical analyses have been performed to examine differences between investigators in patient populations selected for implantation and in the results achieved. Important characteristics of the subjects from different investigational sites were compared for House, Maddox, and all "others" combined. There were no differences between investigators in sex, age at surgery, or duration of deafness of the children enrolled in the study. For age at onset, House and Others had higher proportions of postlingually deaf subjects than Maddox (16% for House and 18% for Others, compared with less than 2% for Maddox). However, all investigators had some subjects in every category: postlingual, prelingual, and congenital. Auditory discrimination and speech production scores for subjects from the three groups were compared using analysis of variance techniques. A few interaction effects between time interval and investigator indicated that not all investigator groups performed similarly over time for all measures. However, postimplant scores were always significantly higher than preimplant scores for all investigators. Differences that did occur appeared to be attributable to differences in subject characteristics.

Auditory Perception↗
PubMed1990

3M/house cochlear implant in children.

Data on 265 children with the 3M/House single-channel cochlear implant have been collected and analyzed for presentation to FDA. Significant improvements from preimplant to postimplant in auditory detection, auditory discrimination/identification, and speech production have been demonstrated. Some children also demonstrate the ability to recognize words and sentences without the aid of speechreading.

Adolescent↗
PubMed1989

Sensorineural loss in chronic otitis media. Is it clinically significant?

Charts of 161 patients with unilateral chronic otitis media were reviewed for evidence of sensorineural hearing loss, defined as the difference in preoperative bone conduction thresholds between diseased and normal contralateral ears. Mean bone conduction differences were small but statistically significant, ranging from 5.6 to 12.8 dB across the frequencies. Approximately 45% of the subjects had differences greater than 10 dB for high frequencies, but less than 12% had a difference greater than 20 dB for the pure-tone average. Significant relationships were found between sensorineural hearing loss and the presence of acquired cholesteatoma in the middle ear, diseased mucosa of the promontory and hypotympanum, and diseased ossicles. These findings suggest that more severe middle ear disease may result in sensorineural hearing loss. However, for the majority of subjects, the amount of sensorineural hearing loss was judged not to be clinically significant.

Adult↗
PubMed1989

Open-set speech recognition in children with a single-channel cochlear implant.

We evaluated the ability of profoundly deaf children using the 3M/House single-channel cochlear implant to understand speech without the aid of speechreading. Fifty-one implanted children over the age of 5 years, who had sufficient cognitive and language skills, were tested using word and sentence stimuli presented in an open-set, auditory-only mode. Fifty-two percent of the children demonstrated some open-set performance on word identification, while 41.5% did so on sentence comprehension. Children who scored open-set had a shorter duration of deafness than those who did not. A larger proportion of children using oral communication demonstrated open-set speech recognition than those using total communication. A multiple regression analysis indicated that communication method accounted for the largest proportion of variability in performance on both the word and sentence tasks. Children achieving open-set auditory recognition, however, included both those using oral communication and those using total communication, children deafened by meningitis and those born deaf, and children with varying durations of deafness.

Adolescent↗
PubMed1988

Cochlear implants in children: benefits and concerns.

Cochlear implants have been used in investigational studies with profoundly deaf children aged 2 to 18 years. Results with the 3M/House implant indicate that this device is safe and effective. The implant provides auditory detection of much of the acoustic speech signal, significant improvement in auditory discrimination compared with preimplant with hearing aids, and improved speech production skills. A longitudinal control-group study of auditory discrimination and a cross-sectional study of speech using age-matched controls support the interpretation that these improvements are due to the cochlear implant. In addition, 26 of 50 children (52%) tested for open-set word recognition and 17 of 41 (41.5%) tested for open-set sentence comprehension demonstrated such abilities using the cochlear implant. Adverse effects have been minimal. Early results from three children with the Nucleus multichannel cochlear implant clearly indicate the efficacy of that device.

Adolescent↗
PubMed1987

Cochlear implants in deaf children.

The results to date with the 3M/House cochlear implant in children have been extremely encouraging. Statistically and clinically significant changes show that the implant can provide improvements in auditory detection and discrimination as well as in speech production. As with any intervention, results range from outstanding for some children (open-set speech discrimination and/or intelligible speech) to minimal for others (no stimulation or little improvement in speech). Until long-term studies can be completed, the implant will undoubtedly remain controversial. However, professionals involved in the care of a child who is hearing-impaired should be informed that the field of cochlear implantation is rapidly expanding. A number of different cochlear implants are currently undergoing clinical trials in adults. Besides the 3M/House device, the FDA has recently approved a second device, the Nucleus Multichannel Cochlear Implant, for investigation in children. The treatment of profound deafness is changing in children with the cochlear implant as an option for those not benefiting significantly from hearing aids. However, some important aspects of a deaf child's management have not changed and will not change: the need for early diagnosis and multidisciplinary management. The first five years of life are the language acquisition years. Proper management during these years is critical if the hearing-impaired child's handicap is not to dominate his or her future and limit potential for a successful, happy life.

Adolescent↗
PubMed1987

Our experience with cochlear implants: have we erred in our expectations?

Many clinicians feel that single-channel cochlear implants are limited in the information they can provide. This has led to some common misconceptions regarding single-channel and multichannel systems. At the House Ear Institute, a growing number of children with the 3M/House single-channel implant are demonstrating open-set understanding of speech on measures designed to test such abilities in children. As a result, we have revised our thinking regarding the potential of this device.

Adolescent↗
PubMed1986

Safety and efficacy of the House/3M cochlear implant in profoundly deaf adults.

The House/3M cochlear implant system is no longer considered investigational. Many years of clinical experience led to development of a clinically feasible program for selecting patients, fitting the device, training patients in its use, and evaluating results. Both laboratory and clinical data support the conclusion that this device is safe and provides significant benefits for profoundly deaf adults. The House/3M cochlear implant has had a significant impact in the treatment of the profoundly deaf, even while in the investigational stage. First and foremost, patients who were previously turned away as "untreatable" were provided with a new option. Furthermore, the professionals--otologists and audiologists--had a new set of tools, including assessment and rehabilitation materials, to use in dealing with the profoundly deaf patient. These patients can now be provided more effective care whether they obtain an implant or a hearing aid. Finally, the introduction of this device stimulated the development of better devices, better assessment tools, and other alternatives. The future calls for device improvements, objective methods for selection of candidates, and expansion of the application of electrical stimulation of hearing to children, to patients with more residual hearing, and to those who require a central electroauditory prosthesis for stimulation in the brain stem. Cochlear implants are rapidly becoming a part of clinical otology and audiology. It is important that accurate information be disseminated among these professionals, that professional training programs teach their students about this area, and that other professionals, such as educators of the deaf, speech/language pathologists, and psychologists who deal with the hearing impaired, become knowledgeable in dealing effectively with the implanted child or adult.

Adult↗
PubMedDate not supplied

Methods and issues in the cochlear implantation of children: an overview.

The single-electrode cochlear implant is undergoing clinical trials in children under Federal Food and Drug Administration regulations governing medical devices. Seven teams from around the United States are participating in this investigation as coinvestigators with the House Ear Institute. The clinical research program involves evaluation and selection for an implant surgery, basic guidance for fitting the device, and follow-up monitoring on a regular basis. As of December 31, 1984, 164 profoundly deaf children have received the cochlear implant. They ranged in age at time of surgery from 2 yr, 5 mo to 17 yr, 11 mo. The majority of children were deafened from bacterial meningitis (N = 98). The pertinent issues involved in the implantation of children include methods of investigation, impact of deafness, potential risks and benefits, and alternatives. While the use of the implant in children continues to be controversial, the evidence to date indicates that this prosthesis can provide significant benefit for a select population of profoundly deaf children.

Adolescent↗
PubMedDate not supplied

Experiences with the Nucleus multichannel cochlear implant in three young children.

Clinical trials for the Nucleus multichannel cochlear implant in children 2 through 9 years of age have been ongoing for approximately 1 year. We describe three children who have used the device for at least 8 months. Based on these three cases, we discuss some factors that might affect the outcome of the Nucleus implant in young children: age at implantation, age at onset of deafness, and duration of profound deafness before implantation. Surgical and rehabilitation issues, including educational settings, are reviewed.

Auditory Threshold↗
PubMedDate not supplied

Present status and future directions of the Ear Research Institute cochlear implant program.

Thirty-three adult subjects have been implanted with single-electrode cochlear implants at the Ear Research Institute. This paper outlines the current status of the subjects; the rehabilitation and testing program; results found with the implant; and future directions of the implant program. Results indicate that implant subjects can score significantly above chance on a variety of discrimination tests. Implant subjects also score significantly better than hearing aid subjects on these tests. Research is continuing on engineering and signal-processing improvements for the single-elecrode implant. Multiple-electrode implants and binaural implants are being considered for future research at the Ear Research Institute.

Adult↗