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Biomedical subjects

K Welzl-Müller

Publications and source records attributed to K Welzl-Müller.

At least 19 recordsLinked to original sources
PubMed2004

[Counselling versus cognitive group therapy for tinnitus. A retrospective study of their efficacy].

BACKGROUND: Both counselling and group therapy have been recommended for supporting patients with chronic tinnitus. It is unclear which of these treatments is superior. SCIENTIFIC QUESTION: This retrospective study aimed at comparing relief from tinnitus distress following counselling with that following cognitive group therapy. Distress relief was also compared to the distress level of the waiting group patients. METHOD: Tinnitus distress was assessed through the Tinnitus Questionnaire (TQ, Goebel and Hiller) at three different times: before treatment (in waiting list patients: at initial contact) and at 3 and 6 months after initial assessment. Data from 21 patients per group were included in the analysis. RESULTS: The initial tinnitus distress scores were similar in all groups (about 48 TQ points out of a maximum of 84). After 3 months, both counselling subjects and group therapy participants exhibited a significant distress reduction of 13 TQ points, which remained stable after 6 months. Patients on the waiting list experienced no distress relief over time. CONCLUSION: Results from our data demonstrate the need for a future prospective study on the comparison of efficacy of counselling vs cognitive group therapy.

Activities of Daily Living↗
PubMed2001

Examples of implemented neonatal hearing screening programs in Austria.

In order to improve early detection of congenital permanent childhood hearing impairment the Austrian ENT society recommended in 1995 that universal neonatal hearing screening be introduced ("Millstätter Concept"). Coverage is presently about 67% for full-term healthy neonates and 86% for neonates from intensive care units. For maternity units, referral rates between 1% and 3.7% have been reported (2.7-15% for intensive care units). The results of the screening test and follow-up in cases of failure have been documented in 37,543 neonates. Of this population, 91 infants (2.4 per 1000) showed bilateral permanent hearing loss. In these children intervention and management of the family started within the first months of life. These results justify the effort involved in introducing universal neonatal hearing screening.

Austria↗
PubMed2001

Epidemiology of permanent childhood hearing impairment in the Tyrol, 1980-94.

In recent years the need for reliable data on permanent childhood hearing impairment (PCHI) has increased, owing to both scientific interest and practical aspects such as implementation of neonatal hearing screening. In order to obtain data about the epidemiology of PCHI in the Austrian state of Tyrol, the medical records of all hearing-impaired Tyrolean children born between 1980 and 1994 were researched. A total of 165 children with at least moderate hearing impairment in the better ear were registered, of whom 52.7% were found to be moderately hearing-impaired, 24.2% severely hearing-impaired and 23.0% profoundly hearing-impaired. Sensorineural hearing loss was observed in 87.3%, conductive hearing loss in 6.7% and mixed hearing loss in 6.1%. As for aetiology, non-syndromic hereditary hearing loss was diagnosed in 22% of the children and syndromic hearing loss in 8%. Congenital malformation of the ear was found in 3%. In 19% of the children, perinatal risk factors were seen, and in 10% a pre-, peri- or postnatal infection had occurred. Aetiology remained unknown in 36% of the children. The prevalence rate of newborn hearing impairment was 1.27/1000 newborns. The results are considered to fit well to the PCHI findings reported from other European regions.

Austria↗
PubMed2000

[Universal neonatal hearing screening--attitude and fears of mothers].

Maternal anxiety in the event of a false positive result is an argument against universal hearing screening in newborns. The aim of this study was to investigate the mothers' attitudes towards neonatal hearing screening and their anxiety in case of a positive result. The study comprises 75 mothers. Using a standardized interview 40 mothers were questioned, 38 of whom already knew about this type of health check. Despite the possibility of a false positive result 33 mothers consented to the general newborn hearing screening. The positive attitude towards screening was associated with knowledge about the test and presence during its performance. Of 20 additional mothers who were interviewed about their anxiety following a positive result their baby had received on the first test, only 2 declared to be very worried. Of 15 additional mothers whose babies had failed the screening, 4 mothers were worried, 2 of whom stated that they had not been well enough informed about the screening. Both scepticism towards neonatal hearing screening and anxiety following a positive result were associated with lack of information and absence during testing.

Attitude to Health↗
PubMed1997

[Optimizing hearing screening by transient evoked otoacoustic emissions in newborn infants].

One of the major drawbacks using transient evoked otoacoustic emissions (TEOAEs) for hearing screening in newborn infants is the high fail rate in normal-hearing children. The purpose of the present study was to improve the overall performance of the test procedure and reduce of the fail rate. Improvement was obtained by 3 modifications: (1) change of the pass criterion in healthy newborns by requiring TEOAEs in at least one ear and nor both ears, (2) performing the test only after the second post-partum day, and (3) using a second-stage screening prior to hospital discharge in newborns who failed the initial test. In all, 3980 newborns from 2 well-baby clinics and 243 newborns from a neonatal intensive care unit (NICU) were screened using an system ILO-88 system program mode quick-check test was completed in 3820 infants. Considering these modifications, the pass rate of healthy newborns was improved from 79.5% to > 99%, and only 0.7% of the false negative (healthy) newborns required further audiological evaluation. Babies from the NICU failed in 3.8% of the screening tests. Overall, the number of newborns who failed the ILO-88 screening test was significantly reduced and the fail rate minimize when compared to previously published experiences with TEOAEs in new-born hearing screening.

Age Factors↗
PubMed1997

Assessment of electrostimulation in children supplied with cochlear implants.

OBJECTIVE: In children supplied with cochlear implants (CIs), there is an urgent need for objective tests for the assessment of electrostimulation. SETTING: An optimized procedure for intraoperative and post-operative applications with short duration test time, based on the measurement of the electrical farfield picked up from surface electrodes on the scalp, is presented; therefore, assessment of stimulation is independent of the stimulating electronic circuitry. OUTCOME: The setup was designed for the COMBI40 multichannel CI using a synchronized sampling technique of the amplified signals. The evaluation procedure includes examination of the time course of the signal and calculation of the input output function. With these options, a straightforward judgment of the electrical performance of the implant in situ, reflecting the input to the auditory nerve, is provided.

Child↗
PubMed1996

[Quality assurance in audiology and pediatric audiology].

For many years quality assurance has been well established in industry. At the same time, quality assurance in the medical services has become more important. The present study was limited to aspects of quality assurance in general and pediatric audiology. Typical quality requirements were defined for these services and quality features established. International recommendations were available as far as the quality of the equipment and methods used was concerned. Strategies to optimize the relationship between the reliability of diagnosis and additional costs are presented in order to improve the quality of the processes involved. Procedures to check the qualitative effect of rehabilitative interventions used are available but not yet standardized. The different audiometric procedures employed and corresponding international recommendations are summarized.

Adult↗
PubMed1995

[Distortion product of otoacoustic emissions in normal hearing and sensorineural hearing loss].

Based on a variety of experimental and clinical studies the diagnostic significance of transient evoked otoacoustic emissions (TEOAEs) is well established. This is also due to the availability of commercial hardware and software which is optimized for the recording of click-evoked OAEs. In cases with distortion product otoacoustic emissions (DPOAEs) the significance for clinical purposes is not yet clear. This study presents results obtained in normal hearing subjects and patients with sensorineural hearing losses (214 ears). The study focuses on three problems: 1. Incidence of DPOAEs in different groups of hearing loss. 2. Level of DPOAEs at various frequencies in each group of hearing loss. 3. Frequency-specific relationships between hearing loss and DPOAEs. Recording of DPOAEs was performed with the ILO92 system and standard configuration (primary tone level, 70 dB SPL). In normal hearing ears DPOAEs were observed at all frequencies above 1 kHz. In cases with moderate hearing loss the detection rate decreased to about 80%. With further increases in hearing loss the detection rate and level of DPOAEs decreased. At frequencies below 1500 Hz even in normal hearing subjects, the level of DPOAEs only slightly exceeded the noise level. The upper limit of hearing loss for which DPOAEs could be observed depended on frequency. In the low-frequency range DPOAEs were absent in ears with a sensorineural hearing loss greater than 35-45 dB; at frequencies between 4 and 6 kHz DPOAEs were observed even in ears with a hearing loss 65 dB.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Click-evoked otoacoustic emissions in a child with unilateral deafness.

In a 6-year-old boy with idiopathic unilateral deafness, click-evoked otoacoustic emissions were recorded in both ears with similar amplitudes and time courses. Following stimulation of the deaf ear, no component of auditory-evoked brainstem potentials was recorded. No space-occupying lesion was observed with high-resolution CT. At retest 1 year later these results were unchanged. In the deaf ear electrostimulation of the cochlear nerve was performed using an ear canal electrode. At a stimulus current of 20 microA the body consistently reported hearing sensation. Click-evoked otoacoustic emission indicated good outer hair cell function. Hearing sensation at low stimulus intensities with electrostimulation indicated fairly good functions of the cochlear nerve. Considering also the results of imaging and auditory-evoked potentials, findings suggested that the deafness was due to an inner hair cell disorder.

Acoustic Impedance Tests↗
PubMed1992

Stapedius reflex in patients with an inner ear prosthesis.

The stapedius reflex elicited by electrical stimulation was investigated in 21 deaf individuals supplied with an inner ear prosthesis. All patients were implanted with the Vienna cochlear implant using intra or extracochlear electrodes. Analog stimulation with sinus bursts of various durations (25, 50, 100, 300, 500 ms) and frequencies (125, 500, 1000, 2000 Hz) was used. The time course of the contralateral acoustic reflex was monitored using a fast-response impedance meter. The stapedius reflex was observed in about half of the cases. Reflex threshold was observed at a stimulation level close to uncomfortable loudness. The time course in case of electrical stimulation differs in some aspects (rise time, onset) from acoustic stimulation in hearing individuals. Temporal integration of the stapedius reflex was observed also in case of electrostimulation through the cochlear implant.

Adolescent↗
PubMed1992

[Modern audiologic diagnosis].

Primary interest in modern diagnostic audiology is assessment of hearing in hearing impaired individuals. The results of the tests are interpreted with reference to site-of-lesion. The first part of this paper comprises a short description of the various testing techniques, including subjective and so-called objective methods. The impact of functional disorders within the auditory system on test results is discussed. In the second part an overview of applications of modern diagnostic audiology is given. These applications comprise: site-of-lesion determination, evaluation of therapeutic effects, prophylactic examination, forensic problems and instrumental rehabilitation (hearing-aids, cochlear implants).

Audiometry, Speech↗
PubMed1991

Acoustic reflex in patients with cochlear implants (analog stimulation).

Stapedius reflexes were tested in 21 deaf patients with the Vienna cochlear implant using intra- or extracochlear electrodes. Sinusoidal bursts of 125, 500, 1,000 and 2,000 Hz were used as stimuli presented in a randomized sequence. The contralateral acoustic reflex was monitored by synchronized sampling of the acoustic impedance of the ear. Results obtained were compared to psychoacoustic sensation values. The reflex threshold always was located close to the uncomfortable loudness level within the subjective dynamic range, or at least above the most comfortable loudness level. Practical applications of reflex testing and limitations of the method for use in children are discussed.

Adolescent↗
PubMed1990

Stapedius reflex growth function in cochlear implant patients.

The growth function of the contralateral stapedius reflex elicited by analog electrostimulation via cochlear implant was investigated in 9 patients and compared to reflex functions obtained for acoustic stimulation in 3 normal-hearing subjects. Sinusoidal signal bursts with the same time pattern were used for the two stimulation modes, the contraction of the middle ear muscle was monitored by sampling the compliance change in the contralateral ear. The reflex amplitudes were found to increase with increasing stimulus intensity in all individuals except in 1 with electrical stimulation. The slope of the intensity function for electrostimulation ranged between 5 and 85%/dB and in the acoustical mode between 2 and 4%/dB. In case of electrostimulation a frequency effect was observed.

Acoustic Stimulation↗
PubMed1990

Dynamic range of the contralateral stapedius reflex in cochlear implant patients.

The dynamic range of the contralateral Stapedius reflex elicited by analog electrostimulation via cochlear implant was investigated in 8 subjects supplied with a Vienna prosthesis. The study comprised patients fitted with intracochlear devices as well as patients with extracochlear devices. Sinusoidal bursts of 125, 500, 1,000 and 2,000 Hz were used as stimulation signals. Only in one patient was saturation of reflex amplitude observed. The dynamic range of the Stapedius reflex was defined either by the difference in stimulus level for reflex saturation or individual uncomfortable loudness level and reflex threshold. Two different methods were used, yielding values between 0.1 and 12 dB, with a median of 4 dB. The individual results were compared with individual psychoacoustic quantities, i.e. subjective dynamic range (difference between sensation threshold and uncomfortable loudness level) and residual dynamic range (difference between most comfortable loudness level and uncomfortable loudness level). The reflex dynamic range is located within the residual dynamic range of electrostimulation. Thus the Stapedius reflex dynamic range can be applied as a rough estimate of minimum residual dynamic range.

Acoustic Stimulation↗
PubMed1988

Stapedius reflex threshold in cochlear implant patients.

The contralateral stapedius reflex elicited by sinusoidal electrostimulation via cochlear implant was investigated in 12 patients. Contraction of the middle ear muscle was monitored by time-resolved synchronized digital sampling of the impedance change in the contralateral ear. The reflex was detected in all patients in whom the uncomfortable loudness level (UCLL) could be reached and who had intact middle ear function. Generally, the reflex threshold is located in the upper part of the dynamic range between the most comfortable loudness (MCL) and the UCLL. The demonstrated method may provide suitable assistance in speech processor adjustment in difficult-to-test patients.

Adult↗
PubMed1986

The benefit of hearing aids: influence of hearing loss and age.

The relation between accessible benefit and hearing loss in combination with age of the patient is analysed. The degree of hearing loss and improvement derived by hearing aid use as found in this work is based on the individually determined speech reception threshold (SRT) for the condition with and without hearing aid in a noiseless environment. It was found that a significant correlation exists between hearing loss and SRT gain by the hearing aid (difference between unaided and aided speech reception threshold) for a pure-tone hearing loss of less than 40 dB at 500 Hz, irrespective of age, whereas for a hearing impairment of 40-60 dB, the gain by using the hearing aid is dependent on the age of the patient. A multiple regression analysis was performed to study the relation between benefit and hearing loss for the two groups of hearing impairment and different age groups.

Age Factors↗