Biomedical subjects

L B Gary

Publications and source records attributed to L B Gary.

6 recordsLinked to original sources

PubMed2001

Vertigo after cochlear implantation.

BACKGROUND: Historically, vertigo after cochlear implantation has not been frequently documented. This differs from the authors' experience in reviewing all adults who underwent implantation at their center from 1995 through 1999. OBJECTIVE: To determine the incidence of vertigo after cochlear implantation and to describe appropriate intervention. STUDY DESIGN: A retrospective case review. PATIENTS: All adults receiving cochlear implants at the Atlanta Cochlear Implant Group from 1995 through 1999. INTERVENTION AND OUTCOME MEASURE: Vertigo was identified through subjective reports, provoked nystagmus, and static force plate evaluation. Vestibular therapy was initiated for each vertiginous patient after cochlear implant surgery. The outcome of treatment was resolution of vertigo and return to functional status. RESULTS: Approximately three-quarters of the adults with implants experienced vertigo or imbalance. Vestibular therapy was beneficial in alleviating these symptoms. CONCLUSION: A significant number of patients experienced vertigo after cochlear implant surgery. Vestibular therapy is a successful treatment of condition.

Adult↗

PubMed1999

Multichannel cochlear implantation in children with cochlear ossification.

OBJECTIVE: To compare results of post-meningitic children who had cochlear implantation with partial or complete drill-out to those who had no drill-out. STUDY DESIGN: This study is a retrospective case review. SETTING: The Atlanta Cochlear Implant Group is a private, tertiary, outpatient clinic. PATIENTS: Eligibility included all our post-meningitic patients, 2-17 years, having a cochlear implant between June 1990 and July 1997. INTERVENTIONS: All subjects had a Nucleus 22 cochlear implant surgically implanted, speech processor programming and follow-up testing in our center, and aural rehabilitation in a variety of therapy settings. MAIN OUTCOME MEASURE: Open and closed set speech discrimination tests. RESULTS: Test performance for speech understanding was highest in the non-ossified group and lowest, but above chance, in the ossified group with complete drill-out. CONCLUSIONS: While children with non-ossified cochleas performed best, even children with extensive ossification requiring complete drill-out benefited from cochlear implantation.

Adolescent↗

PubMed1994

Multichannel cochlear implantation in obliterated cochleas using the Gantz procedure.

Gantz, et al, reported two patients with extensive cochlear ossification in which cochlear implantation was done with a Nucleus 22-Channel Cochlear Implant after extensive cochlear drill-out. One of the patients did well with 20 functioning electrode pairs. We report an additional three patients with extensive cochlear ossification who received Nucleus 22-Channel Cochlear Implants. All three patients had extensive cochlear drill-out as described by Gantz, et al. All three patients have use of all 21 electrode pairs with amperages typical of conventional implantation in two of the three and slightly increased levels in the third. Extensive bilateral cochlear ossification does not seem to be an absolute contraindication for multi-channel cochlear implantation.

Adult↗

PubMed1990

Scala vestibuli cochlear implantation for labyrinthine ossification.

Labyrinthine ossification is a common occurrence in patients with profound deafness. This may run as high as 80 percent in patients deafened by meningitis. Ossification sometimes makes cochlear implantation difficult. Two patients are presented with severe scala tympani cochlear ossification who had scala vestibuli electrode implantation. Their functional and audiologic results seem to be equal to those expected with scala tympani implantation. Scala vestibuli implantation seems to be a viable alternative in patients with scala tympani ossification.

Adult↗

PubMed1986

Auditory brainstem response in young burn-wound patients treated with ototoxic drugs.

Burn-wound patients often require potentially ototoxic doses of aminoglycoside drugs in the treatment of gram-negative sepsis. Cochlear hearing impairment may be an unfortunate consequence of this medical therapy. We evaluated auditory sensitivity with the auditory brainstem response (ABR) in a group of 32 children with acute, severe thermal burns ranging in age from 18 months to 17 years. The mean percent of total body surface area burns was 64%. None of the subjects had a known history of hearing deficits or aminoglycoside therapy, and all yielded a normal baseline ABR upon hospital admission. Eight of the subjects (22%) showed either an abnormal ABR, or no response, at 40 dB prior to hospital discharge. The medical treatment for this group of subjects (gentamicin, amikacin, vancomycin, amphotericin B) was compared to that of a second subgroup of 7 subjects without auditory deficit but with a statistically comparable percentage of burns. The mean dosage of vancomycin was higher for the auditory impairment group than for the unimpaired group. Prediction of ototoxicity in the acute burned patient is extremely difficult as there are numerous factors that may influence the risk of cochlear damage. We conclude, however, that the ABR can be applied in early detection of auditory deficit. Follow-up audiometric assessment is advisable since auditory deficits in this population may be delayed or progressive after discontinuance of drug therapy.

Adolescent↗

PubMedDate not supplied

Auditory brainstem response in auditory assessment of acute severely burned children.

The burn population often requires ototoxic drugs in the treatment of infection. Previous investigations indicate that cochlear damage and auditory impairment may result from this medical therapy. In recent years, the auditory brainstem response (ABR) has assumed an important role in pediatric auditory assessment. We describe a test protocol for ABR assessment in the severely burned child. In a series of 69 acute severely burned children, 13% showed evidence of auditory deficit by the ABR. Based on our experiences, we recommend the inclusion of routine auditory evaluations, including ABR, in the diagnosis and rehabilitation of these children.

Adolescent↗