PubMed Health⌕ Search

Biomedical subjects

M Hülse

Publications and source records attributed to M Hülse.

At least 19 recordsLinked to original sources
PubMed2004

[The efficiency of spinal manipulation in otorhinolaryngology. A retrospective long-term study].

BACKGROUND: The vertebral genesis of many functional disorders in otorhinolaryngology, such as dizziness, hearing-impairment, ear-pressure, ear-pain, foreign body sensation in the throat and dysphonia, is suggested by the success of spinal manipulative therapy, particularly of the atlanto-occipital joint. Up to now, there are no retrospective investigations which show the duration of the therapeutic effect. METHODS: We examined 220 patients with cervical otorhinolaryngological disorders (100 patients with dizziness, 49 with hearing impairment, 47 with tinnitus and 24 with dysphonia) after cervical manipulation lasting more than 6 months. RESULTS AND CONCLUSIONS: The extraordinary satisfaction with the manipulative therapy in 82% of patients with dizziness (46% total relief, 36% high improvement) reflects the high efficiency of this manual therapy. In contrast to these results, only 10% of patients with tinnitus showed an improvement (P<0.001). This retrospective investigation demonstrates that a successful outcome after manual therapy is not based on a "placebo effect".

Atlanto-Occipital Joint↗
PubMed2000

[Vestibulospinal reactions in cervicogenic disequilibrium. Cervicogenic imbalance].

A functional cervical spine disorder is often the cause for persistent vertigo, which can last months or several years. The existence of cervical vertigo is not generally recognized, mainly because an objectivation of the cervical nystagmus is not easily understood by many examiners. In this study we examine additional parameters, which underline the diagnosis of cervical imbalance. The anamnestic statement of staggering refers to a disturbance of the vestibulospinal reactions. In 67 patients in which cervical imbalance was suspected the vestibulospinal reactions were monitored directly before and after manual therapy of the cervical spine. The cranio-corpo-graphie (CCG) and the posturography were used to monitor the results. A highly significant improvement of pathological vestibulospinal reactions was seen after chiropractic manipulation of the spine. These results show that a functional disorder of the cervical vertebrae influences the vestibulospinal reactions. The pathological deficit of the vestibulospinal reactions is not solely a phenomenon of peripheric labyrinth malfunction, failure in the brainstem or in the area of the cerebellum ("brain stem staggering"), but can also be viewed nearly regularly by cervical disturbance of the equilibrium. The results of the treatment can be observed within a few hours.

Adolescent↗
PubMed1994

[Cervicogenic hearing loss].

Existing investigations of cervical hearing disorders have been carried out predominantly in patients in whom those with vertebrobasilar insufficiencies (VBI) could not be distinguished from patients suffering from functional deficit of the upper cervical spine. Since two different syndromes exist, no statement can be made about cervical hearing disorders. That deafness can occur in VBI is uncontested. In contrast, there remains a dispute whether a "vertebragenic hearing disorder" exists. This latter disorder is believed accompanied by tinnitus, a feeling of ear pressure, otalgia and deafness as symptoms of a functional deficit of the upper cervical spine. In reviewing the medical findings of 259 patients with well-defined functional deficits of the upper cervical spine and symptoms of cervical vertigo, subjective hearing disorders occurred in 15%. Audiometric threshold shifts of 5-25 dB, most often in lower frequencies, were observed in 40%. Additionally, results of click-evoked otoacoustic emissions (OAE) were negative in spite of approximately normal hearing. Findings in 62 patients suffering from vertebragenic hearing disorders are reported before and after chiropractic management. Results indicate that these hearing disorders are reversible, as demonstrated by audiometry and OAE. The therapy of choice is chiropractic manipulation of the upper cervical spine. The commoness of vertebragenic hearing disorders emphasizes their clinical and forensic importance.

Acoustic Impedance Tests↗
PubMed1992

[Dysphonia following strumectomy with normal respiratory movement of the vocal cords].

Voice function was phoniatrically investigated pre- and postoperatively in 66 patients undergoing thyroidectomy. Postoperatively we found a disturbance of the voice in 25 patients (43%), though there was a normal function of the recurrent laryngeal nerve. Typical symptoms were a reduced average pitch of the speaking voice, a lowering of the upper and the lower limit of the range of pitch, a lower volume and a fast fatigue of the voice. Eight times the voice remained reduced, even 6 months postoperatively. The cause is not seen in a neural lesion but in a disturbance of the prelaryngeal musculature. The frequency of the voice changes emphasizes the importance of the phoniatric examination, especially in patients who need their voice professionally.

Adult↗
PubMed1991

[Hearing ability after dissection of the vertebral nerve. A long-term study].

To prove the influence of the vertebral nerve on hearing in rabbits, the vertebral artery, together with its sympathetic plexus (n. vertebralis Frank), was unilaterally cut at the height of the first vertebral body, the atlas. Both preoperatively and several times after dissection, auditory and vestibular functions were investigated using BERA and electronystagmography. The hearing threshold was not influenced, neither in the first days after the operation nor as much as six months later. The latencies between wave I and V did not change. Similar results were to be found for the vestibular system. There was no imbalance clinically and it was not possible to detect any electronystagmographic difference between the two vestibular organs. These results indicate, that there is still no experimental proof of hearing loss, as a result of disturbance of the sympathetic vertebral nerve.

Animals↗
PubMed1991

[Functional dysphonia following cervical spine injuries].

After a head or a cervical injury dysphonia and its accompanying globus syndrome are often ignored, even if the existence of these traumatic sequelae are repeatedly reported. Till now there is no coherent idea about their pathogenesis, wherefore in the individual case wide differences exist in the diagnosis, treatment and in the expert opinion. It could be shown in this paper, that a posttraumatic dysphonia, due to a minor trauma, is a well defined disease with an uniform pathogenesis. The diagnosis results from the typical anamnesis of the accident, from the prove of the functional dysphonia and last not least from the prove of a functional deficit of the cervical spine, especially in the height of C 2/3. The right diagnosis allows a causal treatment and enables a just expert opinion.

Cervical Vertebrae↗
PubMed1991

[Cervical dysphonia].

In patients with dysphonia, an increased tension of the muscles of the neck as well as of the prelaryngeal muscles is well known to all phoniatrists. Usually the cause of this tension is only seen in pathological phonation or in a psychic base. In the present report it could be demonstrated that this tension causes itself a functional dysphonia. This tension is produced by a functional deficit of the upper cervical spine. Chiropractic manipulation of the cervical spine can unlock the stiffness of the spine and normalize the voice within a few minutes.

Cervical Vertebrae↗
PubMed1988

[The effect of the upper cervical spine on hearing ability].

A chronic irritation in the upper cervical column of 10 rabbits by implantation of a wire string was performed. The vestibular and auditory functions were investigated by electronystagmography and by BERA before and several times after the operation. A distinct increase of the proprioceptive cervical nystagmus was found already in the first postoperative week. In contrary to the ENG findings the BERA did not show any alteration of the both threshold and latency values. These results indicate that the existence of the proprioceptive cervical hearing loss is very doubtful.

Animals↗
PubMed1984

[Limits of brain-stem audiometry in pedaudiology].

The limitations of BERA in paedaudiology are demonstrated in the light of some own observations, without depreciating the importance of the BERA. On the one hand there are simple faults in the interpretation, on the other great difficulties exist in the diagnosis of hearing loss above 1000 cps and hypoacusis of a higher degree. In the latter case, BERA cannot be used to differentiate it from anacusis. Disturbances in the processing of ultra-short sounds and of sounds with a too short stimulation interval can also cause an incorrect interpretation of the results obtained via BERA.

Age Factors↗
PubMed1983

[Catamnestic studies on the prognosis of sudden deafness].

The progression of the auditory system after the sudden deafness was investigated in 104 patients, one to eighteen years after the first appearance of their disease. The late development shows in 66% a stationary hearing and in 14% an improvement of the hearing. That means that beside a recurrence (7.7%) a slowly aggravation can be found in 12.3%. Stenocardic trouble and angiocardiopathies are peculiarly often reported by the patients. A reliable relation between sudden deafness and cerebral disturbed circulation could not be found.

Cerebrovascular Disorders↗
PubMed1983

[Clinical experience with blood vessel ligation in uncontrollable nosebleed].

Between 1978 and 1980 in the ENT clinics of Mannheim 19 patients with severe epistaxis have been treated surgically. Nearly always epistaxis was due to hypertonus or arteriosclerosis. Before ligation of maxillary or ethmoid arteries Bellocq's nasal packing was used. Ligation was always successful. After one year in three cases we observed a recidive of epistaxis, not due to bad surgical treatment but rich anastomoses of the maxillary artery. It is strange, that artery ligation is recommended, when posterior nasal packing fails, although its complications are more severe and frequent than those of chirurgical treatment including the anesthesiological risk. Ligation in severe epistaxis is effective and of low risk. It is an alternative to posterior nasal packing.

Epistaxis↗
PubMed1981

[Psychogenic deafness - a rare problem in the differential diagnosis of the sudden deafness (author's transl)].

The sudden deafness is in our days a well known clinical picture, which incidence seems to augment. Already in 1950 Fowler described the frequent coincidence of psychosomatic disturbances with the sudden deafness. On these conditions a psychogenic deafness can be taken in some cases for a sudden deafness, if there is not carried out at least one simulation test. An additional hint at an "hysteric" deafness could be the otalgia, which we found in patients. The unilateral hearing disturbance is not a reliable sign against the psychogenic deafness as could be demonstrated in our cases as well as in a case of Hallberg (1956).

Adult↗
PubMed1981

[A practical method to differentiate the sensations of hearing and feeling (auditory and vibration threshold) in the low-frequency range (author's transl)].

An uncomplicated method to differentiate between an auditory and a vibration threshold. It is a well-known problem that it is very difficult or almost impossible to distinguish in a deaf person between the genuine auditory threshold, especially the bone conduction threshold, and a vibration threshold in the range of low frequencies up to 1000 cps. The studies conducted by the authors show that a frequency-modulated tone is extremely suitable for this purpose, because it is very easy to recognize a 5-6% frequency modulated tone of 5 dB (SL) by hearing, whereas it is almost impossible to detect it by feeling. The observations by Fastl (1978) regarding the large inter-individual variation of the frequency modulation threshold does not limit the study conducted by the authors, because the degree of modulation used is far above the threshold. It is not possible to use an amplitude-modulated tone for differentiation between the auditory and the vibration thresholds.

Audiometry↗
PubMed1978

[Symptoms of the experimental auditory tube blockage in man (author's transl)].

The sound of an inhaling apparatus with a vibrator, introduced in both meatusses of the nose, is better heard in both ears during deglutition. This demonstrates a permeability of the Eustachian tubes. The same principle is used in the sonomanometry. We examined this phenomenon in five test persons, in whom we blocked by a pomphus the pharyngeal ostium of the tube during 90--150 min. On this occasion we found the following results: a ) The sound of the vibrator is always heard though the unblocked tube. b) There is a lateralisation in the Weber's hearing test immediately after the blockage of the tube, whereas the Rinne' test mains positive. c) The middle ear pression falls 1 mm H2O per min.

Deglutition↗
PubMed1977

[Cogans's syndrome in childhood (author's transl)].

A case--report is given of a patient with Cogan's syndrome in childhood. This syndrome consists of non-syphilitic interstitial keratitis and vestibuloauditory symptoms. Visual loss is rare but hearing loss is rapidly progressive. A relation to autoimmune diseases especially to panarteriitis nodosa has been suggested by a number of authors.

Autoimmune Diseases↗