[Tinnitus and arrythmia].
Explore the source record for details and available documents.
Arrhythmias, Cardiac↗
Biomedical subjects
M Pilgramm
Publications and source records attributed to M Pilgramm.
[Empirical studies of music listening habits of adolescents. Optimizing sound threshold limits for cassette players and discoteques].
The music habits of 569 pre-teens and teenagers, between 10 and 17 years of age, were examined and exposure to music from portable music players was compared to that in discotheques. Using a questionnaire we determined the length of time spent listening to portable music players and the frequency of disco visits. The individual level of the music heard through portable music players was measured as a free-field corrected short term mean level. The total music exposure (related to 40 hours per week) was calculated from the data and different assumed disco sound levels. We estimated the risk of ear damage according to ISO 1999 standards on the basis of the total music exposure, whereby the mean disco level was varied as a parameter in the range of 95 to 110 dB(A). Taking only the portable music players into account, one can expect that even after 5 years of music, approximately 5% of the total group would have a hearing loss of 20 dB. This percentage clearly rises when additional exposure is given in discotheques having music levels above 100 dB(A). We suggest therefore that for safety reasons the following sound levels should be observed: 90 dB(A) for portable music players and 95 dB(A) for discos. Through adherence to these levels we would expect that 1% of the young people in our study would have a hearing loss > 10 dB, whereas momentary exposure would result in a hearing loss > 10 dB of 10-20%. Therefore we believe that sound level limitations should be enacted immediately for portable music players and in discotheques.
Adolescent↗
[Risk of hearing loss caused by listening to music with head phones].
Sound levels of music played from mini-cassette players via headphones were measured in a nonrepresentative group of 681 pupils whose ages were between 10 to 19 years. Each pupil completed a questionnaire giving the total time spent listening to music each day. The pupils set the music levels (free field corrected short time Leq) between 60 dB(A) and 110 dB(A). In the age group from 12-16 years, 10% chose 110 dB(A). Nearly 50% of the total group usually listened to music less than one hour per day, and just less than 10% listened for four or more hours. The energy equivalent of continuous sound pressure level for an exposure time of 8 h per day was for 55% Leq 8 h < 66 dB(A) and for 7% Leq 8 h > 95 dB(A) while 4% had an Leq 8 h > 105 dB(A). Estimation of the expected hearing losses (HL) were based on ISO 1999: about 10% of the total group were predicted to have a HL > 10 dB at 4 kHz after 5 years. After listening to sound in this manner 0.3% were expected to develop hearing losses at age 25 years that would be severe enough to substantially impair speech intelligibility.
Adolescent↗
Do magnesium infusions protect the inner ear during middle ear surgery? A randomized double blind study.
Joachims et al. recently demonstrated that magnesium was able to protect the inner ear during exposure to noise and fire arms. During middle ear surgery, the inner ear is subjected to noise from fraising and drilling. We saw fit, therefore, to conduct a random double blind study to establish whether magnesium infusions would protect the inner ear during middle ear surgery. We examined 80 patients (38 verum, 42 placebo). The verum patients received 10 mg/kg body weight magnesium 12 hours and 1 hour prior to operation. Plasma and red cell magnesium levels were measured pre-operatively and intra-operatively; they rose as expected. Post-operative auditory tests showed that magnesium had no tendency to prevent inner ear damage. Advocates of magnesium criticize the limited number of patients in our study as well as the administration of the magnesium substitute. In our opinion, however, it should be borne in mind when evaluating these findings that noise from drilling and fraising is only one factor among many which can induce inner ear injury during middle ear surgery.
Adult↗
[Hemodilution therapy of acute inner ear damage].
Two independently conducted randomized clinical studies (sudden deafness; acute acoustic trauma) showed that in terms of hearing gain and the elimination of tinnitus low-molecular dextran 40 and 6% hydroxyethyl starch 40/0.5 do not produce any significant difference in therapy. Clear significant results were obtained with patients who suffered from acute acoustic trauma, when only NaCl-infusions were applied. Both rheologically effective substances show side effects, but they lie in the per-mil-range. On the grounds of measured clinical results we refuse zero or next to zero therapy of patients with acute inner ear damage. In our opinion, the two rheologically effective infusion solutions are equivalent.
Audiometry, Pure-Tone↗
Clinical and animal experiment studies to optimise the therapy for acute acoustic trauma.
Despite extensive educational measures and improved ear protection, acute acoustic trauma still represents a major problem for the young soldier in the Federal Armed Forces. The aim of the investigation was thus to establish the optimum therapeutic scheme that could be applied by the generally young and still inexperienced unit medical officer to patients who had suffered acute acoustic trauma and to demonstrate the therapeutic scheme in animal experiments. In the clinical section, ten studies conducted on 500 patients who had suffered acute acoustic trauma made it possible to show that the combination of low-molecular dextran, or low-molecular hydroxyethyl starch, and hyperbaric oxygenation produced the best therapeutic results in terms of hearing gain and tinnitus elimination by a statistically significant margin. The studies only included patients who showed no tendency towards spontaneous recovery, with strict exclusion criteria being applied. Through animal experiments, it was seen that hyperbaric oxygenation, in the manner in which we conducted it (100% oxygen at 2.5 bar), leads to an increase in the oxygen partial pressure in the perilymph of the guinea pig cochlea. This is due partly to diffusion and partly to the blood flow. In a further experimental approach using animals, it proved possible to show that 60 hours after damage by acoustic trauma and hyperbaric oxygenation, the number of inner ear sensory cells that had suffered morphological damage in the animal was lower than without the hyperbaric oxygenation by a statistically significant margin. At the same time, valuable information was gained on the epidemiology of acute acoustic trauma.
Acute Disease↗
[Development of hearing following damage from acoustic trauma with reference to a subsequent workplace].
60 patients were subjected to follow-up examination approximately one year after they had suffered initial damage due to acute acoustic trauma and received immediate in-patient therapy, in order to determine loss of hearing and development of tinnitus. The result of the study shows that both improvements in hearing and a disappearance of the tinnitus noise can be observed over the year, this being often closely associated with the noise level in the occupation pursued after in-patient treatment. At the same time, instances of progressive deterioration in hearing were also measured, which were virtually independent of the noise level. It is not possible to predict the development of hearing and tinnitus on the basis of the initial damage due to acoustic trauma.
Adult↗
[Calcium antagonists and damage to the organ of Corti in acoustic trauma].
The protective effect of Ca2+ antagonists in acoustic trauma was evaluated by morphometric analysis of the guinea pig cochlea. Damage to the outer and inner hair cells was significantly reduced. Ca2+ antagonists may exert a beneficial influence on the cellular membrane of the sensory cell or on the cochlear vasculature if given in advance and in the early post-traumatic phase.
Animals↗
[Low-molecular-weight hydroxyethyl starch or low-molecular-weight dextran in acute inner ear disorders? A randomized comparative study].
In two independently conducted randomised studies, the therapeutic effects of the low-molecular weight plasma expander dextran 40 (Thomaedex 40) and 6% hydroxyethyl starch 40/05 (Expafusin) in cases of sudden deafness and acute acoustic trauma were compared. No significant differences were observed regarding hearing gain and alleviation of tinnitus. The measured hearing gains corresponded to those reported for dextran in the literature. Hydroxyethyl starch has the advantage that there is no need to take preventive steps against allergies, but is expelled more rapidly than dextran by the body with simultaneous deposition of minimal quantities in the liver. For the time being, the main factor affecting the decision between these two substances will be their sales price.
Adult↗
[Need for rheologically active, vasoactive and metabolically active substances in the initial treatment of acute acoustic trauma].
Two rheologically active and 8 vasoactive and metabolically active substances were compared in eight independent studies, some of which were randomised and double blind, on 400 patients who had suffered acute acoustic trauma. The control group was given saline. Spontaneous recovery was excluded as far as possible. The following substances were tested: Dextran 40, hydroxyethyl starch 40/0.5, naftidrofurylhydrogenoxalate, Vinpocetin, betahistine, pentoxifylline, flunaricine, Regeneresen AU 4 and 0.9% saline. All groups showed superior results to the control group in both long-term and short-term tests with respect to hearing gain and tinnitis improvement. The rheologically effective substances showed no statistically significant variations. None of the vasoactive or metabolically active substances used as adjunctive therapy improved the results achieved with rheologically effective substances alone. These results demonstrate that acute acoustic trauma can be most effectively treated by rheologically active substances; vasoactive and metabolically active substances are unnecessary. Hyperbaric oxygenation is advantageous as an adjunctive therapy.
Adult↗
[A method for relieving tinnitus complaints in long-enlisted soldiers with multiple acoustic traumas--external electrostimulation].
The effect of external electrostimulation (EES) on tinnitus in soldiers with multiple blast trauma was assessed in a controlled study. There was no change in the tinnitus in the untreated control group during an observing period of 5 weeks. However the noise resolved completely within 28 days of therapy in 20% of treated soldiers, in some patients the symptoms were improved. The repeated application of EES is effective in recurrent complaints. This method can be carried out on an out-patient basis and scarcely has any side-effects. It is not suitable for treating tinnitus after acute acoustic trauma.
Adult↗
[Efficacy of naftidrofurylhydrogenoxalate (Dusodril) as adjunctive therapy of patients with acute acoustic trauma. A controlled double-blind study].
A study was carried out on 60 patients who had suffered an acute acoustic trauma. The aim of the study was to examine the effect of using naphtidrofurylhydrogen oxalate (Dusodril Pi. i.v. or Dusodril ret.) as an adjunctive measure alongside dextran-40 infusions (Thomaedex 40). After spontaneous remissions had been largely excluded, the patients were randomly assigned to two therapy groups. Very similar results were obtained in the naphtidrofurylhydrogen oxalate group and in the control group (30 patients each), showing that the use of this drug as an adjunctive therapeutic measure in the treatment of high-frequency hearing loss or alleviated tinnitus does not produce a significant improvement of results.
Adult↗
[Hyperbaric oxygenation--a sensible adjunctive therapy in malignant external otitis].
This study shows the effect of hyperbaric oxygenation as an adjunctive therapy in malignant external otitis on the basis of three cases: one stage I, one stage II, two stages III (according to Ganz). Due to the successes achieved, and basing on a comparative study of the literature, we can conclude, even without a control group, that hyperbaric oxygenation exercises a positive influence on the reduction of Pseudomonas aeruginosa in the external auditory canal, and on the symptoms of pain and regeneration of cerebral nerves injured with a broad-spectrum allergy to antibiotics, even the exclusive application of the hyperbaric oxygenation proved successful.
Aged↗
Hyperbaric oxygen therapy for acute acoustic trauma.
We conducted a study on the effect of hyperbaric oxygen therapy on 122 soldiers following acute acoustic trauma. The patients included in this study, after the effect of spontaneous recovery had largely been excluded, were randomly allocated to four treatment groups. The results of our studies show that hyperbaric oxygen therapy shortens the course of healing with respect to high-pitch perception dysacusis. The results of treatment after an observation period of 6 weeks is also more favorable when patients are treated with oxygen when compared to patients given infusions or vasoactive substances. Similarly, the use of hyperbaric oxygen therapy also reduces the frequency of relapse following discharge from hospital. In contrast, the vasoactive substance chosen in our studies (betahistine) failed to have a favorable effect on the course of healing. Our study has also shown that no method can compare with hyperbaric therapy in eliminating tinnitus following acoustic trauma.
Adult↗
[Hyperbaric oxygen therapy in sudden deafness].
Based on two independent studies, an attempt is made in this paper to demonstrate the effect of hyperbaric oxygen therapy used as a supportive measure to accompany standard treatment in recent acute loss of hearing and in acute loss of hearing where preoperative treatment has proved unsatisfactory. Whereas hyperbaric oxygen therapy is superior to the standard treatment alone as far as the cochlear perception dysacousis and tinnitus in recent acute loss of hearing are concerned, these results could not be reproduced in existing, preoperatively treated acute loss of hearing. As such, hyperbaric oxygen therapy under the strict supervision of a specialist physician has proved an effective supportive measure in the treatment of recent acute loss of hearing.
Audiometry, Pure-Tone↗
[Hyperbaric oxygen therapy of anaerobic brain abscesses following tonsillectomy].
This study describes the clinical course of a 31 year old woman who developed multiple anaerobic brain abscesses six days after tonsillectomy, followed by hemoparesis and dysarthria. In spite of craniotomy, repeated punctures and drainage of pus and high dose local and systemic antibiotics, there was an obvious deterioration in the patient's condition. Hyperbaric oxygen therapy was tried as a last resort. The patient improved quickly, and six months after the tonsillectomy seems to be neurologically symptomfree.
Adult↗
[Measurements of respiratory resistance in tracheal stenosis patients. A comparison of pressure changes with total-body plethysmography].
In this study, the airway resistance of 67 patients who suffered tracheal stenosis was measured by body plethysmography and by the pressure change method. These comparative measurements were carried out in order to assess the value of the pressure change method. There was significant linear correlation between the results for the two methods. The pressure change method is uncomplicated and mobile, and promises to have many practical applications.
Adolescent↗