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Biomedical subjects

P Zorowka

Publications and source records attributed to P Zorowka.

At least 19 recordsLinked to original sources
PubMed2005

[Will adolescents visit discotheque less often if sound levels of music are decreased?].

BACKGROUND: This study investigated whether adolescents are likely to decrease their frequency of discotheque attendance if the sound levels are lowered moderately. METHODS: A sample of 1,213 high school students aged between 13 and 20 years (mean: 15.8 years) were given a questionnaire and asked their views on the current sound levels at discotheques, and whether they would change their attendance if the levels were somewhat lower. RESULTS: Some 53.7% of the respondents wished to keep the current sound levels, while only 2.5% preferred a raise, and 43.8% a decrease. In the case of a moderate decrease, 85% of respondents would not change their frequency of discotheque attendance, while 5% would reduce it, and 10% would increase it. CONCLUSIONS: The results of this study contradict the fears of discotheque operators that adolescents would visit the discotheque less frequently if the sound levels are lowered moderately. To prove the effects of a sound level reduction, however, separate studies are needed.

Adolescent↗
PubMed2003

[Apoplexy, diverticulum or Alzheimer disease? Deglutition disorders in seniors must always be evaluated!].

Problems with swallowing (dysphagia) occur in association with numerous illnesses. In many cases, however, they are either not recognized or considered not to require clarification, since other symptoms are of greater importance. In elderly, often multimorbid patients, neurodegenerative diseases, such as apoplexy, are the most common causes of dysphagia, but medications with central nervous side effects may also impair swallowing. The difficulty may be localized either in the oropharyngeal region or in the esophagus. There is considerable danger that such complications as aspiration pneumonia and malnutrition may occur and thus increase morbidity and mortality. In addition, the quality of life of the patient may also be diminished. The family doctor has the important task of initiating a differentiated diagnosis based on careful history-taking and a clinical examination that should include an inspection of the oral cavity and the nerves supplying the brain. Early treatment, for example, involving a logopedist, can be effective.

Aged↗
PubMed2002

[Hearing loss due to leisure time noise is on the rise. The ear also needs a rest period].

Noise during leisure time is increasingly leading to temporary and permanent hearing loss, with most victims being adolescents and young adults. Particularly harmful is permanent exposure to noise, since the highly sensitive ear is not designed to tolerate it. On average, youngsters aged between 14 and 20 years spend 3 hours and more listening to music. In discos, concerts in particular, as well as listening to music via headphones, sound levels of 100 dB are regularly reached and exceeded, and levels of 90 dB are already considered to represent a definite risk. Noise is, however, experienced as offensive and painful at levels of about 120-140 dB, and this leads to the danger of its harmful effects being underestimated. Treatment of hearing loss depends on whether it is acute or chronic and comprises infusion therapy, stress reduction, acoustic rest or interposed periods free of noise and, where indicated the fitting of a suitable hearing aid. In view of the immense significance of hearing impairment for the economy, public health, and society at large, its prevention--not only by protective, but also preventive, measures--warrants greater attention.

Germany↗
PubMed2002

[40% of hearing aids are not worn. Making sure the device doesn't wind up in the drawer!].

Early diagnosis of a hearing impairment, follow-up and timely effective intervention are the aims of optimal management of the hard-of-hearing patient. Today, every fifth adult has a hearing problem. This means that the general practitioner not only faces a diagnostic challenge, but also needs to concern himself with the prevention of a hearing loss or its further progression. In the event of a hearing aid being required, the individual needs of the patient must be taken into account. Currently available are behind-the-ear and in-the-ear, both as digital and analog devices. The most expensive, smallest and most modern device is not necessarily the best option for the individual patient, and fitting should be a cooperative effort on the part of the ENT physician and the hearing aid specialist. Required is a specific history, comprehensive counseling of the patient, a phase of testing at home and, where necessary, concomitant acoustic training. The German Society for the Hard-of-Hearing has advice centres in many towns and cities that provide information and counseling on rehabilitation and the legal rights of the deaf.

Adult↗
PubMed2002

[Effect of information about hearing damage caused by loud music. For adolescents the music in discoteques is too loud despite loudness limits].

BACKGROUND: Information campaigns are regarded useful to prevent adolescents from hearing-damage due to loud music. This study examined whether adolescents who are informed on the risk of a hearing-damage, exhibit preventive behavior when attending discotheques. METHOD: 253 pupils (age 14 to 19 years) were interviewed about their disco attending habits and about their information on the risk associated with listening to loud music. RESULTS: About 85% of the sample were informed about the risk. Informed and uninformed pupils did not significantly differ in the frequency of disco attendance nor in the frequency of using ear-plugs. However, significantly more informed pupils experienced disco music as too loud (p < 0.05). CONCLUSIONS: Information influences the subjective appraisal of loudness perception, but has little effect on preventive behavior. Instead, experimental forms of educational campaigns may be more effective. Additional provisions (lowering sound levels in discotheques) are necessary.

Adolescent↗
PubMed1998

[Etiology of moderate and profound deafness in childhood].

UNLABELLED: The present study sought to determine the etiology of bilateral profound hearing losses in children living in Germany. Additionally, a comparison with the data of previous investigations in the available literature was used to update causes now known through medical progress. PATIENTS AND METHODS: The medical charts of 314 profoundly hearing-impaired pupils at schools for the deaf in Cologne, Germany, were reviewed. All available data on possible etiological factors were collected. In addition, the families of these children were interviewed using a standardized questionnaire. RESULTS: Sixty children were found to have bilateral sensorineural hearing losses averaging 30 to 60dBHL within the frequency ranges of 500-2000 HZ, while 254 had bilateral hearing impairments of 60 dBHL or greater. The etiology of the hearing disorder could be determined in 218 of the children. Eighty-two children suffered from hereditary deafness and 136 from acquired hearing losses. The etiology could not be determined in 96 children. Hereditary causes included 34 children with mendelian autosomal dominant losses, 46 with autosomal recessive losses and two children with genetic but non-mendelian causes. Immigrants to Germany (mostly from Turkey and the former Soviet Union) were found significantly more frequently among the students of these schools, than among the total population of the Cologne area. In this group of students, autosomal recessive deafness was particularly common as compared to the overall native population. Acquired hearing disorders were broken down into three subgroups: prenatal, perinatal and postnatal disorders. A prenatal etiology was considered in 32 children, 21 of whom had known congenital rubella infection. This entity was significantly less common among younger children. A perinatal etiology was considered in 60 children. Causative factors were birth asphyxia, apnea and/or hyperbilirubinemia. Forty-four children had deafness attributed to postnatal causes, with bacterial meningitis (n = 31) being the most important single factor. The findings reported indicate changing trends for causes of hearing loss in children with severe hearing impairment in Germany.

Adolescent↗
PubMed1998

[Long-term functional outcome of Laccourreye hemipharyngectomy-hemilaryngectomy with reference to oncologic outcome].

BACKGROUND: Various techniques for the treatment of hypopharyngeal malignancies are used to achieve disease control while preserving laryngeal function. PATIENTS AND METHODS: This study details the long-term results of 22 patients (ages 39-80; average age 57 years) following hemipharyngo-hemilaryngectomy (described by Laccourreye) for unilateral hypopharyngeal squamous cell carcinomas (G2-G3; T1-T4; N0-N3). Follow-up was 16-83 months (average 43) and included extensive speech and swallowing assessment. From 1989-1994 the procedure was performed in 26 patients. Two died within one year postoperatively, two were lost for follow-up, and 22 were included in this study. RESULTS: One patient developed recurrent disease with liver metastasis; two patients were successfully treated for recurrent disease. Two patients developed second primary tumors, while all others had no signs of recurrent disease. Fourteen patients had no difficulties eating or drinking. Six patients could only eat soft foods, and two patients required a gastrostomy feeding tube. Nineteen patients had a useful but hoarse voice, and three patients had severe difficulties when communicating. Modulation of voice was decreased because the supraglottic structures (mainly false cord and scar tissue) were used for phonation. Eighteen patients were completely satisfied with their voice. The tracheotomy was closed in 18 patients within six months, while four patients required a tracheostoma for more than two years. CONCLUSIONS: These data show that function-preserving surgical techniques can be successfully used in hypopharyngeal carcinomas even for patients with advanced disease. Useful functional results for swallowing, voice, and airway were achieved in most patients undergoing this procedure.

Adult↗
PubMed1998

[Voice quality after partial laser laryngectomy].

BACKGROUND: We conducted a prospective study to investigate voice quality after transoral endolaryngeal laser surgery in terms of ability to communicate effectively. Eighty patients with T1 or T2 glottic carcinoma were enrolled in the study. The main objective was to identify the influence of type and extent of surgery on postoperative voice parameters after endoscopic laser surgery. MATERIAL AND METHODS: The postoperative mechanism of phonation was assessed by videostroboscopy six months after surgery at the earliest. A phonetogram was produced and its area calculated (relative phonetogram, RP) in relation to a gender-specific normal phonetogram. A speech therapist (ST) and a trained otolaryngologist (TO) rated each voice independently for communication ability in a grade from 1 (poor) to 6 (near normal). RESULTS: After simple cordectomy the mean values were as follows: RP = 24.8%, TO = 3.26, ST = 3.33. When the anterior commissure was completely preserved mean results were better (RP = 34%, TO = 3.92, ST = 3.83). Results were worse following extended cordectomy (RP = 14.7%, TO = 2.82, ST = 3.00) and transglottic resection (RP = 13.7%, TO = 2.30, ST = 2.86), but similar within these two groups. The parameters RP, TO, and ST do not differ significantly between the group who had speech therapy after surgery (N = 33) and the group who did not (N = 47). Voice production at glottic level yields better results for every parameter than supraglottic substitute phonation. The amount of tissue removed was less significant. CONCLUSION: We conclude that postoperative phonatory results correlate with the postoperative mechanism of phonation. There is no linear correlation with the amount of tissue removed. Comparing similar types of resection preservation of the anterior commissure plays a key role. From the data in this study there is no evidence of a significant benefit from speech therapy. The parameter RP is an effective and relatively simple parameter to complete auditive voice assessment.

Endoscopy↗
PubMed1995

Transoral laser resection with staged discontinuous neck dissection for oral cavity and oropharynx squamous cell carcinoma.

Transoral laser resection of oral cavity and oropharynx squamous cell carcinoma (OOSCC) is a widely accepted approach in the absence of cervical lymph node metastases. This study investigated the results of transoral laser surgery and discontinuous neck dissection (ND) for OOSCC with clinically obvious or suspected cervical node metastases. One hundred seventeen patients with infiltrating oral carcinoma were treated for cure with transoral resection of the primary and staged ND. Twenty-nine primaries were classified as T1, 50 as T2, 35 as T3, and 3 as T4. Lymph node metastases were identified in the ND specimen of 36 patients. All patients were followed for a minimum of 3 years unless they died. Estimated tumor-related survival after 5 years is 81% for stage I and II disease of the oral cavity, 86% for stage I and II disease of the oropharynx, 73% for stage III disease of the oral cavity, 65% for stage III disease of the oropharynx, and 21% for stage IV disease of the oral cavity and the oropharynx. Local and regional control of cancer was achieved in 72 (62%) of the 117 patients. Forty-five local and regional recurrences were diagnosed during the follow-up period. Two patients died of distant metastases with no evidence of local or regional recurrence. The combination of transoral laser resection and staged ND for the treatment of OOSCC seems to offer satisfactory cure rates for a selected group of patients. These two minor surgical interventions cause less morbidity than commando-type surgery and lead to low perioperative mortality and morbidity.

Adult↗
PubMed1994

Dimensions of the laryngeal framework in adults.

The increasing application of sophisticated electrophysiological, radiological and surgical methods to the diagnosis and treatment of laryngeal disorders requires a profound knowledge of the size and proportions of the human larynx and it's cartilaginous components. Only inadequate data regarding this subject have so far been accessible. The larynges of 53 patients (28 male and 25 female, age 25-88 years, in the means 59 years) were removed during routine autopsy 12-48 h post mortem and immediately submitted to morphometric investigation. None of the patients had histories or visible signs of laryngeal disease. Anatomical preparations were performed with customary surgical tools and morphometric measurements then carried out with a pair of compasses and a calliper rule. A total of 95 measurements were performed on each larynx. These included, aside from evaluation of the whole organ, identification of the internal and external diameters of the cricoid cartilage, height and length of the thyroid alae in different planes, angle of thyroid laminae, height of arytenoid cartilage, width and length of epiglottic cartilage, and internal and external diameter of first tracheal ring. The results obtained provide a full scale of data determining the size and extent not only of it's cartilaginous components, but of the laryngeal framework as a whole. The knowledge of these data may contribute to a precise positioning of electrodes in laryngeal electromyography, to the planning of laryngeal framework surgery, and to the analysis of CT- and MRI-scans of the larynx.

Adult↗
PubMed1994

[The long-term functional results following velopharyngoplasty as a speech-improving measure].

Forty three out of 148 patients who had undergone velopharyngeal flap graft between 1980 and 1992 to treat velopharyngeal insufficiency, and for whom pre- and postoperative data were available, were studied for the purpose of determining the long term morphological functional results of the treatment. Almost all of the 43 patients (93.5%) had received a velopharyngeal flap graft according to Sanvenero-Rosselli. The remaining 4.7% had received a velopharyngeal adhesion according to Stellmach. Four physicians from the fields of oral surgery, orthodontics, phoniatrics, and logopedics evaluated the pre- and postoperative data as well as the results of the follow-up examination according to subjective criteria from their respective disciplines. All four physicians judged that following velopharyngeal flap graft a gradual improvement in the ability to speak had been achieved in 86% of the patients in the follow-up study. At the time of the follow-up examination 70% of these cases were judged to have achieved a "good" qualitative level of articulation and 21% were judged to have achieved a "usefull" level. The best results were obtained in patients who had been operated on before the age of six. The reason is that in these young patients muscular malfunction and pathological movement patterns can be more easily modified than in older patients. In many cases additional speech improvement was achieved through logopedic therapy following the velopharyngeal flap graft. In the most difficult cases intensive therapy while the patients were still hospitalized proved to be especially effective.(ABSTRACT TRUNCATED AT 250 WORDS)

Cleft Lip↗
PubMed1993

Cognitive skills in achondroplasia.

Increased intracranial pressure and ventricular and subarachnoidal dilatation are common manifestations in achondroplasia. They rarely lead to major neurologic and/or psychomotor deficits and neurosurgical intervention is seldom needed. The present study was undertaken to detect signs of minor cerebral dysfunction and discuss possibilities of their prevention. Thirty children with achondroplasia were compared to 3 control groups: their next-born sibs, 30 children with other forms of dwarfism, and 30 children with normal height. Early development was assessed by means of questionnaires. Cognitive skills were evaluated with the German version of the Cognitive Abilities Test and the Lorge-Thorndike Intelligence Test. Personality data were tested using standardized neuroticism, extraversion, and anxiety scales. Children with achondroplasia had more frequent histories of delayed motor development, retarded speech development, and lower school grades in language-related specialties. Psychometric testing disclosed total and subtest scores in the population-based normal range. In comparison with their sibs and matched controls children with achondroplasia had significantly lower total scores mainly caused by low scores in the subtest "verbal comprehension." We conclude that verbal comprehension is significantly impaired in children with achondroplasia. This partial deficiency is probably related to frequent middle ear infections and resulting conductive hearing loss. Hypotonia with delayed oropharyngeal muscle coordination and parental response to an altered, more infantile instinctive releasing pattern may be contributing factors.

Achondroplasia↗
PubMed1993

Serial measurements of transient evoked otoacoustic emissions (TEOAEs) in healthy newborns and in newborns with perinatal infection.

Detection of hearing impairment in early childhood is difficult. We serially recorded transient evoked otoacoustic emissions (TEOAEs) to search for signs of ototoxicity in term, healthy newborns and compared the results to a second group of term babies treated for perinatally acquired bacterial infection with ampicillin plus either cefotaxime or plus aminoglycoside. At initial evaluation, in the group of 45 healthy children born at term, well reproducible emissions were observed in all but two children. In each of these two, initially well reproducible TEOAEs were detected in one ear only. At the time of the second recording (mean at day 8.5) excellent emissions were seen in all ears of all children. Similarly, in the second group receiving ampicillin plus either cefotaxime or plus aminoglycoside, the height of emissions as well as TEOAE-reproducibility was equal or even increased at the time of the second evaluation in all 17 patients. In the following group of 59 patients, all receiving ampicillin plus aminoglycoside, again TEOAEs were equal or improved at the time of follow-up examinations. In all patients, a reduced general condition tended to be associated with less reproducible TEOAEs. We conclude that at conventional doses in low-risk infants, aminoglycosides are unlikely to cause ototoxicity and that in early childhood serial TEOAE-recording may be useful for evaluation of inner ear function.

Ampicillin↗
PubMed1993

[Improved evaluation of transitory evoked otoacoustic emissions by correlation filtering].

Hearing screening as well as evaluation of cochlear function under therapy with ototoxic agents or patients with various diseases is increasingly done by registration of transient evoked otoacoustic emissions (TEOAE). Usually the standard system ILO 88 Otodynamic Analyser is used, where until now emissions were analyzed subjectively. However, evaluation of signals may be difficult mainly in the hearing threshold area. In this article we describe a method to mathematically analyze registered emissions by correlation-filtering. This allows to better identify small specific responses, to further increase the sensitivity of TEOAE, and offers a more objective means for audiologic diagnoses.

Auditory Threshold↗
PubMed1992

Electrophysiologic investigation of lower cranial nerve diseases by means of magnetically stimulated neuromyography of the larynx.

Zoom endoscopic electromyography of the larynx, as introduced in 1979, has contributed greatly to the diagnosis of lower cranial nerve palsies, but in the early stage of a vagus nerve disorder one cannot investigate the nerve conduction from the brain stem to the laryngeal muscles with electrical stimulation. As with the early diagnosis of facial nerve palsies, up to now the intracranial part of the motoric brain nerves could not be stimulated directly. With a new magnetic coil device (Novametrix, Magstim 200) this intracranial stimulation is easily possible in the awake patient with painless magnetic stimuli that induce a muscle action potential into the laryngeal muscles. Hence, an immediate diagnosis is possible. Two coils with mean diameters of 8.5 or 3 cm were used. The stimulator delivered current pulses of peak amplitude up to 5,000 A with rise times of 140 microseconds and 65 microseconds, respectively, that generated peak fields of up to 2 T. In a healthy population, cisternal stimulation of the vagus nerve leads to a muscular response in the vocal muscle after 4 to 6.6 milliseconds (mean 5 milliseconds). Cortical stimulation leads to such a response after 9.5 to 12 milliseconds. Potentials in healthy individuals have been shown to be very uniform. Stimulation in recurrent nerve palsies may show prolongation of these latencies up to 30 milliseconds. The method is limited by the fact that complete neural blocks cannot be overcome by proximal stimulation. We have applied magnetic stimulation to 190 patients with different disorders of the vagus nerve.(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗
PubMed1991

[Drug therapy of progressive hearing disorders in children].

In 1987 and 1988 Nickisch et al. discussed the effect of infusions of prednisolone, pentoxifylline and, partially, piracetam in Ringer lactate solvent on progressive sensorineural hearing loss in childhood and adolescence. Time of observations was 4 years. Unfortunately long-term investigations could not confirm the initially good therapeutic results of 1987/88. In 35% were found permanently and in 12.5% temporarily better auditory thresholds after infusion. The loss of progressive sensorineural hearing in childhood usually takes a fateful course that can hardly be influenced. As is the case with adults, good therapeutic results can most probably be achieved by infusions starting close to the event, i.e. within 48 hours.

Adolescent↗
PubMed1991

[Rehabilitative measures in hearing-impaired children].

On the basis of certain fundamental data on the maturation processes of the central auditory pathways in early childhood the importance of early intervention with hearing aids is discussed and emphasized. Pathological hearing, that is acoustical deprivation in early childhood will influence the maturation process. Very often speech development is delayed if diagnosis and therapy or rehabilitation are not early enough. Anamnesis, early diagnosis and clinical differential diagnosis are required before a hearing aid can be fitted. Selection criteria and adjustment parameters are discussed, showing that the hearing aid fitting procedure must be embedded in a complex matrix of requirements related to the development of speech as well as to the cognitive, emotional and social development of the child. As a rule, finding and preparing the "best" hearing aids (binaural fitting is obligatory) for a child is a long and often difficult process, which can only be performed by specialists who are pedo-audiologists. After the binaural fitting of hearing aids an intensive hearing and speech education in close cooperation between parents, pedo-audiologist and teacher must support the whole development of the child.

Auditory Pathways↗