Biomedical subjects

R G Matschke

Publications and source records attributed to R G Matschke.

17 recordsLinked to original sources

PubMed1992

[Long-term results of stapedectomy and stapedotomy].

We have followed up 91 patients for 3 or more years after stapes surgery for otosclerosis, 59 by stapedectomy and 32 by stapedotomy. The surgical technique was chosen randomly. Both surgical techniques achieved significant hearing improvement, but in the higher frequencies (3 kHz) the results of stapedotomy are better and more stable than those after stapedectomy. Surgical revision was necessary in 5 patients--1 after stapedotomy, 4 after stapedectomy.

Audiometry, Pure-Tone↗

PubMed1991

[Protection for noise-induced hearing loss using active hearing protection systems].

Though noise induced hearing loss is no longer the most frequent occupational disease in the Federal Republic of Germany, the environmental pollution by the product "noise" in our technical and industrialized world has not been reduced. On the contrary, the situation is worsened by the rising influence of leisure noise. To avoid occupational hearing loss, the "Noise Injury Prevention Code" issued by the insurers would demand wearing personal ear protection, e.g. ear plugs, if ambient noise levels are above 85 dB(A). But there are working places in which such equipment would have precisely the adverse effect, because one of the reasons for possible damage to hearing is radio communication. In military aircraft cockpits for example noise exposure measurements showed ambient noise levels above 90 dB(A) during regular flight service nearly all the time. To be able to understand radio traffic in spite of the noisy environment, the headphone volume must be raised above the noise of the engines. The use of ear plugs can only be of limited value. Whereas pilots with normal hearing show only little impairment of speech intelligibility, those with noise-induced hearing losses show substantial impairment that varies in proportion to their hearing loss. Communication abilities may be drastically reduced which may compromise the reliability of radio traffic. To avoid compromising air security one has to demand a noise protection system which allows to reduce ambient noise levels without disturbing speech intelligibility in the inevitable radio communication. Nowadays active noise cancelling (ANC) systems by electronic compensation in different ways provide effective protection against noise induced hearing loss.(ABSTRACT TRUNCATED AT 250 WORDS)

Acoustic Stimulation↗

PubMed1991

[Experience with surgical therapy in snoring and sleep apnea].

Knowledge of the connection between habitual snoring diseases and obstructive sleep apnoea has stimulated research into sleep disturbance in patients at high risk of cardiovascular disease. Any disturbance of nasal ventilation leads to a higher resistance to breathing and may cause cardiovascular complications in the long run. Anatomical and functional conditions that lead to intermittent incomplete blockage or complete occlusion of the upper respiratory tract must be detected and surgically eliminated, if possible. Surgical procedures for treating snoring and obstructive sleep apnoea may be successful and fill the gap between conservative treatment and continuous nasal positive airway pressure therapy. Our experience in 24 patients in presented.

Adult↗

PubMed1990

Smoking habits in patients with sudden hearing loss. Preliminary results.

Tobacco, especially its content of nicotine, is a drug that has a powerful seductive effect and a dangerous risk of dependence. It is well known that smoking of cigarettes in the industrialized countries of Europe neutralizes an essential part of medical success in that tobacco-induced shortening of life is estimated to equal the possible medical extension of life. Nicotine is the best explored component of tobacco and its effects on heart circulation have been investigated by many research groups. Cigarette smoking raises the body's need for oxygen, because the carbon monoxide that is always inhaled with the smoke partially blocks the haemoglobin. Though acute and combined effects of nicotine and carbon monoxide have been established chronic diseases of the smoker cannot fully be declared. An attempt was made to define some correlation between smoking habits and the risk of a sudden hearing loss. All the patients who were treated in our clinic because of sudden hearing loss were asked to complete a questionnaire anonymously in order to get more reliable answers. However, the outcome was not very encouraging. Only three quarters of our patients responded to the questions, of these only 29% were smokers. However, half of the non-smokers were former smokers. The data are discussed in relation to other investigations.

Adult↗

PubMed1990

Frequency selectivity and psychoacoustic tuning curves in old age.

Frequency selectivity represents an important contributory factor in the understanding of human speech. It refers to the ability of the ear to discriminate between two simultaneously occurring sounds of different spectral composition. The capabilities of frequency selection, time pattern analysis, and information processing can be determined generally only by speech audiometry. Schorn and co-workers (1977) published a simplified method for audiological investigations whereby results obtained at two different frequency values are sufficient. The test tone frequencies of 0.5 and 4 kHz were selected because they are representative of the frequency range of normal speech. To determine the influence of ageing on frequency selectivity we investigated three groups of patients between the ages of 20-30, 40-50 and 60-70 years. All of the subjects had normal hearing according to ISO 7029 standards. The measurements of pure-tone audiometry, speech audiometry, and the psychoacoustic tuning curves were performed sequentially on the same day. The influence of ageing on frequency selectivity mainly concerns frequencies above 2 kHz. This is related to the progressive loss of outer hair cells in the basal parts of the cochlea in old age. Our investigations show that particular attention must be paid to a loss of frequency selectivity in old age. This becomes evident mainly after the 60th year. Frequency selectivity is not significantly disturbed before that age, although pure tone audiograms show high frequency inner ear hearing loss earlier in life.

Adult↗

PubMed1989

[Electronic noise compensation for improving speech discrimination in airplane pilots].

Noise exposure measurements were performed in pilots of the Federal Navy during realistic flight situations. The ambient noise levels during regular flight service were maintained at levels nearly all the time above 90 dB. To avoid occupational hearing loss, the "Noise Injury Prevention Code" issued by the insurers would demand wearing personal ear protection, e.g. ear plugs. But such equipment in the aircraft cockpit would have precisely the opposite effect, because one of the reasons for possible damage to hearing is radio communication. To be able to understand radio traffic in spite of the noisy environment, headphone volume must be raised above the noise of the engines. The use of ear plugs can be of only limited value. Whereas pilots with normal hearing show only little impairment of speech intelligibility, those with noise-induced hearing loss show substantial impairment that varies in proportion to their hearing loss. Communication abilities may be drastically reduced which may compromise the reliability of radio traffic. Cockpit noise has its maximum intensity around 125 Hz and flight helmets and ear defenders are not very effective in low frequency ranges. Sennheiser electronic KG developed an active noise compensation circuit, which makes use of the "anti noise" principle. Here the outside noises picked up by two microphones integrated into the headset are processed electronically in such a way that they largely neutralise the original noise. It had to be made sure that the radio traffic signal was not also compensated and that the signal to noise ratio was clearly increased.(ABSTRACT TRUNCATED AT 250 WORDS)

Aircraft↗

PubMed1988

[Cochlear implant for children? Possibilities--risks--prerequisites].

The development of scientific, technical, medical and psychological knowledge of human hearing and communication has reached a point where it seems possible to liberate totally deaf patients from their acoustic isolation. For some of them there is now reasonable hope that, to a certain degree, hearing and speech may be restored by the use of a cochlear implant. The cochlear implant is a device which directly stimulates the auditory nerve via electrical stimuli and in doing so mimics the function of the auditory system transmitting sound information to the central hearing pathways. It is expected that the human brain is able to "read" this message and, for example, to understand speech. But there are very special risks regarding implantation in children which are reviewed and discussed. Preconditions that have to be met to ethically, justify this experiment are stated, aiming at achieving maximum benefit for the child.

Audiometry, Evoked Response↗

PubMed1987

[Clinical, histologic and bacteriologic findings in peritonsillar abscess].

Peritonsillar abscesses are the main complication of chronic inflammation of the tonsils. They should be considered as emergency cases and require quick and adequate treatment. Although abscess tonsillectomy has been reported since 1932, there is still a vivid discussion about this method of choice. We report on our experiences and findings in 284 cases of peritonsillar abscess. Our experiences show that theoretical considerations against this method of surgical treatment are smaller than the advantages for the patient. The authors recommend abscess tonsillectomy at one time and on both tonsils as treatment of choice in peritonsillar abscess without restriction.

Adolescent↗

PubMed1987

[Risk of noise-induced hearing loss caused by radio communication? Audiologic findings in helicopter crews and pilots of propeller airplanes].

The affects of noise on the human inner ear have been well known for a long time, and measures to prevent occupational noise-induced hearing loss show a clear reduction in the statistics of morbidity. Nevertheless, there are working environments in which the use of ear protection seems to be inapplicable, because communication by speech is indispensable, for example in the cockpit of aircraft. Noise exposure measurements were performed on pilots of helicopters and propeller-machines of the German Federal Navy during realistic flight situations. The ambient noise levels during regular flight service were maintained at levels between 89 dB and 120 dB. Sound protection by flight-helmets and headphones is not only neutralised while using radio and intercom, but the noise during radio-communication is even louder than the noise of the engines. The use of ear protection to avoid excessive noise exposure is only of limited effectiveness. While pilots with normal hearing show only little impairment of speech intelligibility, those with noise-induced hearing loss show substantial impairment that varies in proportion to their hearing loss. Communication abilities may be drastically reduced which may compromise the reliability of radio-communication. The problem may be possibly solved in future by an electronic compensation system for noise.

Aircraft↗

PubMed1987

[Duration and complications following grommet insertion in childhood].

We report 1000 insertions of ventilation tubes in 534 children for secretory otitis media (SOM) within a period of 6 years. In 77.5% of the cases, the air-bone gap was greater than 20 dB. The grommets are allowed to undergo spontaneous expulsion which happened in 319 ears, about 7 months after insertion. SOM recurred in 32.6% of the cases once, in 5.0% of the cases twice, and in 1.9% three times, requiring re-insertion of grommets. Recurrence appeared between 4 and 65 months after the first insertion. In three cases perforations of the tympanic membrane persisted and required tympanoplasty. Tympanometric examination and pure tone audiometry are necessary, in addition to pure tone audiometry to follow up successfully ventilated middle ears and to show recurrence as early as possible. Pre-existing but unsuspected sensorineural hearing loss was discovered in 10 cases. The deprivation of neural auditory pathways in early childhood and the possible retardation of speech development caused by SOM are mentioned. Normal hearing is the most important goal of therapy in children suffering from SOM, and insertion of ventilation tubes is the preferred method of achieving that goal safely. Adenoidectomy and treatment of upper airway infections are indispensable parts of the therapy of SOM. Regular follow up after insertion of grommets and even after their expulsion is necessary because of the high rate of late recurrence of SOM. Induction of cholesteatoma by grommets was not observed.

Acoustic Impedance Tests↗

PubMed1987

[Allergic reaction in therapy with naftidrofuryl (Dusodril). A case report].

There are many drugs marketed for the purpose of altering vascular blood flow in various regions, especially of the central nervous system and in peripheral arterial insufficiency. More than 50 different methods are described for the treatment of sudden deafness. Considerations of the therapy of sudden deafness are influenced by the fact that the cause of the disease is unknown. The dysfunction of the hair-cells of the organ of CORTI is thought to be caused by a deficit of oxygen due to disorders of micro-circulation in the inner ear. The infusion of vaso-active drugs in the early state of disease can lead to a remarkable improvement of hearing whereas the prospect of improvement without treatment remains uncertain. Nevertheless it may be difficult to distinguish the beneficial effects of vasodilator agents from spontaneous improvement. Naftidrofuryl oxalate (dusodril) has been in use for many years and proved its therapeutic value in many studies. It is regarded as non-toxic and is used extensively in Europe. Side effects are only reported rarely, and include decrease of cerebral blood flow, abdominal distension, diarrhoea, oesophageal ulceration, epileptic seizures, aphasia, disturbances of consciousness, hypotension, hypertensive crisis, vertigo and dizziness, depression of cardiac conduction, thrombophlebitis, and allergy. This case report of allergic reaction in a young female patient demonstrates that the intravenous application of this drug may lead to severe complications.

Administration, Oral↗

PubMed1987

[Immunology and deafness. Manifestations of relapsing polychondritis in the ENT area. A case report].

Relapsing polychondritis is a rare episodic systemic disorder characterised by recurrent, widespread, and potentially destructive inflammatory lesions involving cartilaginous structures, the cardiovascular system, and organs of special sense, such as the eyes and ears. Although the aetiology is unknown and its pathogenesis is incompletely understood, experimental evidence strongly suggests that immunological mediated mechanisms are operative. The following case report adds some considerations to the discussion about the immunopathology of the inner ear.

Deafness↗

PubMed1985

[Septum deviation and concomitant sinusitis].

It is generally assumed that there is a relation between nasal obstruction due to deformities of the nasal septum and disease of the paranasal sinuses. We investigated patients with septal deviation and rhinomanometrically determined nasal obstruction and checked the sinuses before septal surgery by radiography, ultrasonography, and endoscopy. The results of our investigation on 150 unselected patients during 1983 support the hypothesis. We found that non-invasive diagnostic methods, i.e. radiography and ultrasound were sufficiently reliable. Furthermore we found that more men are afflicted with deformities of the nasal septum than women. Nearly half of the number of patients needed therapy for the paranasal sinuses. Therefore preoperative diagnosis of sinusitis is essential before nasal septum surgery.

Adult↗

PubMed1985

[Early detection of hearing disorders. A simple method of mass screening in newborn infants].

The necessity of early detection and rehabilitation of hearing impaired children is accepted worldwide, but there are still different opinions about the earliest possible time and the kind of examinations in the Federal Republic of Germany. We report our method of examination of neonates, our results and our conclusions. We think that our method is very simple, easy, quick and can be done by well trained personnel. It is reliable enough to filter out suspicious cases, allowing audiological investigation and treatment, if necessary.

Acoustic Stimulation↗

PubMed1984

[Evaluation of sonography in diseases of the paranasal sinuses].

The diagnosis of disorders of the paranasal sinuses by ultrasound has grown in importance during the last few years and has become easier due to developments in ultrasonic equipment. Nevertheless it seemed to be necessary to evaluate the advertising claims that the method is as reliable as radiography in the diagnosis of pathological conditions of the paranasal sinuses. We investigated 188 maxillary sinuses of adults by sinuscopy and compared the findings to those of radiography and ultrasound. The results are given and discussed.

Adult↗

PubMed1983

[Differential diagnosis of medial neck tumors. 2 cases of thyroid malignancy].

Mobile swellings in the neck are a frequent finding in Ear Nose and Throat practice. Any such swelling demands a thorough investigation since there are many possible causes. In doubtful cases, histological examination is necessary. Two cases are presented in which small mobile nodes in the mid-line of the neck, anterior to the larynx, were the presenting symptom of a thyroid carcinoma. The laboratory findings and thyroid scan were normal in these two patients.

Adenocarcinoma, Mucinous↗

PubMed1980

[A case of olfactory neuroblastoma and Marcumar therapy (author's transl)].

Although nasal polypectomy is a frequently performed procedure in ENT Clinics, tissues taken may only seldom be histologically examined. We have recently uncovered an esthesioneuroblastoma during a routine polypectomy, and believe that even slightly changed "polyps" or fleshy or pinkish-gray appearing "polyps" seen with dicumarol therapy may mask tissue malignancy.

Aged↗