Biomedical subjects

R J Nozza

Publications and source records attributed to R J Nozza.

25 records · Page 2Linked to original sources

PubMed1989

Myringotomy with and without tympanostomy tubes for chronic otitis media with effusion.

We studied 109 children with otitis media with effusion of 2 months' duration or longer that was unresponsive to medical management. Eighty-six subjects who had neither "significant" hearing loss nor defined symptoms were randomly assigned to receive myringotomy, myringotomy with tympanostomy tube insertion, or no surgery, and 23 subjects with significant hearing loss, defined symptoms, or both were randomly assigned to receive either myringotomy or myringotomy with tube insertion. Myringotomy with tube insertion provided more disease-free time and better hearing than either myringotomy alone or no surgery; however, some subjects who underwent myringotomy with tube insertion developed otorrhea or persistent perforation of the tympanic membrane. Myringotomy offered no advantage over no surgery regarding percent of time with middle-ear effusion, number of acute otitis media episodes, and number of subsequent surgical procedures. These results may not properly be extrapolated to less severely affected children.

Acoustic Impedance Tests↗

PubMed1989

Masking level difference at relatively high masker levels: preliminary report.

The binaural masking level difference (MLD) was measured at multiple masking levels (i.e. 500 Hz narrow band noise presented at 50-100 dB overall SPL) in normal hearing subjects and clinical subjects with varying types and degrees of hearing loss. MLD versus noise level (MLD-NL) functions then were derived for each subject. Some growth in the MLD-NL was seen in nearly all cases of hearing loss up to 70 dB in the poorer ear. These findings suggest that the MLD-NL function may provide the basis for extending the diagnostic usefulness of the MLD test in cases of substantive hearing loss.

Adolescent↗

PubMed1988

Binaural release from masking for a speech sound in infants, preschoolers, and adults.

Binaural masked thresholds for a speech sound [ba] were estimated under two interaural phase conditions (NoSo and NoS pi) in three age groups (infants, preschool children, and adults). A computer-based head-turn with visual reinforcement procedure was used to test the infants. Preschoolers were tested using a modified play audiometry task, and adults were tested conventionally with the same apparatus as used with the infants. Differences in masked threshold as a function of both age and interaural phase condition, and differences in the binaural masking level difference (BMLD) with age, were found when the masker intensity was the same for each group. However, testing of adults with maskers of reduced intensity to compensate for hearing threshold differences relative to the two younger groups (a possible confounding variable in the estimate of the BMLD) eliminated the difference in BMLD between adults and preschoolers. The difference between infants and adults remained statistically significant, suggesting a possible developmental change in binaural hearing early in life. The relevance of developmental change in binaural hearing with respect to both infant auditory processing and the methods we use to assess it are discussed.

Adult↗

PubMed1988

Recent advances in audiologic assessment.

Hearing impairment in the developing child can have far reaching and long lasting consequences. In addition to communicative difficulties, children with undetected or misdiagnosed hearing impairment can suffer intellectually, socially, emotionally and/or behaviorally. There is little reason, however, for infants or children with hearing impairment to go without accurate assessment because the pediatric audiologist is now armed with reliable test techniques for virtually every child. This paper is a review of some of the behavioral and physiological methods used by the audiologist to identify and describe the hearing of infants and children. Also included are suggestions for the pediatrician about when it is appropriate to request the help of the audiologist in evaluating an infant or child at risk for or with suspected hearing loss.

Audiology↗

PubMed1987

Efficacy of amoxicillin with and without decongestant-antihistamine for otitis media with effusion in children. Results of a double-blind, randomized trial.

In a randomized, double-blind, placebo-controlled trial involving 518 infants and children who had otitis media with effusion ("secretory" otitis media), we evaluated the efficacy of a two-week course of amoxicillin (40 mg per kilogram of body weight per day) with and without a four-week course of an oral decongestant-antihistamine combination. Among the 474 subjects who were evaluated at the four-week end point, the rate of resolution of middle-ear effusion was twice as high in those treated with amoxicillin, either with or without the decongestant-antihistamine, as in those who received placebo (P less than 0.001), but 69.8 percent of the amoxicillin-treated subjects still had effusion. Among both the amoxicillin-treated subjects and the placebo-treated subjects, resolution was more likely in those with initially unilateral effusion, in those who had had effusion for eight weeks or less, and in those without an upper respiratory tract infection at the four-week end point. Side effects were reported more often in subjects who received decongestant-antihistamine than in those who did not. Among the subjects without effusion at the four-week end point, recurrent effusion developed in approximately half those in both the amoxicillin and placebo groups during the subsequent three months. We conclude that in infants and children with otitis media with effusion, amoxicillin treatment increases to some extent the likelihood of resolution.

Amoxicillin↗

PubMed1987

Infant speech-sound discrimination testing: effects of stimulus intensity and procedural model on measures of performance.

Performance of infants in a speech-sound discrimination task (/ba/ vs /da/) was measured at three stimulus intensity levels (50, 60, and 70 dB SPL) using the operant head-turn procedure. The procedure was modified so that data could be treated as though from a single-interval (yes-no) procedure, as is commonly done, as well as if from a sustained attention (vigilance) task. Discrimination performance changed significantly with increase in intensity, suggesting caution in the interpretation of results from infant discrimination studies in which only single stimulus intensity levels within this range are used. The assumptions made about the underlying methodological model did not change the performance-intensity relationships. However, infants demonstrated response decrement, typical of vigilance tasks, which supports the notion that the head-turn procedure is represented best by the vigilance model. Analysis then was done according to a method designed for tasks with undefined observation intervals [C. S. Watson and T. L. Nichols, J. Acoust. Soc. Am. 59, 655-668 (1976)]. Results reveal that, while group data are reasonably well represented across levels of difficulty by the fixed-interval model, there is a variation in performance as a function of time following trial onset that could lead to underestimation of performance in some cases.

Arousal↗

PubMed1984

Masked and unmasked pure-tone thresholds of infants and adults: development of auditory frequency selectivity and sensitivity.

Detection thresholds for pure tones (1000 Hz and 4000 Hz) in noise and in quiet were estimated for infants at 6 months and 12 months of age and for adults. A visually reinforced head-turn procedure under control of a PDP-11/03 minicomputer was used. An adaptive protocol with a 5-dB step size was employed for the threshold estimates. Infant thresholds were poorer than adult thresholds in each condition. In noise, infant-adult differences were 8 dB (6-month-old infants) and 6 dB (12-month-old infants) at each frequency. In quiet, infant-adult differences were 14 dB (6-month-old infants) and 12 dB (12-month-old infants) at 1000 Hz but were only 7 dB (6-month-old infants) and 5 dB (12-month-old infants) at 4000 Hz. The masking data suggest that infants are at only a slight disadvantage in detecting a target in a background of noise and are consistent with a frequency selectivity mechanism that is proportional to that of adults. The detection-in-quiet data, with greater correspondence among the groups at 4000 Hz than at 1000 Hz, support the notion that hearing sensitivity varies with frequency in a different way in infants than in adults. Data on task performance reveal significant age effects, and the possibility that such effects have biased the observed differences in the estimates of sensory function among the groups is considered.

Acoustic Impedance Tests↗