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Biomedical subjects

T Jauhiainen

Publications and source records attributed to T Jauhiainen.

At least 19 recordsLinked to original sources

Behavioural observation audiometry in testing young hearing-impaired children.

The aim was to examine the accuracy of unconditioned behavioural observation audiometry (BOA) in predicting hearing acuity in children and the validity of test results at various frequencies. The study was designed to longitudinally compare each child's best BOA response level (at the age >12 months) with the conclusive pure-tone threshold of the better ear. The subjects were 119 children derived from a material of 353 children fitted with a hearing aid at Helsinki University Central Hospital. BOA was carried out on 119 children, 19 of whom did not respond to frequency-specific stimuli. The predictive power of BOA depended on the severity of hearing loss. At the hearing level of 30-39 dB, BOA registered 10-15 dB poorer levels than the pure-tone audiometry. The pure-tone averages (0.5, 1, 2 kHz) of 50-69 dB agreed best with the BOA responses. In severe impairments (more than 70 dB HL), the BOA registered too good hearing. Correlation of the results from the two modes to measure hearing level was highly significant (r = 0.71, p = 0.000), and the pure-tone hearing level agreed with that of BOA at the frequencies 0.5 to 4 kHz. Our results show that BOA averages < or =30 dB rarely indicate hearing loss demanding fitting of a hearing aid.

Adolescent

Hearing disability assessment in evaluating hearing aid benefit.

The aim was to study the applicability of an eight-item questionnaire in evaluating the benefit derived from hearing-aid use. Since 1977, 3402 hard-of-hearing patients have been fitted with a hearing aid for the first time and followed up for 3 months in the Helsinki University Central Hospital. The questionnaire included eight situation-specific items in hearing: speech face-to-face, speech in a small and large group, loud speech, in telephone and radio/TV, doorbell, telephone signal. The scoring ranged from 0 to 16. After a 3 months' use of amplification, the questionnaire was completed again. The median (interquartile range) and arithmetic mean (standard deviation) of the prefitting scores were 5.0 (4.0-6.0) and 5.3 (2.33). The postfitting scores were 1.0 (0.0-2.0) and 1.1 (1.17), respectively. The difference was highly significant. An eight-item questionnaire in the evaluation of hearing problems provided a reliable numerical score of disability. Follow-up is important to secure satisfactory results in rehabilitation, especially in old age.

Adolescent

Oral glycerol and intravenous dexamethasone in preventing neurologic and audiologic sequelae of childhood bacterial meningitis. The Finnish Study Group.

To assess the value of adjunctive intravenous dexamethasone (DXM) and oral glycerol (GLY) for the treatment of bacteriologically proved bacterial meningitis, 122 infants and children with bacterial meningitis were randomly assigned to receive DXM intravenously (n = 32), GLY orally (n = 30), DXM plus GLY (n = 34) or neither (n = 26) of these drugs. All patients were treated with the same antimicrobial agent, ceftriaxone. The patients were followed neurologically for as long as 6 months. A thorough hearing evaluation was performed routinely 2 months or more after discharge from hospital. Overall 4 (7%) of the GLY-treated patients, compared with 11 (19%) of those not given GLY, developed audiologic or neurologic sequelae (P = 0.052), the relative risk of sequelae being 2.94 (95% confidence interval, 0.99 to 8.72). The patients who had received GLY showed less severe or profound bilateral hearing impairment than those not given GLY (0 vs. 7%, P = 0.049), and none of them had other neurologic abnormalities 3 or 6 months after discharge, compared with 5 (9%) of those not treated with GLY (P = 0.024). The DXM recipients showed only a tendency to less severe hearing impairment than those not given DXM. In conclusion oral GLY prevented neurologic sequelae in infants and children with bacterial meningitis more effectively than intravenous DXM.

Administration, Oral

Interference of immunoglobulin G (IgG) antibodies in IgA antibody determinations of Chlamydia pneumoniae by microimmunofluorescence test.

In the microimmunofluorescence test for measuring immunoglobulin A (IgA) antibodies against Chlamydia pneumoniae, removal of interfering IgG antibodies made IgA antibody reactivity patterns in 952 serum samples easier to interpret, prozone effects disappeared, and titers increased, especially in the sera with high IgG titers. IgA rheumatoid factors did not interfere in the assay.

Adult

Cochlear implants, vibrators and hearing aids in the rehabilitation of postlingual deafness.

Three groups of postlingually deaf adults were formed by non-random selection. The subjects with some residual hearing were fitted with a powerful hearing aid (HA group, n = 10). The others received either a single-channel vibrotactile aid (V group, n = 8) or a single-channel intracochlear implant (CI group, n = 10). Training containing individual counselling and rehearsal in small groups was arranged. During the follow-up (CI group 2.0 yrs, V group 1.8 yrs, HA group 2.6 yrs), the subject's achievement was assessed by a repetition of audiological testing and written questionnaires. Whereas the HA group obtained the highest scores in the audiological tests, the CI group found the implant most beneficial in everyday life. No significant improvement in the test scores was observed during the follow-up. The extent of personal training, after an initial training period and motivation of the user, did not affect the test scores or the subjective evaluation.

Adult

The Otorhinolaryngology Department in Helsinki: organization and otologic research.

The organization and the otologic research in the Otorhinolaryngology Department of the University of Helsinki are described. The department has 4 surgical wards, each with 22 beds, and a new surgical wing with 6 full-sized operating rooms. The ear research is centered on middle ear histopathology and immunology, focusing especially on secretory and chronic otitis media. There is an audiological and vestibular unit, the latter is expanding rapidly. Acoustic neuroma surgery is performed as team work with a neurosurgeon. The department takes part in a cochlear implant and Audiant prosthesis program.

Audiology

Correlations between meatocisternography and audiological tests in suspected eight nerve tumors.

92 cases of suspected eight nerve tumors are analysed. Correlations between the findings in audiological and vestibular tests, patient histories and findings in conventional x-ray examinations and on the other hand those obtained in meatocisternography with air contrast in computerized tomography are drawn in order to see whether specific features of audiological tests can predict the meatocisternographic finding. The cases with positive findings are verified at surgery.

Audiometry

Associated handicaps in children with hearing loss.

In the differential diagnosis as well as in the rehabilitation of hearing impaired children other disorders affecting language aquisition and speech development need to be taken into account. The rehabilitation programme is highly dependent on the early diagnosis of these additional disorders such as dysphasia, mental retardation of various degrees, cognitive disorders such as dyslexia and dysgraphia, dyspractic and dysarthric disorders of speech production, cleft palate and other anomalies of articulatory organs, autism and other abnormal features of psychic and personality development. In addition children with multiple disorders like malformations, visual disorders, epilepsy, CP and other diseases and handicaps, even though they may not influence language and speech development directly, may still be deprived of possibilities to aquire adequate verbal stimulation. The paper presents a material of 200 children whose hearing loss was diagnosed at the preschool age. Major associated handicaps were found in 35.5% of cases and in 26% they were complicating rehabilitation and development of the child. The frequency of associated disorders and their effect on language and speech development, learning ability and social development is being more closely analysed and discussed.

Adolescent

Vestibular neurectomy and saccus decompression surgery in Meniere's disease.

Results of vestibular neurectomy, total eighth nerve section, and saccus decompression in 42 patients with Meniere's disease are reported. Vestibular nerve section was found in isolated cases to be a very effective method of abolishing the symptom of vertigo. Hearing is not affected but may be lost owing to opening of the vertical canal or disruption of blood supply. Saccus surgery might be the surgical treatment of choice in early cases with good hearing but in patients with fixed non-fluctuating hearing loss, rehabilitation can be effected only by vestibular neurectomy. In bilateral cases either sac surgery or the use of vestibulotoxic drugs is advised.

Adult

Cochlear nerve in neurilemomas. Audiology and histopathology.

Correlative data between the histopathologic changes in the cochlear nerve and audiologic findings are reported in 16 cases of neurilemomas. Poor speech discrimination, positive or absent recruitment, excessive adaptation, or separation of forward vs reverse continuous tone Bekesy tracings did not correlate with the number of preserved nerve fibers. There were several cases with profound hearing loss in which the nerve fiber population approached normal. Histologically, pathologic changes included dilated fibers and increased interfibrillary collagen. In many specimens the fibers were further apart than normally, especially in the immediate vicinity of the tumor, and many lay between tumor cells. The tumor-nerve interface was usually gradual and no abrupt change appeared at the transition from the nerve to the tumor, the Schwann cells appearing to continue as tumor cells. Nonspecific changes apparently due to specimen handling were seen in some areas of most specimens.

Adult