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Biomedical subjects

W Delb

Publications and source records attributed to W Delb.

At least 19 recordsLinked to original sources
PubMed2004

[Psychological distress associated with acute tinnitus].

BACKGROUND: We question whether patients with acute tinnitus can be differentiated in their perceived handicap and emotional distress. Dysfunctional mechanisms for coping with stress and illness in patients with acute tinnitus were investigated. METHODS: Twenty patients (symptoms for less than 1 week) were examined for distress due to tinnitus (TF), degree of depression (BDI), global distress (SCL- 90-R) and coping with stress (SVF). RESULTS: Patients could be differentiated in terms of their psychological distress and annoyance caused by the symptoms. There is a high correlation between the degree of depression, dysfunctional way of coping with stress and emotional distress caused by tinnitus. Dysfunctional stress coping strategies are found more frequently in highly affected patients. CONCLUSION: Patients with acute tinnitus can be differentiated in terms of their distress and the psychological impairment caused by their symptoms. These results suggest that the immediate reaction to the manifestation of tinnitus might be of prognostic value for the level of emotional distress experienced in chronic tinnitus. The question arises of whether psychological intervention in the acute stage of tinnitus might be beneficial.

Acute Disease↗
PubMed2003

Effectiveness of a TEOAE-based screening program. Can a patient-tracking system effectively be organized using modern information technology and central data management?

It has been shown that detecting and treating children with hearing loss at an early age will improve their speech and language development. The implementation of universal hearing screening programs is therefore one of the major goals in pediatric audiology. One problem of present screening programs is high lost to follow-up rates. The aim of this paper was to evaluate the effectiveness of a patient tracking system based on central data management and data transmission via the internet. The screening program was organized as a TEOAE (transitory evoked otoacoustic emissions)-based three-stage procedure and covered a complete German federal state (Saarland). The measurements of the first stage took place in well-baby nurseries (WBNs) as well as neonatal intensive care units (NICUs). Measurements of the second stage were performed by pediatricians and ENT physicians on an outpatient basis. The third stage comprised diagnostic ABR (auditory brainstem response) measurements performed by pediatric audiologists. Using a central data management system we were able to identify and follow every child not screened or with negative results. The overall coverage in the first stage was 93% of all newborns. A screening result of the second stage could be obtained for 90% of the children. Four out of 3,830 children screened turned out to have a relevant hearing loss and were fitted with hearing aids. A TEOAE-based newborn hearing screening system can be organized effectively. Central data management as well as interdisciplinary organization of the follow-up are important prerequisites for the success of a hearing screening program. A follow-up system as proposed in this paper can also be implemented in AABR (automated auditory brainstem response)-based programs.

Database Management Systems↗
PubMed2002

[Evaluation of the tinnitus retraining therapy as combined with a cognitive behavioral group therapy].

BACKGROUND: The study evaluates the effectiveness of a Tinnitus Retraining Therapy as combined with a cognitive behavioral group therapy. PATIENTS AND METHODS: 95 patients suffering from chronic tinnitus (mean age 49,3 years) were included. 16 of these 95 participants served as a waiting list control group. The participants were divided into 3 treatment groups. Group 1 was fitted with wideband noise generators, group 2 with hearing aids. The 3rd group was not supplied with any device. After a detailed audiological and psychological examination and tinnitus counseling all patients took part in a cognitive behavioral therapy for a period of 3 months. RESULTS: 64,5% of our patients improved significantly after the initial group therapy. In contrast, the patients of the waiting list control group showed no significant improvement. This initial treatment effect could be maintained over the period of control. We were unable to show significant advantages of noise generators as compared to cognitive behavioural group therapy alone. CONCLUSION: The Tinnitus Retraining Therapy combined with a cognitive behavioral group therapy is an effective treatment in patients with chronic tinnitus.

Acoustic Stimulation↗
PubMed2002

[Influence of interaural time- and level differences on the binaural interaction components in normal adults].

BACKGROUND: Binaural interaction components of auditory brainstem responses have long been studied and its beta-wave has been shown to be correlated with directional hearing ability. As patients with auditory processing disorders such as patients with some sorts of learning disabilities frequently have difficulties with binaural processing it seems sensible to use binaural interaction components in the diagnosis of these disorders. METHODS: In order to obtain normal values and to investigate the influence of interaural time (ITD) and level differences (ILD) binaural interaction components were measured in 21 adults. Interaural time differences varied between 0 and 1.2 ms and interaural level differences between 0 and 30 dB. RESULTS: beta-latencies increased significantly as interaural time differences increased while beta-amplitudes did not change significantly. In measurements with higher interaural time differences detection of the beta-wave was only rarely possible. The effect of interaural level differences on beta-latencies was less pronounced and not significant as well as the influence of interaural level differences on beta-amplitudes. CONCLUSIONS: In the present study it could be shown that the beta-wave of the binaural interaction waveform is present in almost every normal hearing subject. As amplitudes show a considerable variation beta-latencies seem to be of higher diagnostic value than amplitudes.

Acoustic Stimulation↗
PubMed2001

[Electronic data processing-assisted organization of interdisciplinary universal hearing screening in Saarland].

BACKGROUND: Despite many recommendations and obvious advantages universal auditory screening in new-born children is only beginning to be implemented in the German health system. METHOD: We report on a multistage screening project based on otoacoustic emission measurements. One of the major disadvantages of such programs is the comparatively low specificity of otoacoustic emission measurements which leads to the need for a large number of re-measurements. Thus, the organisation of follow up screening failures is one of the most important factors that influence the effectiveness of screening programs. An additional problem is a drop-out rate which can be as high as 30% of the children that have to be retested. RESULTS: In our program we tried to solve these problems by combining primary screening in maternity wards with retesting by paediatricians using the routine examinations of children (U3 and U4) that are done for almost 100% of German babies. In addition, the data from the children that were screened and that have to be screened are transferred to a central data management system. CONCLUSION: Using this system, the follow up of any individual child can be monitored until a hearing loss has been diagnosed or excluded. Therefore early therapy of children with impaired hearing is possible and psychological and social defects can be avoid.

Audiometry, Evoked Response↗
PubMed2001

[Rare audiometry findings in progressive, monosymptomatic low frequency deafness].

BACKGROUND: Objective audiometric methods such as the measurement of otoacoustic emissions and auditory evoked potentials (click evoked and notched-noise auditory evoked brainstem potentials, auditory evoked cortical potentials) can provide helpful information. However, information derived from the individual test is limited and each method contains specific restrictions. To illustrate the possible audiometric pitfalls this work presents a case history. CASE REPORT: The puretone audiometry showed a severe hearing loss at low frequencies up to 2 kHz, a slight hearing loss for higher frequencies up to 6 kHz and almost normal hearing thresholds above 6 kHz. Transitory evoked otoacoustic emissions could not be detected. While the auditory evoked brainstem responses (ABR) using click-stimuli showed a normal pattern no reproducible responses could be derived using the notched-noise technique. Auditory evoked cortical potentials exhibited a normal N1/P2-complex and were detectable down to stimulus levels 0-20 dB above the individual hearing threshold. DISCUSSION: Click-evoked auditory evoked brainstem potentials are widely regarded as the "gold-standard" of objective audiometry. The example presented in this work shows that in special cases it may provide false negative results. In these special cases auditory tone-evoked cortical potentials may provide better objective information. When objectively assessing the determination of the hearing threshold it may be necessary not only to use all electrophysiological measurements but also to know their methodical restrictions and pitfalls.

Adult↗
PubMed2001

Mandibulofacial dysostosis, microcephaly and thorax deformities in two brothers: a new recessive syndrome?

We report two brothers who presented with mandibulofacial dysostosis, growth retardation, microcephaly, thoracic deformities and conductive hearing loss along with asplenia in one case and aplasia of the gallbladder in the other. The pattern of malformations differs significantly from established syndromes with mandibulofacial dysostosis such as Nager syndrome or Genée-Wiedemann syndrome and also from cerebro-costo-mandibular syndrome. As chromosome analysis revealed normal male karyotypes, we consider this to be a distinct heritable syndrome that may be either autosomal recessive or X-chromosomal recessive.

Abnormalities, Multiple↗
PubMed2000

[Fechtner syndrome. A rare differential Alport syndrome diagnosis].

In this article, we report on a family in which five examined members showed clinical signs of Fechtner syndrome, a condition which consists of hearing loss (49%), macro-thrombocytopenia (100%), leukocyte inclusion bodies (100%), eye anomalies (54.3%), and nephritis (38.7%). Hearing loss in Fechtner syndrome appears to be sensorineural with the higher frequencies primarily affected. One aim of the present report was to work out the clinical appearance of hearing loss compared to hearing loss in Alport's syndrome. The most striking difference between hearing loss in Fechtner syndrome and that in Alport's syndrome was that the vast majority of hearing disorders in the latter occur in male patients, which is not the case in Fechtner syndrome. Hearing loss in Fechtner syndrome develops from the second decade of life and progresses slowly with several episodes of sudden deafness.

Adolescent↗
PubMed2000

The influence of noise on blood flow in the basilar artery (BA) - measurements with transcranial color-coded duplex sonography (TCCD).

Acoustic stimuli are being reported as a cause of changes in resistance in the basilar artery (BA). It was the aim of this study to investigate this effect under standardized conditions dependent upon the intensity of the evoking stimulus. Twenty healthy subjects with normal hearing (male/female 14/6; mean age 26.4 years) were exposed to 'pink noise' for periods of 2 min at 75, 85 and 95 dB(A). Parallel to this, the Doppler spectrum of the BA and both the Pourcelot resistance index and the Gosling pulsatility index were measured by means of transcranial color-coded Doppler sonography. In comparison with the base value (at rest) a significant increase in resistance was noted during noise exposure. The noise-induced resistance changes could be interpreted as a consequence of changes in activity of the various centers of the auditory pathway and cerebral function. Further animal experiments may prove the connection between BA blood flow and resistance and their changes depending on different acoustic stimuli or different hearing pathophysiology.

Acoustic Stimulation↗
PubMed1999

[Outcome of hyperbaric oxygen therapy in therapy refractory tinnitus].

Although many studies are available concerning the treatment of sudden deafness using hyperbaric oxygenation, only a few of these deal with tinnitus. The aim of the present study was to evaluate the therapeutic use of hyperbaric oxygenation in cases of tinnitus. A total of 193 patients, having undergone primary intravenous hemorheologic therapy, were treated with hyperbaric oxygenation. Tinnitus was evaluated before, after ten sessions and after 15 sessions using a tinnitus questionnaire. Additionally, an audiometric examination was performed. Measurable improvements of the tinnitus occurred in 22% of the patients, whereas a moderate improvement was seen in 17% of cases. 10.4% showed an excellent improvement and tinnitus disappeared completely in two patients. The improvement rate decreased in those cases where the time from onset of tinnitus exceeded 40 days. In conclusion, hyperbaric oxygenation seems to be a moderately effective additional treatment in the therapy of tinnitus after primary hemorheologic therapy, provided the time from onset of tinnitus is less than 1 month.

Adolescent↗
PubMed1999

[Retrocochlear deafness in absent cochlear nerve: case report. Role of CISS-3D (Constructive Interference of Steady State) sequence and differential diagnosis].

MRI gains greater importance in the differential diagnosis of retrocochlear hearing loss. Retrocochlear anakusis is rarely caused by aplasia or atrophia of the cochlear nerve. In the following we report about a five year old boy suffering from unilateral deafness, where a strongly T2-weighted CISS-3D MRI sequence demonstrates a missing of the cochlear nerve on the deaf side.

Child, Preschool↗
PubMed1999

Determination of acute noise effects using distortion product otoacoustic emissions.

Because distortion product otoacoustic emissions (DPOAE) are the product of the effect of two sinus tones on the cochlea, a multitude of combinations regarding the amplitude and the frequency ratio of the primary tones exists. The goal of the present study was to directly compare different stimulus combinations described in the literature in the detection of acute noise trauma using DPOAE. In the present study, 13 volunteers were exposed for 1 h to noise that was equivalent to sound levels in a discotheque. Audiograms and distortion product otoacoustic emissions were measured before and after noise exposure using four different stimulus combinations. For three of these settings, L1 was 65 dB, L1-L2 was 25 dB and f2/f1 was varied and set to 1.22, 1.20 and 1.18. For the fourth setting, L1 was at 65 dB, whereas L1-L2 was at 10 dB (f2/f1 = 1.20). A second group of volunteers (n = 14) was measured using identical time periods and setting, but was not exposed to noise. The comparison of different stimulus combinations showed that the stimulus combination L1 = 65 dB and L1-L2 = 25 dB at f2/f1 = 1.18 was best suited for detecting a difference between noise-exposed and unexposed individuals.

Adult↗
PubMed1996

[Detection of hearing loss in patrons of a discoteque using TEOAE and DPOAE].

BACKGROUND: The aim of the study was to investigate the potential and difference of pure tone audiogram, TEOAE and DPOAE in the detection of temporary threshold shift. METHODS: 46 disco visitors who were exposed to disco music at an average intensity of 105 dB (A) for 1, 1 1/2 and 2 hours respectively underwent audiological examination before and after noise exposure. Audiological measurements performed were an audiogram and measurements of the TEOAE and DPOAE using the system ILO 92 (Otodynamics). RESULTS: The frequency range where the threshold shift occurred was around 4000 Hz in the 1 hour group and spread over all frequencies when the exposure time increased. The average threshold shift over all frequencies and probands was 6.2 dB for the 1 hour group, 7.1 dB for the 1 1/2 hour group and 10.1 dB after 2 hours of noise exposure. TEOAE amplitudes showed significant reduction only at 2000 and 3000 Hz. Even at threshold shifts exceeding 15 dB, however not in all cases, a reduction of TEOAE amplitudes occurred. Similar results were obtained regarding the DPOAE measurements. CONCLUSIONS: We conclude that TEOAE and DPOAE are not ideal instruments in the detection of temporary threshold shift after noise exposure.

Adolescent↗
PubMed1994

[Effect of sedation on otoacoustic emissions].

Even though the measurement of transitory evoked otoacoustic emissions (TEOAE) is easy and without problems in babies, sedation might be necessary in children aged between 1 and 4 years. As only very little information is available on the influence of a sedation on the TEOAE, the present study was performed. 35 normal hearing patients who were treated with benzodiazepines as a premedication for an operation were included in the investigation. 15 patients received diazepam and 20 were given flunitrazepam in a dosage of 10 and 1 mg respectively. The TEOAE were measured using the ILO 88 system by Bray and Kemp 1 day before, 1 hour after and 3 days after drug intake. 10 additional subjects of whom measurements were taken at the same time intervals served as controls. No statistically significant changes could be detected before and after drug treatment in respect of amplitudes of the TEOAE and frequency of maximum amplitudes. Hence, we conclude that sedation as used in this study must be considered negligible when measuring TEOAE.

Acoustic Stimulation↗
PubMed1993

[Comparative studies of the ototoxicity of cisplatin and carboplatin].

The application of the potent anticancer drug cisplatin is limited by major side effects such as its ototoxicity and its nephrotoxicity. Since carboplatin has been introduced into clinical use, a platinum derivative with less pronounced ototoxicity and nephrotoxicity is available. The aim of this study was to quantify the ototoxicity of carboplatin comparing it to cisplatin using the wellknown guinea-pig model. Using morphological and functional methods it could be shown that the ototoxic damage was by far higher in a group which had received a total dose of 12 kg cisplatin/kg than in a group which had received a dosage of 90 mg carboplat/kg. Our investigations show that the ototoxic potential of cisplatin in the guinea-pig is more than 9 times higher than that of carboplatin.

Animals↗