PubMed · 10699833
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
J Y Sichel, R Eliashar, I Dano. 2000. Explaining the Weber test.. https://doi.org/10.1016/s0194-5998(00)70071-4
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
OBJECTIVES: To determine the role of intermediate duration ( approximately 3 weeks) middle ear ventilation using office-based laser assisted tympanic membrane fenestration in resolving an episode of otitis media with effusion in adults and children who otherwise would have been treated with insertion of pressure equalization tubes. METHODS: A retrospective chart review of 92 patients (162 ears) was conducted to identify the utility and technical challenges associated with laser assisted tympanic membrane fenestration in an office setting. Clinical characteristics reviewed included: age, gender, duration of effusion, season performed, and hearing and health status of middle ear upon healing of the fenestration. RESULTS: 69% of all patients were effusion free upon closure of the fenestration; 68% of those <3 years; 70% of those 3-7 years; and 70% of those 25-80 years. Some episodes recurred and at final follow-up 64% had normal middle ear structure and function (range of follow-up =1-18 months, mean 2.5 months, median 2.0). Shorter duration of effusion pre-fenestration was more often associated with return to normal middle ear structure and function (P<0.01). Season performed, number of previous episodes of otitis media and pre-treatment tympanometry were not predictive of result. No significant complications were observed. CONCLUSIONS: The use of office-based laser assisted tympanic membrane fenestration is a reasonably safe and effective procedure for the treatment of otitis media in most adults and children. As a minimally invasive otologic procedure, laser assisted tympanic membrane fenestration has great potential to decrease the rates of both antibiotic usage and insertion of ear tubes.
About 200 patients are considered each year for cochlear implant recipiency. Only 1/4 of these candidates actually receive an implant. The aim of the study is to discuss the preoperative procedure we use, which is aimed to exclude patients who would not benefit from an implant. A cochlear implant is an example of very expensive high-profile medical therapy, a single implant costing about 280,000 Austrian schillings. The aim of the preoperative diagnostic procedure is to select the right patients, with a view to providing the best audiologic outcome. During the past 20 years, important parameters have been identified to determine suitable patients. Candidates for a cochlear implant are infants and children (independent of the etiology of deafness or high-grade hearing loss), as well as postlingual deaf adults. Congenitally deaf adults or teenagers are considered unsuitable to receive an implant.
A flat tympanogram predicts a middle ear effusion in about 90% of cases. This paper describes how to perform tympanometry, some common problems when doing it and how to classify the curves in normal (type A), middle ear effusion (type B) or negative pressure (type C). The theoretical background of impedance audiometry is outlined. The stapedius reflex, pneumatic otoscopy, reflexometry and otomicroscopy are described as supplements or alternatives in diagnosing fluid in the middle ear. Tympanometry is recommended as a diagnostic modality for general practitioners.