PubMed · 13728551
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H NEUMANN, M MUNTENESCU. [Technical problems in tympanoplasty].. https://pubmed.ncbi.nlm.nih.gov/13728551/
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A commercial rheometer (Bohlin CVO120) was used to mechanically test materials that approximate vocal-fold tissues. Application is to frequencies in the low audio range (20-150 Hz). Because commercial rheometers are not specifically designed for this frequency range, a primary problem is maintaining accuracy up to (and beyond) the mechanical resonance frequency of the rotating shaft assembly. A standard viscoelastic material (NIST SRM 2490) has been used to calibrate the rheometric system for an expanded frequency range. Mathematically predicted response curves are compared to measured response curves, and an error analysis is conducted to determine the accuracy to which the elastic modulus and the shear modulus can be determined in the 20-150-Hz region. Results indicate that the inertia of the rotating assembly and the gap between the plates need to be known (or determined empirically) to a high precision when the measurement frequency exceeds the resonant frequency. In addition, a phase correction is needed to account for the magnetic inertia (inductance) of the drag cup motor. Uncorrected, the measured phase can go below the theoretical limit of -pi. This can produce large errors in the viscous modulus near and above the resonance frequency. With appropriate inertia and phase corrections, +/- 10% accuracy can be obtained up to twice the resonance frequency.
Otorhinolaryngologists throughout the UK routinely perform middle ear operations. Although the risk of serious complications in the hands of a well-trained surgeon is very low, some of the complications of middle ear surgery are devastating to the patient viz. facial nerve palsy and complete hearing loss. The subject of informed consent is highly topical because of clinical governance and medico-legal implications. We have audited the practice of the Consultant members of the British Association of Otorhinolaryngologists-Head and Neck Surgeons via a postal questionnaire with regards to their consenting process prior to middle ear operations. Our study looked at the practice of discussing different complications and the complication rates, the person consenting, time spent on consenting, and the documentation. We found that wide variations exist in the consenting process. The implications of the results are discussed. This study is particularly pertinent at the present time with the implementation of the new consenting standards document published by the Department of Health.