PubMed · 15418694
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A GLORIG. 1950. Problems in hearing.. https://pubmed.ncbi.nlm.nih.gov/15418694/
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BACKGROUND: The principal factors that decide how deafness affects a child's development are the degree of hearing impairment and the age at which it is diagnosed. A number of factors are thought to increase the risk of hearing impairment: low birth weight, prematurity, perinatal hypoxia and jaundice, among others. The high incidence of deafness in children without risk factors and the introduction of simple new screening tests of high sensitivity and specificity has led many prestigious bodies to recommend universal early detection programmes for deafness rather than screening targeted only at high-risk groups. OBJECTIVES: To compare the long-term effectiveness of a universal neonatal screening and early treatment programme for hearing impairment with: a) screening and treatment only of high-risk neonates and b) opportunistic screening and treatment. SEARCH STRATEGY: Databases searched were MEDLINE (1966 to 2003), EMBASE (1974 to 2003), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2004) and registers of health technology assessment agencies as well as registers of clinical guidelines. SELECTION CRITERIA: Randomised controlled trials comparing universal neonatal screening with either high-risk screening or opportunistic screening for hearing impairment. DATA COLLECTION AND ANALYSIS: Two review authors independently screened the search results to identify suitable trials. MAIN RESULTS: No studies were identified which fulfilled the inclusion criteria. AUTHORS' CONCLUSIONS: The long-term effectiveness of universal newborn hearing screening programmes has not been established to date. There is a need for controlled trials and before and after studies to address this issue further.
The extraordinary improvement of patient outcome after surgical treatment for vestibular schwannomas is relatively recent and has occurred mainly over the last 30 years. The introduction of microsurgical techniques has resulted in increasing degrees of precise anatomical and functional preservation of the facial and cochlear nerves. An expanded microsurgical technique accompanied by continuous electrophysiological monitoring has resulted in marked changes in the primary goals for this surgery. Whereas in the past the primary goal of vestibular schwannoma management was to preserve the patient's life, the objective in vestibular schwannoma treatment today is to preserve neurological function. Long-term follow-up examinations show negligible recurrence rates, indicating that the aim of preservation of nerve function does not limit the completeness of tumor removal with modern neurosurgical techniques. Despite these advances in preserving the anatomical integrity of, for example, the cochlear nerve, losses of function and even deafness may occur postoperatively in some cases. Current biological and technical research in experimental and clinical settings addresses these problems. In this article, the authors report in detail the developments achieved in vestibular schwannoma surgery and the great clinicians to whom these results can be credited.
We have made a bibliographyc review of the most important otology books from the end of the XVIII to the begining of the XIX century. We propose several hipothesis of the diagnoses and treatment of Goya's deafness in relation to the contemporary otological advances.