PubMed · 334505
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F Scharfetter. 1977-10-28. [Vertigo].. https://doi.org/10.1055/s-0028-1105539
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The effect of middle-ear dysfunction and disease on hearing and language development at one year of age was evaluated for 143 high-risk infants. These infants were categorized as normal or abnormal based on otologic history, otoscopic examinations, and on tympanometric examinations. Language was significantly related to gestational age, being delayed by approximately the amount of prematurity. Language scores were therefore adjusted for gestational age. Speech-detection threshold was not related to gestational age, and was used as the measure of hearing. Hearing levels were negatively correlated with adjusted language quotients. Infants with abnormal otologic histories reported were not different from infants with normal histories in either hearing or language development. Infants with bilateral otoscopic abnormalities had significantly higher speech-detection thresholds, but did not differ in language development from those with bilaterally normal otoscopy. Infants who were abnormal bilaterally by tympanometric examination had significantly higher speech-detection thresholds as well as significantly delayed language development. A significant effect on both hearing and language was found among those infants bilaterally abnormal by tympanometry for whom evidence of middle-ear disease was not visualized by otoscopic examination. Implications of these findings are discussed.
Tuning fork tests are used routinely by many otologists. A different group of otologists find the tests inconsistent and unreliable. This controversy has probably developed because the audiometer has replaced the tuning fork in hearing measurement. As a result, the art of use of the tuning fork is poorly learned. This study examines decay, one of the physical parameters of tuning forks. Measurements of acoustic (sound wave) and vibration (stem movement) decay were made. Alteration in decay due to pressure changes on the fork stem were studied. Acoustic signals were generated in an anechoic chamber. Vibration measurements were obtained using an artificial mastoid. Analysis of the signals was accomplished by a system of amplifiers, filters, tape recorders, and a graphic recorder. Tuning fork sound decay is a property of the instrument which occurs every time the fork is struck. The decay is a constant in decibels per second. The acoustic mode and the vibration mode decay at similar rates for the same fork. The strike frequency (a higher frequency than the fundamental produced when the fork is struck) also has a constant decay rate in decibels per second, and it is reported here for the first time. Force of 800 gm. and less applied to the bottom of the stem in vibration measurement caused minimal decay constant changes. When the physical parameters of the tuning fork (including this information on damping) are fully studied, tuning fork testing should become more of a science and less of an art.
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