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At least 19 recordsLinked to original sources
PubMed1988

Sensitivity and specificity of audiological tests in patients with vertigo.

In patients with vertigo a comprehensive test battery has been used for localizing pathological processes responsible for the symptoms. Audiological tests have been an integral part of the otoneurological investigation. However, in many studies the diagnostic sharpness of psychoacoustic tests in the localization of specific disease in the cranial nerve system has been called in question. Other tests, such as stapedius reflex and auditory brainstem response, have been of increasing importance in the diagnostic set-up. The purpose of this paper is to present a survey of the literature regarding the position of audiological tests in otoneurology.

Acoustic Impedance Tests↗
PubMed1987

Quantitative interpretation of audiological test battery. I. A comparison with ABR in 97 cases of unilateral sensorineural hearing loss.

A retrospective study was made of 97 patients with unilateral sensorineural hearing loss who underwent an audiological test battery and ABR during a 2 1/2-year period. The test battery included tone- and speech audiometry, Békésy audiometry, loudness balance test, tone decay test and impedance measurements (reflex thresholds and reflex decay). A quantitative interpretation of each audiological test was tried out and a mean value of included tests (audiological test score ATS), was compared with results of ABR. The audiological test score showed the same predictive value as ABR for detection of acoustic neurinomas. Among the auditory tests, Békésy audiometry had the lowest sensitivity. Eight patients with neurinomas were found in the series. Retrocochlear test results prevailed in another 23 ears, most often in combined hearing loss and vestibular dysfunction and in insidious or longstanding hearing loss. Quantitative interpretation of the audiological test battery is valuable for uniformity in classification of sensorineural hearing loss, and will facilitate extended studies on aetiology and course in auditory dysfunction.

Adolescent↗
PubMed1982

[Behavior of the stapedius reflex in long-term acoustic stimulation].

The present examination shows the action of the acoustic reflex on stimulation with a pure tone of 500 cps which lies 10 dB above the reflex threshold by impedance measurement. The duration of stimulation lasts 5 min. The test results of persons with normal hearing, persons with cochlear and retrocochlear lesions were measured according to the amount, the duration, the beginning, and the speed of reflex decay. The preliminary results permit the following conclusions: Persons with noise-induced hearing loss show no reflex decay for the entire duration of stimulation. Persons with normal hearing show a reflex decay after 2 min. After another 135 sec a constant reflex amplitude is attained. Subjects with cochlear lesions which are not caused by noise show similar reflex behavior. The amount of decay is larger, and the decay begins earlier. Persons with retrocochlear lesions show heterogeneous results, but the average amplitudinal decay is rapid and exceeds 50 per cent. The underlying mechanisms are discussed. In our opinion muscle fatigue plays an important role, which is absent in noise-induced hearing loss due to a permanent muscle training caused by the chronic noise exposure. The main result for audiology lies in the possibility to distinguish clearly between noise-induced hearing loss and other forms of cochlear lesions.

Acoustic Impedance Tests↗
PubMed1979

[Sisi-test - a faulty test method? (author's transl)].

Doubts of reliability of SISI-test are based on lack of understanding and knowledge of what this test can disclose and where it should be placed in an audiologic test battery. Examination of normal hearing medical students with the SISI-test showed much better results than comparable test figures of other authors. There is a distinct difference with regard to the test intensity as well as the test frequency. Results show that their is no reason to disqualify the SISI-test.

Audiometry↗
PubMed1984

Inherited low-frequency hearing loss. A new mixed conductive/sensorineural entity?

Eighteen patients with low-frequency hearing loss ( LFHL ), 10 males and 8 females with an average age of 27 years, were examined in order to classify their hearing loss, i.e. to find the topical site of the hearing lesion and to evaluate the aetiology of the hearing disorder. Based on extensive audiological test procedures, the patients could be subdivided into two groups: Group A comprising 11 patients with true sensorineural hearing impairment caused by various well-known aetiologies, and group B comprising 7 patients in whom no classification of the LFHL could be made because of conflicting test results. In group B, family investigations demonstrated that the hearing loss could be ascribed to inheritance in 6 of the patients. The clinical findings and outcome of the audiological tests are discussed and, on the basis of this and a comparison with other rare entities, a hypothesis of a new, unrecognized entity within LFHL is suggested.

Adolescent↗
PubMed1987

Audiologic diagnosis of central versus eighth nerve and cochlear auditory impairment.

122 subjects divided into four groups according to the site of lesion (cochlea, eighth nerve, brainstem and temporal lobe) were subjected to an audiometric test battery, including pure-tone sensitivity measures, recruitment testing, tone decay, Békésy audiometry, speech audiometry, stapedius reflex measures and auditory brainstem response (ABR) audiometry. The results were contrasted among the four groups by calculating several measures of test performance, including sensitivity, specificity, efficiency, A' (test performance) and plots on the receiver operating characteristic (ROC) space of pure positives versus false alarms. In the differential diagnosis between eighth nerve and cochlear site, the various measures did not rank the tests in the same order: (a) for efficiency: ABR, Békésy audiometry; (b) for A' (similarly to the analysis into the ROC space): ABR, recruitment, Békésy, stapedius reflex, speech audiometry, tone decay. In distinguishing an eighth nerve from a brainstem site, it is important to consider amount of hearing loss, presence of tinnitus, abnormal tone decay and Békésy audiometry patterns. ABR adds significant diagnostic efficiency only when waves II, III and V are detectable: a prolonged I-II interpeak interval (IPI) and a normal III-V IPI are characteristic of the eighth nerve site. ABR gives good diagnostic support in the intrinsic brainstem lesions by suggesting changes in the generator sites of the component waves. The audiometric diagnosis of temporal lobe lesions involving the auditory cortex still relies upon speech audiometry: tests specifically designed for this purpose by Bocca and Calearo and by Jerger - i.e. the 'sensitized sentences' and the identification of synthetic sentences under ipsi- or contralateral competing message - are commendable for their sensitivity and efficiency in distinguishing brainstem from temporal lobe sites. In brainstem sites, the most affected ear is ipsilateral to the lesion for ABR, but contralateral for speech audiometry.

Adolescent↗
PubMed1979

Auditory dysfunction with facial paralysis.

A series of 58 patients with idiopathic facial paralysis were studied to determine if a concomitant cochlear or eight nerve auditory dysfunction could be identified with traditional audiologic tests. Results indicated that only those patients with a facial nerve lesion, proximal to the stapedius branch, experienced reduced tolerance for loud sounds, reduction of speech discrimination at high-intensity levels, and abnormal loudness growth. Such findings suggest that changes in auditory function, accompanying facial nerve paralysis, are a mechanical effect due to absence of stapedial action. Site of lesion tests in this sample failed to demonstrate eighth nerve dysfunction and, thus, does not support a theory of polyneuropathy that involves the auditory nerve.

Adolescent↗
PubMed1986

Hearing loss due to aging (presbycusis).

Presbycusis is the progressive hearing loss caused by histologic changes due to aging. Schuknecht described four histopathologic types of presbycusis and correlated these findings to audiometric data. In a retrospective study, some strict criteria were set to distinguish the "pure" cases of presbycusis in a group of 1,181 subjects, 50 years of age and older, seen in our Audiology Clinic over one year; 91 subjects were found to meet these criteria. An attempt was made to fit the pure tone threshold curves into the types described by Schuknecht and correlate these curves to speech discrimination, tone decay, recruitment, age and sex of these subjects. It was found that: (a) only 50% of these audiograms could be fitted into the described histopathologic types, suggesting that in 50% of the subjects, presbycusis was caused by more than one degenerative process; (b) in 86% of subjects, speech discrimination was excellent or good in quiet; this test therefore may not reflect the difficulties presbycusis have in understanding speech under adverse auditory conditions; (c) subjects with flat pure tone threshold curves had generally good discrimination; (d) no differences were found between males and females; and (e) tests for tone decay and recruitment showed that in most cases the hearing loss was due to cochlear pathology, but these data do not exclude the possibility of central auditory involvement.

Age Factors↗
PubMed1989

Diagnostic vetting of individuals with asymmetric sensorineural hearing impairments.

Audiological and vestibular tests were administered conjointly in a neurological or general ORL clinic to exclude cerebellopontine angle (CPA) tumours. This study aimed to assess the efficiency of various tests in achieving that exclusion with the minimum of unnecessary investigations. All patients received the full battery of auditory brainstem responses, acoustic reflex thresholds and decay, alternate binaural loudness balance and ENG and caloric testing. All patients who did not have normal auditory brainstem responses proceeded to high resolution CT scanning. One hundred and fifteen patients were investigated and four acoustic neuromas were diagnosed. The efficiency of these tests in a general ORL clinic is very much poorer than often suggested, due largely to the number of occasions on which the tests cannot be done, and to the very small proportion of the test population who have CPA tumours.

Adolescent↗
PubMed1983

Acoustic neuromas. Progression of hearing impairment and function of the eighth cranial nerve.

The results obtained by conventional otologic evaluation are reported for fifty-nine patients with acoustic neuromas, sixty-one patients primarily suspected of an acoustic neuroma but in whom Pantopaque cisternography had invalidated the diagnosis, and in seventy-one patients with Meniere's disease. The audiologic tests were confined to the following: pure-tone audiometry, speech audiometry, recruitment examination by ABLB and Metz recruitment tests, and examination for reflex decay a.m. Anderson. Nineteen patients had an audiogram taken at their initial visit with the otologist, and already at this examination--4.2 years before the diagnosis was made--a high-tone hearing impairment was present. Fourteen patients had anacusis in the tumor ear and one patient had an impairment of 90 dB. The audiologic evaluations are based only on patients with hearing equal to or better than 80 dB. There was no connection between preoperative hearing impairment and the age at operation, and anacusis was found in all age groups. Four patients had recruitment by the ABLB test and six patients by the Metz recruitment test. When these two tests were combined, two patients had recruitment by both tests. Twenty percent had pathologic stapedial reflex decay. Only one patient had a normal differential caloric test. It is concluded that the typical patient with an acoustic neuroma has a gradually increasing unilateral hearing impairment of eight years' duration. A pronounced high-tone impairment with PTA of 55 dB and a poor discrimination score are to be expected. The patient is uncertain at pure-tone threshold determination and displays a lack of recruitment at both ABLB and Metz recruitment tests. The patient has a decreased or nonexistent differential caloric reaction in the ear in question. A normal differential caloric test does in all probability exclude an acoustic neuroma; however, all possible audiometric and anamnestic configurations may be encountered, and deviation from the "typical" picture should not lure the investigator into excluding the presence of a neuroma.

Adult↗
PubMed1981

Acoustic neuromas. Diagnostic efficiency of various test combinations.

In the majority of diagnostic tests usually used in the search for acoustic tumors, there is a large difference in the outcome between patients with and without tumors. Because of a possible coherence between the tests applied, a statistical analysis of this connection was performed with the aid of a logistic model. The best single investigation used to differentiate between patients with and without tumors was tomography of the internal acoustic meatus. This examination was used in combination with the differential caloric test and the alternate binaural loudness balance recruitment test to differentiate completely between patients with and without tumors. Results of other examinations did not contribute significantly to the differentiation between patients with and without tumors. This factor did not render the other examinations superfluous because the analysis was valuable only in patients with a hearing level better or equal to 80 dB. By applying the other tests, information was obtained on pressure conditions in the internal acoustic meatus and possible difficulties at surgery, as well as information about the size of the tumor.

Audiometry, Pure-Tone↗
PubMed1993

Use of alprazolam for relief of tinnitus. A double-blind study.

OBJECTIVE: To systematically test the effectiveness of alprazolam as a pharmacological agent for patients with tinnitus. DESIGN: Prospective, placebo-controlled, double-blind study. PATIENTS: Forty adult patients with constant tinnitus who had experienced their tinnitus for a minimum of 1 year and who resided in the Portland, Ore, metropolitan area. Twenty patients were randomly assigned to the experimental group and 20 to the control group. RESULTS: Seventeen of 20 patients in the experimental (alprazolam) group and 19 of the 20 in the placebo (lactose) group completed the study. Of the 17 patients receiving alprazolam, 13 (76%) had a reduction in the loudness of their tinnitus when measurements were made using a tinnitus synthesizer and a visual analog scale. Only one of the 19 who received the placebo showed any improvement in the loudness of their tinnitus. No changes were observed in the audiometric data or in tinnitus masking levels for either group. Individuals differed in the dosages required to achieve benefit from the alprazolam, and the side effects were minimal for this 12-week study. CONCLUSIONS: Alprazolam is a drug that will provide therapeutic relief for some patients with tinnitus. Regulation of the prescribed dosage of alprazolam is important since individuals differ considerably in sensitivity to this medication.

Adult↗