A. Palva

Undistorted And Filtered Speech Audiometry In Children With Normal Hearing

Undistorted and filtered speech tests were carried out in 140 test subjects with normal hearing acuity ranging in age from 4 to 19 years. Routine adult word lists were used in all tests. The intelligibility of undistorted speech rose markedly in the age groups from 4 to 9 years and correspondingly in the filtered speech test up to 11 years, taking the group 16-19 years as basis of reference. According to these results a speech discrimination test can be made in childhood with the same methods as in adults, if the norms are taken into account. In the filtered speech test the binaural test result and the monaural discrimination ability of the left ear were significantly better than the monaural test results for the right ear up to the age of 12-13 years.

Presbyacusis: V. Filtered Speech Test

The effect of age on discrimination of filtered speech was studied with two different frequency bands using the monaural test and Matzkers binaural test. The intelligibility of filtered speech fell very early as a function of age. In the binaural test deterioration was noted in the group 30–39 years, taking the group 20–29 years as basis of reference. The change in intelligibility occurred before any changes appeared in pure tone thresholds in the frequency area of the filtered speech test. After 60 years, a significant asymmetry appeared in discrimination of filtered speech. Intelligibility was better in the binaural test and the monaural test of the left ears than in the right ears. This difference was attributed to the effect of cerebral dominance becoming evident in the degenerated central auditory pathways. Under 60 years of age the compensatory mechanism of the centrencephalic system apparently prevents the effect of cerebral dominance in filtered speech test.

Arachnoid cyst of the intraorbital portion of the optic nerve with unilateral disc oedema and transient shallowing of the anterior chamber. A case report.

An unusual occurrence of chronic monocular disc oedema, visual loss and shallowing of the anterior chamber in a patient with an arachnoid cyst involving a portion of the intraorbital optic nerve was reported. Decompression of the optic nerve sheath through a Krönlein approach was followed by prompt deepening of the anterior chamber and a gradual, delayed relief of the disc oedema. It is concluded that orbitotomy and decompression of the optic nerve sheath should be done before atrophic changes of the optic nerve and visual loss begin to develop.

Can an Operation on a Deaf Ear be Dangerous for Hearing

After a single or modified radical mastoidectomy the hearing of the contralateral ear was followed by pure tone audiometry in 55 patients. In 12 patients a sensorineural--mostly high tone--hearing loss of at least 20 dB was found in the contralateral ear. In six cases this was persistent. The number of patients with hearing loss increased with increasing operation time. The cause of this hearing loss must be the noise of the bone-cutting burr.

Eustachian—tube patency in chronic ears preoperative evaluation correlated to postoperative results

Eustachian—tube patency was measured with Bortnicks technique in 120 chronic ears. The positive test correlated reasonably well with good postoperative results in the normal tympanum and in cases of mild tympanal pathology. In general, the otomicroscopic result as found to provide a more reliable basis for estimation of the prognosis of tympanoplasty. If the formation of adhesions during the primary healing period is prevented, the function of the Eustachian tube can postoperatively be restored, making an aerated tympanum possible.

Comparative Trial of Flunisolide and Beclomethasone Dipropionate Nasal Sprays in Patients with Seasonal Allergic Rhinitis

In order to evaluate the effects of flunisolide and beclomethasone dipropionate nasal sprays on seasonal allergic rhinitis, 45 patients were included in an open parallel comparative trial. The study design was open because of the different dosage schedules for the two preparations. Strict criteria were set up for patient selection, and all patients were carefully examined and assessed before and after the 4‐week trial period. Throughout the whole treatment each patient kept a detailed daily record. A substantial or complete control of symptoms was achieved in 18 of the 21 patients on flunisolide and in 20 of the 22 on beclomethasone dipropionate. No serious side effects were observed. Thus it can be concluded that both test drugs are effective and well tolerated in the treatment of seasonal allergic rhinitis.

Immunological Defects in Children With Chronic Otitis Media

A total of 59 children with chronic otitis media were examined for possible immunological defects by determination of serum gammaglobulin and immunoglobulins IgG, IgA and IgM, and by a tuberculin test, and additionally by noting any lymphopenia. Some divergence from normal values was found in 38 patients (64%). 14 children (24%) showed pathologically low immunoglobulin levels and 7 (12%) even a subtotal absence of one of the immunoglobulin fractions. 8 of the cases (14%) also showed a reduction of gammaglobulin level. In 20 children (34%), the level of one or more of the three major Ig classes was elevated. All except one became clinically normal within a few years, showing normal gamma or immunoglobulin levels when tested. The tuberculin test was positive in all patients. The length and course of the disease in these cases was similar to that in patients with normal test values. Gammaglobulin therapy did not have any beneficail effect. Consequently, it is concluded that although humoral immunological defects may be one aetiological factor, they do not play any major role in the course of chronic otitis media in children.

The Role of the Binaural Test in Filtered Speech Audiometry

The value of the binaural resynthesis test administered according to Matzkers principle can be estimated only when a comparable monaural test can be used as a control. The most common positive finding in the filtered speech test is asymmetrical discrimination. Both parts of the message delivered to either ear must therefore have the same intelligibility in normal material. Binaural intelligibility is highly resistant to degenerative changes in the auditory system, for example. Positive findings in the binaural test are encountered frequently in brain stem lesions with vascular or traumatic aetiology.

Surgical treatment of Meniere's disease.

Results are reported of the effect ov various surgical methods on vertigo in Menieres disease. Minor preocedures like sacculotomy or application of NaCl crystals in the round window may effect a cure, but often results in deaf ears. Vestibular nerve section seems to offer the best of vertigo, while generally still preserving residual hearing.

Auditory Adaptation at Threshold Intensities

Using the technique of manual adaptation test, recordings of perstimulatory changes at threshold were made during a 3-min. stimulation period on 300 patients, suffering mainly of perception deafness. Results are reported of the magnitude of the perstimulatory threshold shift at various frequencies, of the relation of this shift to recruitment phenomenon, and of the frequency of cases with extreme tone decay in various diagnostic groups.