Eugene L. Derlacki

Revision stapes surgery; problems with some solutions

A review of 217 consecutive revision stapes operations performed during a ten‐year period revealed that the surgeon encounters more pathological variables than he does during primary operations. Hence, the technical solutions are less stereotyped and the net results less predictable.

Effect of Conductive Hearing Loss and Middle Ear Surgery on Binaural Hearing

This study investigated whether conductive hearing loss reduces normal binaural hearing advantages and whether binaural hearing advantages are normal in patients who have had hearing thresholds improved by middle ear surgery. Binaural hearing was assessed at a test frequency of 500 Hz using the masking level difference and interaural time discrimination thresholds. Results indicated that binaural hearing is often poor in conductive lesion patients and that the reduction in binaural hearing is not always consistent with a simple attenuation of the acoustic signal. Poor binaural hearing sometimes occurs even when middle ear surgery has resulted in bilaterally normal hearing thresholds. Our preliminary results are consistent with the interpretation that auditory deprivation due to conductive hearing loss may result in poor binaural auditory processing.

Binaural Hearing after Middle Ear Surgery: Masking-Level Difference for Interaural Time and Amplitude Cues

Previous investigations have shown that binaural hearing is often abnormal in patients having conductive hearing losses, and even in patients who have had hearing thresholds corrected by middle ear surgery. The present study assessed further the masking-level difference (MLD) in patients who had previously undergone middle ear surgery. The stimuli were chosen such that the sensitivity to interaural time difference cues and to interaural amplitude difference cues could be assessed independently. Results indicated that the MLD is abnormal in more than a third of 15 patients, even after surgery has restored normal hearing at the frequency of the test. The MLD is more likely to be reduced for the cue of interaural time difference than for interaural amplitude difference. Subjects who had lesions of long duration, early onset, and large asymmetry were particularly likely to have reduced MLDs.

Stapes Prosthesis Comparison

Ninety-four consecutive stapedectomy cases using the Robinson stainless steel prosthesis are compared with 100 consecutive cases using the House stainless steel wire prosthesis. The air-bone gap was closed to within 10 dB in 94% of the cases with the Robinson prosthesis and in 88% of the cases using the House stainless steel wire prosthesis. There appeared to be no difference in the improvement at 2,000 and 4,000 cycles between the two techniques and the results were the same. Statistical study revealed there is no significant difference in the two techniques and there is no other variable.

Introduction of Mr Ralph Lynam

Presented at the 1978 Annual Meeting of the American Academy of Otolaryngology, Las Vegas, Sept lOU. Mr Lynam is addressing his remarks to a momentous undertaking of lions Clubs International to provide their support and recognition to ear and hearing disorders, which until now have been given to many other crippling human afflictions. We are all aware of the tremendously successful support lions Clubs have provided for service to the blind. Now that they are offering a similar dedication to working in behalf of the communicatively handicapped, all of us in otolaryngology must be ready to accept the challenge of doing our share in this magnificent humanitarian effort of Mr Ralph Lynam and lions Clubs International.

CHRONIC PROGRESSIVE DEAFNESS, INCLUDING OTOSCLEROSIS AND DISEASES OF THE INNER EAR: Summaries of the Bibliographic Material Available in the Field of Otolaryngology for 1951

The literature on chronic progressive deafness has become so extensive that it necessitates for abstracting purposes brevity and the omission of repetitive reports. The papers reviewed are arranged under the headings of otosclerosis, Menieres disease, toxic labyrinthitis, acoustic trauma, function and diseases of the labyrinth, hearing tests and auditory training, and miscellaneous contributions on deafness. Otosclerosis Hall 1 studied the bone removed from 120 fenestration operations, correlating the clinical data with the pathology. Various stages of the disease were demonstrated. These changes seemed to center around the vascular spaces, thus supporting the vascular theory of the origin of otosclerosis. The Nylens 2 suggest that a particular vascularization of the otic capsule and/or a metabolic disorder, mainly due to imbalance of the internal glands of secretion, are of importance in the genosis of otosclerosis. At present the most plausible disturbance seems to be a slight primary or secondary dysfunction of the