[Air conduction or bone conduction hearing aids? Comments on hearing aids for sound conduction deafness (author's transl)]. / Luft- oder Knochenleitungshören? Zur Hörgeräteversorgung von Schalleitungsschwerhörigen.

Measuring curves and psycho-acoustical measurements are used for an investigation of the extent to which the bone-conduction hearing aid is equivalent to the air-conduction hearing aid. It can be shown that basically there is no objection against the use of a bone-conduction hearing aid (ear-level aid) for patients suffering only from sound-conduction hearing defects. The air-conduction hearing aid significantly superior in those cases where the requirements to be met by the hearing aid with respect to the frequency range (music) are higher. If the sound conduction disorder is accompanied by a sound paralgia, this means that the essentially reduced dynamic range of the bone-conduction hearing aid significantly restricts the possible applications of the bone-conduction hearing aid.

[Intelligence tests in patients suffering from chronic rhinopathy (author's transl)]. / Intelligenzuntersuchungen bei Patienten mit chronischen Rhinopathien.

In 100 patients referred to the allergy clinic of the First Otolaryngological University Hospital of Vienna because of chronic rhinopathy an exact allergy diagnosis was carried out, comprising anamneses, skin tests and laboratory tests (Rast, Prist). The test results have yielded two or three diagnosis groups: patients with rhinitis vasomotorica nonallergica, rhinitis vasomotorica allergica, and pollinosis. In addition, in all patients an intelligence test by means of WIP (a short form of HAWIE) was carried out. The IQ of all patients tested is, on the average, significantly above the average of the normal population, the variation in all three groups being significantly below the average of the normal population. The reason for the low degree of variation is that patients with low IQ values were missing. Earlier tests carried out by this clinic (allergy-screening test in 3500 school pupils) had shown that the percentage of allergy patients among pupils with low IQs (special schools) and other children (secondary-schools) cannot be assumed to be of a varying degree. This fact demonstrates that although allergy patients with below-average intellectual ability do exist, they obviously do not consult the respective special clinics. This paper tries to explain this phenomenon and suggests that the socially lower strata be increasingly informed about the problem of allergy.

[Determination of the morbidity due to inhalation allergies in Viennese schoolchildren (author's transl)]. / Ermittlung der Morbidität von Inhalationsallergien.

According to the medical literature there is a huge variation of between 0.4 and 49% of the population reported to suffer from inhalation allergies. In general, however, reference is made time and again to the increasing incidence of allergies, particularly in children. In the present study 3,158 Viennese schoolchildren of three different age groups (8, 12, and 16 year-olds) were tested for inhalation allergy. Precise case histories were elicited and skin tests carried out in all children, and if one of these criteria was positive an immunological examination was performed in addition, in order to detect any specific antibodies in the serum. A point system was used for the diagnosis of allergy. The tests showed that 17.6% of the schoolchildren have an allergic predisposition, 10.1% suffer from clinically manifest allergy and 7.5% show a subclinical form. With advancing age the percentage of children suffering from allergies increases significantly: While among the 8 year-olds only 13.6% show a predisposition to allergy (6.8% manifest, 6.8% latent), the incidence among the 16 year-olds is as high as 22.1% (14.2% manifest, 7.9% latent). Among the allergy patients pollen sensitization was found to exist in 71.7% of cases, sensitivity to household-dust mites in 23.1% and 5.2% reacted to multiple allergens. The results of this study are discussed and compared with internationally obtained data.

[Otosclerosis: surgical improvement of hearing and primary labyrinthine efficiency (author's transl)]. / Otosklerose: Operative Hörverbesserung und primäre Innenohrleistung.

The result of stapedectomy in which the stapes were replaced by a Schuknecht prosthesis is examined on the basis of 156 audiograms. Of particular interest is the connection between the degree of restored hearing through surgery and the preoperative bone-conduction hearing loss. The degree of restored hearing can be proved to be independent of the preoperative performance of the inner ear, which means that in patients with a higher degree of inner-ear involvement the raising of the air-conduction hearing threshold is achieved in the same way as in patients without inner-ear involvement.

Influence of aerobiology and weather on symptoms in children with asthma.

Local and central European weather, pollen (Castanea and Poaceae) and spore (alternaria and cladosporium) counts, and asthmatic complaints and drug requirements (expressed as "attack score") were correlated in a group of 40 asthmatic children (21 with recurrent symptoms) during a summer holiday camp for 6 weeks. It was shown that there are significant correlations between the cumulative 24-hour pollen count over 6 weeks and the attack frequency. 2-Hourly counts or daily counts did not correlate with complaints. Consecutive 10-day averages of attacks and pollen and spore counts showed good agreement. The influence of local weather was negligible. Low pressure gradients or high atmospheric pressure was not beneficial. Improvements of lung function are ascribed to training effects.

[Reactions of the nasal mucous membrane as a consequence of allergological skin tests (author's transl)]. / Nasenschleimhautreaktionen als Folge allergologischer Hauttests.

The nasal resistance and the temperature were measured in both nasal lumina immediately before and 20 minutes after an allergological skin test in 75 patients admitted to the allergy ward because of suspected allergic rhinitis. The measurements were carried out by means of a passive anterior rhinomanometer according to van Dishoeck and the results served as parameters of the reaction of the nasal mucous membrane. In order to secure the allergy diagnosis, the skin tests were supplemented by a carefully taken case history as well as by RIST and RAST. The 100 skin test series carried out in this investigation showed an increase in the resistance and in the temperature in most of those patients whose positive skin test result corresponded to the final diagnosis. These reactions were most pronounced in the screening tests, and were also confirmed by the herb, tree and mould tests. Furthermore, the temperature in the nasal lumen increased sooner than the resistance. Thereby it was possible to prove that in allergological skin tests the shock organ, i.e. the nasal mucous membrane in the cases discussed in this paper, shows a marked concomitant reaction if there is a manifest allergy to the allergens used in the test.

[The determination of the aggressiveness of allergizing types of pollen (author's transl)]. / Die Bestimmung der Aggressivität allergisierender Pollenarten.

It is a well-known fact that the same amount of various pollen does not cause the same intensity of complaints in different patients with hay fever. This empirically obtained fact has been made objective and applied to the needs of practical allergology. From 1976 to 1978 qualitative and quantitative measurements were carried out on the pollen content of the air in Vienna. At the same time 300 patients with hay fever, who had been thoroughly investigated, made daily recordings of their complaints during the pollen season. A comparison of the two sets of data shows that they correspond well at the time of grass blossoming, yet differ strikingly during the blossoming of trees and herbs. Therefore, the grass pollen count is taken as the basis for any further calculations. By adjusting the amount of all the other types of pollen to the patients' complaints, "correction factors" are established for those types of pollen that are allergologically most important. These correction factors indicate the relative aggressiveness of the individual types in comparison with the grass pollens. In addition, the frequency of sensitization to individual types of pollen was determined in 500 patients at the First Otolaryngological Department of the University Hospital of Vienna. By multiplying the frequency by the correction factor we arrive at the "potency factor" as a measure of the allergological significance of the respective pollen type. The threshold value is indicated as a further parameter. The threshold value is the pollen count per cubic metre of air required to elicit complaints in the average number of sensitized patients. The threshold value for grass pollens is 50 per cubic metre of air; hence the following formula is derived for the determination of the threshold value: (formula: see text). The potency factor and the threshold factor are valuable parameters in the diagnosis, prophylaxis and therapy of hay fever.

[A modified therapy of hayfever with a depot-preparation (author's transl)]. / Modifizierte Therapie mit einem Depotpräparat bei Gräserpollenallergie.

70 patients with clinically and immunologically verified grass pollen allergy received immunotherapy for the first time in 1977 and 1978. The 70 patients were divided into 3 groups. Group 1 received 18 injections of a 7 grass pollen extract (semi-depot, Allpyral). Group 2 was treated with 3 injections of a tyrosine adsorbed grass pollen vaccine (Pollagen) immediately preseasonal and Group 3 received 5 injections of the same. Therapy was from September 1977 to May 1978. All patients completed dairy cards on a daily basis for the 1978 season including data on additional medication and areas visited. The air pollen concentration was monitored at various sites in Vienna and surrounding area. Reviewing the symptoms of the 3 patients we noted stronger symptoms reported in Group 2 than in Group 1. There was no significant difference in severity of symptoms in Group 1 and Group 3. The data indicate that a treatment with a course of 5 injections of a tyrosine adsorbed grass pollen vaccine is better than a course of 3 injections of the same product, and equivalent to a standard course of therapy with a semi-depot product.

[The relevance of cereal grain pollen in hayfever (author's transl)]. / Die Bedeutung der Getreidepollen bei der Pollinose.

Our studies indicate that rye pollen appears to be an important factor in hayfever in Austria. High air concentration of rye pollen are not only found in the immediate vicinity of the cultivated fields, but also at considerable distance from these fields. It is important to note that the rye plant produces about 8 to 35 times more pollen per anther than the wheat plant. Corn (Zea mays) pollen is found in lower concentrations as an airborn pollen because of its density. The importance of rye pollen in hay-fever has been substantiated in a clinical study and by the "biological exposure test".

[Reduced allergen immunotherapy of grass pollinosis (author's transl)]. / Allergenreduzierte Immuntherapie bei Gräserpollinose.

An excellent model for investigating the maximization of specific immunotherapy is grass pollen allergy. Treatment is more effective when the number of component antigens used are reduced. We know that rye and cocksfoot pollen carry major antigens of grass pollen. A controlled clinical study was carried out with 128 patients divided into 5 groups as follows: Group 1 - treatment with a mixture of 7 grass pollen extracts (Allpyral). Group 2 - treatment with a cocksfoot pollen extract (Allpyral). Group 3 - treatment with a rye pollen extract (Allpyral). Group 4 - treatment with a mixture containing 50% rye pollen and 50% cocksfoot (Allpyral). Group 5 - was control group without immunotherapy. In brief, groups 1 to 4 showed better results than group 5. Group 2-cocksfoot, group 3-rye and group 4-cocksfoot-rye showed significantly better results than group 1-7 grass pollen extract. When severe symptoms were present the group 4, rye-cocksfoot treatment was significantly better than the others. This example illustrates the fact that specific allergen use improves the success of immunotherapy. In grass pollen allergy treatment cocksfoot and rye are of particular importance.

[Injured tongue due to bite of fer-de-lance (author's transl)]. / Bissverletzung der Zunge durch eine asiatische Lanzenotter.

A nine-year-old boy was bitten in the tongue by an Asiatic fer-de-lance, a Trimenesurus wagleri. No generalized toxic reaction developed; there was only locally a massive edema of the tongue leading to a severe dyspnea. The child was intubated and administered antiphlogistics, antibiotics, cortison, a tetanus booster shot as well as parenteral nutrition. After three days the local status was unchanged. Because of the danger of the development of necrosis in the laryngeal region as a result of the toxic effect and the sustained intubation, a tracheotomy inferior was carried out. The status localis improved considerably after surgery, so that a week after the bite the tracheostoma could be closed. Four weeks later no pathological findings were made any more, the tracheostoma had healed up well.