The hearing system under thyroid hypofunction.

The auditory system has been investigated in 50 patients with thyroid hypofunction. Hearing thresholds were estimated by the pure tone audiometry, PTA. The brief tone audiometry, BTA, was carried out, evaluating differences between thresholds of shorter and longer 1-kHz tonal stimuli, 20 and 200 ms, respectively. The objective studies were established by registrations of evoked otoacoustic emissions, EOAEs, and of auditory brainstem responses, ABRs. The thresholds of ipsilateral and contralateral middle-ear muscle acoustic reflexes, ARs, were also compared. By the PTA, sensorineural hearing loss was detected in 74.0% of cases. The BTA revealed disturbances of temporal summation of excitation in cochlear receptors in 26.0% of inspected subjects. The data of the EOAE mostly corresponded to those of the PTA. In some patients, however, the PTA demonstrated normal thresholds, while the EOAEs as well as the BTA indicated abnormalities. The ABR and AR procedures detected the central hearing disorders in 30.0% and 26.0% of the tested patients, respectively. The investigations have shown that the specific hormonal therapy hardly improves either peripheral or central hearing disorders associated with hypothyroidism.

Sense of smell in workers exposed to agricultural odours.

AIM: To investigate the effect of occupational exposure to agricultural odours on sense of smell. METHODS: Olfaction was investigated in 60 employees of dairy and pig-breeding farms and compared to 60 non-farm controls living in the same rural area. Both groups were matched for age, sex and smoking habits. All participants underwent standardized, validated tests for olfactory function and were tested before and after the first day of a working cycle. In addition, farm subjects were also tested in the evening of Day 5 of this period. RESULTS: There was no difference in overall olfactory function between the two groups. Olfactory function was not related to duration of exposure to the odorous environment. CONCLUSION: These results suggest that occupational exposure to strong agricultural odours has no major impact on the sense of smell.

[Endocranial complications in otitis media: what you need to remember]. / Kopfschmerz, Schwindel, Meningismus, Krampfanfall. Steckt vielleicht eine Otitis media dahinter?

Thanks to the potency of antibiotics, life-threatening complications of otitis media are rare. In many cases, however, the symptomatology is veiled, and the course of the disease tends to be protracted. Secondary symptoms may preponderate and often mask those associated with the ear itself. If a case of otitis media fails to clear up, or mastoiditis develops, or sensorineural deafness, vertigo, headaches, seizures, or meningism occur, the possibility of an otogenous complication must immediately be considered and the patient submitted to diagnostic imaging without delay, so as to ensure early surgical treatment of a possible lesion in the ear.

[Indications and performance of diagnostic tympanotomy in children]. / Zur Indikation und Durchführung der diagnostischen Tympanotomie im Kindesalter.

From 1983 to 1987 163 children with an air-conduction loss were admitted for otosurgical treatment to the ENT clinic of the Medical Academy in Dresden. Explorative tympanotomy was necessary in 11 cases, i.e. a proportion of 6 to 7%. Indications of such tympanotomy are progressive middle-ear deafness, alterations of the ear drum and posttraumatic conduction deafness. An essential indication is the suspicion of a tumour.

[The asepsis problem at the office of the ENT physician]. / Beitrag zum Asepsisproblem am Arbeitsplatz des HNO-Arztes.

Microorganisms were determined in a microbiological study in the near environment of ENT working places. We found especially saprophytic flora as Micrococcus sp., Staphylococcus epidermidis and aerobic spore-forming microorganisms on 54 examination instruments of 2 outpatient and 2 inpatient treatment areas. In 22% of the instrument examinations, microbiological controls were negative. There were no pathogenic microorganisms.

[The diagnostic significance of auditory evoked brain stem potentials in multiple sclerosis]. / Zur diagnostischen Bedeutung akustisch evozierter Hirnstammpotentiale bei der Multiplen Sklerose.

30 patients suffering from multiple sclerosis were examined by BERA among other audiological tests. In 47% we stated significant pathological BERA-latencies, in 53% pathological interpeak-intervals. The most patients have symptoms of brainstem, but 3 cases spinal symptoms. There are no constant correlations to subjective hearing threshold measurements. According to literature BERA, especially the measurement of interpeak-intervals, increases diagnostic security of the diagnosis multiple sclerosis.

[Value of computerized tomography in paranasal sinus osteoma]. / Zur Aussagefähigkeit der Computertomographie beim Nasennebenhöhlen-osteom.

An example of a frontal ethmoidal osteoma of extreme dimensions in a juvenile of 16 years of age is discussed. We are studying the question whether preoperative diagnosis via CT can supply pointers to the involvement of neighboring tissue structures.

[Complementary acoustic EEG control while recording early acoustically evoked potentials]. / Ergänzende akustische EEG-Kontrolle bei der Ableitung früher AEP.

An easily performed method for the additional acoustical assessment of the EEG quality by the investigator during recording of human brainstem potentials is presented. By means of feedback of the audibly transposed "noiselike" EEG voltage to the opposite ear of the examined subject (instead of the usual masking noise) the subject can perceive self-produced disturbances (muscle activities) and minimize them for the period of examination. An example shows how this additional rejection of artifacts via "biofeedback" can effectively support methods that are already in use.

The influence of masking on the ipsi- and contralateral brainstem evoked potential.

We have examined clinically and experimentally the masking effects of white noise in registering brainstem evoked potentials and determining the Jewett-wave V. We studied input-output functions as well as latency periods of evoked potentials with masking of non-stimulated contralateral ears in 18 children aged 5-14 years. When differences of 50 dB or more were found between stimulation and masking, the Jewett-wave V could be partially suppressed. Other changes observed included alterations in potential and phase, as well as shifts in the latency period of the potentials. The clinical importance of the measurements determined indicates that findings may be used in examining patients with unilateral sensory hearing impairments to formulate possible differential diagnoses.

[Overview of functional results of tympanoplasty]. / Ubersicht funktioneller Ergebnisse nach Tympanoplastik.

The postoperative functional results of 448 tympanoplasties of Type 1-4, among them the late results, were reviewed via computer for the 1968-1977 decade. The average air-bone-gap decreased from 30.7 to 25.0 dB. There were no significant changes in the bone conduction of single frequencies in the long-term results. The proportion of social hearing increased from 35 per cent (pre-operative) to 52 per cent (post-operative) and to 55 per cent in the long-term results. In 27 patients (6 per cent) residual conditions were seen as in spontaneous tympanoplasty. The results reported in literature are discussed in detail.

[About the immunologic evidence of tumors in the E.N.T. field (author's transl)]. / Zum immunologischen Tumornachweis im HNO-Gebiet.

It is reported about first results of the immunologic evidence of E.N.R. tumors with the help of MEM-tests with application of HEP as antigen. The findings of 31 patients with tumours in the E.N.T. area are confronted with the results obtained from 116 tumour-free control persons and 108 patients with other swelling localisations. The sensitivity of the examinations of E.N.T. tumours was 89.3 p.c., i.e. especially favourable.

[Lymphatic node-metastasis of the neck in unknown primary tumour (author's transl)]. / Zur Halslymphknotenmetastasierung bei unbekanntem Primärtumor.

27 patients with the diagnosis "unknown primary tumour" and lymphatic node-metastasis of the neck were treated within 20 years. These are 11,7% of all neck dissections. In 18 patients the seat of the carcinoma could be found later, especially in the Glandula parotis, in the hypopharynx and in the ground of the tongue. To find the primary tumour the scintigraphy of salivary glands and of the Glandula thyroidea and a careful endoscopy have to be done. The best results of treatment are established after combined surgical-radiological therapy with neck dissection. These patients are free of recurrences on an average of 2,6 years.

[Indication and treatment results in elective neck dissection (author's transl)]. / Indikationen und Behandlungsergebnisse bei elektiver Neck dissection.

Only in about 17 per cent of 129 patients was elective radical neck dissection (RND) carried out in a seven-year-period from 1970 to 1976. In spite of clinical negative lymphatic-nodes-palpation-findings there were 10 observations of histological sured metastases from 22 patients. There occurred especially often tonsil-lateral larynx-entry-and tongue carcinoma of tumour stage T3 as primary localisation. Because of the high seize-rates in the resection-preparations we recommend inclusion of operation in so-called tumour findings more than before in treatment plan.

[Treatment of sudden hearing loss as a clinical problem (author's transl)]. / Die Hörsturzbehandlung als klinisches Problem.

From the methods used in treatment of sudden hearing loss, certain measures have been found to be best for the improvement of microcirculation disturbances in the inner ear, as based on antisludge effects. The effectiveness of drugs such as dextran infusion, procaine, xanthinol nicotinate, beta-pyridylcarbinol and heparin cannot be compared, nor can techniques such as stellate block, ATP-infusions, and pure vasodilators (Betaserc). Analysis of oxygen inhalations have thus far been incomplete. In the following analysis, we compared the results of therapy following stellate block in 50 patients with those obtained after dextran-papaverine infusions in 16 hospitalized patients. Prior to treatment, patient parameters (including average hearing loss and time-factor) were made uniform so that further statistical comparison was possible. In the group of patients treated with stellate block, we found an average hearing improvement to be about 23 dB (as based on analysis of single frequencies at 0.5, 1.0, 2.0, 4.0 kHz). In the group of patients treated with dextran infusions, an average hearing improvement of 18 dB was found. Statistical analysis did not indicate any significant effect differences between either treatment method. Taking other information from the literature into consideration, we may establish that the maximum hearing improvement which can be reached with the discussed treatment methods to be about 20--30 dB.

[Measurements of hearing sensations in ultrasound range by electrical response audiometry (ERA) (author's transl)]. / Objektivierung der Hörempfindungen im Ultraschallgebiet mittels evozierter Potentiale (ERA).

Hearing sensations induced by ultrasound in the frequency range 20-80 kcps are determinable with the Electrical Response Audiometry (ERA). The latency periods of the evoked potentials occured is amounted between 100 and 300 msec. It isn't founded a difference between ultrasound-induced potentials and the potentials evoked by usual tonal stimulies.

[Results of ERA-hearing-tests during infancy (author's transl)]. / Auswertung des Kinder-ERA-Krankengutes an der HNO-Klinik der Med. Akademie Dresden.

The results of 50 children with partial or complex hearing loss, referred to the hospital for diagnosis, were evaluated according to different aspects. Haloperidol (0,1 mg/kg) administered orally causes potential changes similar to those known in the literature for natural sleep and chloral hydrate sleep (Freigang and Kevanishvili 1975). The components N2 and P3 are dominant in the potential picture instead of N1 and P2. Regarding sedation, the drug meets all requirements. The identification of the hearing level by means of the input/output functions could be performed in 24 per cent of all cases, whereas summation curves must be employed in 26 per cent and threshold determinations according to Biesalski in 30 per cent. Deafness is assumed in 20 per cent of the patients with nondetectable AEP. The average hearing loss evaluated according to age groups is between 55 and 70 dB.