Bilateral congenital middle ear cholesteatomas.

Congenital middle ear cholesteatomas remain of interest because of their relative rarity and unknown origin. A 4-month-old child presenting with bilateral congenital middle ear cholesteatomas forms the basis for this report. The nature of the epithelial debris found suggests an external origin. An extended transcanal tympanotomy approach for removal, based upon an operative experience of 11 similar ears, will be discussed.

Development of speech-audiometric materials for native Spanish-speaking adults.

The lack of valid and reliable Spanish speech audiometry materials constitutes an important clinical problem. Such tests necessitate the construction of appropriate materials. Analysis of English and Spanish literature on speech audiometry led to the identification of guidelines for new test materials in the Spanish language. Test lists were devised, recorded and used to evaluate 10 normal-hearing native Spanish-speaking subjects. The results obtained led to a final set of recorded lists. Boston College Auditory Test lists may be used successfully with Spanish-speaking patients. The current study should provide the impetus and sufficient guidelines upon which speech stimuli in other languages may be constructed.

Electro-oculographic findings in Machado-Joseph disease.

Electro-oculographic recordings (EOG) were made on 26 patients with Machado-Joseph disease or at genetic risk for that disease. All patients with clinically apparent disease (ataxia, dysarthria, spasticity, or ophthalmoparesis) had abnormal eye movements. Defects in caloric response, sinusoidal tracking, opticokinetic nystagmus (OKN), refixation saccades, and presence of gaze paretic nystagmus were detected in that order of frequency. Fourteen subjects were clinically at risk but had normal neurologic examinations or minor equivocal signs. Nine of the fourteen had abnormal EOG, with sinusoidal tracking, calories, refixation saccades, OKN, and gaze paretic nystagmus being abnormal in that order. EOG may be useful in early case detection and may contribute to genetic counseling.

Normal neonatal brainstem auditory evoked potentials.

Brainstem auditory evoked potentials present a unique opportunity to assess the neuronal and auditory status of the newborn. To date, sample data have been few in number, thereby limiting their interpretive value. The present study was undertaken in an effort to accrue data generated from a large sample size. One hundred fifty-five normal neonates were tested within the first 36 hours of life. No subjects qualified for inclusion in the High Risk Register for Hearing Loss established by the American Academy of Pediatrics. Each ear was tested independently, using click stimuli at a rate of 30.1 per second at 65 dB HTL. Test runs were replicated for purposes of reliability. A run consisted of 2,000 sweeps of data, each being 10 ms in length. Identification of wave forms were assessed by two or more observers. Total agreement was required from all observers for inclusion of wave peaks for analysis. Latencies of onset of stimulus to peak were obtained. Descriptive as well as inferential statistics were computed. Results provide standardized data for comparison.

Air volumes during connected speech of normal-hearing and hearing-impaired adults.

Aerodynamic characteristics were investigated in connected discourse of normal-hearing and orally trained hearing-impaired adults. Subjects read sentences of various lengths and produced a spontaneous speech sample. Utterances were sensed by a pneumotachograph and recorded oscillographically and by audiotape. Inspiratory and expiratory volumes and expiratory time were measured. Word intelligibility was judged. Hearing-impaired subjects displayed greater ranges of air volumes and expiratory time. From sentence to spontaneous conditions, intelligibility varied systematically with expiratory volume.

Hearing loss and the high speed dental handpiece.

A pure tone air conduction audiometric evaluation was administered to 137 dentists and 80 physicians. The physicians were found to have better hearing threshold levels, notably in the 4000HZ center frequency range. The left ear of right handed dentists showed a greater loss of hearing ostensibly related to proximity to the noise source. Dental specialists showed a loss pattern similar to those of the general dentists. The findings suggest that there may be a cause and effect relationship between hearing loss and use of the highspeed dental handpiece.