Symptome und Diagnosestellung auditiver Verarbeitungs- und Wahrnehmungsstörungen

The definition of an auditory processing disorder (APD) is based on impairments of auditory functions. APDs are disturbances in processes central to hearing that cannot be explained by comorbidities such as attention deficit or language comprehension disorders. Symptoms include difficulties in differentiation and identification of changes in time, structure, frequency and intensity of sounds; problems with sound localization and lateralization, as well as poor speech comprehension in adverse listening environments and dichotic situations. According to the German definition of APD (as opposed to central auditory processing disorder, CAPD), peripheral hearing loss or cognitive impairment also exclude APD. The diagnostic methodology comprises auditory function tests and the required diagnosis of exclusion. APD is diagnosed if a patient’s performance is two standard deviations below the normal mean in at least two areas of auditory processing. The treatment approach for an APD depends on the patient’s particular deficits. Training, compensatory strategies and improvement of the listening conditions can all be effective.     

Periphere und zentrale Recurrensschädigungen und ihre Auswirkungen

Ohne Zusammenfassung     

Irrtümer und Fehler bei der Beurteilung und Behandlung stumpfer und unscheinbarer pfählender Verletzungen im Nasen- und Nebenhöhlengebiet

Ohne Zusammenfassung     

Über die gut- und bösartigen Formen der Kehlkopfpapillome und deren histologisches und klinisches Bild

Ohne ZusammenfassungMit 6 Textabbildungen     

Das G-DRG-System 2006 und seine Auswirkungen auf die Abbildungsqualität der HNO-Heilkunde und Kopf- und Hals-Chirurgie

BACKGROUND: The new G-DRG system for 2006 was published in September 2005. This article presents, analyses, and comments essential changes in the G-DRG system for 2006 and their consequences for ENT-Medicine. RESULTS: The complexity of the G-DRG system has increased significantly. In 2006, the case allocation will be more differentiated for common surgical procedures on the middle ear, nose, paranasal sinuses, salivary glands, and for head and neck cancer. Furthermore, the patient's age and the clinical and complexity level (PCCL) will be of increased relevance in selected case constellations. However, diagnostic endoscopies with rigid instruments will still not be regarded as OR procedures. CONCLUSION: Essential adjustments proposed by the German Association for ENT Medicine (DGHNOKHC) and the ENT Medical Professional Association (HNO-Berufsverband) have been made, and the quality of case allocation of ENT-patients within the G-DRG system improved. Nevertheless, further adjustments to the G-DRG system are necessary.     

Funktionelle und ästhetische Rehabilitation der Mikrotie bei Kindern und Jugendlichen

Background

Microtia leads to a severe functional and aesthetic handicap. Traditionally, the auricle is often reconstructed with cartilage transplants, which is, however, associated with some partially substantial disadvantages. The authors have instead used implants of porous polyethylene for successful ear reconstruction for years, thus, avoiding some of these disadvantages. A significant benefit for the patient is achieved by simultaneous hearing rehabilitation by the implantation of active middle ear prostheses.

Methods

The authors present their surgical concept which allows functional and aesthetic rehabilitation of microtia in children and adolescents in a single operation. In the respective patient collective, audiometric measurements in quiet and noisy environments were conducted pre- and postoperatively, and health-related quality of life was determined using a validated questionnaire.

Results

All patients experienced a substantial hearing gain both in quiet and noisy environments. The evaluation of health-related quality of life showed a significant benefit from the intervention.

Conclusion

Functional and aesthetic rehabilitation of microtia with active middle ear implants and ear reconstruction using porous polyethylene leads to good and reliable long-term results and can increase the health-related quality of life of affected children and adolescents. The main advantage of this concept is the possibility of a single procedure.     

Tonhöhen-Extraktor zur Messung und Steuerung von Stimme und Sprache

Ohne ZusammenfassungGekürzt, unter Weglassen von 6 Abbildungen.     

Ätiologie und Diagnostik von Kopf- und Gesichtsschmerzen aus neurologischer Sicht

Headaches are one of the most frequent outpatient complaints. Patients may describe a symptom indicating an underlying disease, which can range from an ordinary indisposition to a medical emergency. Despite these secondary headaches, there exist idiopathic forms, such as migraine and tension type headaches, which represent the most common types. In order to develop a specific treatment, the diagnosis of headaches and the knowledge of their etiology are very important for physicians. While headaches remain a neurological domain, facial pain syndromes are often seen and treated in other medical fields. Here clinically important facial pain syndromes are reported from a neurological point of view.     

Ein- und zweizeitige Sehnervenläsionen im Tiermodell und dessen klinischer Stellenwert

Background

Surgical optic decompression after trauma has been discussed controversially. The surgical trauma is supposed to produce an additional nerve lesion with the danger of complete loss of vision. Alternatively, conservative high dose cortisone therapy has been recommended.

Methods

The functional and morphological consequences of a lesion after calibrated optic compression in one or two sessions were examined in an animal model using 29 Wistar rats.

Results

Depending on the duration and intensity of the lesion, we observed a linear decline in the number of neurons in the RGC (retinal ganglion cell) layer as well as an increasing reactivity to GFAP (glial fibrillary acidic protein) as an indication of central gliosis of astrocytes; however, this was independent on whether optic compression was performed in one or two sessions.

Conclusions

To reduce secondary damage to the visual nerve and the central visual system that might increase with a persisting lesion, the indication for surgical relief of an eye affected by afference should be considered liberally, especially in view of the low morbidity of rhinosurgical intervention.     

Meßtechnischer und theoretischer Beitrag zum Schwingungs- und Impulsverhalten des Mittelohres

Ohne ZusammenfassungMit 16 Textabbildungen     

Die Otitis und Parasinuitis serosa,neu und einheitlich aufgefaßt

Ohne Zusammenfassung     

Sequenzielle Informationsverarbeitung bei Kindern mit und ohne auditive Verarbeitungs- und Wahrnehmungsstörung

Background

It is a controversial issue whether sequential processing in children with auditory processing disorders (APD) is a unimodal auditory impairment.

Patients and methods

Normal achieving controls (n=12; mean age: 101.1 months; SD 20.3) and children referred to clinical facilities for assessment including children with monosymptomatic APD (n=25; mean age: 90.8 months; SD 9.8), children with developmental language disorder (DLD]) + APD (n=11; mean age: 89.5 months; SD 14.9), children with dyslexia + APD (n=10; mean age: 113.8 months; SD 17.1) were compared using the subtest digit recall of the German version of the K-ABC (Melchers & Preuß 2001) and the K-ABC subtest hand movements in the visual modality.

Results

On average all groups tended to perform alike in visual sequential processing and memory (T-score>50). Normal controls (non-APD) showed on average the best test performance (T-score 57.4; SD 10.5), but the mean performance did not differ significantly from children with APD. All groups also presented on average normal test performance in the auditory modality however, children of the clinical groups were below the age mean (DLD + APD: T-W 43.1; SD 6.8; monosymptomatic APD: T-W 45.8; SD 9.8; dyslexia + APD: 46.7; SD5.8). Children with DLD + APD and those with monosymptomatic APD exhibited a significantly lower but not poor performance in auditory processing of sequences compared to their performance in visual sequential processing. The results of auditory and visual processing of sequences were significantly correlated in the clinical groups DLD + APD (0.58) and monosymptomatic APD (0.34), but not in the smallest group dyslexia + APD (0.48) and in normal achieving controls (0.32).

Conclusion

On the basis of the results of the present study it may be concluded that a normal test performance on visual measure does not exclude a bimodal or pansensory seriation disorder in children with APD. It does, however, indicate the existence of a primary auditory sequential processing deficit, because at least the processing of phonological and visual stimuli was not separately carried out in children with DLD + APD.     

Über Gaumen- und Mesopharynxplastiken

Ohne Zusammenfassung