New perspectives on lyophilized bone allografts

Summary In 1987, at the Congress of Implants in Otology in Venice, Italy, we first presented our experiences with stored lyophilized bone allografts for reconstruction of the tympano-ossicular chain. Since then, we have extended our experiences to include reconstruction of the external bony ear canal, the filling of defects in the mastoid bone, reconstructive nasal surgery and rehabilitation of major bony defects of the face. Additionally, we have tried to improve the preparation of the bony implants used clinically and have started a multicenter collaboration with other European universities.Presented at the First European Congress of Oto-Rhino-Laryngology and Cervico-Facial Surgery, Paris, 26–29 September 1988     

New perspectives on lyophilized bone allografts

In 1987, at the Congress of Implants in Otology in Venice, Italy, we first presented our experiences with stored lyophilized bone allografts for reconstruction of the tympano-ossicular chain. Since then, we have extended our experiences to include reconstruction of the external bony ear canal, the filling of defects in the mastoid bone, reconstructive nasal surgery and rehabilitation of major bony defects of the face. Additionally, we have tried to improve the preparation of the bony implants used clinically and have started a multicenter collaboration with other European universities.     

New perspectives on counselling in audiological habilitation/rehabilitation

Objective: To develop and apply a pedagogical method focusing on Empowerment, Empathy, Competence, and Counselling: the EC programme, and to present an initial evaluation. Design: The EC programme was gradually developed within a study circle framework and in dialogue with study circle leaders and participants (clients) with hearing impairment (HI). An evaluation was carried out with the study circle leaders. Study sample: Seventeen upper secondary school students with HI took part in the development of the programme. Eighteen study circle leaders responded to a questionnaire. Results: The EC programme developed consisted of films, CD, and DVD productions to increase insight into one's own hearing ability, to demonstrate for others what HI means, strategies to evaluate situations, and help to act constructively in social situations. The study circle leaders found most of the course material appropriate and easy to use, as a whole or in parts. The leaders’ evaluations indicated that the clients had increased their knowledge about how the HI affected themselves and others. The clients had improved their self-confidence and their empathic view of others. Conclusion: The EC programme can be used in its entirety or in part. Participation may lead to increased empowerment, empathy, competence and counselling ability.     

Relative effects of low-frequency amplification on syllable recognition and speech quality

A moderate-bandwidth master hearing aid was used to study the relationships among low-frequency response, syllable recognition scores, and perceived speech quality. As measured on KEMAR, this hearing aid provided true high-frequency emphasis in all conditions, with three degrees of relative low-frequency de-emphasis. Subjects were 12 listeners with gradually sloping sensorineural hearing loss bilaterally. Contrary to common expectations, increased low-frequency response yielded a substantial enhancement in speech quality under both quiet and babble conditions, as well as a modest improvement in syllable recognition in quiet. Furthermore, low-frequency amplification, as used in this study, resulted in no observable degradation in syllable recognition in the presence of multitalker babble. The findings have clinical implications in the evaluation and selection of hearing aids when optimization of speech quality is desired.     

New perspectives in non-invasive treatment of sinusitis

A randomized multicenter study of sinuforte efficacy and safety was made in 120 patients with sinusitis. All the patients were randomized into two groups: the study group of 60 patients received monotherapy with sinuforte in a single daily dose for 7 days; the control group of 60 patients received conventional treatment for 7 days. The efficacy of the treatments was assessed by the results of clinical, endoscopic and laboratory tests. The analysis of the study results shows that sinuforte monotherapy is an effective and safe in the treatment of exudative sinusitis of mild and moderate severity.     

Stutterers' self-ratings of speech naturalness: assessing effects and reliability

Using single-subject experiments with 3 adult stutterers, this study evaluated the effects of instructions to stutterers to rate and modify how natural their speech sounds on experimenters' ratings of speech naturalness, stuttering frequency, and speaking rate. The study also included an investigation of the reliability of stutterers' and listeners' naturalness ratings. The stutterers were partway through a therapy program using prolonged speech or rate control. Results showed the stutterers could modify their speech so that their naturalness ratings increased or decreased. These changes were independent of stuttering or speaking rate. Experimenter ratings of speech naturalness were unchanged in conditions where stutterers judged their speech to sound more natural, but paralleled the stutterers' ratings when they judged their speech to sound more unnatural. An attempt to see if stutterers differed in their ratings of how natural their speech sounded or felt showed differences for one stutterer. Reratings of randomized session recordings by experimenters and independent judges showed that their ratings were highly reliable. When the same randomized session recordings were rerated by the stutterers (1 and 3 months after the experiment), their judgments of changes in their speech naturalness, which were not found in the experimenters' ratings, remained consistent and reliable.     

New perspectives in the investigation of disorders of balance

It is a common misconception that all disorders of balance can be attributed to derangements of the vestibular system. In fact spatial orientation is dependent upon the proper coordination of a number of sensory inputs and each of these is susceptible to damage by disease or injury. A variety of new tests is described which have as their aim the indentification of balance disorders resulting specifically from derangements of visual processing, proprioception and the neck reflexes. In addition, attention is given to the differential impairment of linear and circular vection and to the possible clinical application of vestibular evoked potentials.     

Sound amplification negates central effects of a neonatal conductive hearing loss

Neonatal CBA/J mice with external auditory meati removed were raised in a sound-amplified environment. If amplification continued until sacrifice at 24 or 45 days of age, both cochlear nuclear volumes and cross-sectional areas of VCN globular cells were of normal size; without amplification both measurements were significantly reduced.     

The nonauditory effects of noise: review and perspectives for research

This review considered 118 references classified according to nonauditory physiological effects, performance and behavioral effects, sleep disturbance, and communication interference. For each separate category of effect a brief summary was presented of relevant current research, the consequences of noise exposure were sketched, and research needs were suggested in experimental design, in stimulus control and specification, in experimental techniques, and as to appropriate subpopulations to be taken into account. Much was shown to have been accomplished in the past decade, but to date only sparse quantitative data have been reported to express the effects of noise as a dose-response function on physiological processes or on behavior. In almost all studies only a very modest fraction of variance was explainable. It seems especially important to consider other factors along with the physical characteristics of the noise, particularly the interactions of the noise with other toxic agents and with situational and personality factors.     

Salivary nitrates. New perspectives concerning the physiological function of saliva

For many years, nitrate ions have been thought to be "toxic agents", but scientific reality seems very different. The source of nitrate ions is double: exogenous and endogenous, and the metabolism of nitrates is partly salivary. The strong concentration of nitrate ions in saliva has many beneficial physiological effects. Salivary nitrate has anti-infectious effects on the oral cavity and all along the digestive tract. They give cardiovascular protection, are instrumental in the adaptive relaxation of the stomach by acting on smooth stomach muscles and have a protective action on the gastric mucosa.     

New perspectives in the direct microscopic examination of middle ear effusions

Detection and identification of bacteria in middle ear effusions from patients with otitis media with effusion requires sensitive bacteriologic techniques. Direct microscopic examination is very important in this respect. Three staining methods--Gram, Giemsa and the fluorescent acridine orange stain--were evaluated and compared by examining 112 middle ear effusions. Purulent effusions showed more bacteria than mucoid, and mucoid effusions showed more bacteria than serous in the direct microscopic examination of the smears. Acridine orange stain proved superior in detecting bacteria compared with Gram and Giemsa stains and distinguished dead from living bacteria. It is even more sensitive in this way than aerobic and anaerobic cultures. Giemsa stain was superior in the identification of inflammatory cells. Acridine orange and Giemsa stains are recommended in the bacteriocytologic examination of middle ear effusions; Gram stain may provide additional information.     

New perspectives about human laryngeal muscle: single-fiber analyses and interspecies comparisons

BACKGROUND: In companion studies on canine and rodent laryngeal muscle, we observed that (1) muscle fibers in both the canine and rodent posterior cricoarytenoid (PCA) muscles have a slower myosin heavy-chain (MyHC) isoform profile than those in the thyroarytenoid (TA) muscle; (2) the muscle fiber composition of PCA and TA muscles in canines and rodents is complex given the presence of so-called hybrid fibers (fibers coexpressing various combinations of MyHC isoforms); (3) the types and proportions of hybrid fibers are both muscle specific and, in some cases, region specific; and (4) the MyHC isoform profile of canine laryngeal muscle appears to be slower than that of rodent laryngeal muscle, suggesting the possibility that larger mammals have a slower MyHC isoform profile. OBJECTIVES: Given the findings of these companion studies and the fact that very little is known about the MyHC isoform composition of laryngeal muscle fibers, the primary objectives of this study were to determine (1) the types of MyHC isoforms found in the human PCA and TA muscles, (2) if there were regional differences in MyHC isoform composition, (3) if hybrid fibers commonly occur in human laryngeal muscle, and (4) if the MyHC isoform profile of human laryngeal muscle is slower than that of canine and rodent laryngeal muscle. RESULTS AND CONCLUSIONS: The findings of this study clearly demonstrate that both the PCA and TA muscles in humans express 3 types of MyHC isoforms (ie, slow type I, fast type IIA, and fast type IIX MyHC isoforms). At the single-fiber level, there were distinct regional differences and hybrid fibers were a common occurrence. Finally, the data demonstrate that the PCA and TA muscles of humans have a slower MyHC profile than that found in either canine or rodent laryngeal muscle.     

Long-term effects of monaural, binaural and no amplification in subjects with bilateral hearing loss

This study expands upon our earlier work by comparing initial PB scores and audiometric thresholds with results obtained 4-17 years later for subjects with bilateral sensorineural hearing losses who were monaurally aided (n = 48), binaurally aided (n = 19), or unaided (n = 19). Thresholds decreased slightly for all groups, but aided and unaided ears did not differ significantly in this respect, revealing no acoustic trauma effect due to hearing aid use. PB scores decreased significantly only for the unaided ear of the monaurally aided subjects, but not for their aided ear, or for the binaurally aided or unaided groups. These findings suggest an auditory deprivation effect for the unaided ear of those wearing a monaural hearing aid. Changes in PB scores were not correlated with duration between the two test dates. Changes in PB scores were correlated with degree of hearing loss only for the unaided group.     

An update on amplification: some changing directions

This report reviews some of the developments and changes that are occurring in the field of amplification. The discussion focuses on such areas as hearing aid rules and regulations, hearing aid sales and dispensing practices, hearing aid technology, and selection and evaluation procedures.