[Current Audiological Diagnostics].

Today's audiological functional diagnostics is based on a stock of hearing tests, whose large number takes account of the variety of malfunctions of a complex sensory organ system and the necessity to examine it in a differentiated manner and at any age of life. The objective is to identify nature and origin of the hearing loss and to quantify its extent as far as necessary to dispose of the information needed to initiate the adequate medical (conservative or operational) treatment or the provision with technical hearing aids or prostheses. Moreover, audiometry provides the basis for the assessment of impairment and handicap and for the calculation of the degree of disability.

[The Freiburg speech intelligibility test : A pillar of speech audiometry in German-speaking countries].

The Freiburg speech intelligibility test according to DIN 45621 was introduced around 60 years ago. For decades, and still today, the Freiburg test has been a standard whose relevance extends far beyond pure audiometry. It is used primarily to determine the speech perception threshold (based on two-digit numbers) and the ability to discriminate speech at suprathreshold presentation levels (based on monosyllabic nouns).

[The impact of cochlear implants on the quality of life of patients with single-sided deafness].

Background: Unilaterally deaf patients are increasingly supplied with a cochlear implant (CI). In the present study the change in quality of life following implantation was investigated.

Patients And Methods: The study comprised 20 postlingual CI recipients with single-sided deafness, who were divided into two groups: "normal hearing" (group 1) and "moderate impairment" (group 2) contralaterally.

[Human papillomavirus in squamous cell cancer of the head and neck. A study at the Ulm Military Hospital, Germany].

There is increasing evidence worldwide that human papillomavirus is a major risk factor for head and neck cancer. Only few studies on this association have been performed in Germany to date. For the purposes of the present study, tumor specimens from 223 patients with squamous cell cancer of the oral cavity, oropharynx, hypopharynx and larynx were analyzed for HPV DNA and p16INK4a expression.

[Objective hearing tests in pediatric audiology: AGERA recommendations for follow-up diagnosis in infants that fail newborn hearing screening tests].

This paper presents the recommendations compiled by the German Electric Response Audiometry Working Group (Arbeitsgruppe Elektrische Reaktions-Audiometrie, AGERA) and the Association of German Audiologists and Neuro-otologists (Arbeitsgemeinschaft Deutschsprachiger Audiologen und Neurootologen, ADANO) for infants that fail newborn hearing screening (NHS) tests. Outlined are procedures for follow-up diagnosis using objective hearing tests to rule out or confirm a therapeutically relevant auditory defect and assessment of the severity thereof.

Age dependence of otoacoustic emissions: the loss of amplitude is primarily caused by age-related hearing loss and not by aging alone.

The amplitude of otoacoustic emissions (OAE) is known to decrease with increasing age, but it is still unclear whether this is due to aging alone or to age-related hearing loss. This study describes the exploration of a large database (5,142 patients from 0.4 to 89.

Indication for the need of flexible and frequency specific mapping functions in cochlear implant speech processors.

Categorical loudness scaling of electric and acoustic stimuli was performed in cochlear implant (CI) recipients equipped with Nucleus systems in order to achieve a normal loudness perception in the whole dynamic range of acoustic input. For each electrode, the lower and upper limits of electric stimulus were defined by the values corresponding to "very soft" and "too loud". Within this dynamic range, the stimulus strength intervals associated to the verbal categories "soft", "medium", "loud" and "very loud" were determined.

[Quality of life in patients with oropharyngeal carcinoma. Gender influences the subjective evaluation].

Background: The purpose of this study was to evaluate the impact of patient characteristics and surgical interventions on quality of life (QoL) after primary surgery and postoperative irradiation in patients with oropharyngeal carcinoma.

Patients And Methods: Between January 1997 and February 2002, 169 patients with carcinoma of the oropharynx were treated with curative intent. In September 2002, a total of 88 disease-free survivors were identified and included in this study.

[The inferior turbinate: dysregulation and surgical reduction].

Nasal obstruction may be caused by individual anatomy, a dysregulation of the nasal mucosa or, frequently, a combination of both. Persistent allergic inflammation deserves special attention, as initial therapy should not be surgical. The plethora of surgical techniques for the reduction of inferior turbinate volume is a good indicator of unresolved controversies regarding the ideal technique.

The latency of evoked otoacoustic emissions: its relation to hearing loss and auditory evoked potentials.

The latencies of transient evoked otoacoustic emissions (TEOAE), distortion product otoacoustic emissions (DPOAE) and auditory brainstem responses (ABR) have been studied in 173 patients with cochlear hearing impairment. No systematic or significant correlation between the OAE latency and the hearing loss at the corresponding frequency could be found, whereas the ABR latencies increase by a small but significant amount with increasing hearing loss. This can be explained by a broadening of the excited area and its shifting towards a more apical position if the hair cell population in the basal turn is depleted.

[Antibiotic impregnation of cartilage implants: diffusion kinetics of fluoroquinolones].

Background: Antibiotic impregnation of cartilage implants may reduce the risk of bacterial infection and subsequent absorption. The aim of this study was to investigate the penetration kinetics of two quinolone antibiotics into fresh cartilage and the concentrations in the core of lyophilized cartilage after rehydration.

Methods: Fresh human costal cartilage was impregnated with ofloxacin and ciprofloxacin (2 mg/ml) for 2, 15 and 90 min.

[Effect of inner ear hearing loss on delayed otoacoustic emissions (TEOAE) and distortion products (DPOAE)].

Background: The assessment of inner ear hearing loss by means of evoked otoacoustic emissions (EOAE) is already established in practice. Nevertheless, empirical data on the relations between emission and audiologic parameters are required.

Patients And Methods: EOAEs werde measured and analysed in 240 ears with sensorineural hearing loss (excluding cases with conductive and retrocochlear disorders) of 120 patients using ILO88/92 equipment with standard test conditions.

[Differential diagnosis of neck swelling due to suspected metastasis using positron emission tomography].

A noninvasive diagnostic method for the evaluation of a suspicious mass in the neck can be of great value for further diagnostic approach. The differing metabolic activity of malignant and benign tumors offers the possibility to determine the status of a lesion by the quantitative evaluation of the glucose uptake by positron emission tomography (PET). The diagnostic relevance of the metabolic activity has been shown earlier in more than 50 malignant tumors of the head and neck (Reisser et al.

Chronic alcohol consumption--the key risk factor for pharyngeal cancer.

A case-control study on oropharynx and hypopharynx cancer was carried out in the region of Heidelberg (in the southwest region of Germany). This report presents an analysis of the risk associated with alcohol and tobacco consumption based on 105 cases and 420 controls matched for age, sex, and area of residency.

[Laryngeal cancer and occupation--results of the Heidelberg laryngeal cancer study].

We conducted a case-control study of squamous cell carcinoma of the larynx referred to occupational factors in 164 patients compared with 656 controls adjusted for sex, age and area of residence, using a 1-to-4 matched design. Most of the cancer patients (92%) were blue collar workers. Only 8% of the cancer patients had attended technical college, college or university, compared with 31.

[Experience with electrostimulation of the acoustic nerve before cochlea implantation].

The electrical stimulation of the acoustic nerve plays an essential role in the selection of patients for cochlea implantation. The performance of a deaf ear under the conditions of electrical stimulation can be assessed by means of the pre-operative promontory test using a transtympanic needle electrode. Five components of this test were applied to 48 patients: the determination of perception threshold and upper comfortable level for pulse and burst stimulation, the pitch test, the temporal difference test and the gap detection test.

[Diagnostic value of sialochemistry. Results of an albumin study].

In 196 patients suffering from disease of the cephalic salivary glands and in 57 healthy controls the concentration of albumin in parotid and submandibular saliva was measured by the immunodiffusion technique. To summarize the results, albumin seems to be a reliable marker of inflammations of the salivary glands even in the early stages and is therefore recommended for the primary diagnostic and the follow-up of acute and chronic inflammatory conditions of the major cephalic salivary glands. In combination with the evaluation of the flow rate, other sialochemic parameters like phosphohexose isomerase and kallikrein activity, B-mode sonography and fine needle aspiration biopsy the frequency of x-ray examination of the radiosensitive salivary glands may be reduced.

[Occupational exposure to hazardous substances and risk of cancer in the area of the mouth cavity, oropharynx, hypopharynx and larynx. A case-control study].

A case-control study of squamous cell carcinoma of the upper aerodigestive tract conducted in Heidelberg and Giessen (FRG) provided information on occupational factors in 200 patients and 800 controls (adjusted to sex, age and area of living; 4:1 matched design). The number of subjects exposed to wood dusts, organic chemicals, coal products or to cement was significantly elevated in the tumour group. An increased risk for head and neck cancer was observed after exposition to wood dust (RR = 2,2), organic compounds (RR = 2,4), coal products (RR = 2,7) and especially to cement (RR = 4,4).

[Effects of acute nicotine administration on the function of the human parotid gland].

The effect of acute administration of nicotine on the secretory function of the human parotid gland was investigated in 4 male volunteers. After intravenous infusion of 20 micrograms nicotine/kg b.w.

[Tobacco- and alcohol-associated cancer risk of the upper respiratory and digestive tract].

A case-control study of squamous cell carcinoma of the upper aerodigestive tract conducted in the ENT Departments of the University hospitals of Heidelberg and Giessen (FRG) provided information on the role of chronic tobacco and alcohol consumption as risk factors in 200 patients and 800 control subjects (4:1 matched design).--Only 4.5% of the tumour patients were non-smokers in contrast to 29.

[Peripheral neurinoma of the hypoglossal nerve].

Neurinomas of the hypoglossal nerve are rarely reported. In most cases these tumors are intracranial or sited at the skull base. Only a few solitary neurinomas of the twelfth cranial nerve have been reported.

[Electric response audiometry in retrocochlear hearing disorders].

The intensive clinical use of Electric Response Audiometry (ERA) has recently improved the diagnosis of sensorineural hearing loss. The Auditory Evoked Potentials (AEP) allow a precise topodiagnosis of the whole auditory system. However, specific limitations of the different potentials (cochlear, neural, brainstem, thalamic, cortical) have to be considered to avoid an overestimation of ERA.

[Categorizing hearing disorders based on latency deviations in the BERA (brainstem electric response audiometry)].

The dependence of latencies of EAEPs (Early Auditory Evoked Potentials) on stimulus intensity has been determined from measurements at 15 normal hearing subjects. The results are in good agreement with an exponential function, which has been empirically found and fitted to the data. The deviation from this function in case of hearing disorders can be classified in terms of a "latency deviation diagram".