[Optimizing hearing screening by transient evoked otoacoustic emissions in newborn infants]. / Optimierung des Hörscreenings mittels Transient evozierter otoakustischer Emissionen (TEOAE) bei Neugeborenen.

One of the major drawbacks using transient evoked otoacoustic emissions (TEOAEs) for hearing screening in newborn infants is the high fail rate in normal-hearing children. The purpose of the present study was to improve the overall performance of the test procedure and reduce of the fail rate. Improvement was obtained by 3 modifications: (1) change of the pass criterion in healthy newborns by requiring TEOAEs in at least one ear and nor both ears, (2) performing the test only after the second post-partum day, and (3) using a second-stage screening prior to hospital discharge in newborns who failed the initial test. In all, 3980 newborns from 2 well-baby clinics and 243 newborns from a neonatal intensive care unit (NICU) were screened using an system ILO-88 system program mode quick-check test was completed in 3820 infants. Considering these modifications, the pass rate of healthy newborns was improved from 79.5% to > 99%, and only 0.7% of the false negative (healthy) newborns required further audiological evaluation. Babies from the NICU failed in 3.8% of the screening tests. Overall, the number of newborns who failed the ILO-88 screening test was significantly reduced and the fail rate minimize when compared to previously published experiences with TEOAEs in new-born hearing screening.

[Distortion product of otoacoustic emissions in normal hearing and sensorineural hearing loss]. / Distorsionsprodukt otoakustische Emissionen bei normalem Hörvermögen und bei sensoneuraler Schwerhörigkeit.

Based on a variety of experimental and clinical studies the diagnostic significance of transient evoked otoacoustic emissions (TEOAEs) is well established. This is also due to the availability of commercial hardware and software which is optimized for the recording of click-evoked OAEs. In cases with distortion product otoacoustic emissions (DPOAEs) the significance for clinical purposes is not yet clear. This study presents results obtained in normal hearing subjects and patients with sensorineural hearing losses (214 ears). The study focuses on three problems: 1. Incidence of DPOAEs in different groups of hearing loss. 2. Level of DPOAEs at various frequencies in each group of hearing loss. 3. Frequency-specific relationships between hearing loss and DPOAEs. Recording of DPOAEs was performed with the ILO92 system and standard configuration (primary tone level, 70 dB SPL). In normal hearing ears DPOAEs were observed at all frequencies above 1 kHz. In cases with moderate hearing loss the detection rate decreased to about 80%. With further increases in hearing loss the detection rate and level of DPOAEs decreased. At frequencies below 1500 Hz even in normal hearing subjects, the level of DPOAEs only slightly exceeded the noise level. The upper limit of hearing loss for which DPOAEs could be observed depended on frequency. In the low-frequency range DPOAEs were absent in ears with a sensorineural hearing loss greater than 35-45 dB; at frequencies between 4 and 6 kHz DPOAEs were observed even in ears with a hearing loss 65 dB.(ABSTRACT TRUNCATED AT 250 WORDS)

[Headache following epidural anesthesia]. / Kopfschmerzen nach Epiduralanästhesie.

A study of the side effects of epidural anesthesia for painless delivery in 100 patients showed that 90% of the post partum patients were very satisfied with the analgesia and did not consider symptoms post partum to be very debilitating and did not blame the epidural anesthesia for the symptoms. Severe pain in the occiput and the cervical spine occurred in only two cases. In one case, the cerebro-spinal fluid was punctured. Headaches following epidural anesthesia are described as a great disadvantage of this method of obstetric analgesia. However, the headaches were no more common in the group with epidural anesthesia than in the compare group. No correlation was found with puncture of the dura which is suspected in the literature. Retention of urine was not found to be correlated to the epidural anesthesia. Uniformity of the responses by the maternity patients were striking especially if one considered that the social condition and the psychic condition of the individual woman such as attitude to delivery, presence of the husband at delivery, and other factors were not evaluated.