This research assessed the appropriateness of the 1989 ASHA Draft Guidelines for the Identification of Hearing Impairment/Handicap in Adult/Elderly Persons for an institutionalized population. We tested 104 elderly chronic care residents using a conventional audiometer, an AudioScope3TM screener, and the Hearing Handicap Inventory for the Elderly. Results showed that this population is capable of performing these tests. Screening should be done at 2,000 Hz only. However, the prevalence of hearing loss is so high (69%) that we recommend conventional testing of all institutionalized elderly where feasible.

This study reviews the hearing results in 80 consecutive patients who underwent complete removal of histologically proven acoustic neuromas by use of the suboccipital approach. Of these, 56 patients had successful monitoring of cochlear compound action potentials; 20 were not monitored because their surgery predated monitoring; and 4 had unsuccessful monitoring. A significant difference was found in hearing preservation rates between the group in whom compound action potential monitoring was performed and those in whom monitoring was either unavailable or failed (p = 0.02). Overall, 38% (30 of 80) had preserved hearing. There were 51 patients in whom the click threshold for the cochlear compound action potential was measured during surgery. Twenty-one patients had a threshold shift of 20 dB or less, 15 (71%) of these retained serviceable hearing (speech reception threshold < or = 50 dB; speech discrimination score > or = 60%). Of 12 patients in whom the threshold shift was 30 to 60 dB, none had serviceable hearing after surgery. The click threshold shift was predictive of a significant postoperative hearing change (p < 0.001).

This report concerns the diagnostic features of the ABR which are most effective in identifying patients with cerebellopontine angle tumours. The conclusions are based on the results of 40 normal subjects, 35 patients without a cerebellopontine angle tumour and 68 patients without a tumour. One hundred per cent of the tumour patients and ten per cent of the non-tumour patients had abnormal ABR results.

ABSTRACT:The authors present their experience with intraoperative monitoring of cochlear nerve action potentials (AP) in 30 adult patients. Operative procedures were acoustic neuroma excision with attempted hearing preservation and selective vestibular neurectomy in patients with incapacitating Meniere's disease and serviceable hearing (SRT<50 db, discrimination >60%). Loss of AP is detected rapidly and has been demonstrated after manipulation of the cochlear nerve and after coagulation of small arteries on the tumour capsule. Presence of an AP at the end of the procedure usually correlates with postoperative preservation of hearing. AP monitoring appears to be a reliable means of detecting potentially reversible changes in cochlear nerve function intraoperatively. RESUME: Surveillance du nerf cochleaire pendant la chirurgie de Tangle ponto-cerebelleux. Les auteurs decrivent leur experience de la surveillance per-operatoire des potentiels d'action (PA) du nerf cochleaire chez 30 patients adultes. Ces patients subissaient une chirurgie pour l'excision d'un neurinome acoustique avec tentative de preservation de l'ouie ou une neurectomie vestibulaire selective en raison d'une maladie de Meniere invalidante (SRT<50db, discrimination >60%). La perte des PA est d6tect6e rapidement et elle a 6te mise en evidence apres la manipulation du nerf cochleaire et apres la coagulation de petites arteVes sur la capsule tumorale. La presence d'un PA a la fin de l'intervention est habituellement en correlation avec la preservation postoperatoire de l'audition. La surveillance des PA semble etre un moyen fiable de d£tecter peropdratoire des changements potentiellement reversibles dans la fonction du nerf cochleaire.