From the results of hearing test for the hearing impaired children whom we have followed up more than 3 years, we discussed about its reliability and the shift of hearing threshold. Test results showed that hearing test of the children above 3 years was considerably reliable. The fluctuation of hearing loss due to hearing aid usage was observed in some cases of them who had been using hearing aids extending over long period, but this type of threshold shift was reversible to some extent in spite of sensorineural hearing loss. Consequently this seems to be preventible to some extent through either alternative or temporalily interrupted usage of hearing aid.
We observed, for six years, the degree of hearingloss of the 55 young deafend children who have been using hearing aid from 1 to 3 years of age. The results were as follows: 1) About 10% of the young deafened children grow worse in hearing. 2) The further destruction of hearing is noticed at higher percentage among the endogenious deafened children than among the exogenious deafened ones. 3) There is possibility of the further destruction of hearing by the use of hearing aid, but at the same time, pediatric diseases caused by virus infection or by some other factors are possibly to be its causes. 4) The further destruction of deafend children's hearing is to occur all through infancy, but it is especially remarkable at about 7.
A six year follow-up study of the hearing acuity of children wearing hearing aids performed at a public school. It was found that in great majority of cases threshold flucutations remained within ±10dB during 6 years. Deterioration of hearing were observed in aided, in unaided and in some cases on both ears. One case showed reversible thresholod shift every time on the aided ear.
The purpose of this paper is to determine the standard use of hearing aids in children with sensorineural hearing loss. Follow up studies on the audiograms were carried out in 62 children with perceptive hearing loss making use of hearing aids. The results were summarized as follows: 1. About 10per cent of the subjects showed more than 10dB aggravation in hearing after entrance to the special class for hearing impaired children. 2. There was tendency in those cases that he aggravation in hearing was improved in some cases. 3. No definite evidence of acoustic trauma due to the use of hearing aid was found in the residual hearing. 4. Adequate guidance and superintendance are essential for hearing impaired children to use hearing aid effectively.
On hundred five children with bilateral perceptive hearing loss have been followed up a period of one half up to seven years from the first reliable test. The reliability of hearing test to young, untrained hearing impaired children was about eighty five percent on each trial, so the test should be done at least four times to get reliable threshold. Seventy of all did not differed their threshold even after two to seven years. But twenty eight showed progressivity of the hearing impairment. More than half of the reported hereditary or marriage in bleed showed spontaneous progresivity. Ten ears without hearing aid were getting worse threshold spontaneously. Seven were from light hearing loss to moderate, two were light to severe, nineteen were from moderate to severe. Most of these cases deteriorated their hearing ability in all frequency, not only high tone but also low tone. Seven cases improved their hearing slghtly in mainly low tone. These children had been treated with adenotomy, inflation of the eustachiantube, or ear drum massage. These suggested otological treatment improved the conductive hearing disturbance.
48 cases with sensori-neural hearing loss were observed for 6 month or more audiometrically. The characteristic variations of hearing loss were able to observe, according to the kinds of the hearing loss. Little changes were observed in 32 cases with sesori-neural hearing loss. On the other hand, the shift to recovery was shown in cases of acoustic truma and acoustic neuritis. The fluctuation of hearing loss was shown in cases of Meniere's disease and congenital labyrinthine lues. The progression of hearing loss was shown in eleven cases of 5 familial deafness, each one of oto-toxic deafness, Lermoyez's syndrome, meningitis, multiple sclerosis, brain-stem tumor and etiology unknown. They were classified to 3 types, as a function of time course of the progression: gradual, sudden and rapid progressive type. Many cases among them showed gradual progression of hearing loss, and other types were uncommon, especially rapid progressive type was observed in cases of multiple sclerosis and brain-stem tumor.
Hearing of patients of perceptive deafness, most of them due to unknown cause, was studied for more than 3 years until 8 years. The hearing loss was not changed in 35 cases but it was aggravated in 20 cases and fluctuated in 13 cases in this series. The hearing impairment of aggravated group was initiated at the high frequencies and extended to the low frequencies. The hearing loss at low frequeucies was larger in fluctuated group than in aggravated group. One patient in aggravated group showed that the aggravation of haring impairment in one ear was followed by that in the other ear. One patient in fluctuated group showed the fluctuotion of hearing in both ear simultaneously.
Statistical observations are made in 529 ears on the long term variations in the threshold of sensorineural deafness. These cases are all retested audiometrically more than 6 months later. And the differences between the initial audiogram and the last one are statistically examined. A remarkable shift to recovery was shown in cases of so-called sudden deafness and cochlear neuronitis. On the other hand slight progression of hearing loss was observed in deafness due to SM, KM and KDM injection. Little changes were found in other cases.
13 hearing impaired children in special class for hard of hearing were tested audiometory during a year. We found the following results by analysing of speech audiomentory data and hearing aid training. 1) Their audiogram nearly were not change, but speech receptive threshold (S. R. T.) and maximum articulation score (MAS) pointed out a little improvement. 2) The improvement of speech hearing were not influenced by type of hearing loss. 3) Even the ear which had limited dynamic range improved the S. R. T. and M. A. S. by auditory training. 4) The confusion of speech words decreased by auditory training. It seemed important of the detail observation of confusion for training. 5) The progress of adaptation of hearing aid were improved the speech hearing. There-fore the evaluation of the adaptation of hearing aid is done by the improvement of speech hearing.
Twelve items about speech and hearing of 22 students, who have been educated at the special class for the hearing impaired children in the Nijo Junior High School in Kyoto City and whom we have followed for a long period, were compared with the same items of 27 hearing impaired children in the primary school who already started auditory training in their preschoolage. The latter showed better educational effects than the former. This fact suggested us the importance of earier auditory training.
We are going to present the situation of prolonged follow up for young hearing impaired children through four children at Rion Better Hearing Clinic. 1) The situation of development after receiving one month training class. 2) The process of audiogram. 3) The change of continuous training for two years. 4) The general substance of training for two years. The judgment, the countermeasure as well as the conclusion for four young hearing impaired children at present.
In Audiology Japan Vol. 12, No. 1, 1969, eighteen cases were reported who were the hearing impaired and had enrolled in the nursery program of Nippon Rowa Gakko at the age under two years old from July 1965 to May 1968. Now eleven of them are present at kindergarten of the school. Their deafness are very severe. They use two hearing aids separately in each ear, and notice so many sounds. Some of them discriminate musics or songs played by records, and some discriminate several sentences by listening. They have acquiered speech spontaneously, and they speak with normal intonation, accent and rhythem though each sound is not always clear. The achievements of child's developments show that they have developed normally in physically, socially, intelectually, and in language ability, however their oral expressions are not yet complete.
Some of hearing-impaired children who finished the auditory training course of our Hearing Clinic for Mothers and Children affiliated with Hearing Aid Research Laboratory have entered ordinary kindergartens and primary schools. A questionnaire about their integration and adjustment in ordinary class was sent to their teachers. The answers we got were twenty from kindergarten teachers and nineteen from primary school teachers. The results obtained from them are as follows: (1) Generally speaking, their listening attitude in the class was considered to be fairly good, but they need more positive attitude. (2) Their listening ability is fairly good in face-to-face conversational situation, but it is difficult for them to understand teachers' speech in group situation. (3) In terms of their vocabulary, syntax and daily-life conversation, they are doing fairly well, but we found they are somewhat delayed in abstruct thinking. (4) It is shown no significant relation among their hearing acuity, social maturity, listening attitude and ability, and verbal ability. However, it is observed strong significant correlation between educational achievement and verbal ability. (5) We consider that it is necessary in special training of hearing-impaired young children to emphasize more positive attitude, in general, together with the auditory training.
Retrospective study concerning the complaints and hearing of 463 patients who had undergone 8 to 12 years after tympanoplasty were done through questionaires. The obtained informations were those from 121 (26%) patients out of above 463 patients and we were able to examine 55 (12%) patients among those 121 patients. 43% of them complained of otorrhea subjectively, but objective findings classified that true otorrhea had been seen 29% of them and the remaining (14%) were cerumen. The most common problem for these patients was cerumen, with which 66% of patients had been troubled. Compaired with pre-operative hearing, at the time of discharge 32% of them had improved hearing, 61% were unchanged and 7% were aggravated, but about 10 years later 14% had improved hearing, 70% were unchanged and 16% were aggravated.
A system for storage and retrieval of audiograms by digital computer was designed. This system was performed on the basis of off-line operation and the batch processing. Mark sensing sheet was employed for these audiograms. The audiograms and summaries of medical records (ex. diagnosis, hearing loss type, etc.) relating to the audiograms were stored on magnetic tape by optical mark reader. Then, various sets of conditions for retrieval and print out as specified by doctors were given to the computer and the out put respondings to them were obtained from the computer by line-printer. This electronic data processing system had several advantages as follows: 1) The key-puncher to make the punch card or tape was unnecessary. 2) Memorandums and comments were able to note on this mark sheets by color pencil except black. 3) Marked documents and design of print out audiograms were able to read by doctors as same as any other conditional audiograms. 4) It was observed that print out data were extracted from the computer memory without any faults and in a very short time.