bluuebunny/crossref_metadata_2025 huggingface dataset:
The Consulting Teacher Simulation Program
Authors: Lloyd Sandra R.
Published: January 2017

With recent changes in the philosophy regarding placement of handicapped students, special educators are now often asked to serve as consultants to regular educators. A computer simulation was designed to expose special educators to some of the situations they may encounter in this new role. First, a Master Test was developed describing 30 typical consulting situations. Next, “correct” choices on this test were validated by experienced graduates of four university consulting teacher programs. Then the twenty situations on which there was a consensus of opinion were expanded into computer simulations of the problems, in which the participant was shown the likely consequences of each choice and asked to make further decisions to solve the problem. The Mastery Test was given to 19 special educators before and after they completed the simulation. Results indicated that the simulation enabled subjects to choose strategies significantly more like those of expert consulting teachers.
Data-Based Program Modification: A Continuous Evaluation System with Computer Software to Facilitate Implementation
Authors: Fuchs Lynn S. , Deno Stanley L. , Mirkin Phyllis K.
Published: January 2017

This paper provides a rationale for and describes a continuous evaluation system, data-based program modification (DBPM), which has demonstrated technical adequacy, logistical feasibility, and instructional effectiveness. Additionally, the paper illustrates the use of DBPM with a case study, and then describes the DBPM software package that stores, summarizes, analyzes, and displays a graph of student performance data.
The Effects of Noise Reduction on Social Behaviors
Authors: Carbone Vincent J. , Duncan Phillip K.
Published: January 2017

Previous researchers have suggested that noise level reduction is correlated with generalized improvements in untreated social behaviors. While these findings are encouraging it is not dear that this effect can be assumed to occur in a variety of settings with varying social behaviors. In addition, the results of previous studies were obtained by utilizing interval time sampling measurement procedures as opposed to continuous recording.

In this study, electro-mechanical equipment was wired to a stereo in the recreation room of a juvenile shelter care facility. The equipment continuously measured the frequency and durations of disruptions above 85dB during experimental phases. In addition, several corollary social behaviors were continuously measured by trained observers. A contingency of reinforcement was placed on a social behavior in the latter phases of the experiment.

A repeated time series design (reversal) demonstrated experimental control of disruptions above 85dB. However, no change was found in the level of social responding until a direct contingency of reinforcement was applied.

Corollary social behaviors did not show a generalized effect of the contingencies placed upon disruptions above 85dB. The contradictory findings of previous research may be the result of measurement procedures and not differences in responding.
Qualitative Research Methods in Special Education: Ethnography, Microethnography, and Ethology
Authors: Murray Carola , Anderson Jacki , Bersani Hank , Mesaros Richard
Published: January 2017

Although recent publications and conference presentations provide evidence that special educators are interested in new ways of doing research, alternatives to traditional quantitative research practices are not yet well understood Therefore, ethnography, microethography, and ethology—three qualitative methodologies especially relevant to the field's current concern with integrated community-based service delivery—are contrasted according to their disciplinary origins, methods for data collection and analysis, and use of audiovisual technology. Studies that exemplify the special education applications of these methodologies are summarized. Recommendations are made for future use of qualitative methods in special education.
Videodisc Technology: Providing Instructional Alternatives
Authors: Hofmeister Alan M. , Engelmann Siegfried , Carnine Douglas
Published: January 2017

As special educators search for effective and flexible instructional alternatives, consideration must be given to videodisc programs built on the characteristics of effective instruction. The different types of instructional videodisc programs are described and discussed in relation to the needs and resources of the public school. In discussing needs, both staff development and student achievement goals are considered.
Observations from the Development and Field Testing of an Instructional Videodisc Program
Authors: Hofmeister Alan M. , Engelmann Siegfried , Carnine Douglas
Published: January 2017

The paper discusses the development and validation of a series of instructional videodiscs. The different procedures used to ensure the incorporation of the characteristics of effective instruction are presented, along with a discussion of the characteristics of the medium. The validation processes placed an emphasis on field test and revision cycles to ensure that student mastery could be consistently achieved by the finished product.
The Evolution of the Laptop Computer
Authors: Meltzer Laurie J. , Hasselbring Ted S.
Published: January 2017

This article highlights the technological advances that have led to the development of the laptop computer. A chronology of size reduction through four generations of computers is detailed. This chronological history is followed by a discussion of the Dynabook, a speculative computer that served as a conceptual precursor of today's laptop. Finally, the jump from the portable computer to the laptop is discussed.
The Use of Portable Microcomputers to Collect Student and Teacher Behavior Data
Authors: Rieth Herbert , Haus George J. , Bahr Christine M.
Published: January 2017

This article describes the development and implementation of three applications of portable microcomputers (Projects STEEL, MICROS, and UPWARD) to collect, store, transmit, and analyze teacher and student observational data. It identifies the goals of each project and describes development of the observation systems and corresponding computer software. The article also discusses obstacles associated with using portable microcomputers to collect data and describes how, through a series of refinements and with the advent of a second generation of laptop computers, many of these obstacles have been eliminated, now enabling researchers and teachers to more extensively use portable microcomputers to conduct observation studies.
A Computer-Based System for Collecting and Analyzing Observational Data
Authors: Repp Alan C. , Karsh Kathryn G. , Van Acker Rick , Felce David , Harman Martin
Published: January 2017

Applied behavior analysis and other sciences based on data derived from direct observation are often interested in session summaries for each behavioral code of interest. In general, these data are obtained through time-sampling procedures, though they are occasionally obtained through electromechanical means that can preserve data in real time Such a record is an advantage as it offers the researcher additional options in analyzing behavior. This article describes such a system, based on the Epson HX-20, that we have been using for 5 years to collect data for various projects. The article includes examples of some of the programs developed, types of research questions asked, and data analyses conducted.
Using Computer Networking to Increase Active Teaching in General Education Math Classes Containing Students with Mild Disabilities
Authors: Hayden Melissa , Gersten Russell , Carnine Douglas
Published: January 2017

The study examined the effects of frequent feedback to teachers on student performance during math instruction. Three teachers, whose classes contained mainstreamed students with mild disabilities, used the computer networking system to check student understanding of math concepts throughout their math lessons. A multiple baseline design across subjects (teachers) was used to assess the effects of using of the networking system on the time teachers spent on active teaching, feedback and explanations, the number of problems given and number of questions asked. Merely using the networking system led to changes in performance for only one of three teachers. In a second phase, using the networking system with coaching, teachers required students to meet a criterion (usually 80%) to determine whether students needed reteaching or were ready for instruction on a new problem type. Although insufficient data points were available for the third teacher, the results suggest that with coaching on how to use the data generated by the computer networking system, teachers increased the amount of time spent on active teaching, providing feedback, number of problems given, and number of questions asked. Teachers reported that the data shown on the monitor screen enabled them to more precisely determine whether students understood skills presented during the lesson.
Voice Recognition Technology and Persons with Severe Mental Retardation and Severe Physical Impairment: Learning, Response Differentiation, and Affect
Authors: Brown Carrie C. , Cavalier Al R.
Published: January 2017

This study investigated the learning and response differentiation of a variety of voice commands that served to control environmental devices by a person who is severely mentally retarded and severely physically impaired. The contingencies between vocalization and device activation were created by a computer system with voice recognition and environmental control capabilities. Using a multiple-baseline-across-behaviors experimental design, the study shows that the subject (a) learned the cause-and-effect relationship between her voice and the resultant environmental action, (b) differentiated various vocalizations for different environmental actions, and (c) experienced positive affect when she was in control. This application represents the first time in the subject's life that she exerted independent control over her environment.
The Effects of Community Training Using a Videodisc-Based Simulation
Authors: Wissick Cheryl A. , Lloyd John W. , Kinzie Mable B.
Published: January 2017

The purpose of this study was to determine the suitability of using interactive videodisc for developing community based simulations for students with moderate disabilities. A multiple baseline design across students was used to assess the effects of the training package, that made use of an interactive videodisc-based simulation, on the students' skills to locate and purchase an item in simulated and natural convenience store settings. Three adolescents with moderate disabilities were taught how to access the equipment, discriminate items, and shop for snack items in a convenience store. During baseline and intervention phases, purchasing skills were assessed daily in simulated settings and weekly in natural settings. Measures included the number of extra actions to locate an item, percentage of assistance from the teacher, and number of purchasing steps completed correctly. All students learned how to access the equipment, to discriminate visuals of shopping items, and to interact in the simulated store setting. In addition for the simulated settings, students demonstrated a decrease in the number of extra actions needed to locate an item and an increase in the number of purchasing steps performed correctly.
Using an Expert System to Study the Classroom Placement Decision for Students Who are Deaf or Hard-of-Hearing
Authors: Vinsonhaler John , Stewart David , Price Leighton , Hall Brenda
Published: January 2017

This study applies expert systems technology to the problem of deciding whether to place deaf & hard-of-hearing children in mainstream or self-contained classrooms. This application includes: (a) developing a theoretical model of how experts make placement decisions, (b) creating a computer-based expert system to capture this model and to aid teachers and other members of the individualized educational plan committee (IEPC) in the making these decisions, and (c) conducting an empirical study comparing the placement decisions of the human experts with those of the expert system.

The study provides a review of the theoretical model, describes the expert system in some detail and briefly summarizes those aspects of the study related to evaluation of the expert system. In the study, ten teachers made placement decisions for ten representative student-cases. A simulation experiment was run by presenting the same ten cases to the expert system. The decisions of the expert system were found to agree with those of a majority of teachers in 90% of the cases. This and other results indicate the value of expert systems in deaf education.
Software Development in Special Education
Authors: Woodward John , Noell John
Published: January 2017

Over the last ten years, special educators have developed a variety of software programs which attempt to address the unique needs of mildly handicapped students. Much of this work has been funded by the Division of Innovation and Development in the Office of Special Education Programs. This article examines software development techniques used by many of these special educators through the perspective of the software lifecycle. This perspective, which is used intimately by professional software developers, is rarely discussed in the special education technology literature. With rapid advancements in computers, particularly the graphical user interface, the authors argue that traditional programming techniques are becoming less and less viable for software development within the typical funding levels and timelines of federal initiatives. Instead, a trend toward the use of commercial software tools is viewed as inevitable, given these constraints. The article concludes with a brief description of two recently completed, technology-based assessment programs.
Individualization of Teaching and Learning: Where Have We Been; Where are We Going?
Authors: Romiszowski Alexander
Published: January 2017

This article briefly reviews the history of approaches to the individualization of instruction, from earlier “system-controlled” methodologies to the current multimedia/hypermedia-based “learner-controlled” approaches. Some of the reasons for the general failure of earlier approaches are analyzed. This leads to the general conclusion that there is no guarantee that the new approaches will be successful, and that several key areas of research and development require attention. The article concludes with a review of current research on one aspect of the suggested agenda - the support of computer-based learning exercises by means of electronic networking, to create a form of “virtual group discussion” environment capable of supporting individual learners with intelligent, constructive feedback and guidance.
Computer Speech and the Remediation of Reading and Spelling Problems
Authors: Wise Barbara W. , Olson Richard K.
Published: January 2017

A high-quality speech synthesizer (DECtalk, by Digital Equipment Corporation) is very intelligible to children with reading disabilities. Linking the DECtalk to a microcomputer yields a “talking computer” that provides a powerful tool for research and remediation of reading and spelling problems. Two clear and related findings about children with “specific reading disability” (dyslexia) have emerged from previous research: 1) deficits in word recognition primarily cause these children's problems in reading comprehension, and 2) inherited deficits in analytic language processes underlie their difficulties in word recognition. These two findings suggest that speech support for words in text could help these children.

In several studies at the University of Colorado, children with reading problems have read stories and books on talking computers for about 30 minutes a day, usually for 3–4 days per week during most of a semester. The children's word recognition and phonological decoding have improved, compared to the skills of similar students who spent the time in regular classroom language arts instruction. The studies suggest that accurate word feedback supporting the reading of text helps these readers. One goal of the research has been to compare the benefits of presenting unknown words as wholes or in segments for different students. That goal has remained somewhat elusive, with interesting interactions that have been significant but not always stable.

The paper also describes a different line of study using the DECtalk in a spelling program that allows children to explore English sound-spelling patterns as they compare pronunciations of their own spelling attempts and those of the test words. The paper concludes with descriptions of a current home-based reading study and a future study exploring the benefits of computer-based phonemic awareness training prior to the reading instruction.
Access to Knowledge and Expression: Multimedia Writing Tools for Students with Diverse Needs and Strengths
Authors: Daiute Colette , Morse Frances
Published: January 2017

This paper explores the proposal that some nine and ten-year old children with serious writing problems do not make progress because much of their instruction is centered around their weaknesses rather than around their strengths. Many children who cannot read or write well by the time they are in the fourth grade are able to learn from visual and aural sources in relevant contexts, but their work in school relies mostly on textual sources as they progress through the grades. Images and sounds can provide children with information in cultural, social, and emotional contexts that are readily accessible to them. The lack of access to such resources is especially acute for children from backgrounds that differ from the culture assumed by school but also occurs for some children from mainstream backgrounds who work better in visual and aural than in textual modes. Since some of the functions of written language, like providing information and means of expression, can be served by other symbol systems, it is worth exploring children's use of a variety of symbol systems and relationships between visual symbol systems, aural symbol systems, and text. Recent developments in technology make it possible to create multimedia environments in the computer including images, sounds, text, and tools for manipulating and transforming these symbol systems. As children gather and study pictures and sounds on a relevant topic, they may be able to use these images and sounds as springboards for writing and extending beyond familiar contexts. But, there is little research to determine whether and how children use such multimedia tools to build bridges between their lives and the world of text, which they must inhabit to be successful in school.
Access and Meaning: The Keys to Effective Computer Use by Children with Language Disabilities
Authors: Meyers Laura F.
Published: January 2017

Computers can empower children with disabilities to participate in the normal processes of spoken and written language learning. To accomplish this, teachers must put access to computer-based speech output and text under the control of children with disabilities. Then, teachers must support children's construction of internal grammars by providing the language structure needed to link the computer-based speech and text with the children's personal meaning systems. A research project with children with Down syndrome is reported, supporting the contention that combining access to speech and text through technology with teaching methods that provide the language structure to link the speech output and text with personal meaning results in significantly improved language use compared with implementation of identical teaching methods with computers without speech output, or identical teaching methods with pencil and paper. Implications about the requirements for effective computer-based language interventions and about the role of teachers are discussed.
Using Technology to Support a New Pedagogy of Mathematics Teacher Education
Authors: Lampert Magdalene , Heaton Ruth , Ball Deborah
Published: January 2017

Teacher education courses that deliver knowledge about how to change mathematics teaching to prospective teachers are ineffective in challenging their traditional ideas about how to teach. There are few models of good practice for novices to observe and examine. By making multiple images of innovative teaching and learning available for study, hypermedia technology has the potential to represent the complexities of actual work in classrooms in situations where novices can develop images of the kind of practice that reformers espouse. The authors have been designing and experimenting with hypermedia tools in preservice teacher education that involve prospective teachers in this kind of inquiry learning about mathematics teaching. Information about classroom lessons and reflections on these lessons have been assembled to provide an environment in which prospective teachers can pose questions and use data to understand teaching and learning. A course in which such cases were used as the focus of teacher education is described.
A Comparison of Traditional Classroom Instruction and Anchored Instruction with University General Education Students
Authors: Langone John , Malone D. Michael , Stecker Pamela M. , Greene Eric
Published: January 2017

The effects of a traditional instruction format and an anchored instruction format on the immediate and long-term acquisition of knowledge of 100 university general education majors was examined. Participants were administered multiple-choice and essay format pre-tests, post-tests, and follow-up tests. Results revealed somewhat different within group patterns as well as important between group patterns. Both groups performed better on the post-test and follow-up test than on the pre-test. No differences between the two groups on the post-test were recorded. The anchored instruction group outperformed the traditional instruction group on the multiple-choice follow-up test and the traditional instruction group outperformed the anchored instruction group on the essay follow-up test. Implications for future research are discussed.
Multi-University Collaboration via Distance Learning to Train Rural Special Education Teachers and Related Services Personnel
Authors: Grisham-Brown Jennifer , Knoll James A. , Collins Belva C. , Baird Constance M.
Published: January 2017

This article describes a multi-university model for delivering a course via distance learning in Kentucky. The course, Transdisciplinary Services to Students with Deafblindness and Other Multiple Disabilities, was offered through compressed video to students at three (3) universities, one (1) private college and four (4) additional sites. A lead instructor (first author) and a team of specialists from various disciplines (e.g., nursing, vision, physical therapy) taught the course. Participating students at the graduate and undergraduate levels observed team assessments, engaged in consensus building activities and developed group projects to develop their teaming skills. Evaluation data, collected at the end of the course, suggest that this format has promise for teaching courses where single institutes of higher education, particularly those in rural regions, may have limited resources. Suggestions are offered for meeting the challenges associated with this type of delivery.
Accessibility of Special Education Program Home Pages
Authors: Flowers Claudia P. , Bray Marty , Algozzine Robert F.
Published: January 2017

The World Wide Web (WWW) is a universal medium that has revolutionized the dissemination and gathering of information; however, on-line barriers limit the accessibility of the WWW for individuals with disabilities. Federal legislation directs that the provision of assistive technology devices and services enable individuals with disabilities to benefit from the opportunities available to their neighbors and peers without disabilities. The purposes of this study were to evaluate the accessibility of university special education programs' home pages and discuss accessibility recommendations. Eighty-nine special education Web sites were evaluated for accessibility errors. Most (73%) special education home pages had accessibility problems, and the majority of these errors (71%) severely limited access for individuals with disabilities. The good news is that the majority (83%) of the errors can easily be corrected. Recommendations and methods for improving accessibility to the WWW for individuals with disabilities are discussed.
Understanding Twitter use by major LIS professional organisations in the United States
Authors: Zhang Min , Sheu Feng-Ru , Zhang Yin
Published: January 2017

Although Twitter has been widely adopted by professional organisations, there has been a lack of understanding and research on its utilisation. This article presents a study that looks into how five major library and information science (LIS) professional organisations in the United States use Twitter, including the American Library Association (ALA), Special Libraries Association (SLA), Association for Library and Information Science Education (ALISE), Association for Information Science and Technology (ASIS&T) and the iSchools. Specifically explored are the characteristics of Twitter usage, such as prevalent topics or contents, type of users involved, as well as the user influence based on number of mentions and retweets. The article also presents the network interactions among the LIS associations on Twitter. A systematic Twitter analysis framework of descriptive analytics, content analytics, user analysis and network analytics with relevant metrics used in this study can be applied to other studies of Twitter use.
Facial Nerve Recording from the Eardrum: A Possible Method for Evaluating Idiopathic Facial Nerve Paralysis
Authors: Zealear David L. , Kurago Zoya
Published: January 2017

A noninvasive technique has been developed for recording from the facial nerve within the fallopian canal. Following transcutaneous stimulation of the nerve on the face, an antidromic nerve potential can be detected with electrodes placed on the eardrum and enhanced by the technique of averaging. In studies conducted on cats and normal human subjects it has been determined that the primary recording site of the nerve potential is along the tympanic segment of the nerve just distal to the geniculate ganglion. Disturbances in nerve conduction caused by an experimental lesion produced changes in the recorded nerve potential. Thus it seems likely that this technique could assess a developing lesion in a patient with idiopathic facial nerve paralysis. A more accurate and earlier prognosis could be obtained than with conventional peripheral nerve testing techniques, since the severity of the developing lesion itself could be assessed.
Cochlear Hearing Loss in Tympanoplasty
Authors: Bellucci Richard J.
Published: January 2017

In tympanoplasty, trauma to the cochlea is usually caused by the transmission of vibration induced during the removal of cholesteatoma, granulation tissue, and tympanosclerosis surrounding the ossicular chain. In 100 sequential cases 20 showed evidence of cochlear trauma. Hearing was recovered in 10 of these cases during the immediate postoperative period. In nine the hearing was partially recovered but remained below the preoperative bone‐conduction level, and in one there was a total cochlear hearing loss. When the stapes footplate was fractured or dislocated and a perilymphatic fistula developed, profound cochlear hearing loss occurred. This complication usually can be avoided by inspection of the round and oval windows under high magnification and by tissue grafts over the fistula. An unanticipated pathologic fistula of the semicircular canals is another common source of major cochlear damage. Despite all precautions and sometimes without apparent cause, a total cochlear hearing loss may result after a tympanoplasty. Although this is rare, as evidenced by the fact that there were only 15 cases in some 1000 tympanoplasties, before surgery the surgeon must Inform the patient of the risks involved.
Interferon Sensitivity of Fibroblast Cell Cultures Derived from Patients with Neoplasms of the Head and Neck
Authors: Richtsmeier William J. , Johns Michael E. , Cantrell Robert W. , Sorge Kevin
Published: January 2017

Interferon (IFN) is a protein with antiviral activity that has been shown to inhibit the growth of many different types of cells. We have measured the IFN sensitivity of nine cell cultures isolated from patients with squamous cell carcinoma and one with malignant melanoma of the head and neck. Normal‐appearing fibroblast cultures isolated from these tissues appear quite sensitive to the antiviral effects of IFN. When the encephalomyocarditis virus yield reduction assay is used, these diploid cells are as sensitive to IFN‐α as are newborn foreskin fibroblast cultures. A similar anstiviral effect is seen with IFN‐γ. These cells are relatively insensitive to the antigrowth effect of both IFN preparations as measured by 3H thymidine incorporation and direct observations of cell growth. This is the same relative sensitivity as fibroblasts derived from normal patients. Since these cells are at least 100 times less sensitive to the antigrowth action of the IFNs, it appears unlikely that the IFNs play a significant role in the control of normal fibroblast growth, in contrast to the sensitivity of malignant cell lines.
Effects of Human Interferon on Cell Proliferation and Antigens Induced by Epstein‐Barr Virus in Epithelial Hybrid Cells Derived from Nasopharyngeal Carcinoma
Authors: Takimoto Toru , Ishikawa Shigeru , Umeda Ryozo , Ogura Hisashi , Hatano Motoichi
Published: January 2017

The effects of human leukocyte interferon (HulFN‐α) and fibroblast Interferon (HulFN‐β) on cell growth and induction of antigens related to Epstein‐Barr virus (EBV) in a nasopharyngeal carcinoma hybrid cell line (NPC‐KT) were studied. HulFN‐α showed little antiproliferative and anti‐EBV effect on NPC‐KT cells. On the other hand, HulFN‐β showed modest antiproliferative effect on NPC‐KT cells, the effect was dependent on time and HulFN‐β concentration. HulFN‐β alone was ineffective in inhibiting EBV‐related antigens, but NPC‐KT cells treated for more than 1 week with HulFN‐β inhibited the action of the chemical inducer of EBV, n‐butyric acid, and the appearance of EBV‐induced early antigen and EB viral capsid antigen was inhibited more than 50% compared with NPC‐KT cells treated with n‐butyric acid alone.
Nasal Obstruction and Pulmonary Function: The Role of Humidification
Authors: Woodson Gayle E. , Robbins K. Thomas
Published: January 2017

The function of the nose in respiration is poorly understood. This article reports on two studies of the effects of nasal obstruction on pulmonary function. First, blood gases were studied in 71 patients undergoing intranasal surgery. Patients with bilateral nasal packing had an average Po2 drop of 6.9 mm Hg. Lung disease and polyps were more prevalent in patients who showed a significant drop In Po2, and those who became most hypoxic complained of a dry throat. The second study tested the influence of humidification. Pulmonary function and blood gases were measured in 10 subjects before and after nasal occlusion. Those breathing only dry air had a drop in compliance after nasal clipping. When air was humidified, nasal occlusion had no significant effect. Humidification may be an important respiratory function of the nose. Any future studies of the nasopulmonary relationship should adequately control for humidity and bronchial reactivity.
Assessment of Laryngeal Function by Digital Subtraction Laryngography
Authors: Hopp Martin L. , Brown Ben Maurice , Enzmann Dieter R. , Castellino Ronald A. , Levine Paul A.
Published: January 2017

The evaluation of vocal cord function can be problematic in the presence of oropharyngeal tumors, hypopharyngeal tumors, and supraglottic lesions and in noncompliant adult and pediatric patients. The use of computer image subtraction techniques coupled with digital fluoroscopy has inherent high‐quality resolution that can provide an excellent image of vocal cord symmetry and movement. The use of air as the contrast medium provides the ability to measure the extent of vocal cord excursion as well as the extent of piriform sinus lesions. In addition, it is a noninvasive procedure that requires a minimal imaging exposure time, with the result that the patient undergoes minimal radiation exposure.
Facial Electroneurography: Clinical and Experimental Investigations
Authors: Kartush Jack M. , Lilly David J. , Kemink John L.
Published: January 2017

Facial electroneurography (ENoG) appears to be a reliable prognostic test for intratemporal facial nerve paralysis. ENoG is objective and allows a permanent record to be maintained. Nonetheless, occasional inconsistencies in clinical correlation may diminish the utility of ENoG. A qualitative study was undertaken to identify the possible reasons for the inaccuracy of ENoG in some patients. Four clinical groups and one experimental group were studied: (1) normal subjects, (2) patients with acute facial palsy, (3) patients with progressive facial palsy, (4) patients with temporal bone tumors and normal facial function, and (5) animals in which one facial nerve was crushed and repaired. The reliability of ENoG is dependent on careful interpretation of data obtained by optimal electrode placement and stimulus duration.
Neurotologic Evidence of Central and Peripheral Involvement in Patients with Vestibular Neuronitis
Authors: Corvera Jorge , Davalos Roberto L.
Published: January 2017

Quantitative vestibulo‐oculomotor tests and auditory brain stem responses were studied in 22 patients with vestibular neuronitis in a search for evidence of CNS affection. Such evidence was found in 16 of the 22; only in the other six could the examination findings be regarded as the result of damage limited to vestibular neuroepithelium or nerve. It is concluded that vestibular neuronitis can cause CNS signs by itself, probably because of inflammation in the vicinity of the vestibular nerve.
Middle Fossa Surgery
Authors: Miyamoto Richard T. , Althaus Sean R. , Wilson David F. , Brookler Kenneth H.
Published: January 2017

The principal indications for the middle cranial fossa approach to the petrous apex and internal auditory canal are section of the vestibular nerves in vertigo, management of lesions of the labyrinthine segment of the facial nerve, and removal of mass lesions of the internal auditory canal. We report 153 cases of pathosis of the temporal bone and related structures for which this approach was used.
Juvenile Nasopharyngeal Angiofibroma: Diagnosis and Treatment
Authors: Duvall Arndt J. , Moreano Alex E.
Published: January 2017

Juvenile nasopharyngeal angiofibroma (JNA) is an uncommon, histologically benign vascular tumor that occurs almost exclusively in adolescent males. While occasional mention is made of the occurrence of JNA in females and in older males, only four1 cases have withstood rigorous clinicopathological review. This neoplasm accounts for less than 0.05% of all benign lesions that originate in the nasopharynx. Its clinically malignant behavior is a result of its propensity for locally destructive growth and fatal hemorrhage. The evolution in the management of these tumors has been the subject of much interest and much confusion. The advents of computed tomographic (CT) scanning, selective angiography with embolization, and refinements in surgical approaches have revolutionized operative management of these lesions by allowing more realistic selection of surgical candidates, better preoperative planning, and more flexible (yet aggressive) primary surgical treatment. The attendant reduction in morbidity and mortality of contemporary surgical management of this disease has largely obviated the argument of those who advocate use of radiotherapy as the primary treatment modality for this benign lesion. This latter view is based on the reports of massive hemorrhage, significant incidence of incomplete removal, and mortality reported in the older surgical literature. This article details our experience with a series of 31 patients who had clinicopathological diagnoses of JNA and were treated between 1954 and 1984. It furthermore represents an update of our previously reported series.2
Acoustic (Loudspeaker) Facial EMG Monitoring: II. Use of Evoked EMG Activity during Acoustic Neuroma Resection
Authors: Prass Richard L. , Kinney Sam E. , Hardy Russell W. , Hahn Joseph F. , Lüders Hans
Published: January 2017

Facial electromyographic (EMG) activity was continuously monitored via loudspeaker during eleven translabyrinthine and nine suboccipital consecutive unselected acoustic neuroma resections. Ipsilateral facial EMG activity was synchronously recorded on the audio channels of operative videotapes, which were retrospectively reviewed in order to allow detailed evaluation of the potential benefit of various acoustic EMG patterns in the performance of specific aspects of acoustic neuroma resection. The use of evoked facial EMG activity was classified and described. Direct local mechanical (surgical) stimulation and direct electrical stimulation were of benefit in the localization and/or delineation of the facial nerve contour. Burst and train acoustic patterns of EMG activity appeared to indicate surgical trauma to the facial nerve that would not have been appreciated otherwise. Early results of postoperative facial function of monitored patients are presented, and the possible value of burst and train acoustic EMG activity patterns in the intraoperative assessment of facial nerve function is discussed. Acoustic facial EMG monitoring appears to provide a potentially powerful surgical tool for delineation of the facial nerve contour, the ongoing use of which may lead to continued improvement in facial nerve function preservation through modification of dissection strategy.
Acoustic and Perceptual Assessment of Speech Using a Voice‐Prosthesis with Valvular and Manual Occlusion
Authors: Blakley Brian W. , Podraza Bonnie L.
Published: January 2017

Acoustic and perceptual analyses for the accomplished user of a voice prosthesis were performed. The study was performed to discover whether the performance and intelligibility of speech improved with the use of the tracheal stomal (TS) valve as compared with speech achieved by occlusion of the stoma with the thumb. Our data suggest that the speech produced in the patient tested was less desirable with the use of a TS valve than when manual occlusion was used.
Unilateral Parathyroidectomy: The Role of Thallium‐Technetium Subtraction Scans
Authors: Davis R. Kim , Hoffmann John , Dart Douglas , Datz Frederick L.
Published: January 2017

The rationale for using the thallium‐technetium subtraction scan as a preoperative localizing study in previously untreated patients with primary hyperparathyroidism is presented. The concept of unilateral parathyroidectomy is also presented, and the role of preoperative localizing studies in this approach to parathyroid surgery is carefully analyzed.
A Comparison of Postoperative Bleeding Incidence between General and Local Anesthesia Tonsillectomies
Authors: Kennedy Kevin S. , Strom C. G.
Published: January 2017

Portsmouth, Virginia, and Oakland, California Postoperative bleeding after tonsillectomy is a problem that has earned the respect and cautious attention of the most experienced surgeons. The Incidence of postoperative hemorrhage after tonsillectomy, as well as many factors affecting this Incidence, has been extensively investigated. A possible factor that has not been well studied as a possible Influence in postoperative tonsillectomy bleeding is the choice of anesthetic. A study was completed comparing the incidence of postoperative tonsillectomy bleeding between patients operated on using general anesthetic and local anesthetic. One hundred ninety‐two patients consecutively undergoing tonsillectomy at Naval Hospital, Oakland, California, were Included in the study. Three of 150 patients (3%) having general anesthesia and 13 of 87 patients (15%) having local anesthesia experienced postoperative bleeding. Possible factors influencing this difference in postoperative bleeding incidence are discussed. The possibility is suggested that surgeons (and previous reports) may underestimate the rates of postoperative bleeding as a result of patients being treated by other than the operating physcian.
Allergy Management of Refractory Serous Otitis Media
Authors: Hurst David S.
Published: January 2017

Twenty patients classified as having otitis media with effusion (OME) refractory to all previous medical and surgical therapy were entered Into a prospective study to see If classic allergy techniques could diagnose and treat otherwise unresolved effusion and persistent hearing loss in lieu of the re‐Insertion of tympanostomy tubes. RAST testing, skin end point titration and food elimination diets identified a possible allergic etiology in all patients. Among those choosing allergy immunotherapy, 65% maintained normal hearing, normal tympanograms, and the elimination of recurrent infections for three years. The remaining 35% resolved on appropriate food elimination diets. None of the control's symptoms resolved. The history of chronic disease is defined. The pathophysiology of allergic mechanisms and studies attempting to prove or disprove an allergic effect on the middle ear and eustachian tube are reviewed.
Gadolinium‐DTPA Enhanced Magnetic Resonance Imaging in Acoustic Neuroma Diagnosis and Management
Authors: Jackler Robert K. , Shapiro Michael S. , Dillon William P. , Pitts Lawrence , Lanser Michael J.
Published: January 2017

Gadollnium‐DTPA (Gd‐DTPA) is a paramagnetic contrast agent that increases the intensity of acoustic neuromas (AN) on T1‐weighted magnetic resonance Imaging (MRI) scans. Over a 9‐month period we have reviewed Gd‐DTPA‐enhanced MRI scans on 32 consecutive cases (35 tumors) involving the Internal auditory canal (IAC) and cerebellopontine angle (CPA). The majority of patients (84%) were imaged on latest generation 1.5 Tesla scanners. Every tumor studied showed marked enhancement after Gd‐DTPA administration. This improved contrast permitted identification of three small tumors that were not evident on unenhanced scans. Gd‐DTPA appears to be particularly useful in the evaluation of recurrent or residual AN. In three patients with known residual tumor after planned subtotal excisions, the remaining tumor could only be differentiated from surrounding scar, cerebral spinal fluid (CSF), and brain parenchyma after contrast enhancement. In one of these, a small rim of tumor capsule left on the facial nerve was evident only on Gd‐DTPA–enhanced T1 images. Gd‐DTPA also provides a more reliable estimate of the depth of tumor penetration in the IAC. This Information is useful in selecting candidates suitable for a hearing conservation approach.
Summating Potential/Action Potential Ratio in Perilymph Fistula
Authors: Meyerhoff William L. , Yellin M. Wende
Published: January 2017

A prospective study of electrocochleography in patients with clinically suspected perilymph fistula was undertaken to determine its predictive value In that disorder. One hundred forty‐four patients suspected of having perilymph fistula had electro‐cochleography performed—34 of these (39 ears) had exploratory tympanotomy. Of the 19 ears with normal preoperative summating potential/action potential (SP/AP) ratio, ten had perilymph fistula identified at the time of surgery. Of the 20 ears with abnormal SP/AP ratio, 16 had perilymph fistula confirmed at exploration, 18 had resolution of symptoms after oval window and round membrane grafting, and only one ear had postoperative persistence of the abnormal SP/AP ratio. This study suggests that an abnormal SP/AP ratio is not only predictive of endolymphatic hydrops, but also of perilymph fistula (both problems of inner ear fluid imbalance). This study also suggests that, while abnormal SP/AP ratio is fairly specific for inner ear fluid imbalance, it is not sensitive.
Consequences of Middle Ear Bone Dust during Neurotologic Surgery
Authors: Feghali Joseph G. , Benecke James E.
Published: January 2017

Most otologists are cautioned at some point in their training that if bone dust is allowed to enter the middle ear while the mastoid is being drilled, there may be adverse consequences. Two cases of ossicular fixation and conductive hearing loss after retrolabyrinthine vestibular nerve section prompted us to examine the issue of bone dust in the middle ear. In a study of 13 temporal bones that had undergone neurotologic surgery, we found 11 that showed evidence of viable bone dust in the middle ear, and three that had ossicular fixation. Viable bone dust was always encased In a mucous membrane lining. These findings suggest that bone dust that enters the middle ear may indeed remain viable and cause ossicular fixation. The surgeon should therefore take every precaution to prevent bone dust from entering the middle ear during neurotologic procedures in which conservation of hearing is attempted.
Posturography following Rotation: A Model of Posture Control during Vestibular Dysfunction
Authors: Goebel Joel A. , Paige Gary D.
Published: January 2017

Postural stability is Influenced by multiple sensory inputs, including visual, somatosensory, and vestibular cues. Adaptive changes in how these sensory inputs influence posture may occur in the presence of vestibular dysfunction. in this study, we simulated vestibular dysfunction in normal subjects in order to study immediate and adaptive modifications in postural control under reproducible and reversible experimental conditions. Twenty subjects (ages 20 to 35 years) were tested on a force‐detecting platform; the support surface or visual surround was modulated (anterior‐posterior) proportionally to body sway. Vestibular dysfunction was simulated by rotating subjects with their eyes closed at 180 degrees/second for 30 seconds, then rapidly halting rotation. Posturographic measures were obtained during the subsequent 20 seconds. Ten identical rotation trials for each subject were performed, alternating the direction of rotation, and with either the support surface or the visual surround modulated with sway in different subjects. Thus, only one sensory modality could provide Earth‐stable sensory cues. Control groups were tested to assess effects of repeated alternating rotations alone, and effects of repeated posturographic trials alone. Sway was quantified by measuring peak‐to‐peak excursions of the center of mass. Results showed that subjects were more stable after rotation when they were provided with a stable support surface than with a stable visual surround. No subject could maintain stance without at least one Earth‐stable sensory input. improvement of mean sway scores in either group was not significant, although isolated cases did exhibit adaptive changes with improved stability over repeated trials. Control studies suggested that effects of repeated rotations or posturographic trials alone were Insignificant. We conclude that rotatory vestibular stimulation provides a useful model of vestibular dysfunction for the study of multisensory influences on postural control and adaptive processes that help stabilize stance.