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1/2. rupture of the round window membrane.

    A perilymph leak into the middle ear through a ruptured round window membrane results in the symptoms of hearing loss, tinnitus and vertigo, either singly or in combination. The case histories of thirteen patients with such a fistula are described, these patients having in common a predisposing incident which had led to a rise of C.S.F. pressure. Symptomatology and the results of investigation are analysed and operative technique and results discussed. While it appears that vertigo uniformly responds very satisfactorily to operative treatment the improvement in hearing loss and tinnitus is more difficult to predict.
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ranking = 1
keywords = vertigo
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2/2. The need for a participatory conservation programme for the reduction of noise exposure to Thai female workers.

    hearing loss induced in thirty female workers because of exposure to continuous noise was studied in a plastic bag plant in Samutprakarn Province, the largest industrial zone in thailand. The sound level in this plant was 98.5 dBA., 94.0 dBA. and 93.0 dBA. in the weaving, winding and warping sections, respectively. Results of an audiometric test showed a significant relationship between high noise level and hearing loss at frequency 4,000 Hz. A questionnaire survey found that a relatively high number of workers had various symptoms such as: 76.7% general fatigue, 70% headache, 63.3% ear distension and 56.7% vertigo. Concerning the usage of ear protective devices, it was found that 80% of the workers have never used such devices, 16.7% occasionally used them, and 3.3% have always used cotton wool to reduce the high noise level. Their reasons for non-use of ear protective devices were 1) not provided by the employer (86.7%), 2) not necessary (83.3%), 3) accustomed to the noise (63.3%), 4) nobody uses (56.7%), and 5) no loud noise (16.7%). These results point to the need for improving the work conditions and welfare services of the workers at this plant. Also, hearing conservation programmes can be instituted in developing countries through cooperation among the safety inspectorate, the employer and the workers.
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ranking = 0.5
keywords = vertigo
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