In parallel to the beneficial effects on the motor symptoms of PD, STN DBS reduces designated disease-inherent dysarthrophonic symptoms, such as glottic tremor. However, these actions on speech are predominantly outweighed by the general dysarthrogenic effects of STN DBS, probably based on a decline of complex (eg, prosodic) functions. Thus, stimulation-induced speech impairment should be considered a likely problem in the course of this treatment.

Since 1994, the German Registry for hearing Loss in Children has registered data of 1500 children and by now can present results concerning the age at diagnosis of permanent hearing loss in children in Germany. The mean age at diagnosis is still very high. There is a strong correlation between age at diagnosis and degree of hearing loss, i.e., severe and profound hearing loss, is diagnosed distinctly earlier than mild and moderate hearing loss. On average, mild hearing loss is diagnosed with 6.2 years, moderate h.l. with 4.4 years, severe hearing loss with 2.5 years and profound hearing loss with 1.9 years. This corresponds with the results of regional German studies. At least regionally, in other European countries the age at diagnosis is known to be distinctly lower. In 36% of the children registered in Germany the delay between first suspicion and diagnosis of permanent hearing loss is 1 year or more.

Low-frequency masking is a new method for the diagnosis of endolymphatic hydrops. A short acoustic stimulus and a low-frequency masker tone are applied to the same ear in an adjustable phase relationship. We recorded phase-dependent masked thresholds from normal-hearing subjects, and patients with Ménière’s disease and sensory hearing loss without vertigo. In normal hearing, there is a mean maximal difference in masking (modulation depth) of 28 dB between the phase delays of 0° and 270°. In patients with sensory hearing loss without vertigo, modulation depth is reduced due to recruitment. In Ménière cases, the phase dependence may be totally absent and varies as the disease progresses. Therefore, repeated measurements of masking are required: patients and subjects with normal hearing were tested for a period of 1 year. Also, modulation depth is significantly reduced in the contralateral nonsymptomatic ears of Ménière patients. The results indicate that low-frequency masking is a quick, noninvasive and relevant method for the diagnosis of endolymphatic hydrops.

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