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Some patients suffer hearing loss in the early postoperative period following vestibular schwannoma (VS) excision despite having intact hearing immediately after surgery. As this phenomenon has rarely been documented or described, the putative mechanism remains vague. The objective of the current study was to document the patterns of change in behavioural and electrophysiological responses in patients following VS surgery to better describe the phenomenon of delayed hearing loss. In particular, we aimed to determine whether the impairment that eventually leads to delayed hearing loss is neural or cochlear in origin. Auditory function was monitored in six adult patients who underwent surgery at Christchurch Public Hospital for excision of unilateral vestibular schwannoma through the retrosigmoid approach. Patients were assessed pre- and postoperatively by puretone audiometry, speech audiometry, tympanometry, distortion product otoacoustic emissions (DPOAEs), and auditory brainstem response (ABR). When measurable hearing was demonstrated postoperatively, pure-tone audiometry, speech audiometry and ABR were assessed at 24 hour intervals following surgery. Transtympanic electrocochleography (ECochG) was carried out if wave I of the ABR was lost during the postoperative period. Postoperative monitoring revealed that 4 patients suffered permanent anacusis and the remaining 2 patients had permanent hearing preservation. There were no patients who experienced delayed hearing loss in the early postoperative period. A phenomenon similar to delayed hearing loss was observed in case 2 who demonstrated loss of ABR wave I on the 7th postoperative day. Postoperative ECochG recorded in this case showed an enhanced negative SP on the operated side. The findings of this study are discussed in detail with particular reference to the underlying pathophysiology.

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This thesis reports research to investigate the mechanical, thermal and acoustic properties of biodegradable foams in block forms based on wheat starch and developed at Brunel University's School of Engineering & Design, in order to exploit the potential environmental benefits of this renewable and biodegradable class of materials. Two emergent novel technologies have been developed based on a combination of the extrusion foaming of starch in conjunction with the natural adhesive characteristics of moistened starch to produce block foams. Regular Packing & Stacking (RPS), and Compression Bonded Loosefill (CBL), are foam fabrication technologies which have both demonstrated the potential to produce bulk foams based on wheat starch with unique structures and properties - a new class of foam materials in the form of macro-composites reinforced by a network of high-density bonding interfaces. This thesis, as part of a Department of Trade & Industry/Technology Strategy Board funded project, reports an investigation into the following areas to address the scientific and technical issues involved in the further development of the materials and their applications. - The basic properties of the raw materials used in the manufacture of CBL and RPS foams are outlined and the fabrication and preparation of these starch-based foams are described. The limitations of these production techniques are discussed with preliminary work and suggestions made for their enhancement. - Research into the mechanical properties of the CBL and RPS foams includes compression, tensile, creep and dynamic impact tests, whilst the mechanical behaviour of the foams subject to high temperature and high humidity conditions is also reported. - Research into the thermal properties of CBL and high density RPS foams includes testing of the material's thermal conductivity. This aspect of the research also involved a case study detailing the use of RPS in a commercial thermal insulation application. - Research into the acoustic properties of CBL and RPS foams includes tests for sound absorption coefficient and sound transmission loss. - Data obtained from these tests are benchmarked against data pertaining to the mechanical, thermal and acoustic properties of conventional polymer foams in order to provide a basis on which to identify the potential cushioning, thermal insulation and acoustic insulation applications of the starch-based materials. The research has demonstrated the following: - Potential cushioning applications include those limited to the range of static loads within the capabilities of the materials, taking into account the resilience of CBL and RPS which is likely to be compromised by successive impacts. - Tensile forces tend to exploit weaknesses in the macrostructure of these materials. By implication the behaviour of the materials under shear forces would be expected to be similarly compromised. - CBL and RPS exhibited dimensional shrinkage, density increase and significantly reduced mechanical properties under conditions of high temperature and humidity. This suggests that neither CBL nor RPS foams would be suitable for applications in regions where tropical conditions may be encountered unless used in conjunction with other protective materials which would not acutely increase the environmental burden of the products. - Low-density RPS and CBL foams exhibit lower thermal conductivities and hence higher thermal insulation properties compared to many commercially available polymer foams of similar densities. As such these foams have the potential to be used in applications in which a measure of thermal insulation is required. A case study based on an existing commercial application in which the temperature of chilled products must be maintained over a 24 hour period reinforced these findings. - The performance of CBL and RPS starch foams would not provide sufficient functionality to be employed in applications in which dedicated acoustic performance is required, although their sound absorption capabilities may facilitate overall marketability for applications in which a degree of acoustic performance is required if used in conjunction with other materials which demonstrate good acoustic performance. It is anticipated that this work will make significant contributions toward advances in the development of these novel technologies, specifically in terms of establishing an understanding of the properties of the starch-based materials and in identifying potential applications. The research results should thus provide a fundamental element in the basis for the industrial development of these renewable and biodegradable materials.

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