Poznan's program of cochlear and brainstem implantation: a general review.

The cochlear implantation program in Poznan started in January 1994. Within 8 years, 151 patients were implanted (149 cochlear and 2 auditory brain-stem implants). The implanted group comprised 111 children and 40 adults. We have extended the lower age limit for cochlear implant candidates, and the youngest implanted patient was 18-months-old at the time of surgery. We have also implanted six multi-handicapped subjects. All patients were implanted with different nucleus devices (22, 24 M, 24 K, 24 Contour, 24 Double Array and 24 ABI). Insertion of the Nucleus 24 Contour electrode carrier requires a little larger cochleostomy in comparison with conventional straight array. After insertion, the intraoperative measurements are taken (impedance telemetry, electrically evoked stapedius reflex and NRT). The day after surgery, each patient undergoes an X-ray examination (the cochleogram or cochlear view). The calculated length of the electrode array insertion was 12.75-24.0 mm (mean: 22.05 mm) and the degree of electrode rotation was 180-540 degrees (mean: 292.82 degrees). After speech processor switch-on, we performed NRT measurements. Our results indicated that the NRT threshold was in 51.4% of the dynamic range within the group of examined patients. The adults' progress of rehabilitation was checked during individual sessions. The rehabilitation of children included two rehabilitation schedules: continuous ones and weekly rehabilitation camps. The progress of the recovery process of implanted children enabled them to change their school profile from hearing impaired to mainstream. Voice rehabilitation is often monitored by acoustic analysis using the Multi Dimensional Voice Program (MDVP).

[Functional voice evaluation after Reinke's edema treated with CO2 laser and Kleinsasser's microsurgery]. / Ocena czynnosciowa glosu po leczeniu obrzeków reinkego w mikrochirurgii laserowej CO2 oraz w mikrolaryngoskopii metoda wg Kleinsassera.

The authors performed functional evaluation of voice in 124 patients treated with microsurgery due to oedema Reincke in the years 1991-1994. In 90 patients surgery was performed with CO2 laser microsurgery and in 34 patients with microlaryngoscopy according to Kleinsasser. The picture of larynx was registered and evaluated with help of laryngovideostroboscopy. The voice status was evaluated in phoniatric examination, registered on tape and submitted to acoustic analysis. No correlation between method of surgical treatment and quality of voice was observed. However, significantly worse quality of voice was noted in those smoking after surgery.

The acoustic analysis of voice in patients with multi-channel cochlear implant.

The acoustic analysis of the voice was performed in 5 implanted patients (2 children and 3 adults). This analysis was made twice in each patient one week before the implantation and the second time at least three months later. The examination was carried out using the KAY Electronics 4300 instruments and the MDVP program. The comparison of the results showed: decreased F0 value of phonation tone after the surgery in all patients; mean values of jitter and shimmer were increased in relation to norm before and after the surgery in adults and children; the gap between harmonic signal and noise (NHR) was within norm in 2 adults, and in 1 child with prelingual deafness significantly decreased after the surgery. The acoustic analysis of voice of cochlear implant patients, especially children, may be the objective evaluation of progress in speech and hearing rehabilitation. In the process of rehabilitation tendencies pointing out to the normalization of voice especially in patients with prelingual deafness was observed.