[Cochlear implantation through the middle fossa approach]. / Implantacja wszczepu slimakowego z dojscia przez srodkowy dól czaszki.

The inner part of cochlear implant is inserted into inner ear during surgery through mastoid and middle ear. It is a classical method, used in the majority cochlear centers in the world. This is not a suitable method in case of chronic otitis media and middle ear malformation. In these cases Colletti proposed the middle fossa approach and cochlear implant insertion omitting middle ear structures. In patient with bilateral chronic otitis media underwent a few ears operations without obtaining dry postoperative cavity. Cochlear implantation through the middle fossa approach was performed in this patient. The bone fenster was cut, temporal lobe was bent and petrosus pyramid upper surface was exposed. When the superficial petrosal greater nerve, facial nerve and arcuate eminence were localised, the cochlear was open in the basal turn and electrode were inserted. The patient achieves good results in the postoperative speech rehabilitation. It confirmed Colletti tesis that deeper electrode insertion in the cochlear implantation through the middle fossa approach enable use of low and middle frequencies, which are very important in speech understanding.

[Neurofibroma of the parapharyngeal space: a case report]. / Przypadek nerwiakowlókniaka przestrzeni przygardlowej.

Neurofibroma is rarely found arising in the head and neck region. Parapharyngeal space neurofibroma is one of the rare complications of neurofibromatosis type I, occurring in less than 5% of all parapharyngeal space neoplasms. Solitary neurofibroma type II in this location has not been reported so far in literature. In this paper we describe a case of a huge neurofibroma of parapharyngeal space, indicating the main diagnostic procedures (especially CT scan), and report the surgical treatment.

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.

[CT examination of the temporal bones for cochlear implantation]. / Badanie CT kosci skroniowych u osób przygotowanych do operacji wszczepu slimakowego.

CT examinations of temporal bones were performed in 31 deaf patients from qualify diagnostic stage prepared for cochlear implants. Essential for surgical treatment anatomic details were estimated, especially canalis spiralis cochleae was paid to attention. In our group, 8 patients had some CT changes (abnormal findings) which corresponded to different stages of obliteration the cochlea. The majority of patients lost the hearing because of meningitis. In 6 implanted patients CT scan was compared with surgical findings. During the operation 1 patient with patent cochlea on CT scan had partially ossified basal turn.

[Laryngocele]. / Laryngozele.

A large laryngocele treated operatively is presented. The great diagnostic value of CT examination for determining the size and site of the cyst is pointed out. A CT scan makes it possible to choose the best surgical procedure.