HREM, FIM and tomographic atom probe investigation of Guinier-Preston zones in an Al-1.54at% Cu alloy.

An investigation of Guinier-Preston zones in Al-1.54at% Cu alloy annealed for 30h at 100 degrees C was carried out on the same monocrystal with complementary techniques of high-resolution electron microscopy (HREM) and tomographic atom probe-field ion microscopy (TAP-FIM). HREM results show that majority of GP1 zones are monolayers 1-9nm in size. However, some GP2 zones and particles in an intermediate state of growth between GP1 and GP2 stage were also found. From TAP results it follows that GP1 zones with different Cu concentrations ranging from 40% up to 100% Cu coexist. The residual solid solution is very heterogeneous. In the vicinity of GP particles the Cu content in the matrix falls down to zero, the solid solution in other regions contains from 0.7 to 1at% Cu.

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).

[Treatment results of patients with adenoid cystic carcinoma in the Otolaryngology Department at the University School of Medical Sciences in Poznan between 1958-1999]. / Wyniki lecznia chorych na raka gruczolowato--torbielowatego w Klinice Otolaryngologii AM w Poznaniu w latach 1958-1999.

In the years 1958-1999 the ENT Department at the University School of Medical Sciences in Poznan treated 125 patients suffering from adenoid cystic carcinoma located in the head and neck area. The aim of this study was to assess treatment results over a span of 41 years. The cases treated included 68 women and 57 men. The highest incidence of the disease was observed in men in their 70's--16 cases and women in their 50's--19 cases. In a majority of cases, the cancer started in major salivary glands, specifically parotid--51, submandibular--11, sublingual--4. Other places included minor salivary glands located in the palate--15, cheek--8, oral cavity--5 and tongue--4. Other glands affected by the tumor were those in the ethmoidomaxillary area--23. The treatment of choice was surgery with subsequent radiation. All patients were subjected to surgical treatment, 89 of them being subsequently radiated. Local recidivation was observed in 12 patients (i.e. 10%), metastases to neighbouring lymph nodes in 9 patients (i.e. 7%). Distant metastases affected the lungs--4 cases, liver--1 and bone--1.

Audiological assessment of unilateral deafness.

Unilateral deafness constitute medical (aetiological diagnosis, treatment, hearing aid fitting) and social problems (no certification of disability). Following audiological examinations were performed in the study: pure tone audiometry (PTA), impedance audiometry, auditory brainstem responses (ABR), otoacoustic emissions (OAE), as well as balance, taste, examinations and electric sensitivity of the acoustic nerve. In cases of tinnitus the parameters of its character were done. All of our patients underwent X-ray investigations, i.e. ear X-ray by Schüller and Stenvers methods, computerized tomography or magnetic resonance imaging. In some cases phoniatric and logopaedic examinations were performed. For aetiological diagnosis electrophoresis and immunological test (IgG and IgM against mumps) were carried out. The results were presented in two groups of patients with sudden and those of long lasting progressive unilateral deafness. Some of the patients were pharmacologically treated before the evaluation. It is concluded that the statistic analysis could be a basis for the management and prognosis of the unilateral deafness.

[Cochleography and cochlear view as the way of assessment of successful surgical inner ear implantation]. / Kochleogram i projekcja slimakowa jako sposoby oceny skutecznosci chirurgicznej implantacji ucha wewnetrznego.

115 cochlear implantation were performed in ENT Department Karol Marcinkowski University of Medical Sciences in Poznan in 1994-2001. Nucleus Mini System 22 and Nucleus 24 of Cochlear Ltd were used in these operations. Two approaches were performed: middle fossa approach in one case and traditional one. The aim of this study was evaluation of cochleogram and cochlear view as the ways of assessment of successful inner ear implantation. One of X-ray projection were performed in implanted patients 24 hours after implantation. In cochleograms the degree of electrodes rotation in cochlea was calculated. The number of inserted electrodes in cochlea was calculated in cochler view projection. Described X-ray projection were performed in 70 patients. On X-ray projection (cochleograms) rotation degree of electrodes in majority were equal or higher than 250 grades (according to literature it is sufficient for successful speech rehabilitation). X-ray projection--cochlear view confirmed full insertion of electrode.

[Oral cavity and oropharyngeal carcinomas in the materials of the University of Medical Science, ENT Department, in Poznan, in years 1980-1999]. / Rak jamy ustnej i czesci ustnej gardla w materiale Kliniki Otolaryngologii Akademii Medycznej w Poznaniu w latach 1980-1999.

624 patients with malignant neoplasms of the mouth and the oropharynx treated in the ENT Department K. Marcinkowski University of Medical Sciences in Poznan between 1980 and 1999 were analysed. Since the middle of the 90-ies a rapid increase of neoplasms incidence of this location has been observed. The most numerous group were tumours of the palatine tonsil (34.8%), tongue (32.5%), floor of the mouth (5.9%), soft palate (5.3%). Advanced neoplasms which encompassed the tongue, oropharynx, mouth floor base was observed in 134 patients (21.5%). The precise definition of their site of origin primary location was not possible to establish. In the analysed group males were dominating. Heavy smoker and alcohol-abuse constitute the majority of risk-factor patients. Poor dental status and mouth hygiene in this population was observed. In the histological examination squamous cell carcinoma was a dominating. Prognosis in patients with malignant neoplasms of the palatine tonsil were better in comparison with tongue cancer.

[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.

[Does the electrodes insertion depth influence speech rehabilitation progress in CI patients?]. / Czy glebokosc wprowadzenia elektrod ma wplyw na postepy w rehabilitacji mowy u osób z wielokanalowym wszczepem slimakowym?

Many interdisciplinary teams from difference CI centers are studying speech rehabilitation process of implanted patients. Speech rehabilitation progress depend on many conditions like: duration of deafness, age at implantation, cause of deafness. Rehabilitation of postlingually deafened patients is very short. These subjects return very fast to the world of sounds. By the other side speech rehabilitation of prelingually deafened patients needs much more time (years). There are although well seen differences in language skills acquisition inside these groups. It confirmed, that speech rehabilitation after cochlear implantation could depends on others conditions as well. The aim of this study was electrodes insertion depth evaluation (cochleograms) and its influence on speech rehabilitation progress.

[Reconstructive surgery in larynx cancer]. / Operacje rekonstrukcyjne w raku krtani.

Subtotal laryngectomies with larynx reconstruction are an acceptable alternative to the total laryngectomy in T2, T3 larynx cancer treatment. One procedure resection and reconstruction allow for radical oncological treatment with simultaneous preservation of air passage continuity and the function of the neolarynx. In the years 1988-1997 in ENT Dept. of Karol Marcinkowski University of Medical Sciences 38 subtotal laryngectomies with larynx reconstruction were performed. They were: 34 supracricoid laryngectomies with cricohyoidopexy, 2 with epiglotohyoidopexy and 3 supraglotic laryngectomies with reconstruction. The basic criterion of the evaluation of such procedures effectiveness was their oncological radicality. The follow-up period ranged from 2 to 9 years. Local relapse was observed in none of the cases, nodal relapse was started in 2 patients. Another aspect taken into consideration was the function of the neolarynx. In 3 cases two or three laser procedures were performed because of neolarynx lumen structure which were followed by T-dren plasty. In 10 patients temporary swallowing difficulties, especially liquids, were observed in the first three month. Gastrostomy was performed in one case. The authors discuss indications to this type of surgery, operation technique, oncological and functional results. Spirometry results and voice analyses after larynx resection and reconstruction in these patients are presented.

[First experiences in Neural Response Telemetry in patients with Nucleus 24 cochlear implant system]. / Wstepne doswiadczenia w stosowaniu telemetrii odpowiedzi nerwowych u pacjentów z wszczepem slimakowym Nucleus 24.

Nucleus 24 Cochlear Implant System enables bidirectional communication with the implant-telemetry. Information about implant function can be obtained using telemetry. Neural Response Telemetry is a measurement of neural activity in the cochlea as a response to electrical stimulation. Principle of NRT recording, classification of responses and examples of responses obtained in patients implanted in Poznan are presented.

[Dysphagia and speech disorders]. / Dysfagia a zaburzenia mowy.

Swallowing disorders in oral and pharyngeal phase after surgery of mouth, pharynx or larynx are very often interrelated with speech and voice disorders. The results of diagnostic methods of dysphagia and voice/speech disorders based on own material of patients after total laryngectomy, partial tongue resection and cleft palate surgery were presented. Attention was also paid to other etiological factors of swallowing disorders observed in phoniatric practice.

[Critical evaluation of the audiological test results in children]. / Krytyczna ocena wyników badan audiologicznych u dzieci.

Factors influencing results of objective hearing examination in children, i.e. auditory evoked potentials, based on own experiences are presented. "Cross-check" principle as well as observation of dynamic changes concerning development of communicative process should be taken into the consideration.

[The electrophysiological examination of hearing with some metabolic disorders in children]. / Badania elektrofizjologiczne sluchu u dzieci w niektórych schorzeniach metabolicznych.

Electrophysiological examinations of hearing (ABR, SP) in 60 children with insulin-dependent diabetes mellitus and 39 children with obesitas simplex were done. In both groups with normal hearing threshold in pure tone audiometry disturbances in intrastem conduction were noticed.

[Voice acoustic analysis in patients with a hearing aid or cochlear implant]. / Analiza akustyczna glosu u osób, u których zastosowano aparat sluchowy lub implant slimakowy.

The subject of our study was two groups of patients with hearing disorders: 23 cases implanted with multi-channel cochlear device (Nucleus Mini System 22) and 10 patients with perceptive hypoacusis who used hearing aids. The voice acoustic analysis was performed before cochlear implantation or application of a hearing aid and after a 6-month rehabilitation period. The acoustic analysis was carried out by means of a laryngophone connected to KAY 4300 instrument. The estimation of acoustic parameters of a laryngeal tone during rehabilitation process as well as parameters of spectrographic analysis was presented with the use of MDVP and CSL. Voice acoustic analysis can be an objective evaluation of progress in voice and speech rehabilitation process of patients with hearing disorders, particularly small children.

[The possibility of tinnitus suppression by electrical stimulation]. / Mozliwosc leczenia uporczywych szumów usznych metoda elektrostymulacji.

The authors described the treatment of 36 patients with persistent tinnitus. In the past the patients were treated with other methods without positive results. After audiological examinations Promontory Stimulator (Cochlear Co.) for electrical stimulation was used. During the electrical stimulation one electrode was inserted in external auditory meatus and the other on planum mastoideum. Bursts of biphasic pulses of 0.1 ms duration were used during electrical stimulation. Electrical stimulation was applied 10 min. during 10 days. The patients estimated effects of treatment and results are presented in table. The authors obtained satisfactory results in 48% of the patients.

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.