Distortion product otoacoustic emission (DPOAE) in tinnitus patients.

The aim of this study was to determine the effect of tinnitus (experiment I) and the combined effect of tinnitus and sensorineural hearing loss (experiment II) on the distortion product otoacoustic emission (DPOAE) for two age groups of tinnitus patients. Tinnitus patients with normal earing, along with normal-hearing control subjects, participated in experiment I. They were divided into two age groups, below 50 and above 50 years. Experiment I showed that the DPOAE levels in the tinnitus patients were lower than those in the normal-hearing (nontinnitus) subjects. The differences depended on the frequency and the age of the patients, suggesting the confounding influence of presbyacusis. The second group of tinnitus patients with increasing and notch-like hearing loss participated in experiment II. They were also divided into two age groups, below 50 and above 50 years. The data from experiment II showed that DPOAE activity well reflects the increasing and notch-like hearing loss functions up to about 40 dB HL. The effect of age on the DPOAE level was clearly noted only for the tinnitus patients with clinically normal-hearing thresholds and was ambiguous for the tinnitus patients with hearing loss.

[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.

[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.

[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.

[Otoacoustic emission evaluation in patients with tinnitus]. / Badanie otoemisji akustycznych u chorych z szumami usznymi.

Analysis of otoacoustic emission is highly objective, noninvasive and sensitive method representing cochlear function. In The Centre of ENT Rehabilitation in Poznan more than 900 patients were evaluated because of tinnitus. Standard tests were broaden by otoacoustic emission (SOAE, TEOAE, DPOAE) and results are discussed. Our results suggest that otoacoustic emission is possible to record in normally or with moderate hearing loss patients. 18 patients had SOAE. Only 2 patients had the same frequency of SOAE and tinnitus.

[Palisade cartilage tympanoplasty in reconstructing almost total defects of tympanic membrane: own experience]. / Technika palisadowa w odtwarzaniu prawie calkowitych ubytków blony bebenkowej--doswiadczenia wlasne.

The authors described 8 patients with almost total defects of tympanic membrane. The patients were operated on with palisade tympanoplasty technique (m. Heermann) with the use of conchal autografts for reconstruction of the tympanic membrane. The technique is very useful and gives good results.

[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 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.

[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.

[The Poznan program of the treatment of deafness by multichannel cochlear implants]. / Poznanski program leczenia gluchoty przy uzyciu wielokanalowego wszczepu slimakowego.

The authors presented 5 deaf patients with postlingual deafness and application of cochlear implant "Nucleus Mini System 22". In details operative technics and postoperative proceeding were described as well as rehabilitation results in 3-6 months after operation. The authors consider, that in adults with postlingual deafness, application of cochlear implants were giving very good effects.

[The first experience in diagnosis and rehabiliation in patients with cochlear implant "Nuclear Mini System 22"]. / Pierwsze doswiadczenia diagnostyczne i rehabilitacyjne u chorych przed i po zalozeniu wszczepu slimakowego "nucleus mini system 22".

The first qualification for cochlear implant "Nucleus" was performed on the basis of audiological tests. Next stage was conversation with a patient and his family about motivation of longterm rehabilitation. Then the two very important investigations were carried out--the computer tomography which showed inner ear structure, and electric promotory test. In rehabilitation process original "Nucleus" partially modified and Polish linguistic articulation lists were used.

[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.