[The use of thresholds of electrically evoked short-latent auditory potentials for the adjustment of the speech processors in the patients undergoing cochlear implantation].

The objective of the present study was to determine the thresholds of electrically evoked short-latent auditory potentials by the mathematical method and to elucidate the relationship between these parameters and the subjective maximally comfortable levels in the patients undergoing cochlear implantation. The electrically evoked short-latent auditory potentials were recorded in two groups of patients with different stimulation frequency (17 and 43 Hz). The use of the mathematical method of linear regression of the amplitude (peak V) growth function for determining the thresholds of electrically evoked short-latent auditory potentials has a number of advantages over visual detection of the threshold level. To increase the reliability of the data obtained, low stimulation frequencies need to be used when recording electrically evoked short-latent auditory potentials (17 Hz). The calculated thresholds of electrically evoked short-latent auditory potentials can be used to estimate the subjective maximally comfortable levels for the adjustment of the speech processors when it is impossible to register electrically induced stapedial reflexes and electrically induced total action potentials of the auditory nerve in the patients having cochlear implants.

[Organization of remote long-term support of the patients with cochlear implants in distant regions].

The concept of remote long-term support of the patients with cochlear implants is suggested to cope with the problem of the increasingly growing number of patients with cochlear pathology. The authors deem it necessary to provide intraoperative support and postoperative follow-up technologies for the patients living far from the cochlear implantation centres. A scheme for the remote selection of patients and their intraoperative monitoring is proposed with the use of implant telemetry, electrical stapedial reflex (eSRT) testing, auditory response telemetry (ART), and surgical on-line counseling. Remote follow-up and rehabilitation should include cochlear implant tuning, speech therapy, and on-line workshops for the patients and/or specialists. The choice and the use of software and hardware for this purpose are discussed. The concept of remote long-term support turned out to be an efficacious, reliable, time-saving, and cost-effective tool for providing high-tech medical aid to patients with ENT diseases in the Krasnoyarsk kray (territory).

[Complex diagnosis of fragment injuries of the eye and orbit].

The paper presents data on the prevalence and pattern of fragment injuries of the eye and orbit in the Sverdlovsk Region in 2000-2004. It describes the authors' system for complex diagnosis of metallic foreign bodies, which is based on the wide use of electron location in combination with other clinical, instrumental, and special studies. The comparative results of treating patients with the standard and proposed system, which demonstrate the advantages of the latter in small-sized fragments in particular, are given.

[Current problems of cochlear implantation]. / Aktual'nye voprosy kokhlearnoi implantatsii.

The Center of Cochlear Implantation at St-Petersburg ENT Research Institute was set up in 1997. For three years of its activity 19 cochlear implantations were made in patients of different age. All of them received Combi 40/40+ implants (Med-El, Austria). Prospects of cochlear implantation and problems of its introduction in Russia are analysed.

[Rehabilitation and assessment of aural-oral speech development in children with cochlear implants]. / Reabilitatsiia i otsenka slukhorechevogo razvitiia detei s kokhlearnymi implantami.

Updated models of cochlear implants provide good speech audibility and thus complete rehabilitation of children who have lost hearing after learning speech. All the children who lost hearing before learning speech can hear sounds of normal loudness and orient in sound media by means of cochlear implant. However, they need long-term audio-vocal rehabilitation the results of which depend on the age of the child's operation and hi(her) individual traits. Cochlear implants in children aged under 3 years are most perspective. Russian language methodology including 7 tests and 2 questionnaires is described. It is intended for assessment of audio-vocal development in children with cochlear implants and results of audio-vocal rehabilitation as well as of effectiveness of using cochlear implant in children over 2 years of age. Establishment of centers for cochlear implantation and introduction of cochlear implantation state program are recommended.

[On the modeling of acoustic perception in patients with implants]. / K voprosu o modelirovanii slukhovogo vospriiatiia patsientov s implantami.

Four laws of the spectrum division into frequency bands programmed into the implant Combi-40 were applied. After processing of the speech tables using specially developed program, frequency-restricted speech signal was obtained. It contained 8 bands covering 50 Hz each. These were central frequencies of band filters of the speech processor. Training was needed for all examinees with normal hearing to master a new speech picture after which words differentiation reached 100% in all the four variants of the spectrum division. Thus, excess of speech in terms of frequency representation is more than 92.3%. Parallels are given between speech perception of patients with implants and perception of speech changed according to the above program by subjects with normal hearing.

[The characteristics of hearing perception in light of the problem of rehabilitating patients who have undergone implantation]. / Osobennosti slukhovogo vospriiatiia v svete problemy reabilitatsii patsientov, perenesshikh implantatsiiu.

There are significant differences in hearing perception of normal and cochlear implanted individuals. Though the implant processor changes time and frequency characteristics of the speech signal, some implanted patients are able to adapt to their new perception and to return to full understanding of live speech. We make the attempt to understand how the implanted patients percept new picture of speech and suggest the plan of rehabilitation for subjects who lost hearing early.

[Neuropeptides in the treatment of sensorineural hypoacusis in children]. / Neiropeptidy v lechenii sensonevral'noi tugoukhosti u detei.

The examination of 250 children with neurosensory hypoacusis (NSH) demonstrated a 78% efficacy of endaural phonophoresis with dalargin (DPP) and transcranial electrostimulation (TCE) for improvement of acoustic function in the presence of positive ultrasound prognosis. Rheoencephalography and biochemical tests show that neuropeptides improve cerebral hemodynamics and normalize metabolism. Both DPP and TCE promote normalization of protein spectrum of the serum. In addition, TCE normalizes serum magnesium levels and its renal elimination, while DPP normalizes serum content of cholesterol.

[Problem of cochlear implantation: brief introduction]. / Kratkoe vvedenie v problemu kokhlearnoi implantatsii.

The only method of hearing rehabilitation for patients with severe hypoacusis and peripheral deafness is cochlear implantation consisting of insertion of electrodes into the scala tympani and direct electric impulse stimulation of the auditory nerve adjusted to the input acoustic signal. Only few such operations have been performed in this country. Much effort should be devoted to training of specialists and advocating this method among practitioners.

[Localizing foreign ferromagnetic bodies by means of the PF-02 ferroprobe polarity detector]. / Lokalizatsiia inorodnykh ferromagnitnykh tel s pomoshch'iu ferrozondovogo poliusoiskatelia PG-02.

The paper analyzes the problems, facilities and techniques for enhancing the accuracy of localization of a foreign ferromagnetic body. To tackle this problem is associated with further improvement of the parameters and characteristics of an electronic polarity detector unit, by using a new element base. In this connection, a PF-02 polarity detector model with its new construction of a ferroprobe transducer is presented. The device defines the inhomogeneity of static magnetic field acting on the ferroprobe transducer at the gradient range of 0.00024 A/cm2 to 1.2 A/cm2. The clinical testing of the device enables polarity detector to be more effectively used in medicine.

[Inductance transducers for borderline localization of metallic foreign bodies]. / Induktsionnye datchiki dlia pogranichnoi lokalizatsii inorodnykh metallicheskikh tel.

The paper outlines the advantages and disadvantages of a ferroprobe inductance transducer used in the borderline localization of a foreign ferromagnetic body. To eliminate the ferroprobe transducer-inherent disadvantages, a whirl-current inductance transducer has been developed. The transducer localizes a foreign nonferromagnetic and ferromagnetic body in its borderline localization in the eye and in the whole body.

[Localization and removal of metallic foreign bodies using LIT-2 foreign body locator]. / Lokalizatsiia i udalenie inorodnykh metallicheskikh tel s pomoshch'iu lokatora inorodnykh tel LIT-2.

The paper analyzes the advantages and disadvantages of devices used in medical practice to localize and remove foreign metallic bodies. To enhance the accuracy of detection and localization of foreign bodies and the efficiency of medical application of whirl-current locators, a LIT-2 model foreign body locator is presented. Cases of mutual orientation of the device transducer and foreign metallic bodies, the specific features of whirl-current diagnosis with procedures for preoperative and intraoperative localization.

[Use of a universal ferro-probe pole locator PF-01 in medicine]. / Primenenie universal'nogo ferrozondovogo poliusoiskatelia PF-01 v meditsine.

The versatile II phi-01 flux-gate magnetic pole locator is intended for detecting and locating ferromagnetic foreign bodies in human tissue. The sensitivity of the device to magnetic field gradient is 4 mOe/cm on a large scale. The device can be used to locate a hypodermic needle at a distance of 50-90 mm, a sewing needle at 60-122 mm, a routine 7.62-mm bullet at 90 mm and a 5.6-mm bullet at 105 mm.

Use of amplitude-modulated focused ultrasound for diagnosis of hearing disorders.

Focused ultrasound with a frequency of 2.5 MHz and amplitude-modulated in the range of audiometric frequencies (125-8000 Hz) was employed to examine 50 normal hearing persons and in complex diagnostics of over 500 patients suffering from sensorineural deafness, otosclerosis, chronic otitis media, and acoustic neurinoma. Typical diagnostic signs of these diseases were revealed. Modulated ultrasound is shown to offer an improved diagnosis of hearing diseases. The results confirm the previous observation that amplitude-modulated ultrasound may excite not only the acoustic receptors but also the acoustic nerve fibres. Possible mechanisms of the stimulating effect of focused modulated ultrasound are discussed.