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.

[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.

[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 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.

[Pharmacological possibilities in treatment hypoacusis in children]. / Mozliwosci farmakologiczne leczenia niedosuchów odbiorczych u dzieci.

The purpose of this work was to present the dynamics of hearing thresholds and the progress in rehabilitation of hearing and speech according to the treatment applied and probable etiological factor of hypoacusis. Two groups of children were examined. The first group consisted of children with deep sensorineural hypoacusis together with central component of hypoacusis, whereas the second group included children with sudden occurrence of hypoacusis or detorioration of diminished hearing ability. The first group received a treatment with a drug stimulating the function of central nervous system, Cerebrolysin (Minden, D), whereas the other one underwent typical therapy applied in case of sudden deafness (mannitol, hydrocortison, vitamins, enzymes). Both the groups were subjected to objective examination of hearing before and after the treatment. The improvement in examination results in the first group was observed in 36%. In patients suffering from sudden deafness the improvement in hearing after treatment was found respectively in 30%.

[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.

Electromyography of cricopharyngeal muscles in patients with oesophageal speech.

Subject for the examination were 30 patients who during total laryngectomy had had two silver clips for haemostasis inserted into the cricopharyngeous muscle about 3 cm from the sewing place in the midline, facilitating the location of the muscle and the placing of a needle electrode. Twelve to 18 months after laryngectomy and phoniatric rehabilitation, electromyographic examinations were performed. Each EMG recording was evaluated as to amplitude, discharge frequency and time duration of muscle electric activity. EMG recordings made during deglutition and phonation proved dependences of cricopharyngeous muscle activity on quality of oesophageal voice production and higher activity of muscle during phonation than deglutition in patients who developed very good and good oesophageal speech.