[Evaluation of the cochlear implantation users rehabilitation results using psychoacoustic methods]. / Otsenka rezul'tatov reabilitatsii pol'zovatelei kokhlearnykh implantatov s primeneniem psikhoakusticheskikh metodov issledovaniya.

Currently, the number of patients with bilateral sensorineural deafness treated with cochlear implantation (CI) is increasing in the Russian Federation. In this regard, methods of assessing the auditory rehabilitation of this category of patients become more relevant. OBJECTIVE: To investigate the correlation of the speech intelligibility in quiet with frequency resolving power (FRP) of hearing using a ripple-spectrum phase reversion test (RSPRT) in CI users. MATERIAL AND METHODS: The study includes 30 CI users, three of them after bilateral CI, aged from 13 to 63 years with CI usage experience from 1 year to 16 years. 19 patients used CI systems manufactured by Cochlear Ltd. (Australia), 11 patients used CI systems manufactured by Advanced Bionics (Switzerland). All subjects underwent a number of studies including pure tone audiometry (TPA), speech audiometry in quiet using a multi-syllable speech material on a two-channel clinical audiometer AC-40 (Interacoustics A/S, Denmark); PC with recorded phonetic material from which the signal was reproduced, acoustic speaker SP90 (Interacoustics A/S, Denmark), for FRP estimation - RSPRT test in a free sound field, which was installed on the PC and also reproduced through SP 90 speakers (Interacoustics A/S, Denmark) were used. RESULTS: According to TPA results in a free sound field, the sound perception thresholds in all subjects corresponded to the mild degree sensorineural hearing loss. The sound perception threshold in the free sound field in the range from 500 Hz to 4 kHz was within the range of 25-30 dB nHL. The percentage of speech intelligibility in quiet in the free sound field ranged from 5 to 100%. During the FRP study of patients using RSPRT test, the following results were obtained: the average value of RSPRT test results at the frequency of 1 kHz was 1.94 RPO; for 2 kHz - 2.3 RPO; for 4 kHz - 2.2. The significant correlation between the speech intelligibility in quiet and frequency resolution of hearing was obtained at 1 and 4 kHz. The highest correlation coefficient was detected at 1 kHz - r=0.57 (p=0.0005), while at 4 kHz it was lower - r=0.46 (p=0.009), and at 2 kHz - at the boundary of the significance: r=0.34 (p=0.051). CONCLUSIONS: As a result of the study, it was found that there is a correlation between speech intelligibility in quiet and FRP of hearing, which makes it possible to recommend the use of RSPRT in assessing the auditory rehabilitation of patients after CI.

[Application of the matrix sentence test Russian version in children]. / Primenenie russkoiazychnoi versii matriksnogo frazovogo testa u detei.

The Russian version of the matrix sentence test (RUMatrix test) has been shown to be suitable for accurate assessment of speech intelligibility in adults. AIM: To approve the RUMatrix for measurements in children and to evaluate its simplified version (Simplified RUMatrix). MATERIAL AND METHODS: 20 normal-hearing adults and 81 normal-hearing children aged from 5 to 10 years were involved into the study. Both versions of the test were developed by the University of Oldenburg, Germany. The tests contain syntactically homogeneous, semantically unpredictable sentences/phrases presented under the background noise. Each test list is composed of 20 sentences of 5 words for RUMatrix and of 14 speech phrases of 3 words for Simplified RUMatrix. RESULTS: A limitation in the use of the RUMatrix test in children under 10 years of age has been revealed. Evaluation of Simplified RUMatrix test in adults confirmed the perceptual homogeneity of the test list. The results of the RUMatrix test and the Simplified RUMatrix test in children were lower than in adults; they were improving with age and reach adult values by 10 years. One training track of Simplified RUMatrix test should be carried out before the assessment. CONCLUSION: The RUMatrix can be used for children of 10 years and older. The normative data of Simplified RUMatrix both for adults and children of the different ages have been obtained.

[The application of the screening questionnaires for the diagnostics of the central auditory processing disorders in the pediatric practice]. / Ispol'zovanie skriningovykh anket dlia vyiavleniia tsentral'nykh slukhovykh rasstroistv v pediatricheskoi praktike.

Identification and diagnostics of auditory processing disorders (APD) in the children continues to be a challenge. Screening tools help to decide the need for evaluation. However, none of them are used routinely in Russia, nor are there thus far auditory checklist questionnaires in the Russian language. The aim of his study was to approve Children's Auditory Performance Scale (CHAPS) and Fisher's Auditory Checklist in Russian for the children at the age of 5-10 years. The study included 52 children at the age from 5 to 11 years. All of them were native Russian speakers. Pure tone audiometry, immitancemetry, and the Simplified RuMatrix test were performed for all the children. All of them had normal hearing thresholds, speech and language development, and normal academic achievement at school. The parents filled in the CHAPS and Fisher's Auditory Checklist questionnaires in Russian. The mean value of Fisher's Auditory Checklist was 85.7 ± 9.3, the mean value of CHAPS questionnaire was equal to 0.08 ± 0.26. The results obtained with the use of the Russian language questionnaires are in excellent agreement with the test data yielded by the respective English language versions. It is recommended that the clinical assessment for APD should be performed for children with the result of the Fisher questionnaire less than 67 points and with the result of the CHAPS questionnaire less than -1 point. It is concluded that Fisher's questionnaire was more convenient for the parents to fill in.

[Reoperations after cochlear implantation]. / Reoperatsii pri kokhlearnoi implantatsii.

The objective of the present study: the improvement of the quality and effectiveness of the surgical stage of cochlear implantation on the basis of the comprehensive analysis of performed reoperations. PATIENTS: 84 patients of the 2413 ones who had undergone cochlear implantation were re-examined by revision surgery within various periods after the first intervention. MAIN RESULTS: In certain patients, the correction of the intracochlear electrode array position was performed and in 72 cases the replacement of the implant was done. The most frequent cause of the replacement of the implant was the failure of the device. In the case of the extrusion and inflammation, the two-stage surgical treatment was applied. The exposure of the different parts of the cochlear implant with the duration up to 2 weeks was considered as a complication which could be adequately corrected. The surgical treatment of such patients was carried out in a single stage. The reparation processes at the place of the first intervention were strongly expressed, especially in children. Standardization of the cochlear implantation surgical stage based on the determination of its optimum volume in our Center led to a decrease in the number of reoperations and made the learning process easier to master for young otosurgeons. CONCLUSION: It is can be concluded that the reoperation after primary cochlear implantation is a highly effective technique and, taking into account the listed features, doesn't present difficulties for the qualified otosurgeon.

[The results of cochlear implantation in the patient with hereditary and non-hereditary hearing loss]. / Rezul'taty kokhlearnoi implantatsii u patsientov s nasledstvennymi i nenasledstvennymi formami tugoukhosti.

The objective of the present study was to evaluate the effectiveness of rehabilitation of the patients after cochlear implantation in the early and late periods after operation taking into consideration the etiology of congenital deafness. The comprehensive clinico-audiological examination performed during the period from 2010 to 2015 involved 246 children who had undergone cochlear implantation (CI). All children were operated at the National Research Center for Audiology and Hearing Rehabilitation in the period from 2003 to 2013. 83 (56%) patients were aged 1 to 3 years at the time of surgery. Their age varied from 3 to 18 years when they underwent the clinico-audiological examination. Thus, the study is based on the experience with cochlear implantation varying from 3 to 12 years. The genetic analysis revealed mutations in the GJB2 gene in 49% of the children, in agreement with the data of earlier studies. 85% of all the children with GJB2 deafness surgically treated at the age under 4 years attend ordinary institutions of learning. Within 24 months after the onset of the observations the majority of the children with hereditary deafness (63%) were referred to the groups with good and excellent results of the rehabilitation and only 6 (12%) patients presented with unsatisfactory results. It was shown that the acquired causes of the loss of hearing including severe prenatal pathology have a negative influence on the long-term outcomes of rehabilitation. The results of the genetic analysis for the elucidation of the cause of impaired hearing can be employed as a prognostic criteria not only for the prediction but also for the guarantee of the success of cochlear implantation provided the rehabilitative process was initiated in a proper time.

[Application of the mathematical model for prognosis in the rehabilitation of children after cochlear implantation]. / Ispol'zovanie matematicheskoi modeli dlya opredeleniya prognoza reabilitatsii u detei posle kokhlearnoi implantatsii.

Despite the variety of etiological factors, cochlear implantation (CI) remains the only effective method for the rehabilitation of the patients presenting with total deafness. The aim of this study was the enhancement of the efficiency of selection of the candidates for CI, the improvement of the quality of rehabilitation of the patients with cochlear implants, and the determination of the prognostic criteria for clinical trials. PATIENTS AND METHODS: (CI). The decision-making support system (DMSS) based on the artificial neural networks (ANNs) has been created to enhance the efficiency of rehabilitation of the patients with cochlear implants and increase the effectiveness of the selection of candidates for cochlear implantation. The results of the children's rehabilitation after CI have been analyzed by using a mathematical model of artificial neural networks (Kohonen layer). The basis for the assessment of ANNs was formed by the results of the observations of audioverbal perception in 110 patients aged from 6 months to 17 years. The initial data were the average values obtained with the use of the Russian-language version of the Nottingham children's implant profile's test T1 - T3. The testing was performed before CI and 3, 6, 12, 18, and 24 months after it. MAIN RESULTS: The work yielded the four-cluster data structure. It made it possible to estimate the effectiveness of the clinical trials in selected classes depending on the etiology of the disease, the age of the patients, and their experience with the application of hearing aids. The reliable estimation of the dynamics of auditory perception at the stage of rehabilitation and prognosis of the outcomes of CI made it possible to take additional preventive and therapeutic measures in the combination with complementary psychological and educational procedures.

[The Russian-language version of the matrix test (RUMatrix) in free field in patients after cochlear implantation in the long term]. / Russkoyazychnaya versiya matriksnogo frazovogo testa RUMatrix v svobodnom zvukovom pole u patsientov posle kokhlearnoi implantatsii.

The deterioration of speech intelligibility in the patients using cochlear implantation (CI) systems is especially well apparent in the noisy environment. It explains why phrasal speech tests, such as a Matrix sentence test, have become increasingly more popular in the speech audiometry during rehabilitation after CI. The Matrix test allows to estimate speech perception by the patients in a real life situation. The objective of this study was to assess the effectiveness of audiological rehabilitation of CI patients using the Russian-language version of the matrix test (RUMatrix) in free field in the noisy environment. 33 patients aged from 5 to 40 years with a more than 3 year experience of using cochlear implants inserted at the National Research Center for Audiology and Hearing Rehabilitation were included in our study. Five of these patients were implanted bilaterally. The results of our study showed a statistically significant improvement of speech intelligibility in the noisy environment after the speech processor adjustment; dynamics of the signal-to-noise ratio changes was -1.7 dB (p<0.001). CONCLUSION: The RUMatrix test is a highly efficient method for the estimation of speech intelligibility in the patients undergoing clinical investigations in the noisy environment. The high degree of comparability of the RUMatrix test with the Matrix tests in other languages makes possible its application in international multicenter studies.