In vitro culture Muller cell model to study the role of inverted internal limiting membrane flap technique in macular hole closure.

Inverted internal limiting membrane (ILM) flap may constitute a scaffold for Muller cells whose migration and proliferation on its surface begin the process of macular hole closure. The goal of the study was to establish an in vitro model of the interaction between ILM and the Muller cells. Vitrectomy with inverted ILM flap was performed in 23 patients due to a full-thickness macular hole (FTMH). After dissection of the inverted flap, the area of ILM peeling was extended and material was collected for cell culture experiments. Muller cells cultured on adherent cell plates showed significantly better growth than on suspension plates. Our results reveal that the presence of the ILM can overcome the growth inhibitory effect of the non-adhesive surface. Moreover, the ILM appears to be the optimal growth surface under normoxia conditions mimicking the microenvironment after vitrectomy and hypoxia which is natural state for Muller cells. The closure rate of FTMH was 100%. Our study revealed that in non-adhesive culture conditions patient derived ILM constitutes an optimal growth surface for Muller cells. We have demonstrated that the ILM effectively stimulates attachment, proliferation, and survival of Müller cells in conditions of normoxia which is the case after vitrectomy. The results strongly advocate for the use of inverted ILM flap method in macular hole closure surgeries.

Central serous chorioretinopathy induced by drugs metabolized by cytochrome P450 3A4.

The purpose of this study was investigate whether replacing or discontinuing drugs that are inhibitors or substrates of cytochrome P450 3A4 (CYP3A4) may improve the clinical course of central serous chorioretinopathy (CSC). A retrospective observational study included 43 patients with active CSC. Twenty seven patients (32 eyes, group 1) were using drugs that act as substrates or inhibitors of CYP3A4. In 25 of these 27 patients, treatments including steroids, calcium channel blockers, anticoagulants, statins, beta-adrenolytics, angiotensin receptor antagonists, antidepressants, muscarinic receptor antagonists, phosphodiesterase type 5 inhibitors, and others were discontinued or replaced with medications not affecting CYP3A4. Sixteen patients (19 eyes, group 2) not using any medication that affects CYP3A4, were given eplerenone, rifampicin, or laser treatment. Main outcomes measures were assessed by functional and anatomical images obtained using multimodal imaging techniques. The average follow-up time was 12 months. In group I after discontinuing or replacing substrates or inhibitors of CYP3A4, improvements were observed in 18 patients (22 eyes). None of the patients that were using drugs affecting CYP3A4 improved with eplerenone therapy, however, all 18 patients improved after discontinuing the drugs. All these drugs had a blocking effect on eplerenone therapy. Best corrected visual acuity (BCVA) improved in 14 eyes, remained unchanged in 5 eyes, and worsened in 3 eyes. In 21 of the 22 eyes, subretinal fluid absorption was observed with optical coherence tomography (OCT). Mean central retinal thickness decreased from 361 µm to 219 µm. One patient (2 eyes) was unable to change treatment (due to neoplasm), one patient (1 eye) did not agree to change or stop treatment, and seven patients (7 eyes) were lost to follow-up. Of the 16 patients (19 eyes) who were treated with eplerenone, rifampicin, or laser, improvements were observed in 14 patients (16 eyes), two patients (2 eyes) were lost to follow-up, and CSC worsened in 1 eye. We concluded that patients with CSC should not take substrates or inhibitors of CYP3A4. These drugs should be replaced with alternatives that act through other metabolic pathways.

Short-term experience with early steroid withdrawal in African-American renal transplant recipients.

There are limited data on the results of early steroid withdrawal (ESW) in African-American (AA) renal allograft recipients. We examined short-term transplant outcomes in a retrospective, non-concurrent cohort study of 40 AAs who did not (ESW group), and 33 who did [steroid maintenance (SM) group] receive maintenance steroids after day 4 post-transplant. Patients received thymoglobulin (ATG) induction, mycophenolate mofetil, and tacrolimus or sirolimus. Data were analyzed using survival analysis methods and regression models. Patients in the ESW group were older, had lower current panel reactive antibody and fewer re-transplants, and received fewer doses of ATG. One-year graft survival and acute rejection (AR) rates were 100% and 13% in the ESW group and 97% and 15% in the SM group. After controlling for confounders, at 1 year, ESW was not associated with higher risk of graft loss, AR, or worse graft function, but was associated with less weight gain. The SM group had higher cholesterol levels at 3 months and higher risk of post-transplant diabetes mellitus. We did not observe any cases of subclinical rejection. This study suggests that ESW under modern immunosuppression is safe over the short term in at least a subset of AA recipients with risk profiles similar to those studied herein, and could be associated with improved outcomes.

Interactive neuromonitoring methods of cochlea and auditory nerve during induced hypoxia and nerve manipulation.

Methods and instrumentation were developed to monitor cochlea and auditory function during surgery. The system allows real time assessment of the cochlear function during auditory nerve manipulation. A specially designed optic probe, placed on the round window (RW) niche, enables simultaneous acquisition of cochlear blood flow (CBF) and electrocochleogram (ECochG). We developed the acquisition paradigms, signal processing methods and implement them in a computational platform. The neuromonitoring system performs an automatic extraction and analysis of cochlear microphonics (CM), compound action potentials (CAP) and sura mating potential (SP). The system uses envelope detection filters to detect the amplitude of the CM. The CAP signal is processed with zero phase shift spectral filters, tuned to enhance the action potential onset, which is sometimes embedded within the sura mating potential. An automatic peak detection and tracking algorithm is then applied to extract latency and amplitude of CAPs. Long-term assessment of the monitoring system was performed during experimental animal surgeries. The system allowed detailed study of the dynamics of CM, CAP and CBF during nerve manipulation and compression.

Early identification of hearing impairment in patients with type 1 diabetes mellitus.

OBJECTIVE: The aim of this study was to evaluate the cochlear micromechanics and central auditory function in patients with type I diabetes mellitus and to identify the site of possible dysfunction. METHODS: Cochlear activity was evaluated by recording distortion product otoacoustic emissions (DPOAEs). DPOAEs were performed using an ILO 92 Otodynamics Analyser. Functional changes in the retrocochlear auditory pathway were evaluated by auditory brainstem responses (ABRs). DPOAEs and ABRs were measured in 42 normally hearing patients with type 1 diabetes mellitus aged 21 to 42 years, and 33 age- and sex-matched nondiabetic control subjects. RESULTS: Both of the groups (diabetic and control) had normal and undifferentiated results in tonal and impedance audiometry. ABR peripheral transmission time (wave I) and central transmission time (interpeak latencies I-V) were significantly delayed in the diabetic compared with normal subjects, and the mean amplitudes of various DPOAEs were significantly reduced in the diabetic patients compared with the control subjects. CONCLUSIONS: Combined use of different procedures for monitoring central and peripheral portions of the auditory pathway in diabetic patients showed alterations in cochlear micromechanics and the retrocochlear auditory pathway. Hearing impairment in diabetic patients is usually mild and subclinical, and can be detected early by accurate and objective audiometric methods.

[Monitoring of neurophysiologic modalities during surgery for cerebellopontine angle tumors. Personal experiments]. / Monitorowanie neurofizjologicznych modalnosci w trakcie zabiegów operacyjnych guzów kata mostowo-mózdzkowego. Doswiadczenia wlasne.

The purpose of intraoperative monitoring of many modalities is to save some structures of the nervous system being at risk of damaging during surgical procedures. In cerebellopontine angle (cpa) tumour cases these nervous system structures can include cranial nerves (trigeminal, facial, cochlear, accessory), motor and sensory tracts localised within brainstem, and other. Continuous registration of somatosensory and auditory evoked potentials as well as electromyography of masseter muscle, orbicular muscle of eye and trapezius muscle during procedure is the method of brainstem, cochlear tract and cranial nerves status evaluation. Direct stimulation of cranial nerves within posterior fossa using bipolar electrode is the method of facial, trigeminal and accessory nerves localisation, especially in patients with large tumours. In Department of Neurosurgery Silesian University School of Medicine for intraoperative monitoring of many modalities in cpa lesion cases Nocolet Viking IV D unit with special IOM software is employed. Authors presented own experience in such method and effect in treatment of group of 15 patients operated with electrophysiological intraoperative monitoring.

Assessment of the medial olivocochlear efferent system in children. pure tone 1.0 kHz and 2.0 kHz suppressive effects on transient evoked otoacoustic emission.

The role of medial efferent system in regulating outer hair cell function has been studied by many investigators. Usually narrow band noise or white noise as contralateral stimulation (CS) suppressors have been used and changes in OAE amplitudes estimated. Thirty children aged 6-15 years (mean 12.5 +/- 4.7), without any changes in tonal and impedance audiometry and with negative history regarding otiatric diseases were examined. Transient evoked otoacoustic emissions (TEOAE) were recorded using ILO 92 Otodynamics Analyser. CS was performed using 1.0 kHz and 2.0 kHz continuous pure tones of 30 dB SL or 50 dB SL. Effects of CS on TEOAE evoked by click of 80, 70 and 60 dB SPL were investigated. TEOAE analysis included assessment of TEOAE amplitude of half octave frequency bandwidth (HOFBW-1.0; HOFBW-1.5; HOFBW-2.0; HOFBW-3.0 and HOFBW-4.0 kHz) and 0.8 kHz frequency bandwidth (0.8-FBW) amplitudes centred at 1.0; 2.0; 3.0; 4.0 and 5.0 kHz. TEOAE amplitude recorded for stimuli 80, 70 and 60 dB SPL without CS decreased: mean values respectively 6.1 +/- 4.2; 5.4 +/- 4.5 and 3.3 dB SPL +/- 4.3. CS effect on TEOAE was observed for all CS options, however, larger suppressive effect was recorded on TEOAE elicited by 70 dB SPL stimulus using 1 kHz/50 dB SL tone as a suppressor and on TEOAE elicited by 60 dB SPL stimulus using 2 kHz/50 dB SL tone as a suppressor. HOFBW and 0.8-FBW analyses showed the association between the frequency/intensity of the suppressors and decreasing of amplitudes of adequate frequency bands. It is concluded that the described method of investigating of the medial olivocochlear efferent system seems to be sensitive and confirms frequency-dependent suppressive effect on OAE.

Latencies of the 2f1-f2 distortion product otoacoustic emissions measured using a phase-gradient method in young people, in the elderly and in people exposed to noise.

Distortion product otoacoustic emissions (DPOAE) are generally accepted as a good tool for investigating the micromechanics of the cochlea. The 2f1-f2 DPOAE latencies provide significant data regarding travelling waves. In this study the 2f1-f2 DPOAE latencies were measured using a phase-gradient method, with a swept-f2 procedure, for three groups: Group I comprised 60 healthy young people, aged 17-32 years; Group II comprised elderly patients, aged 56-72 years, with presbyacusis; and Group III consisted of 74 miners, aged 19-35 years, who had been exposed to noise for 2-15 years. Measurements were performed for frequencies between 1.0 and 6.0 kHz. In all groups the latencies were fitted using a non-linear regression model. The aim of the study was to compare the latency and amplitude of 2f1-f2 DPOAE in different inner ear pathologies. The highest DPOAE amplitudes were recorded in Group I and in miners with 2-4 years noise exposure (Group IIIa), and the latencies showed a similar pattern. The lowest DPOAE amplitudes were recorded in the elderly and in miners with 8-15 years noise exposure (Group IIIc), but in contrast the longest latencies were measured in miners and the shortest in the elderly. The latency analysis significantly reinforces opinions on the micromechanics of the cochlea, mostly in terms of the cochlear functioning as a filter and amplifier and with regard to the elasticity of the basilar membrane.

Contralateral suppression of TEOAE in diabetic children. Effects of 1.0 kHz and 2.0 kHz pure tone stimulation--preliminary study.

The medial efferent system and its regulating outer hair cell function have not been previously studied in diabetic children. In this study, the group comprised 32 diabetic children, aged 6.0-16.0 years, with diabetes lasting 2.0-9.0 years, with normal tonal and impedance audiometry. A control group consisted of 30 healthy children with similar age and sex distribution. Contralateral stimulation (CS) was performed using 1.0 and 2.0 kHz pure tones on the level of 30 and 50 dB SL. Effects of CS on transient evoked otoacoustic emissions (TEOAE) elicited by click of a level equal to 70 and 60 dB SPL were investigated. Analysis included assessment of TEOAE amplitude and 0.8 kHz frequency bandwidth (0.8-FBW) amplitudes (signal/noise) centred at 1.0; 2.0; 3.0; 4.0; 5.0 kHz. TEOAE-RA recorded for stimulus 80, 70 and 60 dB SPL without CS were decreasing: average values respectively 7.3, 4.7 and 3.9 dB SPL. In the group of diabetic children TEOAE amplitudes, recorded for different click levels without CS, were similar to these recorded in healthy children. It suggested that normal function of the cochlea was preserved, mostly outer hair cells. However, the obtained effects of CS, in comparison with healthy children, were weaker and not so regular. Statistical analysis revealed that the reduction of TEOAE amplitudes for adequate 0.8-FBW in the control group was significantly higher, for both 1.0 kHz and 2.0 kHz CPTs of 30 dB SL and 50dB SL, in comparison with diabetic children. It is concluded that the suppressive effect on OAE in diabetic children is rather weak and seems to be associated with pathological changes in medial olivo-cochlear myelinated fibres.

Cochlear dysfunction and diabetic microangiopathy.

The aim of this study was to evaluate the cochlear micromechanics in type 1 diabetic patients and to compare these findings with diabetic microvascular complications (retinopathy and nephropathy). Cochlear activity was evaluated by recording 2f1-f2 DPOAE. DPOAEs were performed using an ILO92 Otodynamics Ltd Analyser. DPOAEs were measured in 42 normally hearing IDDM patients aged between 21 and 42 years, and 33 age-and sex-matched non-diabetic control subjects. IDDM patients were divided into two groups: 17 patients without microangiopathy and 25 with microangiopathy. Microangiopathy was evaluated with ophthalmoscopy and 24-hour albumin excretion rate into urine. Both groups (diabetic and control) had normal and undifferentiated results in tonal and impedance audiometry. The mean amplitudes of various DPOAEs were significantly reduced in the diabetic groups (with and without microangiopathy) compared with control subjects. No correlation was found between diabetic microvascular complications and DPOAE amplitudes reduction. Our results indicate the existence of an alteration in cochlear micromechanics in diabetic patients with microangiopathy as well as in patients without microangiopathy. The lack of significant correlation between the degree of microvascular complications in the retina or kidneys and DPOAEs amplitude reduction suggest that the impaired functional properties of the outer hair cells are probably caused by early metabolic complications in diabetes (among other things non-enzymatic glycation related to hyperactivity of free oxygen radicals) and not directly by diabetic microangiopathy.

The hearing system in newborns from the Upper Silesia. Assessment of TEOAE depending on selected parameters of delivery disorders.

Transient evoked otoacoustic emission (TEOAE) is an accepted test for screening of the cochlea function in newborns. In this study 300 newborns was tested using TEOAE, as well as analysing such parameters as birth weight, Apgar scale, bilirubinaemia. The study indicated the tendency of TEOAE to decrease in newborns with low birth weight and low Apgar scores. Hyperbilirubinaemia seems to have an influence on cochlea function monitored by TEOAE, especially if there were simultaneously low Apgar scores. A similar tendency, although slightly stronger, was observed in the preterm newborn group. TEOAE seems to be a good method of recording the negative influence on the cochlea activity such factors as low birth weight and asphyxia. Hyperbilirubinaemia with asphyxia acts upon the cochlea similarly. All these tendencies were observed more strongly in the preterm newborn group. It is concluded that TEOAE analysis demonstrated its utility as a screening test assessing the hearing state in newborns, additionally the associations of cochlea activity was found with a few parameters of delivery disorders.

[Assessment of usefulness of PCNA and oncoprotein p53 staining in prediction of the recurrences in subjects operated on for laryngeal carcinoma]. / Ocena przydatnosci oznaczania atygenu proliferacyjnego PCNA i bialka p53 w przewidywaniu wznów u chorych operowanych z powodu raka krtani.

The authors estimated PCNA and P53 in subjects with laryngeal cancer with local or nodal recurrences. The study concerned 54 patients from Upper Silesia aged 37-79 (mean 57 +/- 8.8). The mean value of the PCNA index in subjects with local recurrence (LR) was 24.2% +/- 12.1 while in subjects without LR 22.1% +/- 9.4 (p > 0.05). Additionally, 21 subjects in whom no lymph node metastases were found during laryngectomy were separated from the investigated group. In 16 of them local recurrences were observed and the mean value of PCNA index was 30.9% +/- 12.5. In remaining 5 subjects in whom local recurrences were not developed the mean value of PCNA index was 21.7% +/- 11.2. The analysis of the P53 index in subjects with LR revealed significantly higher values (19.2% +/- 9.1) in comparison with cases without LR (13.2% +/- 6.3). The assessment of the mean values of PCNA and P53 index depending on T, N or stage as well as nodal recurrence did not reveal any statistical significance. Our study revealed usefulness of the P53 and PCNA as markers which could support the histological diagnostic process describing biology of the cancer cells. The demonstrated increase of PCNA and P53 index in patients with LR might be useful in prediction of LR.

[The 2f1-f2 DPOAE amplitudes and latencies in the groups of older people with presbyacusis and young people with normal hearing]. / Ocena amplitud i latencji 2f1-f2 DPOAE w grupie osób starszych z presbyacusis oraz osób mlodych z prawidlowym sluchem.

Otoacoustic emissions have been shown to be useful as indicators of the cochlear function. One of the most valuable techniques is distortion product otoacoustic emission recording (DPOAE), mostly 2f1-f2 distortion, which is described as being present regularly and indicating the strongest connection with hearing level. DPOAE amplitudes are analysed as relating to the frequency (DP-gram) or to the signal levels (input-output function). Another feature of DPOAE providing many details with regard to cochlear mechanics seems to be the assessment of 2f1-f2 DPOAE latencies. In the present study 2f1-f2 DPOAE amplitudes and latencies were analysed and compared in two groups: the elderly with presbyacousis and the young with normal hearing level. All measurements were taken using Otodynamics ILO 92 system. DPOAE latencies were recorded by phase gradient method with fixed-f1 and swept-f2 signal. The following signal parameters were used: f2 ranging from 732 to 6396 Hz, signal levels L1 = L2 = 70 dB SPL, f2/f1 ratio ranging from 1.18 to 1.25. According to the mathematical formula y = 1.412 + exp(7.685-0.7698*ln(f2)) 2f1-f2 DPOAE latencies were calculated in the group of young people at f2 = 1.0 kHz; 2.0 kHz; 3.0 kHz; 4.0 kHz; 5.0 kHz; 6.0 kHz as follows: 12.08 ms; 7.67 ms; 5.99 ms; 5.08 ms; 4.50 ms; 4.10 ms. The analogous analysis revealed the following results in the group of the elderly: y = 2.402 + exp(9.293-1.019*ln(f2)) and calculated latencies--11.9 ms; 7.09 ms; 5.50 ms; 4.71 ms; 4.24 ms; 3.93 ms. The greater differentiation of the latencies measured in low frequency band was observed in the elderly while in the young subjects in mid and high frequency bands. The 2f1-f2 DPOAE amplitudes recorded for the whole frequency band were significantly higher in the young people than in the elderly. No correlation was observed between latencies and amplitudes in both investigated groups.

[A case of laryngomucocele coexisted with pleomorphic adenoma of the larynx]. / Rzadki przypadek laryngomucocele z jednoczesnym wystapieniem gruczolaka wielopostaciowego krtani.

Benign pleomorphic adenomas of the larynx are very rare. Review of the literature showed about 20 cases of this tumours. We present a case of benign mixed tumor located in the false vocal cord and coexisted with laryngomucocele. The tumor was removed by endoscopic laser resection. To our knowledge it is the second published in literature case of benign plemorphic adenoma of the larynx in which treatment was performed by using CO2 laser surgery.

[Assessment of usefulness of PCNA and protein p53 in subjects with laryngeal cancer with local recurrence]. / Ocena przydatnosci oznaczania markera PCNA i bialka P53 u chorych na raka krtani ze wznowa miejscowa.

The authors estimated PCNA and P53 in subjects with laryngeal cancer in whom local or nodal recurrences were observed. The study included 54 patients from Upper Silesia in age 37-79 years (mean 57 +/- 8.8). The mean value of the PCNA index in subjects with local recurrence (LR) was 24.2% +/- 12.1 while in subjects without LR 22.1% +/- 9.4 (p > 0.05). Additionally, 21 subjects were separated from the investigated group in whom no lymph node metastases were found during laryngectomy. Among these subjects in 16 LR was observed (PCNA index was 30.9% +/- 12.5) while in remaining 5 subjects, in whom LR did not develop, PCNA index was 21.7% +/- 11.2. Analysis of the P53 index in subjects with LR revealed significantly higher values (19.2% +/- 9.1) in comparison to cases without LR (13.2% +/- 6.3). Our study revealed usefulness of the P53 and PCNA as markers which could support the histological diagnostic process describing biology of the cancer cells. The demonstrated increase of PCNA and P53 index in patients with LR might be useful in prediction of LR.

[Precancerous states of the larynx: analysis of mono- and polyclonality of the cells with high proliferative index (p53, PCNA)]. / Stany przedrakowe krtani--analiza mono- i poliklonalnosci komórek o wysokim indeksie proliferacyjnym (p53, PCNA).

The aim of the study was analysis of relationship between proliferation index (PCNA) and protein p53 content in dysplastic laryngeal epithelium and the degree of dysplasia, age of patients and smoking. The study population consisted of 45 patients (mean age 57.7 +/- 6.2) with chronic laryngitis. It was revealed epithelial dysplasia varying in intensity in 36 patients and epithelial hyperplasia without dysplasia (acanthosis) in 9 patients--control group. Mean value of p53 protein index was 8.91 +/- 7.43% in dysplastic epithelium and 3.67 +/- 3.4 in hyperplastic epithelium without dysplasia. The difference was statistically significant (p = 0.007). P53 content significantly differed between groups with grade I and grade II dysplasia (p = 0.03) and between groups with grade I and grade III dysplasia (p = 0.03). The difference was found between groups with grade II and III dysplasia and group with hyperplasia without dysplasia. The analysis of the correlation between degree of dysplasia and value of PCNA index showed absence of differences. There was no relationship between smoking, age of patients and Value of p53 and PCNA index.

[The prospective analysis of laryngeal cancer growth dynamics in compliance with evaluation of DNA content and ploidy in cytologic material]. / Ocena prospektywna dynamiki rozrostu raka krtani z uwzglednieniem badania ploidii i zawartosci DNA w materiale cytologicznym.

The aim of this study was evaluation of DNA ploidy in the cytological samples from patients with laryngeal cancer and comparison a type of DNA ploidy with histological grading (G) and staging of neoplasmatic process. The examinations were performed on 47 patients operated due to laryngeal cancer (3 women, 44 men, mean age 58). Cytological material was collected from squamous carcinoma tissue by imprinting method. Slides were staining by Feulgen method in order to quantitative analysis of DNA by static cytophotometry. In studied material, aneuploid, polyploid and hypoploid tumors were found in 22 patients and diploid tumors were found in 25 cases. Analysis of DNA ploidy type distribution in correlation to G feature showed:--diploid type were dominated in G1 and G2 tumors,--aneuploid and polyploid type were dominated in G3 tumors. Hypoploid and polyploid tumors were appeared in patients with metastases to cervical lymph nodes more frequently than in patients without metastases. Analysis of DNA ploidy complete traditional histopathological diagnosis of laryngeal cancer and may be useful in predicting metastases to cervical lymph nodes.

[Assessment of utility of nm 23 antigen as a metastatic potential marker in laryngeal cancers: preliminary study]. / Ocena przydatnosci oznaczania antygenu nm 23 jako markera potencjalu przerzutowego raków krtani--doniesienie wstepne.

The aim of the study was the analysis of the utility of nm 23 protein in prediction of cervical lymph node metastases in patients with laryngeal cancer. A preliminary study was performed in 35 patients with laryngeal cancer with cervical lymph node metastases, which were confirmed by histopathologist. The control group consisted of 30 patients with laryngeal cancer without cervical lymph node metastases. In statistical analysis T and N were taken into account. In the investigated group with metastases the presence of positive immunostaining was found in 11% of cases while in the control group in 20%. The analysis of the presence of nm 23 protein revealed a weak usefulness of this marker as a factor which predicts the presence of the cervical metastases.

[Evaluation of cochlear function by means of otoacoustic emission in children treated with cytostatic drugs in the course of bone marrow proliferative diseases]. / Ocena funkcji slimaka za pomoca otoemisji akustycznej u dzieci leczonych cytostatykami w przebiegu chorób rozrostowych ukladu krwiotwórczego.

The aim of study was cochlear function estimation by means otoacoustic emission in children treated by leukaemia cytostatic drugs in course of the bone marrow proliferative diseases. The children after treatment of acute lymphoblastic leukemia or nongranulomatic malignant lymphoma according to BFM programme were examined in this study. Audiologic examination of children included tonal audiometry, tympanometry and otoacoustic emission as well. The results were compared to the findings of control group consisted of healthy children have never suffered from ear diseases and have never used ototoxic drugs. No significant differences in tonal audiometry and TEOAE were observed. Aggressive treatment of leukaemia does not result in hearing loss.