Henryk Skarzyński

Publications of Henryk Skarzyński

• [Quality of voice after implantation of hyaluronic acid to the vocal folds - preliminary report].

  Authors: Agata Szkiełkowska, Beata Miaśkiewicz, Marc Remacle, Henryk Skarzyński

  Otolaryngologia polska. The Polish otolaryngology. 11/2011; 65(6):436-42.

  Method of vocal folds implantation with allogenic materials has been applied in medical centre all over the world for over 30 years. this voice improving method is usually applied in severalMethod of vocal folds implantation with allogenic materials has been applied in medical centre all over the world for over 30 years. this voice improving method is usually applied in several indications such as: presbyphonia, vocal folds paralysis, glottis insufficiency, vocal fold scars or sulcus vocalis. all of these illnesses prevent the patients to obtain full glottis closure and produce good quality voice. TO assess quality of voice after implantation of hyaluronic acid to the vocal folds. Consisted of 15 patients, who underwent surgical implantation of hyaluronic acid to the vocal folds. 10 patients had the procedure performed on both sides of the larynx, this group included 6 patients with vocal insufficiency of the glottis, 2 with scars and atrophy of the vocal folds and 2 with presbyphonia. In 5 cases the hyaluronic acid was applied on one side of the larynx. The group included 4 patients with vocal folds paralysis and one person with single sided scars and atrophy of the vocal fold. Each patient was examined with videostroboscopy and underwent objective and subjective assessment of voice. Hyaluronic acid was injected surgically under Jet Ventilation general anesthesia. In two cases during the procedure scars were removed from the vocal folds. All patients after hyaluronic acid augmentation took part in the rehabilitation program that included series of voice emission exercises before operation and up to 3 months after the procedure. Examination was performed 1, 3 and 6 months after injection. In all cases improvement of quality of voice was obtained which was stated by a physician and the patients subjectively. Improvement of harmonic voice structure was confirmed by spectrographic record. Acoustic examinations revealed that the improvement was obtained within parameters describing frequency, amplitude disturbance and noise existence. Injection of the hyaluronic acid to the vocal folds improves functional phonation and quality of voice in cases of patients with glottis insufficiency. Injection of the hyaluronic acid to the vocal folds is an efficient method improving quality of voice and can be safe alternative for no surgery method in rehabilitation of voice. This method is a simply, effective and quickly to improve of voice disorders.

• Mutation analysis of mitochondrial 12S rRNA gene in Polish patients with non-syndromic and aminoglycoside-induced hearing loss.

  Authors: Małgorzata Rydzanicz, Maciej Wróbel, Agnieszka Pollak, Wojciec Gawecki, Damian Brauze, Magdalena Kostrzewska-Poczekaj, Irena Wojsyk-Banaszak, Urszula Lechowicz, Małgorzata Mueller-Malesińska, Monika Ołdak, Rafał Płoski, Henryk Skarzyński, Krzysztof Szyfter

  Biochemical and biophysical research communications. 03/2010; 395(1):116-21.

  Mutations in mitochondrial DNA have been reported as associated with non-syndromic and aminoglycoside-induced hearing loss. In the present study, we have performed mutational screening of entire 12SMutations in mitochondrial DNA have been reported as associated with non-syndromic and aminoglycoside-induced hearing loss. In the present study, we have performed mutational screening of entire 12S rRNA gene in 250 unrelated patients with non-syndromic and aminoglycoside-induced hearing loss. Twenty-one different homoplasmic sequence variants were identified, including eight common polymorphisms, one deafness-associated mutation m.1555 A>G and three putatively pathogenic variants: m.669 T>C, m.827 A>G, m.961 delT+C(n)ins. The incidence of m.1555 A>G was estimated for 3.6% (9/250); however, where aminoglycoside exposure was taken as a risk factor, the frequency was 5.5% (7/128). Substitution m.669 T>C was identified only in patients with hearing impairment and episode of aminoglycoside exposure, which may suggest that such additional risk factors must appear to induce clinical phenotype. Moreover, two 12S rRNA sequence variants: m.988 G>A and m.1453 A>G, localized at conserved sites and affected RNA secondary structure, may be new candidates for non-syndromic and aminoglycoside-induced hearing loss associated mutations.

• Stuttering patients' opinions on the Digital Speech Aid.

  Authors: Joanna Ratyńska, Agata Szkielkowska, Renata Markowska, Marek Kurkowski, Marzena Mularzuk, Henryk Skarzyński

  Medical science monitor : international medical journal of experimental and clinical research. 08/2009; 15(7):CR355-60.

  BACKGROUND: The Digital Speech Aid (DSA) is a portable device used to reduce stuttering. It incorporates delayed auditory feedback (DAF) and frequency-shifted auditory feedback (FAF). Due to itsBACKGROUND: The Digital Speech Aid (DSA) is a portable device used to reduce stuttering. It incorporates delayed auditory feedback (DAF) and frequency-shifted auditory feedback (FAF). Due to its small size, the DSA can be used by the stutterer in everyday life. MATERIAL/METHOD: Three hundred thirty-five stutterers aged 6-64 years were included in the study. A subgroup of 100 stutterers who had used the device for at least six months was asked to fill out a questionnaire of 25 questions about their opinion of the device. The data were analyzed and the factors determining the patients' satisfaction with the device were investigated. RESULTS: The analysis showed that the patients used the DSA regularly for about 3 hours daily. Most patients applied the device at home; only small number used it at work or at school. Most patients (70%) reported decreased fear of speaking and improved self-confidence during communication when using the device (78%). Eighty-eight percent of the patients described the device as very useful or useful in everyday life. That patients' satisfaction with the device was not related to objective speech improvement but to a subjective feeling of increased self-confidence and decreased fear of speaking. CONCLUSIONS: The DSA is positively judged by patients as an option in stuttering therapy. Its effect can be attributed not only to fluency improvement, but also to increased self-confidence and reduced fear of speaking.

• Bilateral electric stimulation from auditory brainstem implants in a patient with neurofibromatosis type 2.

  Authors: Henryk Skarzyński, Robert Behr, Artur Lorens, Robert Podskarbi-Fayette, Krzysztof Kochanek

  Medical science monitor : international medical journal of experimental and clinical research. 07/2009; 15(6):CS100-4.

  BACKGROUND: Recent developments in the field of electronic hearing prostheses have allowed for the introduction of auditory brainstem implants in patients with neurofibromatosis type 2. CASE REPORT:BACKGROUND: Recent developments in the field of electronic hearing prostheses have allowed for the introduction of auditory brainstem implants in patients with neurofibromatosis type 2. CASE REPORT: Bilateral electric stimulation from 2 sequentially placed auditory brainstem implants was applied in a 27-year-old man with neurofibromatosis type 2. CONCLUSIONS: Results of the present case support further application of bilateral electric stimulation from auditory brainstem implants for patients with neurofibromatosis type 2.

• Results of partial deafness cochlear implantation using various electrode designs.

  Authors: Henryk Skarzyński, Artur Lorens, Anna Piotrowska, Robert Podskarbi-Fayette

  Audiology & neuro-otology. 02/2009; 14 Suppl 1:39-45.

  Nineteen adults and 9 children who received a unilateral cochlear implant between 2002 and 2007 were included in the study. All subjects were preoperatively diagnosed with significant residualNineteen adults and 9 children who received a unilateral cochlear implant between 2002 and 2007 were included in the study. All subjects were preoperatively diagnosed with significant residual hearing in low frequencies, termed as 'partial deafness', and were implanted according to a 6-step round window surgical technique for partial deafness cochlear implantation. Hearing was preserved to a great extent in the partial deafness cochlear implantation (PDCI) group. After a short period following activation of the cochlear implant, highly significant improvement in the recognition of monosyllabic words was observed. With a developed round window surgical procedure and limited electrode insertion, hearing can be preserved in the majority of patients with partial deafness. PDCI is a feasible means of treating individuals who have good low-frequency hearing but severe to profound hearing loss in the mid to high frequencies.

• [Tinnitus in young patients up to 35-years old]

  Authors: Danuta Raj-Koziak, Grazyna Bartnik, Henryk Skarzyński, Adam Piłka, Anna Fabijańska, Beata Borawska

  Otolaryngologia polska. The Polish otolaryngology. 02/2008; 62(4):476-9.

  According to our observations tinnitus is becoming increasingly common amongst younger persons. About 25% of patients registered in our Tinnitus Clinic, are below the age of 35. Group of 235 tinnitusAccording to our observations tinnitus is becoming increasingly common amongst younger persons. About 25% of patients registered in our Tinnitus Clinic, are below the age of 35. Group of 235 tinnitus patients ranging in age from 18 to 35 years old were evaluated for this study. There were no other pre-selection criteria except the age. All of the patients answered the questions concerned with the cause of tinnitus. The results of our research indicate that infections (68.5%), noise exposure (27.7%) and stress (23.4%) are the most frequent cause of tinnitus among patients below 35 years.

• [Application of the middle ear implant in case of high frequency hearing loss--case study]

  Authors: Henryk Skarzyński, Anita Obrycka, Anna Piotrowska, Artur Lorens

  Otolaryngologia polska. The Polish otolaryngology. 02/2008; 62(5):606-12.

  People who suffer from hearing impairment complain mainly of a problem with communication. Wearing hearing aids can often compensate some problems related with moderate to serve sensorineural hearingPeople who suffer from hearing impairment complain mainly of a problem with communication. Wearing hearing aids can often compensate some problems related with moderate to serve sensorineural hearing loss. Many of hearing aids users complain of some problems associated with plugging the ear canal, such as feedback, unpleasant sound while eating, unnatural sound of their own voice, physical discomfort. The alternative method for some group of patients with sensorineural loss is the middle ear implant. In the middle ear implant the sound is converted into mechanical vibrations that directly drive the ossicular chain inside the middle ear. It leaves the ear canal open and ear drum undisturbed. The sound quality is improved and residual hearing is preserved. Additionally feedback is reduced while comfort improved. 53-year-old man with bilateral sensorineural hearing loss (mild at low frequencies up to 1000 Hz in combination with serve degree at high frequencies) was implanted with Vibrant Soundbridge system. Tests of speech comprehension in quiet were performed using monosyllabic word lists. Improvement in patienfs score was observed while testing with Vibrant Soundbridge. Patient also reports significant improvement in subjective assessment. Application of the Floating Mass Transducer for sound processing results in significant improvement in sound quality. Results obtained indicate a high level of benefits with the Yibrant Soundbridge.

• M34T and V37I mutations in GJB2 associated hearing impairment: evidence for pathogenicity and reduced penetrance.

  Authors: Agnieszka Pollak, Agata Skórka, Małgorzata Mueller-Malesińska, Grazyna Kostrzewa, Bartłomiej Kisiel, Jarosław Waligóra, Paweł Krajewski, Monika Ołdak, Lech Korniszewski, Henryk Skarzyński, Rafal Ploski

  American journal of medical genetics. Part A. 11/2007; 143A(21):2534-43.

  Despite research the role of the M34T and V37I variants of GJB2 in causing hearing impairment (HI) remains controversial. Our purpose was to test a hypothesis that M34T and V37I are pathogenic butDespite research the role of the M34T and V37I variants of GJB2 in causing hearing impairment (HI) remains controversial. Our purpose was to test a hypothesis that M34T and V37I are pathogenic but have distinct features resulting in a reduced penetrance. We screened for known GJB2/GJB6 mutations 233 Polish consecutive unrelated subjects with non-syndromic, sensorineural HI who were previously found to carry 35delG mutation on one chromosome. The most frequent mutations were also analyzed in approximately 1,000 controls. We found that M34T and V37I were significantly (P << 10(-6)) overrepresented among patients, but their penetrance was estimated as 1/10 relative to mutations of undisputed pathogenicity. This finding apparently could not be explained by low degree of HI associated with M34T and V37I since another mutation causing comparably mild HI (L90P) did not have reduced penetrance. Subsequent analyses showed that the patients with M34T/35delG and V37I/35delG had significantly later onset of HI than patients with other genotypes (P < 10(-6)) including the L90P/35delG (P = 0.006). Also, among these patients (but not others) a strong correlation between the degree of HI and its duration was found (r = 0.79, P < 10(-5)). We tentatively suggest that M34T and V37I might cause mild HI characterized by relatively late onset and progression.

• [Value of multidetector computed tomography in detection of congenital inner ear malformations and its usefulness in qualification for cochlear implantation]

  Authors: Mariusz I Furmanek, Anna Piotrowska, Henryk Skarzyński, Romana Bogusławska-Walecka, Jerzy Walecki

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(4):585-90.

  AIM: The aim of the study was retrospective review of multidetector computed tomography (MDCT) findings in group of patient with suspected congenital inner ear malformation and comparison of CTAIM: The aim of the study was retrospective review of multidetector computed tomography (MDCT) findings in group of patient with suspected congenital inner ear malformation and comparison of CT reports with the data concerning qualification for cochlear implantation, electrode choice and surgical technique modification. MATERIAL AND METHOD: 40 subjects, aged from 18 months to 32 years, with suspected inner ear malformation, underwent MDCT in protocol for temporal bone assessment as a part of preoperative assessment before cochlear implantation. CT results were compared with the data concerning qualification for implantation, electrode choice, ear choice and possible technique modification. RESULTS: Normal CT scan were found in 18 subjects. Bilateral Michel deformity was found in 1 patient, bilateral cochlear aplasia in 1 case, common cavity in 1 case. One side cochlear hypoplasia with the cochlear aplasia was found in 1 case. Bilateral cochlear hypoplasia was found in 2 cases, bilateral incomplete partition type I in 2 cases, bilateral incomplete partition type II in 4 cases, bilateral large vestibular aqueduct without notable malformation of the cochlea in 2 cases. Various malformations of semicircular canals without notable malformations of the cochlea were found in 8 cases. MDCT affected ear choice in 6. In 2 cases decision of implantation was cancelled. In 1 case two stage procedure was conducted. CONCLUSIONS: MDCT is valuable method in diagnosing inner ear malformations. It is an essential part of preoperative assessment as its results affect decision of implantation, ear choice, and possible procedure modification.

• [Application of implantable electronic prostheses for patients with hearing impairment]

  Authors: Artur Lorens, Anna Piotrowska, Henryk Skarzyński, Anita Obrycka

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 10/2005; 19(111):487-9.

  Introduction of implantable electronic prostheses to the clinical practice has created new possibilities of hearing and language communication improvement. Currently implants of various types areIntroduction of implantable electronic prostheses to the clinical practice has created new possibilities of hearing and language communication improvement. Currently implants of various types are used as prostheses implanted in the external ear, temporal bone, middle ear, inner ear and brain stem. Applying appropriate acoustic and electric stimulation they allow us to effectively improve auditory abilities and introduce born deaf patient to the world of sounds or bring back to the world postlingually deafened patient.

• [New method of partial deafness treatment]

  Authors: Henryk Skarzyński, Artur Lorens, Anna Piotrowska

  Otolaryngologia polska. The Polish otolaryngology. 02/2004; 58(4):811-6.

  At present, hearing loss is treated using prosthetic devices--either a hearing aid or a cochlear implant. Hearing aids are chiefly used for mild to severe hearing loss. In profound hearing loss andAt present, hearing loss is treated using prosthetic devices--either a hearing aid or a cochlear implant. Hearing aids are chiefly used for mild to severe hearing loss. In profound hearing loss and deafness, current treatment is based on cochlear implant placement. There is another large group of patients whose hearing impairment is characterized by normal or slightly elevated thresholds in the low-frequency band with nearly total deafness in higher frequencies. We propose to describe this type of hearing impairment as partial deafness. The patients in this group remain beyond the scope of effective treatment by hearing aids only. Such patients have not been considered before for cochlear implantation, because it was feared that this intervention would damage the functioning part of the cochlea. A new method for the treatment of partial deafness treatment was applied in the case of a young woman. A partially-inserted cochlear implant was used to restore hearing at high frequencies, while preserving low-frequency acoustic hearing in the implanted ear. The results demonstrate a substantial improvement in speech discrimination and communication skills when electric stimulation on one side was combined with acoustic stimulation on both sides.

• A new method of partial deafness treatment.

  Authors: Henryk Skarzyński, Artur Lorens, Anna Piotrowska

  Medical science monitor : international medical journal of experimental and clinical research. 05/2003; 9(4):CS20-4.

  BACKGROUND: There is a significant group of patients whose hearing impairment is characterized by normal or slightly elevated thresholds in the low frequency band with nearly total deafness in highBACKGROUND: There is a significant group of patients whose hearing impairment is characterized by normal or slightly elevated thresholds in the low frequency band with nearly total deafness in high frequency range. These patients remain beyond the scope of effective treatment by hearing aids. We name this kind of hearing loss 'partial deafness'. CASE REPORT: A new method of partial deafness treatment was applied in the case of a young woman. A partially-inserted cochlear implant was used to restore hearing at high frequencies, while preserving low-frequency acoustic hearing in the implanted ear. CONCLUSIONS: The results demonstrate a substantial improvement in speech discrimination and communication skills when electric stimulation on one side was combined with acoustic stimulation on both sides.

• [Plan of therapy and rehabilitation in stuttering patients]

  Authors: Agata Szkiełkowska, Joanna Ratyńska, Andrzej Czyzewski, Henryk Skarzyński, Marek Kurkowski, Marzena Mularzuk, Renata Markowska

  Otolaryngologia polska. The Polish otolaryngology. 02/2003; 57(4):555-9.

  The aim of the paper is to present the program of therapy and rehabilitation in stuttering patients based of the digital speech aid. The device has been applied to 130 patients aged 6-47 y.o. 85% ofThe aim of the paper is to present the program of therapy and rehabilitation in stuttering patients based of the digital speech aid. The device has been applied to 130 patients aged 6-47 y.o. 85% of the patients had statistically significant instant improvement of speech fluency after application of digital speech aid. After completing diagnostic process, the patients were enrolled for the rehabilitation program which comprised of training with the use of speech aid, speech therapy, psychotherapy, audio-psycho-linguistic stimulation with the use of the Tomatis Method, physiotherapy, relaxation exercises, phoniatric rehabilitation and medical therapy. After 6 months of therapy and rehabilitation a statistically significant improvement of speech fluency was found in 124 patients, i.e. in 96%. The therapeutic programme based on the use of digital speech aid proves effective for majority of stuttering patients.

• [Physiotherapy of Eustachian tube dysfunction in adults--preliminary report]

  Authors: Renata Markowska, Agata Szkiełkowska, Joanna Ratyńska, Henryk Skarzyński

  Otolaryngologia polska. The Polish otolaryngology. 02/2003; 57(2):277-81.

  The paper presents preliminary results of Eustachian tube dysfunction treatment with the use of vibroaerosols in adult patients. 21 patients aged 16-73 y.o. (mean age 49 y.o) have been included inThe paper presents preliminary results of Eustachian tube dysfunction treatment with the use of vibroaerosols in adult patients. 21 patients aged 16-73 y.o. (mean age 49 y.o) have been included in the study. The treatment included inhalation of medicines individually selected for the patient, based on the results of the physical examination. The patients have been divided into 2 groups, depending on the type of tympanogram. Group I included patients with type A tympanogram and abnormal Eustachian tube patency test result. Group II comprised of patients with type B or C tympanogram and abnormal Eustachian tube patency test result. After treatment, subjective improvement has been observed in 88.9% of the ears, objective improvement in 61.5% of the ears. In group II, objective improvement observed by the change of tympanogram has been observed in 85% of ears. Lack of correlation between objective and subjective improvement have been observed in 26% of the ears. In 11.1% of the ears no benefit from treatment has been observed. The correlation between subjective and objective improvement has been observed in 74% of ears. It appears that treatment with the use of vibroaerosols is beneficial for patients with Eustachian tube dysfunction.

• [Phoniatric and laryngologic symptoms in motor neuron disease (MND)].

  Authors: Beata Miśkiewicz, Agata Szkiełkowska, Joanna Ratyńska, Anna Skoczylas, Henryk Skarzyński

  Otolaryngologia polska. The Polish otolaryngology. 64(3):171-6.

  Motor neuron disease is a progressive neurologic disorder characterized by degeneration of motor neurons in the cerebral cortex, brain stem and spinal cord. Was to present methods of therapy andMotor neuron disease is a progressive neurologic disorder characterized by degeneration of motor neurons in the cerebral cortex, brain stem and spinal cord. Was to present methods of therapy and rehabilitation in patients with MND and the role of phoniatrician and otolaryngologist in diagnostic and therapeutic process. MATERIAL AND METHOD, RESULTS: The material of present study consists of 3 patients in the age of 38 to 55 who were admitted to The Institute of Physiology and Pathology of Hearing in Warsaw, Poland. Patients underwent laryngological, phoniatric and neurologopedics examinations. They were treated with phoniatric and logopedics rehabilitation strategy applying manual therapy of voice, speech exercises and courses of physiotherapy. As a result of therapeutical management, quality of speech and voice were improved. 1. Disorders of voice and speech may be early symptoms of motor neuron disease; 2. Patients with motor neuron disease require multidisciplinary therapy, including otolaryngologists and phoniatricians; 3. Acoustic analysis of voice (MDVP) presents more often disorders in frequency range than amplitude changes; 4. Intensive and regular excercises are crucial for the improvement in speech communication.

• [The prevalence of tinnitus in 7-year-old children in the eastern of Poland].

  Authors: Danuta Raj-Koziak, Adam Piłka, Grazyna Bartnik, Anna Fabijańska, Krzysztof Kochanek, Henryk Skarzyński

  Otolaryngologia polska. The Polish otolaryngology. 65(2):106-9.

  Tinnitus in children is still rarely mentioned in medical literature. The prevalence of pediatric tinnitus has been reported to range between 3-37% and higher in children with hearing loss. TheTinnitus in children is still rarely mentioned in medical literature. The prevalence of pediatric tinnitus has been reported to range between 3-37% and higher in children with hearing loss. The objective of this study was to estimate the prevalence of the tinnitus in 7 years old children and to conduct statistical analysis of the relation between tinnitus and hearing loss. In this study 60 212 children and their parents were asked about the presence of tinnitus by answering a questionnaire at home. Additionally, children were asked if they can hear noise in their ears or head, before hand hearing screening test at school was conducted. The hearing screening test was performed using screening audiometer with air conduction. The results showed that tinnitus was present in group of 8164 children (13.6%). Between children directly asked for tinnitus, 33% mentioned of having it. Over 75% of children did not complained of tinnitus spontaneously to parents. Children with hearing loss reported tinnitus twice more comparing to children with normal hearing. Tinnitus is frequent complain among 7 years old children. Children with hearing loss reported tinnitus twice more comparing to children with normal hearing. It is recommended to include to a questionnaire an inquiry about the presence of tinnitus during hearing screening tests performed recently more frequently at primary schools for early detection and diagnosis of tinnitus.

• [Application of simultaneous auditory evoked potentials and functional magnetic resonance recordings for examination of central auditory system--preliminary results].

  Authors: Rafał Milner, Mateusz Rusiniak, Tomasz Wolak, Ewa Piatkowska-Janko, Patrycja Naumczyk, Piotr Bogorodzki, Andrzej Senderski, Małgorzata Ganc, Henryk Skarzyński

  Otolaryngologia polska. The Polish otolaryngology. 65(3):171-83.

  Processing of auditory information in central nervous system bases on the series of quickly occurring neural processes that cannot be separately monitored using only the fMRI registration.Processing of auditory information in central nervous system bases on the series of quickly occurring neural processes that cannot be separately monitored using only the fMRI registration. Simultaneous recording of the auditory evoked potentials, characterized by good temporal resolution, and the functional magnetic resonance imaging with excellent spatial resolution allows studying higher auditory functions with precision both in time and space. was to implement the simultaneous AEP-fMRI recordings method for the investigation of information processing at different levels of central auditory system. Five healthy volunteers, aged 22-35 years, participated in the experiment. The study was performed using high-field (3T) MR scanner from Siemens and 64-channel electrophysiological system Neuroscan from Compumedics. Auditory evoked potentials generated by acoustic stimuli (standard and deviant tones) were registered using modified odd-ball procedure. Functional magnetic resonance recordings were performed using sparse acquisition paradigm. The results of electrophysiological registrations have been worked out by determining voltage distributions of AEP on skull and modeling their bioelectrical intracerebral generators (dipoles). FMRI activations were determined on the basis of deviant to standard and standard to deviant functional contrasts. Results obtained from electrophysiological studies have been integrated with functional outcomes. Morphology, amplitude, latency and voltage distribution of auditory evoked potentials (P1, N1, P2) to standard stimuli presented during simultaneous AEP-fMRI registrations were very similar to the responses obtained outside scanner room. Significant fMRI activations to standard stimuli were found mainly in the auditory cortex. Activations in these regions corresponded with N1 wave dipoles modeled based on auditory potentials generated by standard tones. Auditory evoked potentials to deviant stimuli were recorded only outside the MRI scanner. However, deviant stimuli induced significant fMRI activations. They were observed mainly in the anterior cingulate gyrus, insula and parietal lobes. These regions of the brain are related to attention and decision-making processes. The results showed that applied paradigm is suitable for investigation of acoustic processing on the level of auditory cortex. Technique of the simultaneous AEP-fMRI registrations seems to be promising for investigation of more complex nervous processes in central auditory system with good temporo-spatial resolution.

• Preservation of residual hearing in children and post-lingually deafened adults after cochlear implantation: an initial study.

  Authors: Henryk Skarzyński, Artur Lorens, Patrick D'Haese, Adam Walkowiak, Anna Piotrowska, Lech Sliwa, Ilona Anderson

  ORL; journal for oto-rhino-laryngology and its related specialties. 64(4):247-53.

  OBJECTIVE: To investigate whether the residual hearing of severely hearing-impaired children and adults could be preserved using the soft surgery approach. PATIENTS AND METHODS: This project employedOBJECTIVE: To investigate whether the residual hearing of severely hearing-impaired children and adults could be preserved using the soft surgery approach. PATIENTS AND METHODS: This project employed a prospective study design. All testing and surgery took place in the Institute of Physiology and Pathology of Hearing, Warsaw, Poland. Twenty-six patients (7 children and 19 post-lingually deafened adults) with residual hearing were assessed. Subjects were assessed using conventional pure-tone audiometry at least 1 month prior to surgery. Cochlear implant surgery with a Med-El Combi 40/40+ standard electrode array was conducted, using the soft surgery approach. Pure-tone audiometry thresholds were re-assessed at least 1 month after surgery. The researchers assessed change in auditory thresholds using pure-tone audiometry to determine preservation of residual hearing. RESULTS: Sixteen of 26 patients (62%) retained their residual hearing within 5 dB HL of pre-operative scores. Only 5 of 26 patients (19%) lost all measurable residual hearing after cochlear implantation. This suggests that surgeons are often able to preserve residual hearing during cochlear implant surgery using the soft surgery technique. CONCLUSIONS: Preservation of residual hearing is an important consideration in cochlear implantation in the light of changing selection criteria for cochlear implant candidates, and as younger children are receiving implants. This is important, as we do not know yet the long-term effects of inner ear damage due to traumatic insertions of electrodes. This finding suggests a good prognosis for future possibilities of re-implantation.