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EN
Early diagnosis of congenital defect of hearing poses new challenges for a multidisciplinary team of pedoaudiologists, ENT (ear-nose-throat) specialists and speech therapists. This study assessed the perception of phonemes in children with a cochlear implant and the possibilities of applying acoustical solutions in the audiologic evaluation. The participants were 17 implanted children, aged 5-9 years, who received a cochlear implant when they were from 18 months to 3 years old. Detection thresholds and discrimination score were assessed. This study also aimed at verifying the possibilities of applying the digital audioprocessing algorithm in clinical practice. The test based on the phonemes aa, uu, ii, ss, sh (Ling 5 sound test) was used. The test was modified in the frequency domain - the main aim of this modification was to improve the precision of the reconstruction of the audible threshold. The results indicated significant correlations between pure tone audiometry results and thresholds of phoneme detection [dB SPL]. The identification score in this group was 95-100% for sound pressure level 65 dB SPL.
EN
The loss of cognitive function, in addition to physiological changes, is the main illness of patients in geriatric units. There are many factors affecting cognitive ability in elderly patients. Undoubtedly, one of them is the physiological aging process of the hearing organs. One of the methods to assess cognitive functioning is the Mini-Mental Sade Examination (MMSE). The paper presents an assessment of the impact of hearing aids in patients with hearing loss on the outcome of cognitive assessment in MMSE. Analysis of the study results provides answers to questions about the improvement of mental functioning in geriatric patients with hearing loss assessed by MMSE after starting to wear hearing aids.
PL
Utrata funkcji poznawczych jest obok zmian fizjologicznych głównym schorzeniem pacjentów oddziałów geriatrycznych. Istnieje wiele czynników wpływających na zdolności kognitywne pacjentów w podeszłym wieku. Niewątpliwie jednym z nich jest fizjologiczny proces starzenia się narządu słuchu. Jedną z metod oceny funkcjonowania poznawczego jest Krótka Skala Oceny Stanu Psychicznego (Mini-Mental Sade Examinotion – MMSE). W pracy przedstawiono ocenę wpływu zaprotezowania słuchu aparatami słuchowymi u pacjentów z niedosłuchem na wynik oceny czynności poznawczych w teście MMSE. Analiza wyników przeprowadzonych badań dostarcza odpowiedzi na pytania dotyczące poprawy funkcji umysłowych u pacjentów geriatrycznych z niedosłuchem, ocenianych metodą MMSE po zaprotezowaniu słuchu aparatami słuchowymi.
EN
Introduction: Surgical treatment of deafness by cochlear implants is used for more than 40 years, and during this period permanently, gradual and significant expansion of indications for this surgery has been observed. Material and methods: In our Department in the years 1994-2018 1480 cochlear implantations were performed, both in adults (647) and in children (883). In this study current indications and the rules for eligibility of patients based on 25 years of experience are presented. Results: Indications for cochlear implantation in adults are: 1) bilateral postlingual deafness, 2) bilateral sensorineural hearing loss - in pure tone audiometry > 70 dB HL (average 500-4000 Hz) and in speech audiometry in hearing aids understanding < 50% of words for the intensity of the stimulus 65 dB, in the absence of the benefits of hearing aids, 3) bilateral profound hearing loss for high frequency with good hearing for low frequency, in the absence of the benefits of hearing aids, 4) some cases of asymmetric hearing loss with intensive tinnitus in the deaf ear. An indication in children is bilateral sensorineural hearing loss > 80dB HL confirmed by hearing tests, after about 6 months of rehabilitation with the use of hearing aids. Discussion: Although cochlear implantation is used for more than 40 years, the indications for this treatment underlies constant modifications. They concern the age of eligible patients, implantation in patients with partially preserved hearing, as well as treatment for patients with difficult anatomical conditions. In many countries, bilateral implantations are commonly performed, and more and more centers recommend this treatment in the case of unilateral deafness or asymmetric hearing loss, especially with the accompanying tinnitus in the deaf ear.
EN
Introduction: Profound hearing loss significantly affects the quality of life of deaf people as well as their families. Observation of the benefit from the use of cochlear implants in deaf patients allows to assess the success of treatment with this method and its impact on the quality of life of these patients. The aim of this study was to determine the quality of life in patient after the cochlear implantation in the material of Department of Phoniatrics and Audiology of the Medical University in Poznań. Material and methods: The study involved implanted patients who voluntarily joined to the project entitled "Observational study of the implanted patient (Cochlear-IROS)". It has a prospective character, it is an international and long-term study, covering the observation of patients up to three years after implantation. Standardized HUI and SSQ questionnaires were used. 70 patients were included in the analysis, the mean age at the time of the cochlear implantation was 47.6 years. In the research group there were 33 men and 37 women. In the whole group, the patients' age at implantation was at least 18 years, max. 80 years. Results: The results of the SSQ questionnaire, which deals with the self-assessment of hearing ability in everyday situations, indicate that in the subjective assessment of patients one year after surgery the speech hearing improved by 77%, spatial hearing by 84%, and the quality of hearing by 49%. The general quality of life before the first connection of the sound processor according to the HUI questionnaire, the patients rated at 0.49 (0-1 scale, where 0 - corresponds to the death condition and 1 - full health). After one year from the implantation, this rating increased to 0.56. Conclusions: The implantation of the cochlear implant significantly increases the patient's quality of life, its physical and emotional functioning. Statistically significant better self-assessment of patients mainly concerned hearing speech and spatial hearing - especially after 1 year of connecting the speech processor.
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