Wiesław Konopka

Time–frequency analysis of transiently evoked otoacoustic emissions of subjects exposed to noise

Transiently evoked otoacoustic emissions (TEOAE) were measured from 124 ears from two subject groups: healthy subjects (62 ears), and workers (62 ears) exposed to noise of jet engines. The recordings were analyzed using the method of adaptive approximations based on a matching pursuit (MP) algorithm. The method allows for description of the signal components in terms of their amplitude, frequency, latency, and time-span (or duration). The purpose of this work was to determine the repeatability and usefulness of these parameters in studies of hearing impairment of populations exposed to potentially harmful noise. Good distinction between the two datasets was achieved in all investigated frequency bands when amplitude was used as a discrimination parameter. Also latency was affected in frequency bands starting at 2000 Hz, while the time-span parameter associated with the duration of the waveform was less influenced by noise.

Resonant modes in transiently evoked otoacoustic emissions and asymmetries between left and right ear.

A number of single-frequency resonant modes in click evoked otoacoustic emissions (OAEs) was investigated. The OAE modes were identified by means of an adaptive approximation method based on the matching pursuit (MP) algorithm. The signals were decomposed into basic waveforms coming from a very large and redundant dictionary of Gabor functions. The study was performed on transiently evoked otoacoustic emissions (TEOAEs) from left and right ears of 108 subjects. The correspondence between waveforms found by the procedure and resonant modes was shown (both for simulated noisy data and for single-person TEOAEs). The decomposition of TEOAEs made distinction between short and long-lasting components possible. The number of main resonant modes was studied by means of different criteria and they all led to similar results, indicating that the main features of the signal are explained on average by 10 waveforms. The same number of resonant modes for the right ear accounted for more energy than for the left ear.

Congenital and acquired cytomegalovirus infection and hearing evaluation in children.

OBJECTIVES Congenital cytomegalovirus (CMV) infection is one of the most common intrauterine diseases. In all, 1% of live births is affected by cytomegalovirus infection, while 90% neonates with perinatal infection do not show symptoms of disease. Symptomatic CMV is present in 5-10% of children. Typical clinical signs of CMV infection are microcephalia, mental retardation, progressive major amblyacousia, and neuromuscular infection. Hypoacusis is present in 30-60% of children with congenital symptomatic CMV - in most cases it is bilateral and applies to high frequency hearing loss. The purpose of this article is to emphasize the importance of hearing evaluation in children with congenital and acquired cytomegalovirus infection. PATIENTS AND METHODS A group of 70 children had serological and genetic screening for CMV DNA, using PCR method, in urine and blood. In this group, 52 children were diagnosed with congenital CMV and 18 children had acquired CMV. Audiological examinations including PTA, ABR, TEOAE and immittance audiometry were performed. RESULTS Bilateral sensorineural hearing losses were found in 9 children, associated with mental and physical retardation, brain malformation and microcephalia, and unilateral losses in 3 children. In 40 cases, we did not observe hearing loss, although the level of bilirubin was high, and splenomegaly, hepatomegaly and paralysis of facial nerve were present. In the group of children with acquired CMV, we did not notice hearing loss. CONCLUSIONS This research proved that CMV infection often caused hearing loss. In spite of this, all children with congenital and acquired CMV should be monitored and assessed throughout their lifetime by an audiologist.

Resonant modes and musical ratios in otoacoustic emissions

The ratios between frequency components of evoked otoacoustic emissions (OAE) were investigated for 100 ears. The signals were decomposed by means of an adaptive approximation method into basic waveforms coming from a very large and redundant dictionary of Gabor functions. The high time-frequency resolution of the method and the parametric representation of the waveforms allowed for an estimation of the frequency ratios of the basic components. A repetitive occurrence of the “fifths”, “fourths” and octaves connected with the Pythagorean temperament was found. The octaves containing “fifths” were identified. This kind of sequences in OAE tend to appear in the same form for tonal stimulations of different frequencies and for broadband stimuli. The significance of the results was confirmed by comparison to Monte Carlo simulations of the null hypothesis of random distribution of frequency modes. These findings support the resonance theory of hearing, which binds musical ratios with the geometrical spacing of outer hair cells in the cochlea.

Evaluation of Bone Conduction Implant Stability and Soft Tissue Status in Children in Relation to Age, Bone Thickness, and Sound Processor Loading Time.

Objective To measure the stability, as determined by implant stability quotient (ISQ) values, of bone conduction implants placed using FAST (one-stage) surgery in children to look for the differences between various ages and indications. To monitor the status of the peri-implant soft tissue using the classification proposed by Holgers et al. Study Design It was a prospective, open, multicenter study performed in two investigation centers. Patients Twenty-two subjects under 18 years of age implanted with the Cochlear BIA300 and BIA400 types of devices at the ENT Departments of Children’s Hospitals in Bydgoszcz and Lodz in Poland. Intervention(s) Implantation and use of the bone conduction implant system. The implants were placed unilaterally or bilaterally according to a one-stage surgical procedure as per normal practice at the hospitals. Loading time was adjusted to individual patient, and it was based on the assessment of implant stability and status of the soft tissue. Main Outcome Measure(s) The attention was given to the differences in the ISQ values obtained during the subsequent visits in the various age and indication groups. Resonance frequency analysis was performed as per the routine follow-up schedule at the hospital. Results Age at the time of implantation on average was 9.8 years (min. 5.2 yr; max. 16 yr). On average, ISQ value on each of the study observations in this group equaled to 59.17 (median, 58.79). Seventh to tenth day post-surgery seemed to be a sensitive period as the lowest ISQ values (on average: 56.38 ISQ) were recorded for these dates. On average, implant was loaded 7.5 weeks after surgery in the study group (min. 2 wk, max. 14 wk). In none of the subjects the significant decrease of the implant stability values after sound processor loading was observed. Statistically significant correlation rate (p < 0.05) showed that the thicker the bone the higher the obtained ISQ value on each of the visits. It was also confirmed that the younger the implanted child, the higher the skin reactions grade at the 2 to 4 weeks post-sound processor fitting. There was no correlation observed between the time of the sound processor fitting and the skin reactions status.

Elektrostymulacja jako alternatywna metoda leczenia szumów usznych

Summary Introduction The aim of the study was to evaluate the influence of the selective electrical stimulation of the hearing organ on tinnitus in people with sensorineural hearing loss. Material and methods The study comprised 248 tinnitus patients treated by using electrical stimulation. The material was divided into two groups, regarding the method of stimulation. In group I – 168 people, transtympanal electrical stimulation of the promontory was applied, whereas in group II – 80 people, hydrotransmissive technique was used. ENT examination, audiological and radiological diagnostics, as well as the evaluation of the audiometric parameters of tinnitus was performed. The patients were asked to fill in the questionnaire concerning tinnitus. In 80 patients hydrotransmissive electrical stimulation was conducted using the own prototype device, in 168 patients – transtympanal stimulation, after local anaesthesia with Xylocain gel. Results On the whole, in group of 248 patients, subjective improvement (decrease in the severity of tinnitus) was noticed in 130 people (52.4%), comprising 32 cases (13%) of total relief. In 93 patients (37.5%) tinnitus remained unchanged, and in 25 (10.1%) the deterioration was observed. The comparison of the results of two electrical stimulation methods, showed the superiority of hydrotransmissive one (improvement in 58.75% of patients), however, the number of cases of total relief was greater in the case of transtympanal method (15.5%). Considering subjective evaluation, as well as audiometric (the intensity and the frequency parameters, MML) the hydrotransmissive method appeared to be more effective (improvement in 53.75%) comparing to transtympanal stimulation (improvement in 44.6%). Conclusions On the basis of studies conducted in the Clinic and the long history of the electrical stimulation administration in tinnitus treatment, it can be stated that this method may by applied in cases, in which other therapeutical methods failed.

Ossifying fibroma–cementoma of jaw. Differences in histopathological nomenclature

Ossifying fibroma (cementoma) is a tumor of mesenchymal origin which represents about 1% of odontogenic tumors. It is commonly found in patients under 25, more often so in women. As its growth is slow and painless, it is usually accidentally detected by dental radiological examination. The aim of our study was to present the histopathological dilemma concerning the naming of a rare odontogenic tumor of the jaw. The authors present a rare jaw tumor, a benign ossifying fibroma, in the maxilla of a 12-year-old girl treated surgically, and they discuss the difficulty in making a definitive histopathological diagnosis. The clinical and histological criteria for identifying this type of tumor are still uncertain, as the most common sites, that is the tooth-bearing areas of the mandible, are very rare in the maxilla. The differentiation from the central fibro-osseous lesions in the maxilla bones is discussed. The final diagnosis of ossifying fibroma was based on the WHO classification. A literature search reveals a fundamental flaw in defining a unified classification for this type of change. As there is no clear diagnostic criterion, few repeatable diagnoses can be found. Although individual researchers tend to use their own means of classification in their routine work, the WHO classification should be applied.

Centralne zawroty głowy w przebiegu guzów tylnego dołu czaszki

INTRODUCTION Many pathologies of the posterior fossa can induce vertigo or dizziness. Usually they are due to benign or malignant tumors. The aim of our study was to present the cases of the patients with central vertigo attended to the Otorhinolaryngology emergency department of the University Hospital. MATERIAL AND METHODS The authors present three cases of the posterior cranial fossa tumors. All of the patients underwent a battery of audiovestibular tests. Each patient presented with positional vertigo, and electronystagmography revealed positional nystagmus indicative of a central lesion. In these cases positional vertigo was the first and only presenting symptom of central nervous system disease. CONCLUSIONS The findings in these cases emphasize the need of looking for positional nystagmus in patients with suspected posterior fossa lesions as well as radiological diagnosis by using CT or MRI.Summary Introduction Many pathologies of the posterior fossa can induce vertigo or dizziness. Usually they are due to benign or malignant tumors. The aim of our study was to present the cases of the patients with central vertigo attended to the Otorhinolaryngology emergency department of the University Hospital. Material and methods The authors present three cases of the posterior cranial fossa tumors. All of the patients underwent a battery of audiovestibular tests. Each patient presented with positional vertigo, and electronystagmography revealed positional nystagmus indicative of a central lesion. In these cases positional vertigo was the first and only presenting symptom of central nervous system disease. Conclusions The findings in these cases emphasize the need of looking for positional nystagmus in patients with suspected posterior fossa lesions as well as radiological diagnosis by using CT or MRI.

Hydrotransmisyjna elektrostymulacja narządu słuchu w leczeniu szumów usznych

Summary Introduction The aim of the study was to evaluate the influence of electrical stimulation on severe tinnitus. Material and methods The study comprised 46 patients (66 ears) suffering from severe tinnitus, persistently or temporarily, 27 women and 19 men, ranging in age from 22 to 84 years, on average 55. The material was divided into two groups. Group I was treated using electrical stimulation, whereas group II was being applied additionally the kinesitherapy of the cervical part of the vertebral column. The average duration of tinnitus was similar in both groups and equals 4.5 years. All the patients were administered medicines, without expected result. Otolaryngological, audiological diagnostics was conducted as well as head and cervical computer tomography. The patients were asked to fill in the questionnaire concerning tinnitus. The electrical stimulation was performed using silver electrode which was dipped in saline solution in external auditory canal. Direct current was used, the intensity ranged from 0.15 mA to 1.15 mA. Fifteen electrical stimulations were entire treatment administered twice or three times a week. Before and after treatment the subjective evaluation of tinnitus was made. Results The subjective improvement was noticed in 36 people (n 46 ears – 71%). Persistent tinnitus was registered in 30 ears and temporary in 30 ears, in 6 tinnitus disappeared completely. On the basis of audiometric tests improvement was noticed in 33 ears (55%). In group I in 17 ears (44%) – in 4 ears tinnitus disappeared, in 13 partial relief was noticed, 10 ears were without any change and in 12 ears the intensification of tinnitus was recognized. In group II in 16 ears improvement was observed, in 2 of them tinnitus disappeared, in 14 decreased. In 9 ears no change was obtained and in 2 intensification was noticed. Conclusions Electrical stimulation can be an alternative therapy in severe tinnitus treatment. The administration of kinesitherapy of cervical column may have an additive effect on tinnitus treatment.INTRODUCTION The aim of the study was to evaluate the influence of electrical stimulation on severe tinnitus. MATERIAL AND METHODS The study comprised 46 patients (66 ears) suffering from severe tinnitus, persistently or temporarily, 27 women and 19 men, ranging in age from 22 to 84 years, on average 55. The material was divided into two groups. Group I was treated using electrical stimulation, whereas group II was being applied additionally the kinesitherapy of the cervical part of the vertebral column. The average duration of tinnitus was similar in both groups and equals 4.5 years. All the patients were administered medicines, without expected result. Otolaryngological, audiological diagnostics was conducted as well as head and cervical computer tomography. The patients were asked to fill in the questionnaire concerning tinnitus. The electrical stimulation was performed using silver electrode which was dipped in saline solution in external auditory canal. Direct current was used, the intensity ranged from 0.15 mA to 1.15 mA. Fifteen electrical stimulations were entire treatment administered twice or three times a week. Before and after treatment the subjective evaluation of tinnitus was made. RESULTS The subjective improvement was noticed in 36 people (n 46 ears--71%). Persistent tinnitus was registered in 30 ears and temporary in 30 ears, in 6 tinnitus disappeared completely. On the basis of audiometric tests improvement was noticed in 33 ears (55%). In group I in 17 ears (44%)--in 4 ears tinnitus disappeared, in 13 partial relief was noticed, 10 ears were without any change and in 12 ears the intensification of tinnitus was recognized. In group II in 16 ears improvement was observed, in 2 of them tinnitus disappeared, in 14 decreased. In 9 ears no change was obtained and in 2 intensification was noticed. CONCLUSIONS Electrical stimulation can be an alternative therapy in severe tinnitus treatment. The administration of kinesitherapy of cervical column may have an additive effect on tinnitus treatment.

Wpływ tonsillektomii na stężenie cynku w surowicy krwi

Summary Introduction The zinc is one of the most important trace elements that take part in cellular metabolism. It is a cofactor of more than 200 enzymes. It enables the healing and regeneration of tissues. The proper oral mucosa metabolism depends on correct level of the ion. Aim The aim was to evaluate the tonsillectomy influence on zinc serum level. Material and methods The zinc serum level was carried out on 32 patients (18 women and 14 men) before and after tonsillectomy. The measurement was assessed on the biochemical laboratory system Olympus® AU560. The t-Student test for dependent sampling was used for statistical analysis considering critical value p Results The average serum zinc level before operation was from 93,2 μg/dl. After the treatment the average level decreased to 81,5 μg/dl. Conclusions The tonsillectomy causes significant zinc serum depletion (p