WHAT IS MANAGEMENT IN PDT?

Transcription

1 H. Skarżyński, ż ń ki A. Lorens, M. Porowski, PH P.H. Skarżyński, ż ń ki Ł. Olszewski IN WARSAW COCHLEAR IMPLANT PROGRAM ( ) WHAT IS MANAGEMENT IN PDT? C. NEW INDICATIONS SELECTIONS OF CANDIDATES B. A. NEW TECHNOLOGIES GROWING EXPERIENCE NEW POSSIBILITIES, PROSPECTS FOR MILIONS OF PEOPLE

2 Our Auditory Implant Program 1992 The first cochlear implantation (H. Skarżyński) 1998 The first auditory brainstem implantation (Warsaw, Wuerzburg, Innsbruck) 2003 The first middle ear implantation (H. Skarżyński) 2005 The first bilateral cochlear implantation 2006 First direct stimulation of the round window membrane (H. Skarżyński) 2008 The first bilateral auditory brainstem implantation 2009 New concept of PDT (H. Skarżyński) MANAGEMENT IN PDT A. GROWING EXPERIENCE > 3000 hearing implants

3 MANAGEMENT IN PDT A. GROWING EXPERIENCE ROUND WINDOW APPROACH was a challenge: a) at the first Cochlear Implantation b) at presentation of the first results and experiences in residual hearing preservation - 5th ESPCI - Antwerp 2000 Skarżyński H., Lorens A., Piotrowska A.: Residual acoustic hearing in the ear before and after cochlear implantation c) at the PDT in adults (2002) and in children (2004) Skarzynski H., Lorens A., Piotrowska A. A new method of partial deafness treatment. Med Sci Monit Apr; 9(4):CS20-4. SURGICAL PROCEDURE STEP 1 ANTROMASTOIDOTOMY PROF. H. SKARŻYŃSKI STEP 2 POSTERIOR TYMPANOTOMY TO ALLOW VISUALIZATION OF THE ROUND WINDOW NICHE STEP 3 PUNCTURE AND INCISION OF THE ROUND WINDOW MEMBRANE STEP 4 APPROACH TO THE SCALA TYMPANI DIRECTLY THROUGH THE ROUND WINDOW MEMBRANE (PARTIAL INSERTION OF THE ELECTRODE ARRAY) STEP 5 ELECTRODE FIXATION IN THE ROUND WINDOW NICHE WITH FIBRINE GLUE (MEMBRANE MUST BE PARTIALLY UNCOVERED TO PRESERVE ITS MOBILITY) STEP 6 FIXATION OF THE DEVICE IN THE WELL IN TEMPORAL BONE

4 HEARING PRESERVATION COCHLEOSTOMY / ROUND WINDOW N= 550 Ave eradge hearing loss COCHLEOSTOMY ROUND WINDOW Skarzynski et al., Preservation of low frequency hearing in partial deafness cochlear implantation (PDCI) using the round window surgical approach. Acta Otolaryngol Jan;127(1):41-8. MANAGEMENT IN PDT A. GROWING EXPERIENCE Sk ki t l R lt f P ti l D f C hl I l t ti U i V i Skarzynski et al.: Results of Partial Deafness Cochlear Implantation Using Various Electrode Designs, Audiol Neurootol 2009, 14,

5 Electric-Acoustic Stimulation Round Window Approach Electrode 20 mm Hearing Aid Skarzynski H., et al.: Electric acoustic stimulation in children. Adv Otorhinolaryngol. 2010;67: Epub 2009 Nov 25. NEW CONCEPTION PARTIAL DEAFNESS TREATMENT PROF. H. SKARŻYŃSKI 2009

6 MANAGEMENT IN PDT B. TECHNOLOGY STANDARD ELECTRODE B. TECHNOLOGY MANAGEMENT IN PDT FLEX ELECTRODE

7 NEW ELECTRODE SRA CLINICAL TRIAL PROF. H. SKARŻYŃSKI 2008 Skarzynski H., et al.: A new cochlear implant electrode design for preservation of residual hearing: a temporal bone study, Acta Oto-laryngologica, April 2010, Vol.130, Nr 4, UTILIZING SEVERAL SYSTEMS WITH VARIOUS ELECTRODES Standard MED EL M Flex COCHLEAR SRA Y Y 15 X X (Helix) Section Y-Y Sesction X-X

8 MANAGEMENT IN PDT C. NEW INDICATIONS RESULTS CHILDREN PDT EC

9 PDT EAS RESULTS Results of preservation of pre-operative hearing in the over 7-year observation period IN ADULTS 94,7 % Sk ki t l R lt f P ti l D f C hl I l t ti U i V i Skarzynski et al.: Results of Partial Deafness Cochlear Implantation Using Various Electrode Designs, Audiol Neurootol 2009, 14,

10 PDT MATERIAL N = 68 children Results of preservation of pre-operative hearing 100% Skarżyński H. et al. Residual acoustic hearing in the ear before and after cochlear implantation in children MONOSYLLABIC WORDS IN QUIET

11 MONOSYLLABIC WORDS IN NOISE MANAGEMENT IN PDT C. SELECTIONS OF CANDIDATES 1. Development of screening tests in the school age population. p 2. Active overview of indications for hearing aids. 3. Optimal care over the patients.

12 C1. DEVELOPMENT OF SCREENING EXAMINATIONS MODERN SCREENING DEVICE PLATFORM FOR SENSE ORGANS SCREENING Gold medal Eureka Brussels Eureka Brussels 2009 C1. DEVELOPMENT OF SCREENING EXAMINATIONS The Program Eastern Poland > 5700 schools children

13 C1. DEVELOPMENT OF SCREENING EXAMINATIONS 2010 The Program Western Poland 4621 schools children C1. CONTINENTAL SCREENING

14 INSTITUTE OF PHYSIOLOGY AND PATHOLOGY OF HEARING WARSAW / POLAND C3. CARE OVER PATIENTS TELEFITTING Odessa

15 PERSPECTIVES Additionally to the previous achievements of PDT we develop new solutions and extend our activity that is based on application of fmri in research on auditory pathway. BIOIMAGING RESEARCH CENTER

16 NEXT WAW WAW 10 April25 27, 2010 WAW August November, waw European Federation of Audiology Societes (EFAS) Warsaw, Poland 10 th EFAS Congress June 22 25,

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