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Introduction. Comparison of recordings of air-conduction and bone-conduction auditory brainstem responses (ABRs) offers a possibility of recognizing, in a more reliable way, the degree of conductive hearing losses, and quantitatively assessing the size of the air-bone gap. Aim. The aim of the study was to compare the latency and threshold of wave V evoked by a click and a 1000 Hz tone-burst for air and bone conduction. Material and methods. A group of 66 sensorineural and conductive hearing loss children at the age between 9 and 12 were examined. ABR responses were recorded for both stimuli and conduction types at stimulus intensities varied in 10 dB steps. In order to assess the usefulness of the bone conduction ABR method for hearing sensitivity evaluation, the ABR wave V threshold values were compared with the hearing threshold values obtained in audiometric tests. Results. The latency of wave V for tone-burst stimulus at 1000 Hz was longer than that for the click stimulus, irrespective of the stimulation conduction type. Statistical analysis did not reveal any significant differences between the latencies measured in ABRs evoked by air and bone conduction, irrespective of the kind of stimulus applied in the group of children with sensorineural hearing loss. Significant differences were found in the group of children with conductive hearing loss. Conclusions. Auditory brainstem responses elicited through bone conduction can be a valuable supplement to standard ABR for air conduction. [ABSTRACT FROM AUTHOR]

Introduction. Auditory brainstem responses (ABR) play a key role in early diagnosis in children. In clinical practice, they are usually measured by applying air-conduction stimulation. However, in some cases, such as microtia or congenital atresia, there is a need to evaluate auditory threshold also by bone conduction. Aim. The aim of the study was to compare the latency and threshold of wave V evoked by a click and a 1000 Hz tone pip for air and bone conduction. Material and methods. A group of 40 normal-hearing children at the age between 9 and 12 were examined. ABRs were recorded for both stimuli and conduction types at stimulus intensities varied in 10 dB steps. Results. Statistical analysis did not reveal any significant diferences between the latencies measured in ABRs evoked by air and bone conduction, irrespective of the kind of stimulus applied. The diferences between ABR and audiometic thresholds determined for the 1000 Hz and click stimuli at respective frequeny ranges were within 10 dB. Conclusions. The characteristics of ABRs evoked by the click and 1000 Hz tone pip using air and bone conduction are similar. [ABSTRACT FROM AUTHOR]

Background: Music is for many people an integral part of their lives. In recent years, loud music, whether recorded or played live, has been a significant source of noise. The aim of the study was to assess the relationship between exposure to high sound levels and temporary threshold shift (TTS) in people working as fitness instructors., Material and Methods: The study included a total of 29 people (26 women and 3 men, age: 33±6 years) employed in 8 fitness clubs. The sound levels and the frequency characteristics of noise were assessed using individual dosimetry. Hearing threshold was evaluated by pre- and post-exposure pure tone audiometry (PTA), yielding a total of 116 audiograms., Results: Occupational exposure of fitness instructors to noise lasted 60-120 min and the A-weighted sound pressure level (L Aeq,T ) in their workplace ranged 76.3-96.0 dBA (M = 87.1 dB). In 12% of individual measurements, the maximum admissible intensity (MAI) value for noise at the workplace was exceeded (MAI = 85 dB). In 41% of the surveyed instructors, a TTS of ≥6 dB at 4 kHz was observed., Conclusions: Fitness instructors may be a risk of hearing impairment related to their work. Med Pr. 2021;72(4):391-7., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Introduction: There are many ways of presenting the treatment's results for otosclerosis. Because of loss of the uniform standard, it is impossible to compare these results between various health centres. But the most important is, which way of presenting seems to be the best., Aim: The aim of the study was to propose a scheme of presenting the treatment's results for otosclerosis., Material and Methods: In order to devise method, medical documentation of 81 patients, treated for otosclerosis in Otolaryngological and Oncological Laryngology Clinic with Audiology and Phoniatrics Department, was analysed retrospectively., Results: The received results were analysed for each patient and divided into 3 groups: first - changes of the air conduction, second - changes of the air-bone gap, third - changes of the bone conduction. The value of the air-bone gap is a measure of surgeon's effectiveness interpreting as the reconstruction of the conductive chain in the middle ear. The loss of bone conduction before and after the operation can evaluate the improving hearing after the operation of otosklerosis due to overclosure and also can take under consideration the sensoneurinal hearing loss induced by moving of the stapes. Only comparison these three parameters is correct to evaluate the operation's results, especially the air conduction. So that de Bruijn et al. proposed a diagram, called Amsterdam Evaluation Hearing Plots - AEHPs. That diagram compares the pre-operative mean air-bone gap to post-operative change of loss of air - conduction. Thanks to that, the overclosure and post-operative sensorineurinal hearing loss were taken under consideration., Conclusions: The presentation of the treatment's results for otosclerosis should include, besides the air-bone gap, the air conduction and bone conduction too. The AEHPs meet the requirements., (Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.)

Unlabelled: Surgery is the most effective method of improving hearing in patients with otosclerosis. The level of improvement depends on the stage of the disease and the chosen surgical method., The Aim of This Study: is to present hearing results in patients treated surgically by means of different types of prostheses and methods of vestibule sealing., Material and Methods: 230 cases (160 men, 70 women) between the age of 21 and 64 (median 36 years) treated for the first time in the Department of Otolaryngology of Medical University in Gdańsk underwent epidemiologic and clinical analysis. The researches took into account the level of hearing improvement based on the reduced air-bone reserve for frequencies 0.5, 1.0, 2.0 i 4.0 kHz in groups with where prostheses type 1 and 2 were used., Results: 230 stapedotomies were performed. In 110 patients prosthesis type 1 was used (PTFE) and in 120 type 2 (piston PTFE with platinum tape). Each vestibule was sealed with homogenic fat tissue or fibrin sponge. After 6 weeks from the operation the air-bone reserve was reduced by 5 to 30 dB, the reserve existed after one year from the operation in some patients. 35% of the patients presented with vertigo after the operation and 5% with tinnitus., Conclusions: Stapedotomy is a method of hearing improvement in patients with otosclerosis. Best results are achieved when prosthesis type 2 is used and homogenic fat tissue serves to seal the vestibule. Broad opening of the vestibule may be the cause for vertigo and lack of hearing improvement occurrence., (Copyright © 2012 Polish Otolaryngology Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.)

Aim of the Study: To evaluate the influence of high frequency hearing loss (> 8000 Hz) on distortion product otoacoustic emissions registered in the frequency range from 0,5 to 8 kHz., Material and Methods: 280 ears with tinnitus and normal hearing (0.25-8 kHz) divided into 3 groups depending on the degree of high frequency hearing loss: group A--hearing threshold up to 20 dB for 10, 12.5, 14 and 16 kHz (68 ears); group B--hearing threshold 25-40 dB HL for at least one of four EHfs (93 ears); group C--hearing threshold above 40 dB HL for at least one of four EHFs (119 ears). For each group mean audiogram and DP-gram were obtained and statistical analysis was used for comparison across these groups., Results: Mean DPOAE values in group C were significantly lower in comparison with group A for the frequency range 2-8 kHz, and in comparison with group B were significantly lower for the frequency range 4-8 kHz., Conclusions: High frequency hearing loss (above 8 kHz) has a relevant influence on distortion product otoacoustic emissions registered at frequencies below 8 kHz in tinnitus patients. The greater is hearing loss above 8 kHz, the lower is DPOAE value below 8 kHz., (2012 Polish Otorhinolaryngology - Head and Neck Surgery Society.)

Aim of the Study: To compare safety, reliability and usefulness of two deafening protocols on animal mouse model, based on aminoglycosides exposure, Material and Method: Adults mice, Bulb/C, deafened with kanamycine 14 days treatment (group I), single kanamycin injection followed by etacrinic acid administration (group II) and control group. Hearing evaluation performed with ABR recordings on 6th day after drug exposure, Results: Both protocols were not able to guarantee complete ablation of the inner ear in tested animals. Although short deafening strategy was more effective (83.33% deaf mice) it was combined with high rate of mortality during general anesthesia for hearing evaluation., Conclusions: Variable outcomes in deafening mouse animal model implies the necessity of hearing evaluation every time prior to the pathophysiological as well as molecular studies. Mice exposed to severe oto- and nephrotoxic insult do not recover after anesthetic drug administration, thus harvesting inner ear tissues especially as the source of RNA should be performed immediately after ABR recordings., (Copyright © 2012 Polish Otolaryngology Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.)

Introduction: The aim of the work was to analyse sudden deterioration of hearing and/or vertigo occurrence as an early symptom of posterior cranial fossa tumours., Material and Methods: Among 1.394 people who reported vertigo and hearing impairment and were hospitalised at the Department of Otolaryngology and Laryngological Oncology Military Teaching Hospital in Lodz within the years of 2007-2010 twenty-seven patients were analysed. This group included 19 women aged 20-80 (mean age 45.7 years) and 8 men aged 25-73 (mean age 54.0 years) who had posterior cranial fossa tumours diagnosed on the basis of MRI. Each patient underwent a detailed interview, otorhinolaryngological and otoneurological examinations, pure tone, speech and impedance audiometry, suprathreshold tests (SISI, TDT), tinnitus pitch and frequency evaluation, auditory brainstem response (ABR), complete videonystagmography., Results: The studied material revealed: acoustic neuroma in 15 patients, cerebellar meningioma in 5 patients, cerebellar cyst in 4 patients and cerebellar angioma in 3 patients. Sudden vertigo was present in 27 patients, including mixed-type vertigo in 15 cases and central vertigo in 12 cases. In 19 patients dizziness was accompanied by tinnitus. In 22 patients hearing disorders were diagnosed in a form of: sensorineural hearing loss in 14 subjects, bilateral in 7 subjects, left-lateral in 5 subjects and right-lateral in 2 subjects respectively, as well as deafness in 8 patients, including left ear deafness in 5 cases, right ear deafness in 1 case and bilateral deafness in 2 cases (7.4%)., Conclusions: The early phase diagnosis of a posterior cranial fossa tumour as a cause of sudden hearing deterioration and/or vertigo is very seldom and often accidental because GPs, also otolaryngologists, who follow routine and economy, are not used to referring given patients for complete and objective audiological, otoneurological and imaging diagnostics., (Copyright © 2011 Polish Otolaryngology Society. Published by Elsevier Urban & Partner (Poland). All rights reserved.)

Aim: The aim of this study is to present indications, surgical technique and first results of fully implantable middle ear implant (Otologics Carina), first time in Polish clinical practice., Material and Methods: 24-years-old patient with bilateral moderate sensorineural hearing loss. The surgery with fully implantable middle ear implant was performed on November 11th, 2008 (implant device Otologics Carina). Two months after the surgery the patient was admitted to hospital for the first fitting. Audiological tests were performed before the surgery and after on every fitting visit (4 fitting visits so far)., Results: Postoperative bone and air conduction thresholds confirmed no cochlear damage due to the surgery. Free field pure tone and speech audiometry proved better results in aided conditions compared to unaided. Further fitting sessions are planned in 6-8 weeks intervals in order to improve hearing thresholds along with anti-feedback adjustments., Conclusions: Our results confirm that fully implantable middle ear implant is a viable treatment for adult patients with moderate sensorineural hearing loss. In selected cases it may become an alternative to conventional hearing aids.

Unlabelled: Impedance measurements are routinely performed during the cochlear implantation. These measurements make possible to check, whether all electrodes work correctly and are useful in the monitoring of implant's functioning during rehabilitation. The analysis of the impedance's changes makes possible to estimate, what processes happen in tissues and liquids of the inner ear around the electrode., The Aim of the Study: The aim of the study was to estimate changes of the electrodes' impedance in cochlear implants users., Material and Methods: Measurements of the impedance was performed on every electrode introduced into the cochlea. Impedance measurements were investigated in 42 adult persons operated at the Department of Otolaryngology Medical University of Lublin. The impedance of electrodes in cochlear implants users was measured during operation, during the activation of the speech processor and during following settings of the speech processor., Results: During activation of the speech processor we observed elevated values of the impedance, higher then during intra-operating-measurement. On the second fitting impedances decrease and then were stable at this level during one year follow-up., Conclusions: Increasing values of impedance during first fitting of the speech processor support the hypothesis that a layer of fibrous tissue forms around the electrode because of the inflammatory changes or due to exudation of protein. Such changes could be observed after cochlear implantation. Impedance values decrease after first fitting and remain stable. This may suggest that electrical stimulation prevents from adverse changes in the cochlea.

Objectives: To estimate binaural asymmetric sensorineural hearing loss in own material of patients treated in Dept. of Phoniatrics and Audiology., Material & Methods: The retrospective analysis was performed on the group of 1816 patients hospitalized in 2008 due to hearing disorders. Asymmetry of hearing loss was classified on Margolis and Saly criteria in PTA, and in ABR results in children., Conclusions: Binaural asymmetric sensorineural hearing loss was found in 70 patients (3.9%). In a group of 46 differences of inter-aural threshold level in PTA were estimated on 21 to 30 dB. After audiological examination 14% of this patients were qualified for MRI investigation, in 2 (3%) of them acoustic neurinoma was found. The hearing aids fitting were performed in 44% of a group of 70 patients.

Introduction: The aim of the study is to analyze the relationship between otoscopic tympanic membrane abnormalities, results of impedanace and extended-high-frequency audiometry in subjects with history of treatment of secretory otitis media (SOM) and ventilation tube insertion., Material and Methods: 97 subjects treated because of SOM were examined in years 1999-2000. Videootoscopic examinations, extended-high-frequency audiometry and tympanometry with ispilateral acoustic reflex were performed in each patient. The results were analysed in three groups: no otoscopic abnormalities (BZO), retraction pockets (KR) and atrophy and myringosclerosis (AM). The results were compared to otologicaly healthy control group in the same age., Results: The most common tympanic membrane abnormality were focal atrophy (64.7%) of ears and myringosclerosis (37.2%). Mean pure-tone audiometric threshold were significantly higher in groups KR and AM than in control and BZO groups. Low degree of positive correlation was found between the presence of myringosclerosis and atrophy and audiometric thresholds above 1 kHz. No such correlation was observed with the presence of retraction pockets. In the BZO group middle ear admittance was observed significantly higher than in control group. The absent ipsilateral stapedial reflex was observed in 10.8% ears in BZO group, 16.9% in AM and 33.3% in KR. No correlation was found between the parameters of tympanometric evaluation and results of extended-high-frequency audiometry., Conclusions: In ears treated because of SOM with ventilation tube insertion the middle ear compliance is higher. In the presence of myringosclerosis and atrophy higher audiometric thresholds are observed. Tympanic membrane abnormalities have been more clearly indicated by the absent ipsilateral stapedial reflex than tympanometry.

Unlabelled: In otosclerosis patients the most common procedure followed at Otosurgical Dept. Medical University of Lodz is stapedotomy with insertion of teflon-piston prosthesis. When surgery is finished a whisper hearing test is done from the 1 meter distance for brief intraoperative hearing improvement assessment. There is a number of patient who report subjective intraoperative hearing improvement which is not confirmed by postoperative pure-tone audiometry (2-3rd post-op day)., The Aim of the Study: was the analysis of factors influencing stapedotomy (teflon-piston procedure) patients in which intraoperative hearing improvement was not confirmed by postoperative pure-tone audiometry., Material and Method: Retrospective analysis of postoperative hearing results in patients who underwent stapedotomy (teflon-piston operation) at the Otosurgical Dept. Medical University of Lodz from 2005 to 2009., Results: The total number of 142 stapedotomies were analyzed. In 27 ears no hearing improvement was reported (19.1%). Among them 18 reported intraoperative hearing improvement not confirmed on postoperative pure-tone audiometry and 9 cases intraopertively reported no hearing improvement. Patients in Group A (hearing improvement 1-2 month post stapedotomy)--12 cases (44.4%) with hearing improvement confirmed by pure-tone audiometry and Group B--5 cases (55.6%) in which no sign of hearing improvement in pure-tone audiometry was reported., Conclusion: In patients who intraopertively reported hearing improvement not supported by the pure-tone audiometry the following factors seem to play a vital role: a) strong suggestion and willingness of improvement after surgical treatment, b) specific condition of the whisper hearing test at the operating room environment, c) patient's stress during the surgery and strong fear of possible revision surgery.

Introduction: Otitis media with effusion is the most common cause of hearing loss in children and myringotomy with tympanostomy tube insertion is recommended procedure to deal with the problem. The objective of the present study was to determine the results of treatment, incidence and prevalence of middle ear sequelae and hearing results among children with chronic otitis media with effusion who received standard treatment with tympanostomy tubes., Material and Methods: The group of 97 patients treated by tympanostomy tubes insertion in the years 1999-2001 was reevaluated after mean period of follow up 7.3 years. At the control examination videootoscopy and audiologic examinations were performed. Audiological assessment consisted of tympanometry and pure-tone thresholds of air and bone conduction., Results: Recurrent otitis media with effusion requiring tube insertion occurred during follow up period in 23.7% of patients. At the control examination 16.5% of children had an ongoing otitis media or ventilation tube in place or tympanic membrane perforation. Most common tympanic membrane abnormality were focal atrophy (67.2% of ears) and myringosclerosis (39.5%) followed by retraction pockets of pars flaccida (29.9%) and tensa (9.6%). Mean pure-tone audiometric threshold were significantly higher in ears with tympanic membrane abnormality by the difference did not excide 5dB HL in ears with focal atrophy and myringosclerosis and 6.5 dB HL in ears with retraction pockets., Conclusions: As the percentage of recurrences after tympanostomy tubes insertion are not uncommon prolonged period of follow up of those children is recommended. Although ventilation tubes have proven very effective in improving hearing in short term, they have not proven effective in preventing long-term sequelae of tympanic membrane and some degree of hearing loss. The decision about surgical treatment should be taken cautiously taking into account the chance of spontaneous resolution.

The main tumor of cerebellopontine angle are vestibular schwannoma (80-90%). Most of them are unilateral lesion but 5% of them are bilateral pathological mass. There are genetic disease like neurofibromatosis type 1 and 2. According to National Institute of Heath Consensus Development Conference the best treatment method is microsurgery. The possibility of hearing preservation surgery give middle fossa approach and suboccipital approach, radiotherapy or auditory brainstem implants and cochlear implants. The aim of the study is case report of the patient suffered from bilateral vestibular schwannoma. Early diagnosis and therapy enable hearing preservation and good facial nerve function.

Background: Toys play an important role in the development of the sight and hearing concentration in children. They also support the development of manipulation, gently influence a child and excite its emotional activities. A lot of toys emit various sounds. The aim of the study was to assess sound levels produced by sound-emitting toys used by young children., Material and Methods: Acoustical parameters of noise were evaluated for 16 sound-emitting plastic toys in laboratory conditions. The noise level was recorded at four different distances, 10, 20, 25 and 30 cm, from the toy. Measurements of A-weighted sound pressure levels and noise levels in octave band in the frequency range from 31.5 Hz to 16 kHz were performed at each distance., Results: Taking into consideration the highest equivalent A-weighted sound levels produced by tested toys, they can be divided into four groups: below 70 dB (6 toys), from 70 to 74 dB (4 toys), from 75 to 84 dB (3 toys) and from 85 to 94 dB (3 toys). The majority of toys (81%) emitted dominant sound levels in octave band at the frequency range from 2 kHz to 4 kHz., Conclusions: Sound-emitting toys produce the highest acoustic energy at the frequency range of the highest susceptibility of the auditory system. Noise levels produced by some toys can be dangerous to children's hearing.

The knowledge of the physiology of the normal ear is important to understand the function of the ear. It is especially crucial in the reconstruction of the destroyed ear to apply the knowledge of the normal ear. We present results of tympanic membrane vibrations measurements using Laser Doppler Vibrometer in human temporal bone specimens. Six temporal bone specimens were harvested within 48 hours of death and stored cooled until preparation. The preparation included mastoidectomy with posterior tympanotomy and partial resection of the facial nerve to visualize the stapes with its footplate. We measured velocity and displacement of each quadrant of the tympanic membrane and the umbo with the laser Vibrometer equipped with velocity and displacement decoders. The sensor head OFV-534 produced and read the reflected laser beam directed at a measured point with a dedicated micromanipulator attached to an operating microscope. A retro-reflective tape was used to enhance the reflection of the laser beam. Vibrations were induced by a acoustic stimulation at the tympanic membrane. The results of the measurements were corrected to a sound pressure in the external ear canal. Laser Doppler Vibrometer system allows an undisturbed measurement of vibrations in the middle ear. Posterior quadrants of the tympanic membrane have greater velocity and displacement than anterior quadrants in lower frequencies up to 2 kHz.

The purpose of this study was to determine whether distortion product otoacoustic emissions (DPOAEs) can be used to distinguish among four groups with audiometrically normal-hearing sensitivity: (1) control adults without tinnitus or hyperacusis, (2) patients with tinnitus alone, (3) patients with hyperacusis alone, and (4) patients with both tinnitus and hyperacusis. Two types of DPOAE measures were evaluated: (1) the distortion product (DP-)gram measured with fixed primary levels as a function of frequency, and (2) DPOAE input/output (I/O) functions for a range of primary levels between 45 and 70 dB sound pressure level (SPL) at 1000, 2000, and 4000 Hz. DP-grams did not clearly distinguish between the control and patient groups. There was, however, a consistent trend for the three patient groups to have decreased average DP levels at 4000 and 6000 Hz; this notch in the DP-gram was not observed in the response configuration for the control group. In the three patient groups, 51 to 74% of these individuals had DP levels that were outside of the 95% confidence range for the control group. The average slopes of the I/O growth functions for each of the patient groups were consistently steeper than those for the control group; however, the slope values were indistinguishable among the patient groups. About 60% of the patients' DPOAE responses (in each group) were categorized as abnormal based on their slope values. Thus, DPOAE measures can be used with at least partial success to distinguish controls from patients with tinnitus, hyperacusis, or both tinnitus and hyperacusis, but not to discriminate among the respective patient groups. These findings suggest that the pathology represented among the patient groups is consistent at the level of the cochlea; however, diagnostic tests targeted at higher centers of processing are needed if the individuals in these groups are to be distinguished among themselves. In all participants, DPOAEs with fixed primary levels as a function of frequency were measured. There was a consistent trend for the three patient groups to have decreased average DP-gram levels at 4000 and 6000 Hz; this notch in the DP-gram was not observed in the response configuration for the control group. In the three patient groups, 51 to 74% of these individuals had DP levels that were outside of the 95% confidence range for the control group. Thus, DPOAE measures can be used with at least partial success to distinguish controls from patients with tinnitus, hyperacusis, or both tinnitus and hyperacusis, but not to discriminate among the respective patient groups. These findings suggest that the pathology represented among the patient groups is consistent at the level of the cochlea; however, diagnostic tests targeted at higher centers of processing are needed if the individuals in these groups are to be distinguished among themselves.

The populations at risk of adverse effects of noise include, in addition to adults, also children and juveniles, the two groups considered to be particularly vulnerable to noise-induced hearing loss and numerous other adverse systemic effects of exposure to noise. Major sources of noise exposure in children's and youth's environments include incubators at neonate intensive care wards, toys (such as e.g. rattles, squeeze toys, percussion cap toys, pistols), fireworks, pop and rock music concerts, aerobic courses and personal portable music players. This paper reports dB-A noise levels associated with those noise sources, and also combined dB-A levels of noise from external and internal sources prevailing at schools. The suggested preventive steps specified in the CE-HAPE (Children's Environment and Health Action Plan for Europe) and PINCHE (Policy Interpretation Network on Children's Health and Environment) include legislative measures to limit the intensity and time of exposure to noise and classes/education actions for youths and parents.

Aim: Retrospective analysis of the post-op hearing results in stapes surgery using different types of materials for stapes prosthesis after 12 months follow up., Material and Methods: The total number of 350 otosclerosis patients who underwent surgical treatment at the Otosurgery Department, Medical University of Lodz from 1980-2002. All patients included in the study were divided into 4 groups: group 1 (N=54)--Portmann's method interposition, group 2 (N=160)--stapes replaced with the Shea-type prosthesis, group 3 (N=60)--platinum wire prosthesis (Zini-type), group 4 (N=76)--teflon-piston operation (Fisch-type)., Results: The 12 months post-op mean value for air-bone gap (500, 1000, 2000 Hz) presented the following values: group 1-19 dB, group 2-15.9 dB, group 3-18.4 dB, group 4-13.5 dB. The percentage of patients with the mean air-bone gap value of 15 dB or less (500, 1000, 2000 Hz) has the following values in each group: group 1-75%, group 2-81.3%, group 3-83%, group 4-85%., Conclusions: 12 months post-op hearing results compared between the 4 studied groups showed statistically not significant differences. Our experience with teflon-piston prosthesis shows the lowest post-op mean value of the air-bone gap.

Introduction: The aim of the study was the comparison of hearing before and after ear surgery in patients with chronic otitis media according to Fowler and Sabine criteria., Material: The study comprised 42 patients (42 ears), aged 19-72 (26 females and 16 males). The patients were divided into three groups, considering the type of surgery; Group I--20 ears after myringoplasty, group II--14 ears after mastoidectomy with canal up and myringoplasty and group III--8 ears after the mastoidectomy with canal down., Methods: Audiologic examination was performed together with the evaluation of hearing loss according to the criteria of Fowler and Sabine (CPT), before and 3 months after the ear surgery. The difference of 20% (CPT) was considered improvement or deterioration of the hearing., Results: On the basis of the intraoperative examination, chronic otitis media with perforation was found in 18 patients, granulating otitis media in 16 patients and the chronic otitis with cholesteatoma in 8 patients. The myringoplasty was performed in 20 patients, the mastoidectomy with canal up and myringoplasty in 14 patients and the mastoidectomy with canal down in 8 patients. In 14 ears of group I (70%) hearing improvement was noticed, and in 6 (30%) remained unchanged. The mean hearing loss according to CPT in this group was 40.39% before ear surgery and 24.26% after. In group II in 6 ears (43%) hearing improvement was observed, whereas in 8 (57%) remained unchanged. The mean hearing loss according to CPT in this group was 71.40% before and 61.85% after surgical treatment. In group III, hearing improvement was noticed in 37% of ears and in 5 (63%) did not change after the ear operation. The mean hearing loss (CPT) in this group was 81.57% before treatment and 71.37% after., Conclusions: Considering early evaluation of hearing the best results were obtained in patients subjected to myringoplasty and conservative operations of the middle ear with canal up procedure.

Introduction: The amplitude of click evoked otoacoustic emissions can be suppressed (reduced) with contralateral acoustic stimulation (CAS). This is thought to be due to the inhibitory control that the medial efferent auditory nerve exerts on outer hair cell function. One commonly used test of medial olivocochlear (MOC) function in humans involves measuring the degree of suppression of ipsilateral otoacoustic emissions (OAEs) by CAS. This effect is called contralateral suppression, efferent effect or olivocochlear reflex. Aim of the study. The objective of this study was to measure cut-off level of contralateral suppression, sensitivity and specificity of the efferent test., Material and Methods: To evaluate the function of MOC system click evoked otoacoustic emissions (CEOAEs) with and without continuous contralateral broadband noise (BBN) stimulation were recorded in 14 patients with multiple sclerosis, 16 patients with unilateral cerebello-pontine angle tumor and control group matched for age and gender. BBN was presented at 50 dB SL and otoacoustic emissions were recorded in response to nonlinear clicks at 70 +/- 3 dB SPL., Results: The cut-off level was established at -1.4 dB. For 1.4 dB cut-off level of contralateral suppression the sensitivity of the efferent test was 90% and specificity was 70%., Conclusions: To conclude, assessment of efferent suppression may be a useful addition to the battery test employed in the investigation of multiple sclerosis and cerebello-pontine angle tumors. The MOC suppression test may provide a tool for an early diagnosis of the brainstem pathology.

Unlabelled: Nephrotic syndrome (NS) is connected with an increase of glomeral permeability. It generates numerous, reversible electrolic and biochemical disturbances. THE AIM of the work was complex evaluation of hearing organ in children in the course of NS., Material: 28 children aged from 7 to 17 years suffering from primary glomerulopathy, without renal failure and 28 healthy children in the relative age (control group)., Method: In children with NS hearing tests (pure tone audiometry, impedance audiometry, BAEP, DPOAE) have been performed twice: in acute phase and in non-symptomic phase. Such parameters as total protein, albumines, globulins, cholesterol, sodium, potassium, calcium, magnesium were evaluated., Results: In oedematous stage the concentration of total protein, albumines and calcium were significantly decreased and the concentration of cholesterol was increased. Children with NS presented much worse hearing than healthy subjects, even after the symptoms dissapeared in acute phase such parameters of BAEP as peak III latency and interpeak I-III interlatency were elongated and DPOAE values were decreased. In normal phase BAEP parameters were similar to those in normal group but DPOAE parameters were still much worse than in healthy children. Some of the biochemical parameters correlated with hearing results in children with NS., Conclusions: Hearing organ in children with NS in the course of chronic glomerulopathy is significantly worse than in healthy children. It is probably connected with repeated biochemical and electrolytic disturbances that cause partly reversible alterations in the cochlea, acoustic nerve and brain stem. It may be also caused by ototoxic drugs.

Introduction: The aim of this work was to assess the value of impedance audiometry in the differential diagnostics of hearing disorders, especially in patients suffering from tinnitus., Material and Methods: The analysis dealt with results of the audiological tests in 198 patients (116 female and 82 male), hospitalised in 2007 due to their hearing deterioration, tinnitus or sudden deafness. The conducted audiological tests covered threshold and suprathreshold pure tone audiometry, speech audiometry, BERA and impedance audiometry. RESULTS OF THE STUDIES: Women (58.5%) and people over 50 years old (58.6%) constituted the majority of the patients. In 166 (83.8%) patients the conducted tests via impedance audiometry did not prove any deviations from the normal condition, the lesions referred to both ears in 32 (16.9%) patients and one ear in 17 (8.5%) patients. An incorrect tympanogram was found in 23 people, including type As in 11, type Ad in 2, type B in 4 and type C in 6 subjects. Low values of acoustic receptivity of the middle ear were noted in 20 ears, whereas high values in 11 ears. In 3 ears we found low values of the gradient (below 0.3), high values--in 11 ears. The middle ear pressure between -170 and -350 daPa was noticed in 20 ears, and positive values, above +50 daPa up to +75 daPa, in 3 ears. Disorders in the stapedial reflex registration were observed in 38 (19.1%) patients. The assessment of the conducted subjective and objective audiological examinations allowed to recognise bilateral perceptive hearing injuries in 139 patients, including 49 (25.9%) of cochlear origin with OWG, in further 70 patients the hearing loss referred to higher frequencies and was rather slight., Conclusions: The own experiences indicated that the impedance audiometry constitutes the integral part of contemporary audiological diagnostics and still remains an objective method facilitating quick, non-invasive evaluation of the functions of particular elements in the middle ear.

Introduction: The purpose of speech audiometry is to extend the diagnostics of central auditory processes. First audiometric tests were monaural tests introduced in the fifties by Bocca and Calearo to diagnose Central Auditory Processing Disorders (CAPD). Monaural tests are characterized by low redundancy, which allows for deciphering a given word or phrase only if the amount of accessible information exceeds a required minimum. Until now, a new monaural filtered speech test has been drawn up at the Department of Phoniatrics and Audiology. The purpose of the research was to draw up and assess the effectiveness of monaural low redundancy tests, in which the acoustic signal has been compressed or noise has been added., Materials and Method: 35 people with normal hearing, aged 16-60, have been examined. The test material included: a compressed speech test, in which the speech signal has been accelerated by 25% with the use of Cool Edit Pro 2.0; the pauses between the words have not been shortened a speech-in-noise test, in which the noise has been added with the use of Cool Edit Pro 2.0. The signal/noise ratio has been set at the level of 10 dB. The examination has been conducted at three different volume levels: 25, 35 and 45 dB., Conclusions: Best results have been achieved at the volume level of 45 dB (above hearing threshold); There were differences in results at volume levels 25 dB and 35 dB in compressed speech test and at volume level 25 dB in speech in noise. Both tests have shown the influence of age on the test result which suggests undiagnosed CAPD among people (with normal hearing) aged over 55.

For many years otosclerosis has been an interesting otologic problem in regard to pathological and clinical aspects. Many various conceptions of otosclerosis development which finally lead to the stapes immobility in the oval window were discussed. Resent genetic studies indicate that genetic factors as a cause of otosclerosis possibly in combination with other factors localize 3 genes responsible for otosclerosis to chromosom 15q25q-q26, 7q34-36, 6p21-22. The aim of the study was audiometric evaluation of 1380 patients out of 1716 stapes operations performed in years 1973-2004. Audiometric assessment for air and bone conduction was performed according to the European Academy of Otology and Neuro-Otology (EAO-NO) criteria. Postoperative air-bone gap 11-20 dB for speech frequencies (500, 1000, 2000, 4000 Hz) was obtained in 64.8% and in 28.9% was less than 10 dB. Postoperative air-bone gap (11-20 dB) recognized as a good result is determined by factors such as preoperative hearing loss, onset and duration of the disease, advanced and multiple otosclerotic foci, patient's age etc. Actually postoperative air-bone gap shows the improvement of air and bone thresholds obtained post stapedotomy versus preoperative air bone gap. In previous years an "over-closure" effect was taken into consideration. Hearing improvement post stapes surgery which included the "over closure" effect was obviously better. The authors indicate the necessity of standardization of audiometric results post ear surgery.

Introduction: In obliterative type of otosclerosis the stapes footplate is greatly thickened and diffusely replaced by a massive otosclerotic masses that fill in the oval window niche, often annular ligament cannot be visualized. In the case of obliterative otosclerosis the only effective way of treatment is surgery., Material and Methods: The analysed group consisted of 53 patients with primary obliterative otosclerosis. In the control group there were 30 consecutive patients treated for otosclerosis. The auditory organ was assessed on the ground of the following criteria for the frequencies 0.5, 1, 2 and 4 kHz.: 1. Change of pure tone thresholds of air conduction (AC) 2. Change of pure tone thresholds of bone conduction (BC) 3. Change of pure tone thresholds of air-bone gap (ABG) as the difference between the mean AC and BC thresholds before the operation (AC0 and BC0) and 12 months after the operation (AC1 and BC1)., Results: Postoperatively mean value of change of AC thresholds in the analysed group was about 24 +/- 2 dBHL and in the control group about 25 +/- 2 dBHL (no significant difference). In the analysed group the mean value of BC thresholds varied about 8 dBHL and in the control group about 11 dBHL (no significant difference). The average values of ABG after the operation varied about 14 +/- 1 dBHL in both--the analysed and the control group. Postoperatively the mean value ABG was amounted to 20 +/- 1 dBHL in the analysed group and in the control group to 18 +/- 1 dBHL (no significant difference). On the basis of the subjective assessment completely subsidence of aural tinnitus reported 70% patients in the analysed group and 80% patients in the control group., Conclusion: 1. The incidence of obliterative otosclerosis represents 9,6% of all otosclerotic patients treated surgically. 2. Stapedotomy is the treatment of choice in patients with obliterative otosclerosis, because significant improvement of AC, BC and ABG 12 months after the operation was reported, mean values did not differ between the above and control group. 3. Complete subsidence of aural tinnitus was reported in 70% patients with obliterative otosclerosis.

Introduction: Otitis media with effusion is a common problem in childhood. The tympanostomy tubes is a standard treatment of persistent otitis media with effusion in children which improves hearing level. However some pathological changes of the tympanic membrane and middle ear few years after treatment are observed. The aim of the study was prevalence of middle ear sequelaes in children with persistent otitis media with effusion treated by tympanostomy tubes 4-10 years after treatment., Material and Methods: The group of 61 patients aged between 1-13 with otitis media with effusion treated by tympanostomy tubes in Department of Otolaryngology Childrenís Hospital in Warsaw between 1994-2001 were controlled. 113 ears treated with tympanostomy tubes were examined 4-10 years after treatment. At the examination otomicroscope, pure-tone audiometry and tympanometry were used., Results: Out of the 113 ears after ventilation tubes insertion as a method of otitis media with effusion treatment in 83 (73%) developed one or more middle ear sequelaes. Myringosclerosis in 47 ears (41,59%), segmental atrophy in 19 ears (16,81%), atrophy in 14 ears (12,38%), disfunction of Eustachian tube in 8 ears (7,07%), otitis media with effusion in 7 ears (6,19%), perforation of tympanic membrane in 6 ears (5,3%), chronic otitis media in 2 ears (1,76%), retraction pocket in 2 ears (1,76%) and tympanostomy tube in the middle ear cavity in 1 ear (0,88%) were found. No cases of cholesteatoma were found. In 22 ears (19,46%) the conductive hearing loss was greater than 20 dB. In 4 ears (3,5%) mixed hearing loss and in 3 ears (2,6%) receptable hearing loss was diagnosed. Tympanogram type A was in 86 ears (76,1%), tympanogram type B was in 11 ears (9,7%) and tympanogram type C was in 12 ears (12,6%)., Conclusions: In children with otitis media with effusion treated with tympanostomy tubes the amount of sequelaes increased with time. In children with otitis media with effusion who started treatment with tympanostomy tubes in age to 4 years old the amount of sequelaes is less. The follow-up is recommended up to 8 years after the treatment.

Unlabelled: The most probable place generating tinnitus in auditory pathway are outer hair cells (OHC) inside cochlea. To asses their activity otoacoustic emission is used. The goal of the investigation was estimation the features of otoemission DPOAE in groups with tinnitus patients with cochlear hearing loss, estimation of diagnostic value of DPOAE parameters for analysis of function of the cochlea in investigated patients emphasizing DPOAE parameters most useful in localizing tinnitus generators and estimation of hypothetic influence of hyperacusis and misophony on parameters of DPOAE in tinnitus patients with cochlear hearing loss. The material of the study were 42 tinnitus patients with cochlear hearing loss. In the control group there were 21 patients without tinnitus with the same type of hearing loss. Then tinnitus patients were divided into three subgroups--with hyperacusis, misophony and without both of them, based on audiologic findings., Method: after taking view on tinnitus and physical examination in all the patients pure tone and impedance audiometry, supratreshold tests, ABR and audiometric average and discomfort level were evaluated. Then otoemission DPOAE was measured in three procedures. First the amplitudes of two points per octave were assessed, in second--"fine structure" method-- 16-20 points per octave (f2/f1 = 1.2, L1 = L2 = 70 dB). Third procedure included recording of growth rate function in three series for input tones of value f2 = 2002, 4004, 6006 Hz (f2/f1= 1.22) and levels L1=L2, growing by degrees of 5dB in each series., Results: DPOAE amplitudes in recording of 2 points per octave and fine structure method are very valuable parameters for estimation of cochlear function in tinnitus patients with cochlear hearing loss. Decreasing of DPOAE amplitudes in patients with cochlear hearing loss and tinnitus suggests significant role of OHC pathology, unbalanced by IHC injury in generation of tinnitus in patients with hearing loss of cochlear localization. DPOAE fine structure provides us the additional information about DPOAE amplitude recorded in two points per octave, spreading the amount of frequencies f2, where differences are noticed in comparison of two groups--tinnitus patients and control. Function growth rate cannot be the only parameter in estimation of DPOAE in tinnitus patients with cochlear hearing loss, also including subjects with hyperacusis and misophony. Hyperacusis has important influence on DPOAE amplitude, increases essentially amplitude of DPOAE in the examined group of tinnitus patients.

Introduction: Osteogenesis imperfecta (OI) is a genetic disorders of connective tissue. Hearing loss has been repeatedly reported as a major syndrome of osteogenesis imperfecta. The hearing loss in OI is predominantly of the conductive type., Material and Methods: The family (mother and two daughters) suffering from osteogenesis imperfecta are presented., Results: Audiological examination is presented. It revealed various types of hearing loss in members of family (conductive, sensorineural, mixed)., Conclusions: On this example variety of hearing problems in this disease are demonstrated. Etiology and classification of osteogenesis imperfecta, clinical proceeding and treatment are presented.

Unlabelled: Chronic renal failure (CRF) causes a lot of systemic side-effects, among them: neurological and otological complications. In present study hearing evaluation was made in young patients, using distortion product otoacoustic emissions (DPOAEs) and auditory brainstem responses (ABR)., The Aim of Study: (1) objective assessment of hearing organ activity in CRF children, (2) localization of hearing organ part involved in CRF, (3) establishing best parameters of ipsilateral stimulation in DPOAEs for clinical use., Materials and Methods: Hearing acuity was assessed in 22 CRF children ranging in age from 9 to 17 years and 18 healthy children ranging in age from 10 to 18 years. At first pure tone audiometry and tympanometry were evaluate. Only patients with normal middle ear condition and hearing threshold better than 30 dB HL were put forward further investigations. Objective assessment of hearing condition included: (1) DPOAEs using DP-gram format. Two simultaneous pure-tone signals (primaries) were presented to the ear at two different frequencies (f1 and f2, where f2 > f1) and the 2f1-f2 were analyzed. Five pairs of non equal level and L2 were used L1 and L2: panel A1: L1 = 65 and L2 = 60 dB SPL, panel A2: L1 = 63 and L2 = 55 dB SPL, panel A3: L1 = 59 and L2 = 45 dB SPL, panel A4: L1 = 55 and L2 = 35 dB SPL, panel A5: L1 = 51 and L2 = 25 dB SPL; (2) ABR investigation using click stimulus, at 90 dB nHL level. Wave I, III, V latencies and intervals I-III, III-V, I-V were evaluated. Our results reviled significantly lower mean DPOAEs amplitudes in CRF children when compare to healthy children, at all frequencies measured. No differences in ABR evaluation were observed. Most optimal DPOAEs parameters in clinical use seem to be panel A1, A2 and A3 of level L1 and L2.

Background: The aim of the study was to assess the influence of short-term impulse noise on the size of temporary threshold shift in soldiers using hearing protectors during exposure., Material and Methods: The study covered 80 subjects with normal tympanic membrane and thresholds measured by pure tone audiometry lower than 20 dB. There were two groups: I--composed of 40 soldiers protected during shooting and II--comprised 40 young males which did not shoot (controls). Transient evoked otoacoustic emissions were performed by an ILO 292 Echoport Otodynamics device 3-5 min before shooting and 2 min, 1, 2 and 3 h after shooting., Results: The results showed that post-exposure changes in soldiers who used ear-muffs were not significant., Conclusion: The use of hearing protectors is strongly recommended because most of them seem to sufficiently attenuate impulse noise from firearms.

Unlabelled: In present study cochlear function was evaluate in young chronic renal failure (CRF) patients using distortion product otoacoustic emissions (DPOAEs)., The Aim of Study: (a) objective assessment of cochlear function in CRF children, (b) establishing best parameters of ipsilateral stimulation in DPOAEs (DP-gram format) for clinical use. Hearing acuity was assessed in 19 CRF children and 18 healthy children. At first pure tone audiometry and tympanometry were evaluate. Only patients with normal middle ear condition and hearing threshold better than 30 dB HL were put forward further investigations. Objective assessment of cochlear function included DPOAEs using DP-gram format. Our results reviled significantly lower mean DPOAE amplitudes in CRF children when compare to healthy children, at all frequencies measured. Most optimal DP-gram parameters in clinical use seems to be level L1 and L2 equal respectively: 65 and 60 dB SPL; 63 and 55 dB SPL; 59 and 45 dB SPL.

One of the problems in the stapes surgery is the floating footplate. The frequency of incidence of this complication is 2% to 5.8% of all operations. The authors present the results of stapes operations in a group of 28 cases (2.5%) from all the 1120 operations, in which the surgeon experienced a floating footplate. The hearing results were evaluated on the base of the average gain of air-conduction thresholds and air-bone gap levels at 500, 1000, 2000 and 3000 Hz. The improvement of hearing we observed in 24 patients, 4 patients heard worse.

The use of frequency-specific stimuli in recording auditory brainstem responses (ABR) allows for hearing objectivity concerning the given frequency. Non-linear intensity growth (logon) and linear intensity growth (tone burst), 1000 Hz frequency short tone stimuli are most commonly used. Differences between hearing threshold values and other ABR measures in recordings obtained after stimulation with broad-band click and logon were analysed in a group of high-risk infants. 71 infants aged 1 to 9 months (36 girls and 35 boys) were included in the group. Broadband envelope shaped 2000-4000 Hz repeated 5 times per second clicks, acquisition and analyse time 12.5 ms and Gauss shaped 1000 Hz logon and tone bursts repeated 4 times per second, acquisition and analyse time 20.0 ms were used as stimuli. Click induced mean threshold values were the same after stimulation with logon, tone bursts and clicks. Wave 1, III and V latencies decreased with stimulus frequency. Mean amplitudes of waves I, III and V obtained after logon stimulation were slightly higher than after tone burst stimulation.

The goal of our study was analysis of characteristic interrogation, audiometry and distortion products otoacoustic emission in patients with normal hearing and complaining of tinnitus. We examined the group of 24 ill patients with hearing threshold up till 25 dB HL and with tinnitus and the control group of 18 with no audiological complains. All the patients were made tonal audiometry and the discomfort level as well as tinnitus frequency and intensity were evaluated. For each ear separately, we examined DPAOE of DP-gram function with resolving power of half the octave and the fine structure on the level of stimulation L1 = L2 = 70 dB. In the group of patients average time of tinnitus was 1.5 year. Average hearing threshold in patients with tinnitus was 18 dB HL for air conduction and 11 dB HL for bone conduction, average discomfort threshold--93 dB HL. In the control group hearing threshold was comparatively 16 dB and 10 dB HL and average discomfort threshold--95 dB HL. In the tinnitus group 8 patients (21%) complained of hyperacusis. The differences between the two groups in DP-gram were observed mainly in high frequencies (higher than 3000 Hz). In DP-gram fine structure in the group of patients with tinnitus we noted wider span of otoemission decreases (over the octave) compared to control group. In the tinnitus group among 20 examined ears with decreases of otoacoustic emission DP--fine structure only in 6 patients (30%) the frequency of tinnitus given by the patient was overlapping with the frequency for which decreases of otoemission were observed. In both groups we observed decreases of DPOAE for some frequencies but in the patients with tinnitus we noticed the lack of otoacoustic emission in wider span of frequencies, mainly in higher frequencies compared to controls.

In a group of 153 patients, the result of unilateral stapedectomy was evaluated using Glasgow Benefit Plot. Pure tone average at frequencies 0.5; 1; 2; and 3 kHz of operated and non-operated ear were used to distribute patients to pre- and post-operative groups. In 26 (79%) of 33 patients with unilateral hearing loss, bilateral normal hearing was achieved. Thirty one (46%) of 68 patients with asymmetric bilateral hearing loss and 37 (71%) of 52 patients with symmetric bilateral hearing loss had unilateral normal hearing after the operation. Twenty (29%) patients of the group III had bilateral symmetrical hearing loss after surgery. Stapedectomy was less beneficial for 17 (25%) of 68 patients with asymmetric hearing bilateral loss and 15 (29%) 52 of patients with symmetric bilateral hearing loss, who still had asymmetric hearing loss after the operation. Evaluation of hearing tests using the Glasgow Benefit Plot enables to evaluate patient's hearing disability and to predict possible benefit from surgery for individual cases.

Presentation of otosclerosis in eighties and nineties was compared on the basis of analysis of patients' documentation. A group I of 80 patients treated in 1980-1990 and a group II of 148 patients treated in 1991-2000 were compared with regard to sex, age, incidence of oval window obliteration and bilateral disease. Bone conduction and air conduction threshold and air-bone gap were also compared. There was no difference between two groups regarding sex, age and bone conduction threshold. Oval window obliteration was found in 8 (10%) patients of group I and in 7 (4.7%) patients of group II and the difference was not significant. Bilateral otosclerosis was diagnosed in 77 (96.3%) patients of group I and in 121 (81.8%) patients of group II and the difference was significant (p < 0.01). Air conduction threshold and air-bone gap in patients treated in nineties were significantly smaller than in eighties (p < 0.001). In the last decade patients with otosclerosis presented with smaller hearing loss, smaller air-bone gap and had bilateral disease less frequently than patients in eighties.

At the ENT Rehabilitation Centre as part of ENT Department University of Medical Sciences in Poznań over 900 patients with tinnitus were diagnosed and treated. Among them were 128 patients over 65 years of age, who in addition to tinnitus, reported hearing loss. After a battery of audiological tests, blood tests and additional specialist consultation, mixed hearing loss was found in 5 patients and senso-neural hearing loss (presbyacusis) was found in remaining 123 patients. For various reasons only 75 patients began treatment. Treatment of tinnitus was threefold: electrostimulation: 40 patients (53%); fitting of hearing aid: 29 patients (39%); TRT according to Jastreboff's model: 6 patients (8%). The authors described results of treatment patients with tinnitus and presbyacusis. The treatment model adopted at the ENT Rehabilitation Centre in Poznań has produced satisfactory therapeutic results.

Of the 150 patients admitted in 2001 to the Tinnitus Center located at the Nofer Institute of Occupational Medicine, Łódź, Poland, 80 were subjected to complex examinations consisted of standardized questionnaire on medical history, psychological tests and audiological assessment. The diagnostic procedure was completed for 52 patients (23 females and 29 males; mean age: 53 years). In this group, five patients were found to have conductive hearing loss due to chronic eustachtis or otosclerosis. They were excluded from further studies. Among the other 47 patients, 26 showed normal hearing threshold and 21 suffered from uni- or bilateral sensorineural hearing loss. Hyperacusis was diagnosed in 16 cases. The measurements of brainstem evoked potentials revealed V wave latency asymmetry in 7 cases, which implied the necessity to perform CT or MNR. In neither of cases did this diagnosis confirm the suspected tumor development (n. VIII neurinoma or pontocerebral angle tumor. The preliminary assessment of treatment efficacy for subjective tinnitus with use of retraining therapy yielded the following conclusions: 1. The application of hearing aid brings about an immediate improvement in the patient's self-assessment of hearing and a better tolerance towards tinnitus. 2. A systematic all-day wear of noise generators contributes to the patient's increased tolerance towards tinnitus, improved mental condition and alleviated hyperacusis. 3. The efficacy of the tinnitus retraining therapy, following Jastreboff, depends on providing the patient with detailed information on the causes and mechanisms of tinnitus development. 4. The negative diagnostics for tumor within the cranial cavity has not only a soothing effect on the patient as it relieves his/her stress, but it can also be a good starting point for the tinnitus retraining therapy.

900 patients with tinnitus were treated between January 1998 and August 2000 in ENT Rehabilitation Center in Poznan. Unilateral tinnitus was observed in more than 50% of the patients. In all the patients a history was taken paying a special attention to the loudness estimation by the patient and to the influence of the tinnitus on the everyday life. Laryngological, audiological and neurological examinations and laboratory tests were performed. In some cases endocrinological examination was performed. In the group of patients with unilateral tinnitus a special attention was paid to the possibility of ponto-cerebellar angle tumour. After audiological diagnostics CT or MRI examinations were performed. Authors emphasize, that in patients with unilateral tinnitus a proper observation is required to exclude expansive process within the acoustic nerve.

Study was carried out in frequency range 8-18 kHz with audiometer AS 10 HF. Lack of internationally accepted reference value of the hearing threshold of air conduction at extended frequency range resulted in own evaluation of the audiometric zero point for air conduction at the range 8-18 kHz in "otologically healthy" subjects younger than 20 years. They were divided into subgroup A and B according to age. Investigation of the threshold values for air conduction at extended range of high frequencies were base for evaluation of the audiometric zero value for the used equipment.

The evolution of threshold values of air conduction in the extended high frequency range (9-18 kHz) at patients suffering from the active pulmonary tuberculosis treated with the combined therapy (SM, INH, RFM, PZA). There were audiologically examined 13 patients (the average age 41.2) suffering from the active pulmonary tuberculosis and treated with the combined therapy (SM, INH, RFM, PZA). In 13 tuberculosis patients the full range of audiometric tests and measurements including: the pure tone audiometry, acoustic impedance and the extended high frequency range threshold audiometry (9-18 kHz) have been applied before starting the treatment with SM, INH, RMP and PZA and in the two months later--after its completion. The reference group was composed of 10 audiologically healthy individuals (the average age 40.2). A significant hearing loss with respect to air conduction within the extended range of high frequencies (9-17 kHz) was stated. The said hearing pathology can be diagnosed at earlier stages by the use of the extended high frequency range audiometry than through applying methods of conventional audiometry.

The aim of the study was to assess the acoustic environment of soldiers attending a one year basic military service. The study material comprised 13 types of weapons used by this group of soldiers. During the target practice, the following parameters were measured separately for the right ear and the left ear: equivalent sound pressure level A (LA eq, Te); maximum sound pressure level A (LA F max) and peak sound pressure level C (LC peak). The measurements covered several single shots or a shot series. In addition, a spectroanalysis in 1/3-octave band frequency of 40-50,000 Hz, was conducted. There were following values of measurements in the direct vicinity of the ears: LA eq, Te fell within the range of 106.2-119.5 dB (mean, 112.2 dB) for the right ear and 104.2 dB-118.4 dB (mean, 113.2 dB) for the left ear; LA F max within the range of 124.5-132.3 dB (mean, 128.3 dB) for the right ear and 116.3-135.1 dB (mean, 128.1 dB) for the left ear; LC pcak within the range of 151.8-156.5 dB (mean, 154.8 dB/155 dB) for the right ear and 151.9-156.2 dB (mean, 155.4 dB) for the left ear. In the noise spectrum, components of audible frequencies predominated, 160-300 Hz (mainly for high caliber weapon); 1600-6300 Hz for the right ear and 2500-4000 Hz for the left peak (small caliber weapons); 6300-16,000 and ultrasonic 25,000-50,000 Hz. No significant differences were found in the measurements of the right ear and the left ear.

Measurement results of click evoked otoacoustic emissions (EOAE) and distortion products otoacoustic emissions (DPOAE) in a case of sensorineural hearing loss in a case of sensorineural hearing loss in a patient with a history of oticus zoster with nerve VII palsy are presented. Feasibility of using otoacoustic emissions measurements for hearing loss type identification is discussed.

The authors present views, selected from the literature, on the development and significance of impedance audiometry as well as on the clinical application of this objective method in audiological and otoneurological diagnosis. Special attention is paid to the usefulness of impedance audiometry in objectivization of the hearing threshold and detection of simulation in the diagnosis of occupational hearing impairments.

The authors present the results of hearing improvement in a group of 50 patients who underwent bilateral stapedotomy. For the estimation of hearing improvement after the surgery the following criteria were used: 1. a comparison of air and bone conduction thresholds before and after the surgery, 2. an airbone gap before and after the surgery according to Toss, 3. hearing improvement index and 4. bilateral hearing loss index.

The purpose of this work was to present the dynamics of hearing thresholds and the progress in rehabilitation of hearing and speech according to the treatment applied and probable etiological factor of hypoacusis. Two groups of children were examined. The first group consisted of children with deep sensorineural hypoacusis together with central component of hypoacusis, whereas the second group included children with sudden occurrence of hypoacusis or detorioration of diminished hearing ability. The first group received a treatment with a drug stimulating the function of central nervous system, Cerebrolysin (Minden, D), whereas the other one underwent typical therapy applied in case of sudden deafness (mannitol, hydrocortison, vitamins, enzymes). Both the groups were subjected to objective examination of hearing before and after the treatment. The improvement in examination results in the first group was observed in 36%. In patients suffering from sudden deafness the improvement in hearing after treatment was found respectively in 30%.