\u0418\u0442\u043e\u0433\u0438 \u0412\u0441\u0435\u043c\u0438\u0440\u043d\u043e\u0433\u043e \u043a\u043e\u043d\u0433\u0440\u0435\u0441\u0441\u0430 \u0430\u0443\u0434\u0438\u043e\u043b\u043e\u0433\u0438\u0438 \u0432 \u0438\u0437\u043b\u043e\u0436\u0435\u043d\u0438\u0438 \u041c\u043e\u043d\u0438\u043a\u0438 \u041b\u0435\u043d\u0445\u0430\u0440\u0434\u0442 — \u043d\u0430 \u0430\u043d\u0433\u043b\u0438\u0439\u0441\u043a\u043e\u043c \u044f\u0437\u044b\u043a\u0435.<\/p>\n
Day 1 was devoted to basic research<\/strong><\/p>\n (Thomas B. Friedman, Inna A. Belyantseva, Robert Morell) and from the Department of Physiology of the University in Kentucky, <\/strong>USA<\/strong> (Gregory I. Frolenko) talked about<\/strong><\/p>\n Overview of the genetics of early onset human deafness<\/strong><\/p>\n Shaping stereocilia from top to bottom<\/strong><\/p>\n Using massively parallel sequencing to identify the genetic cause of hearing loss in a new patient<\/strong><\/p>\n TRPA1 \u2013 mediated cell signaling pathways in cochlear protection and damage<\/strong><\/p>\n \u00a0<\/strong>The question was raised: What will the physician do with this information and will the patient want to know?<\/p>\n Next gene sequencing and genetic studies are needed.<\/p>\n <\/p>\n This session was chaired by the world-renowned scientist Jos J. Eggermont from the Department of Psychology at the University of Calgary, Canada, who also had an invited lecture on \u201cEffects of long-term moderate level noise exposure on the cortical representation of sound: implication for speech perception\u201d.<\/strong><\/p>\n One key statement in this lecture, which is relevant for parents to remember, was: the audiogram does not tell us about the problem!<\/p>\n Topics covered in this session were:<\/strong><\/p>\n Investigation of the neural link between the two ears \u2013 Contra-lateral modulation of ABR before and after unilateral cochlear ablation in a mouse model<\/p>\n D-methionine administration protects ABR thresholds and hair cells from kanamycin induced ototoxicity in pigmented guinea pigs<\/p>\n Auditory processing disorder and imaging of corpus callosum fibers using diffusion tensor imaging<\/p>\n An application of ERP-fMRI technique for assessment of auditory attention<\/p>\n The speakers were <\/strong>R.V. Harrison from the Department of ORL at the University of Toronto,<\/p>\n Kathleen Campbell from the Southern Illinois University School of Medicine, Springfields, USA,<\/p>\n D. L. McPherson from the Brigham Young University, Provo, Utah, USA and<\/p>\n M. Rusiniak from the Institute of Physiology and Pathology of Hearing, Warszawa.<\/p>\n \u00a0<\/strong><\/p>\n Another session on a highly scientific and technical level on <\/strong><\/p>\n An adaptive signal detection paradigm for use with sensory evoked potentials (McPherson)<\/p>\n Analysis of otoacoustic emissions fine temporal structure (O. Belov, Moscow)<\/p>\n Auditory nerve neuropathy and brain-stem auditory neuropathy due to infantile thiamine deficiency: long-term auditory sequelae (J. Attias, Haifa, Israel)<\/p>\n For parents it may be relevant to know that \u201cThiamine is crucial for normal auditory development and function, and its deficiency may be considered an acquired metabolic cause of neuropathy of the auditory system in infants\u201d.<\/p>\n Spectrum resolving power of hearing as measured by rippled-noise probes (A. Supin, Moscow)<\/p>\n Nonlinear effects in the auditory masking of the high-frequency pulsed sounds by noise with a rippled structure of the amplitude spectrum (L. Rimskaya-Korsakova, Moscow).<\/p>\n \u00a0ABSTRACTS CAN BE PROVIDED UPON REQUEST!<\/strong><\/p>\n \u00a0<\/strong><\/p>\n Day 2 started with a symposium on <\/strong><\/p>\n Moderator was Robert Cowan, <\/strong>Melbourne<\/strong> <\/strong><\/p>\n Panelists were Roland Laszig, <\/strong>Freiburg<\/strong>, <\/strong>Germany<\/strong>, Th. Nikolopoulos, <\/strong>Athens<\/strong>, P. Skarzynski, Warszawa and George Tavartkiladze, <\/strong>Moscow<\/strong><\/strong><\/p>\n Here are some key facts and statements from this symposium<\/strong><\/p>\n Roland Laszig states that there is good reason to do something in case of monaural hearing:<\/p>\n 70 \u2013 93 % of patients have a difference in the hearing level between the two ears, 54 \u2013 84 % suffer from Tinnitus.<\/p>\n 53 adults were enrolled in a study to look at the results of CI for single sided deafness in Freiburg.<\/p>\n (There is also experience with 3 children). The duration of deafness was less than 10 years.<\/p>\n Better hearing as compared to CROS and Baha was achieved in all patients (this refers to speech understanding, spatial hearing and quality of speech as well as localization of sound \/ speech).<\/p>\n Suppression of Tinnitus was achieved in 95% of the group.<\/p>\n Th. Nikolopoulos emphasizes that temporal bone imaging is important to avoid surprises for the surgeon!<\/p>\n \u201cSoft surgery\u201d to preserve residual hearing is desirable. The term was \u201ccoined\u201d by Ernst Lehnhardt.<\/p>\n P. Skarzynski talks about \u201cPartial Deafness Treatment\u201d and claims 3756 CI patients in the course of 20 years, out of which 1512 were treated for \u201cpartial deafness\u201d.<\/p>\n George Tavartkiladze emphasizes the need for objective measures in CI, professional candidate selection and speech processor adjustment.<\/p>\n Stapedius reflex measurements should be made intra-op and post-op during SP fitting.<\/p>\n The most common objective measurement method in use is Neural Response Telemetry.<\/p>\n Electrically evoked brainstem responses (EEBR): for SP adjustment it is possible for use contra-lateral EESR. Sometimes it is necessary to exclude some electrodes from the map, and the decrease in speech discrimination is very small.<\/p>\n There is a significant reduction in spread of excitation in perimodiolar electrodes.<\/p>\n We find a good correlation between NRT and behavioral thresholds.<\/p>\n 50% of patients with Single Sided Hearing Loss do not want any solution because they do not want to wear anything on their head. Many patients do not even realize they have a problem.<\/p>\n An open question is still how predictive the results are from adults for children.<\/p>\n School screening has shown that 10% of children have a hearing problem.<\/p>\n Roland Laszig expresses his conviction that we have no other choice than providing a CI to children as early as possible. We do not know enough about neuroplasticity to be able to wait.<\/p>\n Roland Laszig also believes that robotic surgery is in an early stage, it is still expensive, but in a few years we will have the support from robots in CI surgery.<\/p>\n <\/p>\n This was a Round Table moderated by Th. Nikolopoulos<\/strong><\/p>\n Panelists were Sandro Burdo (<\/strong>Varese<\/strong>, <\/strong>Italy<\/strong>), R. Gray (<\/strong>UK<\/strong>), R. Filipo (<\/strong>Rome<\/strong>, <\/strong>Italy<\/strong>) G. Kyrafinis (<\/strong>Greece<\/strong>) and R. Laszig (<\/strong>Germany<\/strong>).<\/strong><\/p>\n Here some answers to interesting questions:<\/p>\n Is it advisable to provide a CI under the age of 6 months?<\/em><\/p>\n All panelists agreed that this is not the case, unless the child had meningitis.<\/p>\n Which tests are useful for a 6 months old child to base the decision on?<\/em><\/p>\n EABR, cortical responses, emissions with and without HA, compare clinical results with behavioral<\/p>\n In Freiburg also electrocochleography is used and they do not recommend the use of HA for 6 months any longer, less is fine, cortical responses are not measured on a routine basis, behavioral responses sometimes delay the decision, ASSR is useful.<\/p>\n At which age are children too old for a CI?<\/em><\/p>\n Sandro Burdo: at around 5 years, the key is whether a child has oral communication<\/p>\n Roland Laszig: There is no sharp edge! Important is the training background, is there any residual hearing? What is the level of expectation from the parents?<\/p>\n Roger Gray: the cochlear nucleus is important. By the age of 13 years the degeneration is complete<\/p>\n Bilateral CI is supported by all panelists, however in the UK funding is only available in case the HL is > 90dB.<\/p>\n Sandro Burdo: \u201cAll children \u2013 whether deaf because of Connexin 26, i.e. deaf born, or acquired \u2013 are hungry for sound\u201d<\/p>\n Would you implant a child at the age of 2 years, suffering from 70dB HL across the range, diagnosed at 18 months?<\/em><\/p>\n R. Laszig would, R. Gray no because of lack of funding, Filipo in Italy would be careful and S. Burdo in Italy would implant one CI and continue with HA on the other side.<\/p>\n What about HA trials?<\/em> S. Burdo minimum 3 months, not only HA but also vibrator, R. Laszig advocates HA for training and adapt the children to wear the outer components of the CI.<\/p>\n R. Gray is also for trials for 3 months except for in case of meningitis (this is an emergency case).<\/p>\n Which communication mode is best?<\/em><\/p>\n S. Burdo: My centre is an oral centre, candidates who use sing language go to another centre<\/p>\n R. Laszig: We offer a chance<\/p>\n R. Gray: A signing environment may hinder the development of spoken language<\/p>\n What about a deaf child from a deaf family?<\/em><\/p>\n In case another family member, e.g. the grandmother will talk to the child a CI is indicated.<\/p>\n These children do very well and use bimodal communication.<\/p>\n What is an absolute contraindication?<\/em><\/p>\n R. Laszig: the absence of the auditory nerve, the absence of the cochlea, in case the patient or the parents are not able to mechanically use the device, fatally sick persons who have a life expectancy of only a couple of months<\/p>\n \u00a0<\/strong><\/p>\n There were parallel sessions on<\/strong><\/p>\n which I obviously could not attend.<\/p>\n The Neonatal Hearing Screening comprised four presentations about the situation in the UK, Mexico and Latin America, Belarus and Russia and was chaired by Adrian Davis from the UK.<\/p>\n The Speech Perception comprised five presentations, mainly about various tests (e.g. multi-frequency Animal Sound Test, HEARD, Matrix) and was chaired by Frans Coninx from the Netherlands and Inna Koroleva from St. Petersburg.<\/p>\n Another invited lecture was then by Giancarlo Cianfrone on \u201cStrategies for early detection of psychological comorbidity in tinnitus patients\u201d.<\/p>\n Another three parallel sessions were held before lunch.<\/p>\n <\/p>\n chaired by Roland Laszig<\/strong><\/p>\n Robert Cowan had three presentations as the author of two. R. Briggs attended the conference in <\/strong>Baltimore<\/strong> at the same time.<\/strong><\/p>\n The topics were:<\/strong><\/p>\n Six years experience with a totally implantable cochlear implant<\/strong><\/p>\n The microphone of this device is embedded in the titanium case. The \u201cinvisible hearing\u201d can also be used with an external processor. Research looks at the results and compares speech perception with the \u201cinvisible hearing\u201d and the \u201cconventional hearing\u201d (with the external SP).<\/p>\n At 55dB patients are still getting recognition, but all lower when using the \u201cinvisible hearing\u201d (no external SP).<\/p>\n All patients are affected by body noise; there is little or no adaption to body noise.<\/p>\n Some use the 3G during the day and the invisible hearing during the night.<\/p>\n The external also charges the internal device.<\/p>\n It is clearly beneficial to hear also while sleeping, swimming etc.<\/p>\n The battery autonomy is dropping over time (6 years and 16 hours without charging).<\/p>\n The battery will have to be replaced after 16 years when using it 10 hours a day.<\/p>\n The microphone is a key issue, because we need to avoid the body noise.<\/p>\n The other question is, whether we will have a long-term rechargeable battery.<\/p>\n Surface modifications to improve performance of cochlear implant electrode arrays<\/strong><\/p>\n A drug eluting electrode is a feasible vehicle for delivery of therapeutic agents into the cochlea.<\/p>\n The goal is to modulate the tissue response.<\/p>\n Clinical experience with the Nucleus slim straight electrode array<\/strong><\/p>\n This is a new electrode, specifically designed to preserve residual hearing. First results are very promising.<\/p>\n S. Haumann from the MHH, <\/strong>Hannover<\/strong> presented on<\/strong><\/p>\n Predictions of success with cochlear implants using neural networks<\/p>\n \u00a0<\/strong><\/p>\n There were again parallel sessions on<\/strong><\/p>\n which I could obviously not attend.<\/p>\n Both sessions comprised four lectures.<\/p>\n The session on rehabilitation was chaired by R. Harris from Canada, the session on genetics by T. Friedman.<\/p>\n \u00a0<\/strong><\/p>\n Moderator was Roland Laszig and topics covered were<\/strong><\/p>\n —\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Asymmetric hearing loss<\/p>\n —\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Partial deafness<\/p>\n —\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 conductive and mixed hearing loss<\/p>\n —\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 single sided deafness (SSD)<\/p>\n Most of these topics were covered in previous lectures. We can provide written information upon request.<\/p>\n \u00a0<\/strong><\/p>\n The afternoon was dedicated to<\/strong><\/p>\n Cochlear Implantation (<\/strong>three sessions)<\/strong><\/p>\n Screening Programs <\/strong><\/p>\n Speech Audiometry<\/strong><\/p>\n Humanitarian Audiology<\/strong><\/p>\n \u00a0<\/strong><\/p>\n Was chaired by Monika Lehnhardt and Sandro Burdo<\/strong><\/p>\n Topics were the following:<\/strong><\/p>\n Scalability of post-operative care for CI-recipients presented by Monika Lehnhardt<\/strong><\/p>\n The full text and slides are available and will be uploaded on the weblog<\/p>\n New frontiers in the remote cochlear implant fitting presented by Vigen Bakhshinyan<\/strong><\/p>\n The full text and slides are available and will be uploaded on the weblog<\/p>\n Perception of temporal cues of environmental and speech sounds by cochlear implanted patients presented by <\/strong>I.<\/strong> Koroleva<\/strong><\/p>\n The role of the initial period in the rehabilitation of deaf children after cochlear implantation \u00a0<\/strong><\/p>\n presented by Albina Sataeva<\/strong><\/p>\n Speech-hearing system formation of hearing impaired children \u2013 this title was changed by<\/strong><\/p>\n Emilija Leongard and she spoke about a natural and auditory verbal approach when working with children<\/strong><\/p>\n We will receive her manuscript in Russian and English and will upload it in the weblog<\/p>\n The development of musical pitch perception and production in children with hearing aids and children with cochlear implants<\/strong><\/p>\n This presentation should be given by Christine Rocca , who did not make it to the meeting.<\/strong><\/p>\n P. Boyle from ABC presented in her place. <\/strong><\/p>\n A couple of very impressive videos were shown and the only question was: \u201cWhy not <\/strong>use music in the rehabilitation for children with CI\u201d.<\/p>\n FOX Fitting to Outcomes eXpert: preliminary results of a multi-centric study in Advanced Bionics\u2019 users presented by D. Gazibegovic <\/strong><\/p>\n This software seems to improve the fitting process, especially in the early time (first two weeks) and it seems recommendable for all CI manufacturers to agree on a common platform<\/p>\n Development of a Mandarin expressive and receptive vocabulary test for children using cochlear implants by <\/strong>Lena<\/strong> Wong from the <\/strong>University<\/strong> of <\/strong>Hongkong<\/strong><\/strong><\/p>\n There are 27,8 Mio hearing impaired people in China (2,1% of the total population).<\/p>\n In the years 2006 to 2013 the total number of CI will be 17.750 (donation from Taiwan).<\/p>\n In the years 2012 to 2015 another 16.000 CI will be funded by the Chinese government.<\/p>\n At the same time there are less than 100 audiologists in the country and basically no speech therapists. What a challenge!<\/p>\n Electrode array impedances fluctuation in normally functioning cochlear implants presented by M. Litvak from <\/strong>Tomsk<\/strong>, <\/strong>Russia<\/strong><\/strong><\/p>\n Quote from L.S. Vygotsky: \u201cDeafness does not change only the child\u2019s attitude to the world but primarily has an influence on his\/her relationship with people\u201d.<\/p>\n <\/p>\n A poster session (25 posters) concluded the day.<\/strong><\/p>\n \u00a0<\/strong><\/p>\n Day 2 started with a symposium on<\/strong><\/p>\n Moderator was L. Hickson<\/strong><\/p>\n Panelists L. Wong, G. Keidser, A. Laplante-Levesque<\/strong><\/p>\n This was an excellent symposium with highly competent ladies who discussed whether evidence based practice is the way the profession has to go.<\/p>\n <\/p>\n The key-note lecture of this conference was on <\/strong><\/p>\n The outstanding presenter was David Kemp from the <\/strong>UK<\/strong> \u2013 the discoverer of otoacoustic emissions<\/strong><\/p>\n He covered various aspects during his one hour presentation.<\/p>\n He highlighted how long it can take from detecting \/ inventing something to application in practice.<\/p>\n What makes a discovery to invention? How long does it take to clinical application?<\/p>\n Application is often handicapped by a lack of common standard for normal thresholds.<\/p>\n He illustrated this phenomenon on steam power, which finally enabled the industrial revolution.<\/p>\n What turns a laboratory phenomenon into a useful clinical test?<\/p>\n We waited 1700 years for steam to cause the industrial revolution!<\/p>\n He spoke about Roentgen, Thomas Gold, Bekesy, Alexander Graham Bell\u2026<\/p>\n David Edward Hughes \u2013 the inventor of the radio and audiometer in 1879.<\/p>\n David worked on transient evoked emissions of the earth to storms as a detector of lightening<\/p>\n He believes that middle ear power diagnostics is the future!<\/p>\n We see 15 dB variations \/deviations in the commonly used OAE machines, which is unacceptable<\/p>\n No OAE machine manufacturer claims compliance with the standard, because the standard does not make sense.<\/p>\n He mentioned a very interesting book \u201cWhat fire is in mine ears\u201d (Progress in auditory mechanics) published by Springer Verlag.<\/p>\n The vast majority of sensory hearing loss involves an outer hair cell dysfunction, but this is not for all hearing dysfunctions.<\/p>\n OAE are a leakage of energy out of the functioning cochlea \u2013 they are only a by-product!<\/p>\n We still do not fully understand \u2013 look at Stagner, Martin & Martin 2012.<\/p>\n The cochlear functional homeostasis is a bounce effect \u2013 a reaction to loud sound challenge.<\/p>\n This is not fatigue, this is excitation.<\/p>\n David Kemp proved again to be a visionary.<\/p>\n <\/p>\n Another invited lecture was on <\/strong><\/p>\n Experimental data on protection against inner ear damages<\/strong><\/p>\n Presented by Gaetano Paludetti<\/strong><\/p>\n \u00a0<\/strong><\/p>\n This was followed by the Lunch Symposium by Advanced Bionics<\/strong><\/p>\n Mike Sundler presented data on hearing aids and cochlear implants:<\/p>\n 10 Mio hearing aids p.a. and a turnover of 15 billion CHF;<\/p>\n 30.000 cochlear implants p.a. with a turnover of 800 million CHF).<\/p>\n \u00a0<\/strong>The performance for speech perception increased dramatically from 10% with the early coding strategies to 100% with the latest (in quiet)!<\/p>\n He stated that the original goal of designers of CI was to develop an aid to lip reading.<\/p>\n Clearvoice was approved in 2012.<\/p>\n Neptune \u2013 the latest speech processor of ABC \u2013 is appealing to consumers (cosmetically, \u201cdesigned to be used in the swimming pool\u201d).<\/p>\n There is a technology match between Sonova and Advanced Bionics, there is potential for synergy.<\/p>\n He believes that the perimodiolar concept has not proven a real advantage.<\/p>\n The FOX fitting system addresses the increasing number of recipients and lack of audiologists .<\/p>\n There are better results after two weeks, there is continuous progress, less deviation.<\/p>\n Other questions like potential risks during surgery were addressed by a surgeon from Casablanca and<\/p>\n P. Boyle spoke about T-Mic Wireless Connection, Automatic Gain Control and Programmable IDR.<\/p>\n <\/p>\n In the afternoon we had another special session on<\/strong><\/p>\n Moderated by F. Grandori from <\/strong>Milano<\/strong>, <\/strong>Italy<\/strong><\/strong><\/p>\n Hearing loss in adults \/elderly is happening very slowly. Habituation is evident!<\/p>\n \u201cIntegration through immediate intervention\u201d was funded by the EC in the years 2008 to 2011.<\/p>\n SUN \u2013 Speech Understanding in Noise test<\/p>\n Hearing \u201cAcuity\u201d, supra-threshold performance is a multi-choice test with a touch screen interface.<\/p>\n It is available in Italian, German, English, French, Spanish and Mandarin, not in Russian yet.<\/p>\n It is easy, fast, comfortable low cost, tested in non-clinical setting.<\/p>\n The sensitivity is 83% and the specificity 74% (in a controlled environment).<\/p>\n Adrian Davis <\/strong>spoke about the fact that there are 4,9 Mio people with a hearing loss in the UK and 3,8 Mio do not have a hearing aid!<\/p>\n We are faced with a \u201cdemographic time bomb\u201d.<\/p>\n We need to address the current need, prevalent need and future need.<\/p>\n Screening helps us to address all of these.<\/p>\n Should there be a universal screening for the population over 60 years of age?<\/p>\n Probably all we need is a target \/ sub-population screening.<\/p>\n It should be opportunistic, e.g. in hospitals or at the General Practitioner.<\/p>\n <\/p>\n There were three sessions on Hearing Aids and one on the Vestibular Function<\/strong><\/p>\nBiological and Genetic Basis for Hearing Loss<\/strong><\/h2>\n
\nDistinguished speakers from the Laboratory of Molecular Genetics, National Institute of Deafness and Other Communication Disorders, National Institutes of Health, <\/strong>Rockville<\/strong>, <\/strong>Maryland<\/strong>, <\/strong>USA<\/strong><\/strong><\/p>\nAuditory Research <\/strong><\/h2>\n
Electrophysiology and Psychoacoustic<\/strong><\/h2>\n
The Implantable Technologies in Rehabilitation of Patients with Hearing Loss<\/strong><\/h2>\n
Cochlear Implantation \u2013 Criteria continuously changing<\/strong><\/h2>\n
Neonatal Hearing Screening <\/strong>and Speech Perception<\/strong><\/h2>\n
Cochlear Implantation <\/strong><\/h2>\n
Rehabilitation <\/strong>and Genetics<\/strong><\/h2>\n
The Cochlear Satellite Lunch Symposium <\/strong>was on <\/strong>\u201cPerformance. And more\u201d.<\/strong><\/strong><\/h2>\n
The Cochlear Implantation II session <\/strong><\/h2>\n
Evidence Based Practice in Audiology<\/strong> <\/strong><\/h2>\n
Auditory biophysics and instrumentation \u2013 important pillars of audiology<\/strong><\/h2>\n
A New Era of Innovation<\/strong><\/h2>\n
Early Hearing Detection and Intervention for Adults<\/strong><\/h2>\n