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Pioneering Treatment for the Deaf
July 4, 2014   
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The Institute of Physiology and Pathology of Hearing in Kajetany near Warsaw is a leading Polish research institute and a highly specialized hospital providing comprehensive care for patients suffering from hearing, balance, speech and sinus problems. The institute is where the world’s largest number of operations to improve or restore hearing has been performed for years.

The Institute of Physiology and Pathology of Hearing in Kajetany near Warsaw is a leading Polish research institute and a highly specialized hospital providing comprehensive care for patients suffering from hearing, balance, speech and sinus problems. The institute is where the world’s largest number of operations to improve or restore hearing has been performed for years.

The main unit of the institute is the World Hearing Center, the hub of its research, educational and clinical activities, founded in 2012.

The institute develops innovative methods for the diagnosis and treatment of congenital and acquired hearing, voice, speech and balance disorders. Such disorders affect about 1 billion people around the world. This is the result of not only illness and accidents, but also physiological processes that accompany aging. People are living longer these days and want to remain active longer. A loss of hearing makes work and daily functioning difficult, and it also affects a person’s quality of life. Doctors are continuing to look for new treatments for people with hearing problems.

Progress has been extremely fast in this area. Experts are coming up with new surgical methods as well as new technology for gene therapy and various types of implantable devices. The Institute of Physiology and Pathology of Hearing in Kajetany has a track record of internationally renowned achievements in this field. Its research and clinical teams have operated on thousands of patients. The institute’s collaboration with other research centers has helped develop many modern diagnostics methods and hearing aids.

In addition to conducting research, the institute provides comprehensive care for people with congenital and acquired disorders affecting their hearing, speech and balance. Every year more than 12,000 patients are hospitalized here and about 18,500 surgical procedures are performed. About 70 operations to improve hearing are performed every day.

So far, nearly 4,000 cochlear implants have been implanted at the institute, which makes it one of the global leaders in this field. Cochlear implants are surgically implanted electronic devices that take over the function of damaged sensory cells in the inner ear.

In the institute’s outpatients’ clinic, otolaryngologists, audiologists, phoniatricians, speech therapists, teachers of the deaf, clinical engineers and technicians provide more than 200,000 consultations and examinations a year.

“In 2012, an extremely important event took place in Polish medicine and science: a unique global institution called the World Hearing Center opened its doors,” says Prof. Henryk Skarżyński, founder and director of the Center. “It is the result of hard work by many people and financial spending. Notably, this extraordinary project, worth more than zl.120 million, was completed within just over a year. More than a third of the money needed for the project was generated by a team of scientists.”

The World Hearing Center was built and equipped using funds available under the European Union’s Innovative Economy Operational Programme and disbursed by Poland’s National Center for Research and Development (NCBiR). The project started in October 2009 and ended in June 2014. The NCBiR co-financed the zl.120 million project to the tune of more than zl.87 million. The rest came from the Institute of Physiology and Pathology of Hearing’s own funds. This huge amount of money was allocated for purposes including outfitting the facility with state-of-the-art equipment in information technology, telecommunications and medicine. Thanks to this, a wealth of educational, research and development facilities have been put in place to train specialists in rare fields of medicine such as clinical engineering, physics, acoustics, biocybernetics, speech therapy, surdopedagogy—education of deaf/hearing impaired children, and surdopsychology—psychology focusing on deaf people and those with hearing impairments.

In its first year, the center held six international courses and scientific workshops. These trained more than 180 young doctors from all over the world on an intramural basis and about 20,000 through operations broadcast live online.

Innovation at the World Hearing Center is also about telemedicine. A National Teleaudiology Network has been launched there to conduct remote consultations involving patients and specialists from several centers at a time, as well as remote rehabilitation and telefitting, or a system for the remote adjustment of speech processors in patients with cochlear implants. This makes it possible to save patients expensive trips to specialized medical centers. Patients also have better access to experienced, qualified staff. Specialists, in turn, can gain experience in a hi-tech environment.

The speech processor is an external part of a cochlear implant. It is located behind the patient’s ear and is powered by tiny batteries, just like a hearing aid. It picks up sound from the environment, converts it into electrical impulses and transmits them through the skin to an internal part of the implant. From there, the electric impulses are sent through an internal cable to an array of miniature electrodes in the cochlea, the auditory portion of the inner ear. The electrodes stimulate individual fibers of the auditory nerve.

Scientists working at the institute say that long-term and well-coordinated medical care and rehabilitation are needed for implant patients to achieve the best possible results after surgery. It is necessary to tune the parameters of electrical stimulation of the auditory nerve to the patient’s needs. The patient needs speech therapy, and consultations with educators and psychologists may also be needed. With the innovative speech processor adjustment system, the device can be programmed remotely.

The National Teleaudiology Network is controlled from a command center at Kajetany. Twenty-three telemedicine positions have also been created here as part of the project. The network comprises 20 collaborating centers manned by a trained group of specialists: speech therapists, psychologists, educators and dispensing audiologists. At their disposal they have teleconferencing equipment, computer systems equipped with clinical diagnostics interfaces, applications for programming speech processors and other audiological equipment that can be controlled remotely by specialists at Kajetany. They collaborate with experts from other centers during teleconsultations and telecare, including tele-rehabilitation and planned and emergency tele-diagnosis.

“Many innovative solutions in science, education and clinical practice have been put to use at the World Hearing Center,” says Skarżyński. “In order to conduct scientific research, we have set up unique units provided with the latest research equipment. The center also boasts modern teams of experts and superbly equipped workstations for both experienced and up-and-coming professionals. A leading field is work on partial deafness.”

The researchers are supported by an information system for processing the results of sensory screening tests based on an open standard for the exchange of e-data and other database systems.

The center’s innovative character is also reflected in the organization of work and investment in the development of science. Numerous projects, including pioneering scientific and clinical programs, are carried out here, setting the standards for modern therapeutic procedures. Currently, Polish patients are among the first in the world to have access to the latest, most advanced medical technologies in this field.

“Since the center opened at Kajetany more than a year-and-a-half ago, I have launched three pioneering operating programs for implanting Codacs, Bonebridge and Baha 4 Attract System cochlear implants,” says Skarżyński. “This is why patients want to be treated at our center. They come to Kajetany from across the country and from abroad.”

The World Hearing Center has no counterpart among centers for the treatment of hearing disorders internationally. “It cannot, however, be the only such facility out there,” says Skarżyński. “That’s why we are working to develop a network of such centers around the world. We need to make sure that information about the achievements of Polish medicine spreads to Africa, Asia and South America. This is one of our most important tasks for the coming years.”

Turning on the Sound

The cochlear implant is one of the greatest medical and technological achievements of the last 30 years, according to Skarżyński, who performed Poland’s first cochlear implant operation on a completely deaf patient on July 16, 1992. Since then the institute has turned on the sound or turned up for volume for thousands of people who are either congenitally deaf or who have lost all or part of their hearing and for whom traditional hearing aids have proven ineffective.

“Once they’ve had the operation, these patients can function in society on an equal footing with everyone else; they can work and study normally, and enjoy life to the full,” Skarżyński says.

Telemedicine

The Telefitting system developed by researchers and physicians at the Institute of Physiology and Pathology of Hearing is an example of a telemedicine service. Telemedicine is a rapidly developing application of clinical medicine where medical information is shared via telephone, the internet or other networks for consulting purposes, and sometimes in order to carry out remote medical procedures or examinations.

High Success Rate

Otosurgery, or surgery of the ear, has entered a new era these days, according to Prof. Henryk Skarżyński, the founder and director of the Institute of Physiology and Pathology of Hearing in Kajetany near Warsaw. Thanks to the rapid development of surgical methods, today it is possible to help almost every patient, Skarżyński says.
According to Skarżyński, “socially adequate” hearing can be restored to around 90 percent of the patients who undergo reconstructive procedures at the Institute of Physiology and Pathology of Hearing. According to the professor, progress made in this area in recent years is far greater than in any other specialized field of medicine.

Karolina Olszewska
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