The 11th Congress of the European Federation of Audiology Societies took place in Budapest on June 19th -22nd 2013. Previous Congress, in 2011, was organized by the Institute of Physiology and Pathology of Hearing in Warsaw. The EFAS 2013 was attended by over 700 participants from 25 countries, including ten employees represening the IPPH. The Conference was complemented with numerous workshops and satellite symposia as well as the 50th National Conference of the Audiology Sections of the Hungarian Society of Oto-Rhino-Laryngology, Head and Neck Surgery. The main organizer and president of the Congress was professor dr. József Géza Kiss from the University of Szeged.
The key points of EFAS 2013 concerned the following issues:
1. Hearing screening programs in Europe:
a) in newborns – a comparison of the results of ABR and OAE testing (i.a. Poland/Kajetany – Prof. H. Skarżyński, Italy/Rome – Prof. F. Grandori, Belgium/Leuven – Prof. J. Wouters, Austria/Innsbruck – K. Prof. Stephan);
b) in children of school age (performed by prof. H. Skarżyński – Poland/Kajetany)
2. Evaluation of long-term benefits from cochlear implants:
a) Germany / Freiburg: an indication of the psychological aspects (low self-esteem and family pressure) and social aspects (low awareness of the environment and limited mobility of patients);
b) Switzerland / Zuerich: a tendency to perform cochlear implantation in young patients and in a growing number of adults;
c) Poland / Warsaw-Kajetany: an indication of the increasing effective implantations in prelingual deafness, bringing significant benefits for the patient;
d) Italy / Rome: a social analysis indicates that patients who got the implant before they were 6 years old can speak and those who have a prosthesis since they were 10 or older communicate primarily through sign language;
e) United Kingdom / Nottingham: observations show that most children with hearing loss do not attend regular schools, which results in large social and psychological limitations of patients;
f) Holland / Nijmegan: people with CI have significant problems with social integration, and therefore it is advisable to include them in social interactions both with individuals with normal hearing and with hearing loss;
g) Hungary / Szegod: there was a suggestion that pre- and postlingual hearing loss should not be compared in straightforward manner, because the stimulation via the implant is of a different kind and also the etiology of the disorders differs. The solution is to create subgroups for both types of the hearing loss.
3. Treatment of partial deafness: evaluation of different types of acoustic stimulations; opportunity to preserve residual hearing and the relation with the implantation depth and the type of the electrode (Germany/Hannover – Prof. Thomas Lenarz, Belgium/Antwerp – Prof. P. van de Heyning, Poland/Warsaw-Kajetany – Prof. H. Skarżyński); a need to prevent overlapping of the natural tonotopic cochlear organization and channels of stimulation by means of an implant (especially in the case of short insertions); indications that a slight deterioration of the pure-tone audiometry after cochlear implantation is not related to the presence of the device in the cochlear structures nor the surgery per se, but is the result of both the etiology of hearing loss and the progressive growth of the disorder.
4. Comparison of the effectiveness of bilateral cochlear implantation and bimodal stimulation: the effects
a) head-shadow (blocking the way of the sound waves to the contralateral ear, especially in case of high-frequency sounds, when the wavelength is shorter than the dimensions of the head; in binaural hearing, there occur differences in the intensity of the sounds coming from various sources);
b) summation (a profit from binaural hearing is the ability to use information from both ears);
c) squelch (elimination of redundant information by selecting the ear with a higher ratio between the signal and the tinnitus); ongoing debates whether such benefits are at the same level in the bimodal stimulation, i.e. when a cochlear implant is in one ear and a hearing aid is in the other.
5. Speech tests to assess the benefits from a cochlear implant: validation tests of language adaptation – AAST, Matrix, Digit Triplet.
6. Modeling sensorineural hearing loss: a discussion on advanced mathematical algorithms.
7. Overview of hearing aid devices other than cochlear implants: the effectiveness of treatment with Baha and BoneBridge implants (in mixed and conductive hearing loss > 35dB in the bands of 500 – 3000 Hz and unilateral sensorineural hearing loss in patients with deformations of the ear areas) and Vibrant Soundbridge implanted to the middle ear (sensorineural and conductive bilateral hearing loss).
8. Auditory neuropathy: new methods of a differential diagnosis.
9. Tinnitus and auditory hypersensitivity: eliminating symptoms with cochlear implantation; psychological aspects of disorders (depression, anxiety).
10. Balance disorders: a diagnosis and treatment.
11. Central auditory disorders: controversies related to the etiology, differential diagnosis, cognitive and emotional aspects of disorders.
12. The processing of auditory information at higher levels of the auditory pathway:
a) electrophysiological studies (AEP , EEG, ERP ) – a diagnosis and prediction of benefits from the application of certain medical solutions; an impact of musical training on the processing of auditory stimuli; the repeatability of measurements; the need for frequent training of professionals;
b) fMRI neuroimaging – the results indicate good functional flexibility of the brain; in the case of unilateral hearing loss, there occur the bihemispheric brain responses, contrary to the case of the natural hearing, when the responses occur mainly the hemisphere contralateral to stimulation; in the case of applying one cochlear implant, there appears one semilateral hyperagitation; the ongoing works are performed to describe the complex brain networks responsible for speech processing – the left hemisphere dominates in processing of stimuli rapidly changing with time (20-80ms), while the right hemisphere is the main location of slower processing of auditory stimuli (over 100 ms).
13. Genetics and molecular biology: the numerous etiological mechanisms of congenital hearing loss (50 % of cases are genetic-autosomal, mitochondrial in eg. Turner or Down syndrome and environmental – as a result of hypoxia, infections, or certain drugs) indicate the amount of the costs of screening programs – there are ongoing debates over the necessity of their conduct and scope;
14. New commercial products: presentation of a Cochlear-Nucleus 6 implant and an Advanced Bionics-Neptune waterproof sound processor.
The team from the Institute of Physiology and Pathology of Hearing was invited to take part in a number of scientific events, what is the sign of recognition of scientific achievements and position of Institute’s specialists and the scientific level of the works reported. Professor Henryk Skarżyński was a member of the Scientific Committee of the Congress. The Committee was selected by the prestigious international scientific body. Other types of research activities in which the team from the Institute participated are presented hereinbelow.
Scientific activity
| Representative of the IPPH | |
| Organization and leading scientific session | Prof. H. Skarżyński:
“European School Children Hearing Screening” A. Lorens, Ph.D.: “Combined Acoustic And Electric Hearing” Dr. P.H. Skarżyński “Auditory Electrophysiology” Dr. A. Piotrowska: “Audiological Rehabilitation. Speech tests independent from language”
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| Speeches in a thematic scientific session delivered at the invitation | Dr. A. Piotrowska:
“European School Children Hearing Screening: Hearing Screening in School-Age Children in Poland – past, present and future” Dr. M. Matusiak: “Rehabilitation for children and adults after cochlear implantation – long term follow-up programs in Europe. Polish experience” |
| Oral presentations of personal research results | Dr. A. Piotrowska:
“Minimal hearing loss in school age children – prevalence and consequences” “Diagnostic pure-tone evaluation after hearing screening in school children” A. Lorens. Ph.D.: “Application of Nucleus SRA electrode (CI422) in subjects with various levels of residual low-frequency hearing” “Validation of the Auditory Adaptive Speech Test in the group of patients with Partial Deafness” “Frequency and place overlap in Electric and Acoustic stimulation after Partial Deafness Treatment” W.W. Jędrzejczak, Ph.D.: “Chirp-evoked otoacoustic emissions in adults and children” “0.5 kHz tone burst-evoked otoacoustic emissions in schoolchildren” “Linear and nonlinear click evoked otoacoustic emissions and removal of a short-latency stimulus artifact” Dr. P.H. Skarżyński: “Nationwide network of teleaudiology in postoperative care over implanted patients” “15 year experience with hearing preservation and over decade achievements with Partial Deafness Treatment “Assessment of effectiveness of algorithms applied in Vivosonic integrity device for rejection of muscle artefacts in ABR recordings” Dr. M. Matusiak: “Assessment of hearing preservation in relation to cochlea size in substantial low frequency hearing cochlear implantation” “Insertion depth angle in relation to hearing preservation in partial deafness cochlear implantation” A. Pollak, Ph.D.: “MTHFR 677T as an important determinant of a degree of hearing loss among Polish males with postlingual sensorineural hearing impairment” A. Wąsowski, Ph.D.: “Expert telefitting mode with the help of support specialists for cochlear implant recipients” K. Cieśla, MA: “Electrophysiological resting state activity in comorbid dyslexia and Central Auditory Processing Disorders”
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| Oral presentation of the results contained in the poster | J. Kobosko, Ph.D.:
“Coping strategies, self-esteem, symptoms of psychopathology and cochlear implant satisfaction in postlingually deafened adults” Dr. A. Piotrowska: “Council Conclusions on early detection and treatment of communication disorders in children, including the use of e-Health tools and innovative solutions” L. Śliwa, Ph.D.: “Evaluation of repeatability of transiently-evoked otoacoustic emissions (TEOAE) in young subjects” “Assessment of intra- and intersubjective variability of wave V amplitude in Stacked- ABR measurement” K. Cieśla, MA: “Brain correlates of sound frequency discrimination – a simultaneous ERP-fMRI study “Application of high-resolution fMRI for Primary Auditory Cortex mapping” |
| Co-authorship in other works presented | Prof. W.J. Sułkowski:
„Hearing and leisure-sound exposure in school-age children Dr. V.Koci: “Music perception in patients after Partial Deafness Treatment” Dr. U.Lechowicz: “Novel N714H mutation in WFS1 identified by exome sequencing and linkage analysis as a cause of autosomal dominant hearing loss “
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The summary of scientific activities of the Institute representatives and representatives from other Polish centers.
| Scientific activity | Institute of Physiology and Pathology of Hearing | All other scientific and clinical centers in Poland |
| The Scientific Committee of the Congress | Prof. Henryk Skarżyński
Prof. Wiesław Sułkowski |
Prof. Alicja Sekula |
| Organization of sessions / panels; moderators of debates | – H. Skarżyński
– A. Lorens |
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| Participation in sessions at the invitation | – A. Piotrowska
– M. Matusiak |
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| Oral presentations |
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B. Śpiewak (2)
D. Buchman (1) E. Ozimek (1) |
| Poster presentations |
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A. Sekula (1)
H. Czerniejewska (1) |