**Treatment of Partial Deafness: The Polish School in World Science** Provisional chapter Treatment of Partial Deafness: The Polish School

Henryk Skarżyński and Piotr Henryk Skarżyński

Additional information is available at the end of the chapter Piotr Henryk Skarżyński

http://dx.doi.org/10.5772/67234 Additional information is available at the end of the chapter

in World Science

Henryk Skarżyński and

#### Abstract

[37] Sainath, T. N., Kingsbury, B., Mohamed, A., Saon, G., & Ramabhadran B. (2014). Improvements to filterbank and delta learning within a deep neural network frame-

[38] Lin, P., Lyu, D.‐C., Chang, Y.‐F., & Tsao, Y. (2015). Speech recognition with temporal

[39] Lin, P., Lyu, D.‐C., Chang, Y.‐F., & Tsao, Y. (2015). Temporal alignment for deep neural

[40] Sagayama, S., & Itakura, F. (1978). On individuality in a dynamic measure of speech, in

[41] Furui, S. (1986). On the role of spectral transition for speech perception, *J. Acoust. Soc.* 

[42] Zeng, F.‐G., Nie, K., Stickney, G., Kong, Y.‐Y., Vongphoe, M., Bhargave, A., Wei, C., & Cao, K. (2005). Speech recognition with amplitude and frequency modulations, in *Proc.* 

[43] Zeng, F.‐G., & Shannon, R.V. (1994). Loudness‐coding mechanisms inferred from elec-

[44] Francart, T., & McDermott, H. J. (2013). Psychophysics, fitting, and signal processing for combined hearing aid and cochlear implant stimulation, *Ear Hearing*, 34(6), 685–700.

[45] Sainath, T. N., Kingsbury, B., Saon, G., Soltau, H., Mohamed, A. R., Dahl, G., & Ramabhadran, B. (2015). Deep convolutional neural networks for large‐scale speech

tric stimulation of the human auditory system, *Science*, 264, 564–566.

*Proc. Spring Meeting of Acoust. Soc. Japan* (in Japanese), 589–590.

work, in *Proc. ICASSP*, 6839–6843.

152 Advances in Clinical Audiology

neural networks, in *Proc. Interspeech*.

networks, in *Proc. IEEE GlobalSip*.

*Nat. Acad. Sci. USA (PNAS)*, 2293–2298.

tasks, *Neural Networks*, 64, 39–48.

*Am.*, 80(4), 1016–1025.

Introduction of the method of treatment of partial deafness with cochlear implants has given many patients the previously inaccessible chance to (re)enter the world of sounds. This method of treatment had been developed and introduced to the world's medicine by H. Skarżyński in 2002, after the extensive research since 1997. This task involved creation of a multispecialty team of experts, development of a special surgical method, and concept of the therapy reflecting on the world largest number of hearing improving surgeries being performed for 13 years averaging 15,000 otosurgical procedures yearly. This chapter introduces the treatment of partial deafness, considered as the Polish School in world science and medicine.

Keywords: partial deafness, partial deafness treatment, otosurgery, cochlear implant, hearing preservation, inner ear structure preservation

#### 1. Introduction

Treatment of partial deafness, both congenital and acquired, with application of cochlear implants is for many patients regardless of their age practically the only chance of entering or returning to the world of sounds. Cochlear implants have been in use for more than 40 years and had been applied in more than 200 thousand people globally. Application of cochlear implants in treatment of classic partial deafness is, on the other hand, the matter of the last 15 or so years. This method of treatment, which is applied to an inner ear which is in a part fully functional and in another part completely deaf, had been introduced to the world medicine by

© 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons

Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and eproduction in any medium, provided the original work is properly cited.

Skarżyński in 2002 [1]. This important breakthrough had been preceded by research studies which had been conducted in the Institute of Physiology and Pathology of Hearing since 1997, regarding preservation of even the smallest residual hearing which would then be supplemented with a "new hearing" achieved through a cochlear implant [2–4]. Development of a special surgical method and concept of the therapy had been a great challenge requiring involvement of many specialists: ear surgeons and other physicians, clinical engineers, and many other professionals working in the field of hearing rehabilitation [5, 6]. This treatment method had been applied at the beginning to patients whose preoperative hearing was at the level of residual hearing and since 2002 to those whose hearing in low-frequency ranges was good. In these patients their preoperative hearing levels would enable from 5 to 16% of speech understanding [1]. When this hearing is supplemented with electric stimulation obtained with a cochlear implant, patients can achieve complete speech understanding and free communication with their environment [7, 8]. This had been a groundbreaking approach in science and medicine as it had demonstrated the previously negated feasibility of electric stimulation within the partially functional inner ear [9].

Presentation of this program and a resultant Polish School are a reflection of the largest in the world number of hearing improving surgeries being performed for 13 years—on average 15 thousand otosurgical procedures yearly. Established criteria which an achievement or event should fulfill in order to be considered a school in modern science are commonly known and involve a significant achievement and confirmation of the results and importance of the school through the large clinical material supported by the longitudinal follow-up. A very important, although difficult to achieve, indicator confirming the existence and importance of school's output is the marks of appreciation, awards, citations, and opinions in relevant fields of science. The partial deafness treatment (PDT), considered as the Polish School in world science, meets all the abovementioned criteria and many more.

The step-by-step surgical procedure has been described by Skarżyński et al. in 2010 [7]. Cochlear implantation in the partial deafness treatment is in all patients undergoing this procedure performed in the worse hearing ear. The procedure is performed in all cases using the six-step Skarżyński round window approach for partial deafness treatment with different straight electrodes. It can be a 28 mm, 25 mm, or 24 mm slim straight electrode with different numbers of contacts and diameters 0.3 mm at the tip and 0.6 mm at the proximal end. The surgical steps are in order:


Steroids are administered as a routine in every case: 0.1 mg/kg/day dexamethasone i.v. in two doses per day for 3–4 days.
