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Every European will be sure that before his child starts education, he / she will be examined and if a hearing or speech defect is detected, he / she will go to a specialist. This will give equal educational opportunities to all young residents of the European Union. Poland wants to implement this priority during its presidency.
60% of parents are unaware that their children suffer from hearing or speech impairment. Meanwhile, it is them that give these children an unequal chance of competing with their healthy peers. As a result, they learn less and achieve the same results as their healthy colleagues much more difficult. The scale of the problem is huge because – as research shows – every fifth school-age child has hearing problems. For many, although audiological tests show no changes, disturbances in the brain prevent them from being able to focus or understand everything they hear. – For a long time we can say that we are able to help almost every patient – says prof. Henryk Skarżyński, director of the Institute of Physiology and Pathology of Hearing in Kajetany.
Prof. Henryk Skarżyński and the International Center of Hearing and Speech in Kajetany
We owe our European achievements in the treatment of hearing defects to prof. Henryk Skarżyński. In 2002, he performed the world’s first implant surgery for a partially deaf patient, and two years later, the same surgery for a child for the first time. In 2008, in Kajetany, for the first time in the world, a bilateral brainstem implant was implanted.
Prof. Skarżyński did not want these operations to remain only a spectacular medical event. He thought about creating a team of doctors (otolaryngologists, audiologists, phoniatrists) and other specialists (psychologists, speech therapists, educators, engineers and technicians) who would diagnose, prepare for surgical treatment and for a very complex and long-term rehabilitation of patients with various hearing problems. Therefore, in 1996, the Institute of Physiology and Pathology of Hearing was established in Poland, but prof. Skarżyński planned to expand the scope of research and medical services from the very beginning. It became possible thanks to the realization of another great undertaking – the construction of the International Center of Hearing and Speech in 2003 in Kajetany near Warsaw. The Center is an internationally unique facility that performs the largest number of hearing improvement surgeries in the world. Soon, the World Hearing Center will be built there, where modern teaching and clinical facilities will be created for the purposes of training and providing services to patients in the best conditions.
Hearing disorders diagnosis
— In our field, we managed to catch up with the world, and in selected areas, to make spectacular, but not one-off, but permanent, pioneering discoveries. It changed the chances of thousands of sick people. For a long time, we can say that we are able to help almost every patient – says prof. Skarżyński. However, in order to help the sick person, the defect must be detected. In Poland, screening for newborns has at least 18 years of tradition. At the beginning of this century, thanks to the support of the Great Orchestra of Christmas Charity, the program of such research covered all newborns throughout Poland. This makes it possible to detect 1-2 out of every thousand newborns with severe hearing impairment. However, some disorders do not develop until preschool and early school age. Research has shown that every fifth child of this age has various types of hearing impairment, thus 100 times more often than in newborns. Children develop many hearing impairments as a result of recurrent infections of the upper respiratory tract. Research at this age is best carried out in kindergartens or schools, because then a large number of children can be tested. Early detection of the defect allows for the initiation of more effective therapeutic activities. They can even be run by parents. – If they know that their child has a slight hearing impairment, they will start speaking slower and louder to him. Thanks to this, the baby will be able to develop like a healthy peer. They will pay attention to how their child is pronounced. If he has difficulty concentrating, they will not talk to him when the TV is on – explains prof. Skarżyński.
That is why we will be striving for all children in the EU to be tested in schools during our presidency.
Diagnostics via the Internet
A Polish achievement in the field of hearing tests is the Internet telemedicine portal operating since 2000, which provides interactive diagnostic and rehabilitation systems: I hear, I speak, Tinnitus, I see. Hearing and speech tests, diagnostics of visual impairment, tinnitus and hypersensitivity to sounds can be carried out in Polish and English via the website. – It is not a clinical defect detection system, but it allows for a preliminary diagnosis, which informs the patient that they should be examined by a specialist – says Prof. Skarżyński. The system is designed to conduct hearing screening tests, primarily in children and adolescents. This is important because early detection of a hearing impairment and the use of appropriate therapy allows to obtain satisfactory results in 92% of cases and reduce the costs of treatment almost four times compared to the costs of delayed therapy.
Innovative solutions have been developed by the Institute of Physiology and Pathology of Hearing in cooperation with the Department of Sound Engineering at the Gdańsk University of Technology. The portal has already been visited by 16 million Internet users from 68 countries around the world.
Post-implant care
Another Polish achievement is the possibility of using an Internet connection to conduct tests and consultations remotely and to adjust the cochlear implant system to patients after surgery without the need to come to Kajetany. After the implant surgery, the patient must learn to recognize sounds that he will begin to hear. Therefore, long-term and very systematic rehabilitation is necessary. However, visits to Kajetany require a long and time-consuming journey. The patient – usually a small child – is tired of the journey, which makes it impossible to make a reliable diagnosis. Thanks to the use of an Internet connection for remote examinations and consultations as well as for adjusting the cochlear implant system, the patient reports to the center closest to his place of residence, cooperating with the Institute. The specialists from the Institute can carry out all necessary measurements and consultations, and the clinical engineer, being in his office at the International Center of Hearing and Speech in Kajetany, can take control of the remote computer and reprogram the patient’s speech processor based on the measurement results. Last year, the world’s first National Hearing Telerehabilitation Network was established, currently comprising 20 centers located in all regions. In 2010, the first foreign center in Odessa, Ukraine, was included in the Network.
Poland wants to share these experiences with Europe.
Text: Halina Pilonis