Early Brainstem Evoked Response Audiometry (BERA) is a modern noninvasive, objective neurophysiol... more Early Brainstem Evoked Response Audiometry (BERA) is a modern noninvasive, objective neurophysiological method for evaluation of hearing threshold. This method is applied in the complex otoneurological diagnostic procedure. The aim of the complete functional diagnostic procedure of hearing impairment in children is to determine the hearing level for the purpose of an early, adequate and quality hearing stimulation which affects the morphophysiological development of the complex auditory system. There are programs for early detection of the hearing impairment which give high-risk register. The registry consists of the following factors: family history of childhood hearing impairment, congenital perinatal infection, anatomical malformations involving the head or neck, birth-weight less then 1500 g, hyperbilirubinaemia, asphyxia with acidosis, usage of ototoxic drugs (high dosage of aminoglycosides). Hearing level is determinated by well-formed V wave on the lowest level of the stimula...
Kao rezultat sve većih očekivanja i zahteva korisnika asistivnih tehnologija u cilju povećanja nj... more Kao rezultat sve većih očekivanja i zahteva korisnika asistivnih tehnologija u cilju povećanja njihovih sposobnosti i postizanja većeg ste- pena samostalnosti i nezavisnosti u funkcionisanju, dolazi do sve inten- zivnijer razvoja i primene asistivnih tehnologija. Na obaveznost i neop- hodnost primene i ovog vida podrške i pomoći osobama sa različitim vi- dovima invaliditeta posebno su ukazala različita zakonska akta i kla- sifikacije. Ukazano je i na neka pitanja koja se u radu diskutuju kao što su: faktori koji utiču na izbor pomoćnih tehnologija, korisnost primene i barijere za njihovu primenu. Na rezultate korišćenja uticaće kako sre- dinski, tako i lični faktori, odlike samog proizvoda i pravilna procenu potreba korisnika. Koristi primene ovih tehnologija su brojne, ali je neo- phodan i stručan, profesionalan pristup prilikom njihovog odabira i rada sa korisnicima i njihovim porodicamaDue to growing expectations and demands from users of assistive technologies, and with the aim ...
Medial olivocochlear pathway represents the final part of efferent acoustic pathway which comes f... more Medial olivocochlear pathway represents the final part of efferent acoustic pathway which comes from the superior olivary complex ending at outer hair cells. Activation of medial olivocochlear system (MOCS) alters the cochlear output decreasing the travelling wave within cochlea. Stimulation of MOCS provides protection against moderate levels of noise, encoding noise signals as well as selecting hearing attention. Activation of MOCS can be performed using contralateral acoustic stimulation. The principal result of presentation of contralateral acoustic stimulation during screening of transient evoked otoacoustic emission (TEOAE) is an attenuation of the TEOAE amplitude. Thirty-eight ears were examined in this study: twenty-eight ears from 14 normal-hearing adults and 10 patients with unilateral deafness. Healthy subjects were exposed to contralateral broad-band noise of various intensities (40, 30, 20 and 10 dB SL), as well as 30 dB SL pure tone stimulation (1 kHz and 4 kHz). A decr...
Neck, as a structure very closely connected with oral cavity and pharynx, with great number of ly... more Neck, as a structure very closely connected with oral cavity and pharynx, with great number of lymph nodes, (about 2, 3 of all are in the neck), is sometimes a localization of purulent inflammatory process but its incidence is not so high as the incidence of inflammations of surrounding organs and tissue. Deep neck abscesses are localized under the upper fascial layer. They have a serious clinical picture which could be further complicated if inflammation spreads on vessels or neck organs. If the processes spread toward the mediastinum because of the communication space between medial and deep fascial layer with mediastinum, it could be mediastinal inflammation with high mortality. The aim of this study is evaluation of results of treatment in patients with deep neck abscesses and phlegmons treated at Clinic in a ten year period (1988-1997). This study comprised 21 patients who were treated at the ENT Clinic in Novi Sad during 1988-1997. The group consisted of 5 female and 16 male p...
Surgical treatment of otosclerosis with stapedotomy leads to the improvement of subjective and ob... more Surgical treatment of otosclerosis with stapedotomy leads to the improvement of subjective and objective problems in patients with otosclerosis. A prospective study included patients who had been treated surgically at the Department for Ear, Nose and Throat in Novi Sad in the period from September 2006 to September 2007. On the basis of the appropriate diagnostic procedures, 33 patients were diagnosed with otosclerosis. Functional hearing was assessed before and after surgery by means of pure tone audiometry. The comparison of functional results before and after surgery revealed no changes in pure tone average of bone conduction threshold (average hearing threshold for hearing range), whereas pure tone average of air conduction and pure tone average of the gap showed statistically significant improvement. The results of this study demonstrated the applicability of stapedotomy as a method for successful management of otosclerosis. This way of examination offers a new perspective on p...
Introduction. The first cochlear implant surgery was performed at the Center for Cochlear Implant... more Introduction. The first cochlear implant surgery was performed at the Center for Cochlear Implantation of the Department of Ear, Nose and Throat Diseases, Clinical Center of Vojvodina in 2002 after long preparations and that was the first successful cochlear implantation in Serbia. Material and Methods. Over the period from November 2002 to November 2013, 99 patients underwent surgical procedures and 100 cochlear implants were placed. Results. The analysis encompassed 99 patients, the youngest and the oldest one being 1 year and 61 years old, respectively. Prelingual and postlingual deafness developed in 84 (84.9%) and in 15 (15.1%), respectively. Postlingual deafness was observed in all 11 adult patients. The prelingual deafness was diagnosed in 84 (95.4%) children, whereas in four (4.6%) children it occurred after the development of speech between 6 and 8 years of age. Progressive hearing loss was observed in 11 patients - seven adults and four children. The majority of our patien...
Introduction. The rehabilitation process involves a whole team of experts who participate in it o... more Introduction. The rehabilitation process involves a whole team of experts who participate in it over a long period of time. Development of Robotics and its Application in Medicine. The Intensive development of science and technology has made it possible to design a number of robots which are used for therapeutic purposes and participate in the rehabilitation process. Robotics in Medical Rehabilitation. During the long history of technological development of mankind, a number of conceptual and technological solutions for the construction of robots have been known. By using robots in medical rehabilitation it is possible to implement the rehabilitation of peripheral and central motor neurons by increasing the motivation of patients for further recovery and effectiveness of therapy. The paper presents some technological solutions for robot-assisted rehabilitation of patients of different age groups and some possibilities of its use in the treatment. Conclusion. Using robots in standard...
Background/Aim. A more recent method, the auditory steadystate response (ASSR), has become more a... more Background/Aim. A more recent method, the auditory steadystate response (ASSR), has become more and more important test method due to difference that was found in previous investigations between hearing thresholds determined by the ASSR and the pure-tone audiometry (PTA). The aim of this study was to evaluate the reliability of the ASSR in determining the frequency specific hearing thresholds by establishing a correlation between the thresholds determined by PTA, as well as to evaluate the reliability of ASSR in determining the hearing threshold with respect to the level of hearing loss and the configuration of the PTA findings. Methods. The prospective study included 46 subjects (92 ears) which were assigned to groups based on their level of hearing loss and audiometric configuration. All the subjects underwent determination of hearing thresholds by PTA and ASSR without insight into their previously obtained PTA results. Results. The overall sample differences between the ASSR and ...
Introduction. A cochlear implant is a small electronic device that can provide a sense of sound t... more Introduction. A cochlear implant is a small electronic device that can provide a sense of sound to a person who is profoundly deaf or severely hard-of-hearing. Cochlear implants bypass the damaged hearing systems and directly stimulate the auditory nerve. Signals generated by the implant are sent by way of the auditory nerve to the brain, which recognizes the signals as sound. Hearing through a cochlear implant differs from normal hearing and takes time to learn or relearn. Cochlear implantations have been performed at the ENT Clinic in Novi Sad since 2002. The aim of this retrospective investigation was to evaluate performance of cochlear implanted patients in regard to the age of hearing loss identification, age at implantation, as well as complications. Material and Methods. During a 5-year period (2002-2007), 45 patients underwent cochlear implantation (46 implants) at the ENT Clinic in Novi Sad. Only four patients were postlingually deaf adults. Forty-one implanted patients wer...
Objective evaluation of hearing threshold and detection of hearing impairment are the basic prere... more Objective evaluation of hearing threshold and detection of hearing impairment are the basic prerequisites for hearing and speech rehabilitation. In infants and early pre-school children tonal audiometry is not possible. Though subjective, tonal audiometry is the most reliable method for evaluation of hearing threshold. Therefore, in children of this age, hearing threshold is evaluated by objective electroacoustic methods: early brainstem auditory evoked potentials (BAEP) and acoustic stapedius reflex. In 60 adult examinees (120 ears) with normal hearing we analyzed the correlation between biological hearing threshold determined by tonal audiometry and threshold of ipsilateral stapedius reflex, as well as response threshold determined by brainstem evoked response audiometry (BERA). We found a statistically significant correlation between biological hearing threshold and response threshold evaluated by brainstem evoked response audiometry. The linear Pearson correlation coefficient of...
Relief of pain after tonsilloadenoidectomy in preschool children is the precondition of good post... more Relief of pain after tonsilloadenoidectomy in preschool children is the precondition of good postoperative recovery of that group of patients. The aim of this project is to study, to estimate and to relieve the pain. It focuses on dosage and ways of using medication, and establish the difference between Paracetamol and Ibuprofen i.e. their respective effects after oral, rectal or rectal-oral application. This (prospective/open-ended) study included 50 children recovering from tonsilloadenoidectomy, 5.7 years of age on average, classified into 5 groups according to medication used and method of treatment. Postoperative pain was evaluated using accepted anaesthesiological criteria with 3 scales of pain estimation: cognitive, behavioral and vegetative, also taking into consideration side effects and liquid intake. In this study Ibuprofen proved to be a stronger, more efficient and longer active drug compared to Paracetamol. There was no irritation in the digestive system and there was ...
Sound challenged vestibular symptoms in humans were described in the early work of Tullius back i... more Sound challenged vestibular symptoms in humans were described in the early work of Tullius back in 1929 [1]. In 1958, when Geisler et al. recorded shortlatency responses to auditory click (through the nape of the neck), those responses were believed to originate from the cerebral cortex [2]. For the first time in 1964, Bickford, Jacobson and Cody presented their theory describing characteristic responses to a click sound stimulus originating from the vestibular apparatus [3]. In a study of 30 healthy people they reported the responses to sound stimulation received by “adequate muscle tension” and concluded that their origin was in the vestibular rather than the cochlear part of the inner ear. Later studies of Cody and Bickford in 1969, and Townsend and Cody in 1971 [2] suggested that this response occurred by activation of the vestibular organ, especially the sacculus. Despite these
Sažetak Uvod. U procesima rehabilitacije ucestvuje citav tim strucnjaka koji su angažovani tokom ... more Sažetak Uvod. U procesima rehabilitacije ucestvuje citav tim strucnjaka koji su angažovani tokom dužeg vremenskog perioda. Razvoj robotike i primena u medicini. Intenzivnim razvojem nauke i tehnike dizajniran je veci broj robota koji se koriste u terapijske svrhe i ucestvuju u procesu rehabilitacije. Robotika u medicinskoj rehabilitaciji. Tokom duge istorije razvoja covecanstva poznata su brojna idejna i tehnoloska resenja za konstrukciju robota. Primenom robota u medicinskoj rehabilitaciji moguce je sprovođenje rehabilitacije perifernog i centralnog motornog neurona, uz povecavanje motivacije pacijenta za dalji oporavak i uspesnost terapije. U radu su prikazana neka tehnoloska resenja za robotom potpomognutu rehabilitaciju pacijenata razlicitih uzrasnih grupa i neke mogucnosti primene u postupku lecenja. Zakljucak. Ukljucivanje robota u standardne fizioterapijske protokole koji podrazumevaju veci broj ponavljanja, tacno doziranje, kvalitetno osmisljavanje i prilagođenost individual...
Early Brainstem Evoked Response Audiometry (BERA) is a modern noninvasive, objective neurophysiol... more Early Brainstem Evoked Response Audiometry (BERA) is a modern noninvasive, objective neurophysiological method for evaluation of hearing threshold. This method is applied in the complex otoneurological diagnostic procedure. The aim of the complete functional diagnostic procedure of hearing impairment in children is to determine the hearing level for the purpose of an early, adequate and quality hearing stimulation which affects the morphophysiological development of the complex auditory system. There are programs for early detection of the hearing impairment which give high-risk register. The registry consists of the following factors: family history of childhood hearing impairment, congenital perinatal infection, anatomical malformations involving the head or neck, birth-weight less then 1500 g, hyperbilirubinaemia, asphyxia with acidosis, usage of ototoxic drugs (high dosage of aminoglycosides). Hearing level is determinated by well-formed V wave on the lowest level of the stimula...
Kao rezultat sve većih očekivanja i zahteva korisnika asistivnih tehnologija u cilju povećanja nj... more Kao rezultat sve većih očekivanja i zahteva korisnika asistivnih tehnologija u cilju povećanja njihovih sposobnosti i postizanja većeg ste- pena samostalnosti i nezavisnosti u funkcionisanju, dolazi do sve inten- zivnijer razvoja i primene asistivnih tehnologija. Na obaveznost i neop- hodnost primene i ovog vida podrške i pomoći osobama sa različitim vi- dovima invaliditeta posebno su ukazala različita zakonska akta i kla- sifikacije. Ukazano je i na neka pitanja koja se u radu diskutuju kao što su: faktori koji utiču na izbor pomoćnih tehnologija, korisnost primene i barijere za njihovu primenu. Na rezultate korišćenja uticaće kako sre- dinski, tako i lični faktori, odlike samog proizvoda i pravilna procenu potreba korisnika. Koristi primene ovih tehnologija su brojne, ali je neo- phodan i stručan, profesionalan pristup prilikom njihovog odabira i rada sa korisnicima i njihovim porodicamaDue to growing expectations and demands from users of assistive technologies, and with the aim ...
Medial olivocochlear pathway represents the final part of efferent acoustic pathway which comes f... more Medial olivocochlear pathway represents the final part of efferent acoustic pathway which comes from the superior olivary complex ending at outer hair cells. Activation of medial olivocochlear system (MOCS) alters the cochlear output decreasing the travelling wave within cochlea. Stimulation of MOCS provides protection against moderate levels of noise, encoding noise signals as well as selecting hearing attention. Activation of MOCS can be performed using contralateral acoustic stimulation. The principal result of presentation of contralateral acoustic stimulation during screening of transient evoked otoacoustic emission (TEOAE) is an attenuation of the TEOAE amplitude. Thirty-eight ears were examined in this study: twenty-eight ears from 14 normal-hearing adults and 10 patients with unilateral deafness. Healthy subjects were exposed to contralateral broad-band noise of various intensities (40, 30, 20 and 10 dB SL), as well as 30 dB SL pure tone stimulation (1 kHz and 4 kHz). A decr...
Neck, as a structure very closely connected with oral cavity and pharynx, with great number of ly... more Neck, as a structure very closely connected with oral cavity and pharynx, with great number of lymph nodes, (about 2, 3 of all are in the neck), is sometimes a localization of purulent inflammatory process but its incidence is not so high as the incidence of inflammations of surrounding organs and tissue. Deep neck abscesses are localized under the upper fascial layer. They have a serious clinical picture which could be further complicated if inflammation spreads on vessels or neck organs. If the processes spread toward the mediastinum because of the communication space between medial and deep fascial layer with mediastinum, it could be mediastinal inflammation with high mortality. The aim of this study is evaluation of results of treatment in patients with deep neck abscesses and phlegmons treated at Clinic in a ten year period (1988-1997). This study comprised 21 patients who were treated at the ENT Clinic in Novi Sad during 1988-1997. The group consisted of 5 female and 16 male p...
Surgical treatment of otosclerosis with stapedotomy leads to the improvement of subjective and ob... more Surgical treatment of otosclerosis with stapedotomy leads to the improvement of subjective and objective problems in patients with otosclerosis. A prospective study included patients who had been treated surgically at the Department for Ear, Nose and Throat in Novi Sad in the period from September 2006 to September 2007. On the basis of the appropriate diagnostic procedures, 33 patients were diagnosed with otosclerosis. Functional hearing was assessed before and after surgery by means of pure tone audiometry. The comparison of functional results before and after surgery revealed no changes in pure tone average of bone conduction threshold (average hearing threshold for hearing range), whereas pure tone average of air conduction and pure tone average of the gap showed statistically significant improvement. The results of this study demonstrated the applicability of stapedotomy as a method for successful management of otosclerosis. This way of examination offers a new perspective on p...
Introduction. The first cochlear implant surgery was performed at the Center for Cochlear Implant... more Introduction. The first cochlear implant surgery was performed at the Center for Cochlear Implantation of the Department of Ear, Nose and Throat Diseases, Clinical Center of Vojvodina in 2002 after long preparations and that was the first successful cochlear implantation in Serbia. Material and Methods. Over the period from November 2002 to November 2013, 99 patients underwent surgical procedures and 100 cochlear implants were placed. Results. The analysis encompassed 99 patients, the youngest and the oldest one being 1 year and 61 years old, respectively. Prelingual and postlingual deafness developed in 84 (84.9%) and in 15 (15.1%), respectively. Postlingual deafness was observed in all 11 adult patients. The prelingual deafness was diagnosed in 84 (95.4%) children, whereas in four (4.6%) children it occurred after the development of speech between 6 and 8 years of age. Progressive hearing loss was observed in 11 patients - seven adults and four children. The majority of our patien...
Introduction. The rehabilitation process involves a whole team of experts who participate in it o... more Introduction. The rehabilitation process involves a whole team of experts who participate in it over a long period of time. Development of Robotics and its Application in Medicine. The Intensive development of science and technology has made it possible to design a number of robots which are used for therapeutic purposes and participate in the rehabilitation process. Robotics in Medical Rehabilitation. During the long history of technological development of mankind, a number of conceptual and technological solutions for the construction of robots have been known. By using robots in medical rehabilitation it is possible to implement the rehabilitation of peripheral and central motor neurons by increasing the motivation of patients for further recovery and effectiveness of therapy. The paper presents some technological solutions for robot-assisted rehabilitation of patients of different age groups and some possibilities of its use in the treatment. Conclusion. Using robots in standard...
Background/Aim. A more recent method, the auditory steadystate response (ASSR), has become more a... more Background/Aim. A more recent method, the auditory steadystate response (ASSR), has become more and more important test method due to difference that was found in previous investigations between hearing thresholds determined by the ASSR and the pure-tone audiometry (PTA). The aim of this study was to evaluate the reliability of the ASSR in determining the frequency specific hearing thresholds by establishing a correlation between the thresholds determined by PTA, as well as to evaluate the reliability of ASSR in determining the hearing threshold with respect to the level of hearing loss and the configuration of the PTA findings. Methods. The prospective study included 46 subjects (92 ears) which were assigned to groups based on their level of hearing loss and audiometric configuration. All the subjects underwent determination of hearing thresholds by PTA and ASSR without insight into their previously obtained PTA results. Results. The overall sample differences between the ASSR and ...
Introduction. A cochlear implant is a small electronic device that can provide a sense of sound t... more Introduction. A cochlear implant is a small electronic device that can provide a sense of sound to a person who is profoundly deaf or severely hard-of-hearing. Cochlear implants bypass the damaged hearing systems and directly stimulate the auditory nerve. Signals generated by the implant are sent by way of the auditory nerve to the brain, which recognizes the signals as sound. Hearing through a cochlear implant differs from normal hearing and takes time to learn or relearn. Cochlear implantations have been performed at the ENT Clinic in Novi Sad since 2002. The aim of this retrospective investigation was to evaluate performance of cochlear implanted patients in regard to the age of hearing loss identification, age at implantation, as well as complications. Material and Methods. During a 5-year period (2002-2007), 45 patients underwent cochlear implantation (46 implants) at the ENT Clinic in Novi Sad. Only four patients were postlingually deaf adults. Forty-one implanted patients wer...
Objective evaluation of hearing threshold and detection of hearing impairment are the basic prere... more Objective evaluation of hearing threshold and detection of hearing impairment are the basic prerequisites for hearing and speech rehabilitation. In infants and early pre-school children tonal audiometry is not possible. Though subjective, tonal audiometry is the most reliable method for evaluation of hearing threshold. Therefore, in children of this age, hearing threshold is evaluated by objective electroacoustic methods: early brainstem auditory evoked potentials (BAEP) and acoustic stapedius reflex. In 60 adult examinees (120 ears) with normal hearing we analyzed the correlation between biological hearing threshold determined by tonal audiometry and threshold of ipsilateral stapedius reflex, as well as response threshold determined by brainstem evoked response audiometry (BERA). We found a statistically significant correlation between biological hearing threshold and response threshold evaluated by brainstem evoked response audiometry. The linear Pearson correlation coefficient of...
Relief of pain after tonsilloadenoidectomy in preschool children is the precondition of good post... more Relief of pain after tonsilloadenoidectomy in preschool children is the precondition of good postoperative recovery of that group of patients. The aim of this project is to study, to estimate and to relieve the pain. It focuses on dosage and ways of using medication, and establish the difference between Paracetamol and Ibuprofen i.e. their respective effects after oral, rectal or rectal-oral application. This (prospective/open-ended) study included 50 children recovering from tonsilloadenoidectomy, 5.7 years of age on average, classified into 5 groups according to medication used and method of treatment. Postoperative pain was evaluated using accepted anaesthesiological criteria with 3 scales of pain estimation: cognitive, behavioral and vegetative, also taking into consideration side effects and liquid intake. In this study Ibuprofen proved to be a stronger, more efficient and longer active drug compared to Paracetamol. There was no irritation in the digestive system and there was ...
Sound challenged vestibular symptoms in humans were described in the early work of Tullius back i... more Sound challenged vestibular symptoms in humans were described in the early work of Tullius back in 1929 [1]. In 1958, when Geisler et al. recorded shortlatency responses to auditory click (through the nape of the neck), those responses were believed to originate from the cerebral cortex [2]. For the first time in 1964, Bickford, Jacobson and Cody presented their theory describing characteristic responses to a click sound stimulus originating from the vestibular apparatus [3]. In a study of 30 healthy people they reported the responses to sound stimulation received by “adequate muscle tension” and concluded that their origin was in the vestibular rather than the cochlear part of the inner ear. Later studies of Cody and Bickford in 1969, and Townsend and Cody in 1971 [2] suggested that this response occurred by activation of the vestibular organ, especially the sacculus. Despite these
Sažetak Uvod. U procesima rehabilitacije ucestvuje citav tim strucnjaka koji su angažovani tokom ... more Sažetak Uvod. U procesima rehabilitacije ucestvuje citav tim strucnjaka koji su angažovani tokom dužeg vremenskog perioda. Razvoj robotike i primena u medicini. Intenzivnim razvojem nauke i tehnike dizajniran je veci broj robota koji se koriste u terapijske svrhe i ucestvuju u procesu rehabilitacije. Robotika u medicinskoj rehabilitaciji. Tokom duge istorije razvoja covecanstva poznata su brojna idejna i tehnoloska resenja za konstrukciju robota. Primenom robota u medicinskoj rehabilitaciji moguce je sprovođenje rehabilitacije perifernog i centralnog motornog neurona, uz povecavanje motivacije pacijenta za dalji oporavak i uspesnost terapije. U radu su prikazana neka tehnoloska resenja za robotom potpomognutu rehabilitaciju pacijenata razlicitih uzrasnih grupa i neke mogucnosti primene u postupku lecenja. Zakljucak. Ukljucivanje robota u standardne fizioterapijske protokole koji podrazumevaju veci broj ponavljanja, tacno doziranje, kvalitetno osmisljavanje i prilagođenost individual...
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