July is a month of the most important anniversaries in the history of the Institute of Physiology and Pathology of Hearing. In 2016, when we are celebrating the jubilees of 20^th anniversary of the Institute and 25^th of the Polish program of deafness treatment these dates are particularly meaningful.

Twenty four years ago, on 16 July 1992, Prof. Henryk Skarżyński as the first surgeon in Poland performed a cochlear implantation in a deaf adult. One day later, on 17 July, he performed the same surgery in the first in Poland child. Through these pioneering surgeries Prof. Skarżyński has opened a new chapter in a history of ear surgery.

This groundbreaking cochlear implantation in a deaf patient gave rise to opportunities and hopes of thousands of deaf patients in Poland. On the day of surgery in the hospital were present seven TV stations and a crowd of journalists. It was a huge surprise. Information about pioneering surgical procedures is typically published after successful completion of the operation. Prof. Skarżyński, however, had informed the media about planned surgery already a week before. It was an act of incredible courage, a proof of good preparedness and trust in the society, as underline even today media representatives who had witnessed that medical milestone 24 years ago.

– Today many people have forgotten that work, effort and risk. Preparations for the first cochlear implantation in a deaf person took two years. It is my duty to recall the names of people who trusted and supported me in these hard times, generously supporting the Polish deafness treatment program – reminiscences Prof. Henryk Skarżyński. – Its implementation would not have been possible without the support of such people as Bishop Alojzy Orszulik – then the vice-secretary of the Polish Episcopal Conference, Prof. Wiesław Chrzanowski – Speaker of the Sejm, Prof. Andrzej Stelmachowski – Speaker of the Senate, Prof. Zofia Kuratowska – chairman of the Social Fund of Solidarity. The program received a direct and indirect support from my friends – the members of the board of our Foundation: Prof. Stefan Kruś and Prof. Grzegorz Opolski, Prof. Janusz Cianciara, Prof. Walerian Staszkiewicz, Prof. Janusz Piekarczyk, Roman Chojnowski MS, Jolanta Herman MA, Dr. Stanisław Wójcikiewicz, Prof. Jarosław Deszczyński, Dr. Waldemar Mysiak, Elwira Ludwikowska and other members of the Foundation. Among the scientists and medical experts who have become directly involved in the program there were: Doc. Maria Góralówna, Dr. Anna Geremek-Samsonowicz, Dr. Małgorzata Mueller-Malesińska, Dr. Joanna Szuchnik, Jadwiga Hoffman Eng. and hearing prosthetist Mr. Andrzej Herszhorn.

That first implantation in 1992 has been a start of the Polish program of treatment of deafness with cochlear implants. A part of this program has been the establishment, on the initiative of Prof. Henryk Skarżyński, of the first in Poland and second in Europe Diagnostic-Treatment-Rehabilitation Center for the Deaf and Hearing Impaired “Cochlear Center” aimed to provide comprehensive care for patients. The Center has been ceremonially opened by the Prime Minister Hanna Suchocka on 14 July 1993. In the opening ceremony took part Minister Jerzy Koźmiński, Bishop Alojzy Orszulik, Bohdan Jastrzębski – voivode of Warsaw and Minister Grażyna Andrzejewska-Sroczyńska – Government Plenipotentiary for Disabled People.

One week before the official opening, the ‘Cochlear Center’ visited the wife of the President of France Danielle Mitterrand.  Her Foundation had granted to a newly established center the specialist surgical microscope.

− I remember huge disbelief of the whole delegation accompanying Ms. Danielle Mitterrand and their questions are we sure that we will be able to open our center in a few days – remembers Prof. Skarżyński. – At that moment we had ready only the entrance hall and one consulting room, in which we have places that very modern surgical microscope. Not many people from outside knew that we have been working night and day, almost without sleep. But we made it! – adds proudly Prof. Henryk Skarżyński.

Opening of the Center was a huge success. At that time creation of an institution of such great international role has been possible because Poland has opened itself to the world, was ready to accept new solutions, new challenges. Several weeks from the opening the Center was receiving several tens of patients daily, performing about 200 specialist examinations, which was still only a drop in the ocean. Since its very beginning the ‘Cochlear Center’ has conducted also scientific activities. Two months after its opening it has organized the 1^st International Scientific Conference of Cochlear Implants.

Ten years after the first cochlear implantation in a deaf patient in Poland, Prof. Henryk Skarżyński has broken through another barrier – he started treating patients with a partial deafness. On 12 July 2002 Prof. Henryk Skarżyński performed first in the world surgery of cochlear implantation in an adult patient with partial deafness. It has been a start of the Program of Partial Deafness Treatment.

Medical community at that time believed that insertion of an implant electrode to an inner ear must result in irreparable destruction of a residual hearing. For that reason treating of people with partial deafness was considered impossible. Implantation would destroy that part of the cochlea, responsible for reception of low frequencies, which functioned normally, thus depriving the patient of what was left of his hearing. Surgical technique developed by Prof. Henryk Skarżyński, involving accessing the inner ear through its round window with a properly flexible electrode has proven to be an effective method allowing preserving the low-frequency hearing. There were also misgivings if auditory centers in the brain will be able to integrate information received in the way of simultaneous electric and acoustic stimulation of auditory receptors in the same ear. Dominant opinion in audiology was that it is impossible. Clinical engineers of the Institute have developed, however, a special procedure for fitting of a speech processor which enabled such integration.

That milestone surgery performed by Prof. Skarżyński has been transmitted life through the internet. It has an audience of several thousands of specialists from the whole world.

− Our first patient was a student of psychology; she was perfectly aware of what the process involves and means. Without an adequate attitude of a patient we would not have been able to decide about the surgery. Kasia could hear low frequency sounds, but was deaf for mid and high frequencies. – recalls Prof. Skarżyński. – After performing a whole battery of tests available at that time I decided to try – for the first time in the world – not only to perform that surgery, but also to show its course online.

Before 2002 cochlear implantation surgeries were performed only in cases of profound hearing loss of total deafness. A large group of patients, with a so-called partial deafness, had been considered to be out of the range of possible treatment.

When 25 years ago Prof. Henryk Skarżyński was starting preparation for introducing cochlear implant program in Poland, he did not even dream that in future he will create a ‘Polish school of otosurgery’ of partial deafness treatment in world’s science. An inspiration to work has been for him a travel, in 1988, to Paris for the I EUFOS Congress. He was representing Poland in the European Regional Round table with delegations from former Czechoslovakia, former GRD and Hungary. Today, young doctors and scientists from all continents can train at numerous courses, workshops, seminars and conferences in the World Hearing Center under his management.

– Promoting for many years the „Polish school of otosurgery” we have achieved an important position in world’s science – says Prof. Skarżyński – For this reason the international scientific community has entrusted us with organization of several important events. The closest of them is the 1^st World Tinnitus Congress, which will bring to Warsaw more than 2 thousand eminent experts from all continents. President of Poland Mr. Andrzej Duda is the honorary patron of this event. Also next year we are organizing the 25^th meeting of the International Evoked Response Audiometry Study Group IERASG, established in 1968 elite scientific society affiliated at the International Society of Audiology. Following years will see more scientific events: in 2019 the Institute will organize the World Congress of Otology, and in 2020 – which is more near than we think, we will be the organizers of the 34^th World Congress of Audiology in Warsaw – lists proudly Prof. Skarżyński.

The center in Kajetany is today an undisputable global leader in ORL implantology in terms of the number of hearing improving surgeries performed every year (circa 15 thousand procedures). Specialists from the World Hearing Center have under their care nearly 5 thousand hearing implant users.