February 25^th marks the International Cochlear Implant Day and the 62^th anniversary of world’s first implantation of a cochlear implant. In Poland, the first surgery making use of this technique to restore hearing in a deaf patient was performed on July 16^th, 1992 by Prof. Henryk Skarżyński. On the next day, a surgery was performed to implant a cochlear device in a deaf pediatric patient; this was also the first surgery of this type to be performed in Poland. International Cochlear Implant Day is an excellent opportunity for wider promotion of the benefits offered by novel technologies in the treatment of various hearing disorders.

World’s first cochlear device implantation was performed in Paris by a French otosurgeon Charles Eyries in collaboration with medical physicist Andre Djourno on February 25^th, 1957. The implant allowed only for general perception of sounds in patient’s environment rather than for speech recognition and was therefore removed due to patient’s disappointment. Despite the limited technical capabilities of the device, the researchers were able to see in their experiment a great potential for the future. The accomplishment of the French researchers inspired Prof. William House to take up his own research at his university in Los Angeles. In 1961, his group managed to implant electrodes facilitating stimulation of acoustic nerve to two patients. John Doyle, previously collaborating with Prof. House, was the first physician to place an electrode within the cochlea in 1964. In 1972, Prof. House started the world’s first program for the treatment of hearing loss using serially produced cochlear implants. A similar program was started in Europe by Claude-Henri Chouard in Paris (in 1973), and by Kurt Burian in Vienna (in 1975).

Poland joined this elite group in 1992 thanks to the efforts of Prof. Henryk Skarżyński, who performed Poland’s first surgery to implant a cochlear device in a deaf patient and thus not only sparked new hope in thousands of hearing-impaired patients, but also started the program for the treatment of complete hearing loss in our country. The procedure constituted a breakthrough for Polish otosurgery. Failure of the procedure would mean the program being postponed for years while its success would provide a unique stimulus for the development of otosurgery, audiology, rehabilitation, and early diagnostics of hearing disorders in neonates. This complex, multidisciplinary program was then joined by other physicians, psychologists, speech therapists, educators, engineers and audioprosthetic technicians. Preparations for the first implantation of a cochlear device had lasted for two years.

Thanks to the success of these first surgeries, the program for implantation of cochlear devices was started and subsequently followed by the entire grand program of modern otosurgery and audiology. Prof. Henryk Skarżyński contributed to the establishment of world’s renowned medical centers such as the Institute for the Physiology and Pathology of Hearing and the World Hearing Center. More than 400 thousand procedures were performed at the Institute over the last 20 years; in addition, last 25 years witnessed the establishment of nearly 200 new clinical programs, including programs involving virtually all innovative otosurgical implant solutions. State-of-the-art technologies are made available at the Institute to Polish patients as the first or nearly first recipients of these technologies in the world. The most recent example is provided by Poland’s premiere implantation of HiRes Ultra 3D Cochlear Implant with MRI Hassle Free technology. The implant is dedicated particularly to elderly patients and facilitates magnetic resonance scans being acquired in patients using magnetic fields of up to 3T. The surgery was performed by Prof. Henryk Skarżyński in December 2018.

Each novel otosurgical solution is of great importance considering the increasing percentage of individuals with partial hearing loss in our aging societies. This means that the number of implant recipients will also be rising. As of today, the Institute for the Physiology and Pathology of Hearing provides care to more than 8,000 patients with various types of hearing loss treated with cochlear implants; among these is the world’s largest group of patients who had had their surgery performed in a single site.

– Today, one may safely say that modern surgical methods and technologies make it possible to help nearly every patient presenting with hearing impairment regardless of its origin and be it due to outer, middle, or inner ear disorders – says Prof. Henryk Skarżyński – According to data collected by the specialists at our Institute over the 26 years of its clinical and research activities, there are more than 1 billion individuals worldwide who suffer from various types of hearing disorders affecting their everyday life, particularly their ability to communicate with others. This is a great civilizational challenge which generates great social and economic costs – adds Prof. Skarżyński.

According to the WHO (data of 2016), global costs due to hearing loss are indeed enormous as they amount to:

• USD 67-107 billion – costs for the healthcare systems excluding the costs of hearing aids
• USD 105 billion – costs due to reduced productivity – unemployment and early retirement
• USD 573 billion – social costs – social isolation, problems with communication, stigmatization
• USD 3.9 billion – costs of educational support for children aged 5-14 and suffering from various hearing problems.

– When untreated, hearing loss is a challenge not only to those immediately affected, but also to their families, communities, and countries – says Dr. Etienne Krug, Director of WHO’s Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention. – Cost-effective interventions may reduce the impact of hearing loss and ensure that life possibilities for hearing-impaired individuals will be the same as those of healthy ones. Such interventions, benefiting both individuals and state budgets, should be replicated wherever they are required.

In Poland, patients have access to state-of-the-art technologies allowing for restoration of hearing, improvement in its quality, and good communication with others. Institute’s specialists are pioneers in implantation of various types of devices and treatment of various congenital and acquired hearing disorders. Since 2003, the Institute has continuously performed the largest number of hearing improvement surgeries in the world. Numerous projects as well as pioneering scientific and clinical programs were carried out at the Institute to establish new standards for therapeutic management. It was only during the slightly more than five years since the World Hearing Center was established when Prof. Henryk Skarżyński initiated more than ten unique programs and performed numerous pioneering surgeries involving implantation of novel hearing devices.