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    A PRESENTATION OF A CASE OF A CHILD SUFFERING FROM AUTISM
    (Filozofski fakultet Skopje, 2005-06)
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    Zhivka Dimitrovska
    The most intense period in the discourse and language is within the first three years form one’s life, a period when the brain develops and grows. These abilities can be best developed in an environment full of sounds, emotions, looks and consistent exposure to language and conversation by the others. The root of this development is the desire for communication or to get into interaction with the environment (1). In the third, fourth and the fifth year of one’s life the vocabulary grows rapidly and the child starts to pick up the language rules. The communicational problem of the autistic people varies, depending on the intellectual and social status of the individual. The development of speech and language goes up to a certain degree, but not up to a level of normal ability. Some people’s speech is not developing at all, but others have a rich vocabulary and are able to talk about some topics of interest with a great curiosity. Many of them have a large memory for information which are just heard or seen; some have abilities to read, but not to understand what they read. Around 10% show outstanding abilities in specific areas as calendar calculation, talent for music or math (2). Most of them have a problem with the effective use of language and words, the meaning of a sentence, intonation and rhythm. This affects and disturbs the ability for interpretation and interaction with the environment. Some scientists connect these kinds of problems with the theory of mind or the reduced ability of thinking.
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    КОСКЕНИОТ КАНАЛ НА КОХЛЕАРНИОТ НЕРВ (BCNC) КАЈ ДЕЦА СО БИЛАТЕРАЛНИ ТЕШКО СЕНЗОНЕВРАЛНО ОШТЕТУВАЊЕ НА СЛУХОТ - КАРАКТЕРИСТИКИ И ЗНАЧЕЊЕ
    (SHMSHM/AAMD, 2021-08-30)
    М. Докоска
    ;
    С. Николова
    ;
    ;
    Цели: Цел на оваа ретроспективно аналитичка студија е одредување на вариациите на ширината од коскениот канал од кохлеарниот нерв кај пациенти со билатерално, тешко сензоневрално оштетување на слухот, која е корисна информација во предоперативната евалуација на децата кандидати за кохлеарна имплантација. Материјали и методи: Во оваа студија ретроспективно беа евалуираи КТ на 11 деца на возраст од 2-12 години, со билатерално тешко сензоневрално оштетување на слухот ,на кои во периодот Јули - Декември 2019 година на Универзитетската клиника за уво, нос и грло во Скопје им беше вграден кохлеарен имплант. Аксијалните пресеци од нивните КТ снимки беа користени за мерење на ширината на коскениот канал од кохлеарниот нерв. Резултати: Од добиените резултати просечната вредност на ширината на BCNC кај нашата група на пациенти изнесува 1.5± 0.3мм, минимум 1.0 мм, максимум 2.3мм. Заклучок: Вредностите за ширината на BCNC се движат во широки граници и дополнителни истражувања се потребни за нивна спореба со вредностите кај пациенти кои имаат нормален слух.
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    Вербална комуникација кај деца родени со расцеп на усна и непце
    (Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2009)
    Митевски Стојан
    ;
    ;
    Левенска Горица
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    Speech Perception Outcomes after Cochlear Implantation in Children with GJB2/DFNB1 associated Deafness
    (AVES Pub., 2014)
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    Emilija Sukarova-Stefanovska
    ;
    Valentina Ivanovska
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    ;
    Ilija Filipche
    Background: Cochlear implants (CI) for the rehabilitation of patients with profound or total bilateral sensorineural hypoacusis represent the initial use of electrical fields to provide audibility in cases where the use of sound amplifiers does not provide satisfactory results. Aims: To compare speech perception performance after cochlear im-plantation in children with connexin 26-associated deafness with that of a control group of children with deafness of unknown etiology. Study Design: Retrospective comparative study. Methods: During the period from 2006 to , cochlear implantation was performed on 26 children. Eighteen of these children had un-dergone genetic tests for mutation of the Gap Junction Protein Beta 2 (GJB2) gene. Bi-allelic GJB2 mutations were confirmed in 7 out of 18 examined children. In order to confirm whether genetic fac-tors have influence on speech perception after cochlear implantation, we compared the post-implantation speech performance of seven children with mutations of the GBJ2 (connexin 26) gene with seven other children who had the wild type version of this particular gene. The latter were carefully matched according to the age at cochlear implantation. Speech perception performance was measured before cochlear implantation, and one and two years after implantation. All the patients were arranged in line with the appropriate speech percep-tion category (SPC). Non-parametric tests, Friedman ANOVA and Mann-Whitney’s U test were used for statistical analysis. Results: Both groups showed similar improvements in speech per-ception scores after cochlear implantation. Statistical analysis did not confirm significant differences between the groups 12 and 24 months after cochlear implantation. Conclusion: The results obtained in this study showed an absence of apparent distinctions in the scores of speech perception between the two examined groups and therefore might have significant implica-tions in selecting prognostic indicators of speech perception follow-ing cochlear implantation. (Balkan Med J 2014;31:60-63)
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    THE ROLE OF AGE ON SPEECH DEVELOPMENT IN SUBJECTS WITH COCHLEAR IMPLANTS
    (Институт за јавно здравје на Р Северна Македонија = Institute of Public Health of R North Macedonia, 2021-06-30)
    ;
    Mira Jovanovska
    The cochlear implant has been approved as a method of treating bilateral deep deafness since the 1980s, and since then candidate selection methods have changed several times. Initially, the candidates were only adult patients, and in 1990 the cochlear implant was approved for the first time in children under 2 years of age by the US Food and Drug Administration. In 2000, the same US Administration reduced the limit to one year. The aim of this study was to determine the effect of age at cochlear implantation on speech recognition abilities. Concerning the age groups in which the subjects were assigned to, the best results on the tests were achieved by the group who underwent cochlear implantation at the youngest age. In conclusion, the benefit from cochlear implant in subjects with pre-lingual hearing impairment of the most severe degree has to be stressed and it is much bigger in comparison to individual amplifying hearing aids. If cochlear implant is placed at the youngest age, the results might lead to even 100% of active involvement in the social life of individuals with this kind of impairment.
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    ВЕРБАЛНА И АУДИТИВНА ПЕРЦЕПЦИЈА КАЈ ЛИЦА СО СЛУШЕН АМПЛИФИКАТОР И КОХЛЕАРЕН ИМПЛАНТ
    (Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2012)
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    ;
    Ѓорѓеска Билјана
    ;
    Јовановска Мира
    Verbal and auditory (hearing) perception is a subjective experience of one acoustic stimulus of different form and origin (tone, noise, speech, murmur, roar). These perceptions include reception of hearing stimulus, signals and acoustic signs, their processing and retaining (storing). Ability for auditory and verbal perception in a hearing disabled person is much lower or fully disabled. It depends on the level and type of hearing disability and type of amplification. The aim of this paper was to define the level of improvement of hearing and verbal perceptions in hearing disabled persons. A total of 31 patients were included in the study from the University Clinic for Ear, Nose and Throat in Skopje, with a diagnosis of severe bilateral hearing disability. After being diagnosed, they were included into a rehabilitation program and tested, with hearing aids. After six months period, the results of the conducted test for development of auditory perception-Lip Profile (listening progress) showed an insignificant improvement of auditory and verbal perception comparing to the period when the subjects were without hearing aids. Due to the minor improvement, the same patients were included into a treatment with insertion of a Cochlear implant. Conclusion: After six months - period of rehabilitation treatment there was a significant improvement of auditory and verbal perception in comparison with the period when patients had hearing aids.
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    DEVELOPMENT OF HEARING PERCEPTION IN SUBJECTS WITH COCHLEAR IMPLANT
    (Macedonian Association of Anatomists, 2021-04-02)
    Development of speech is a highly integrative process which has to incorporate harmonic functioning of many aspects such as anatomical, physiоlogical, auditory, mental, emotional and social. Anatomical physiological bases of hearing have been well studied. Cochlear iplant is recommended in subjects who do not have any significant increase of the sound through the individual hearing amplifiers or have small benefit and also in subjects whose impairment is over 90 dB to500, 1000, 2000 and 4000 Hz. The aim of this study was to estimate the development of hearing perception in subjects with prelingual hearing impairment who used cochlear implant with regards to perception and identification of sounds from external environment. The results of the Test for development of hearing perception showed progression during the follow up period at 6, 12 and 24 months. It was concluded that the longer the cochlear implant was used, the better results were achieved.
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    Assessment of Speech Development in Children with Cochlear Implants in Republic of Macedonia Using Monosyllabic-Troche Polysyllabic Test (Closed-Set)
    (ID Design 2012, 2013-03-27)
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    Background: Electric stimulation of the auditory nerve via cochlear implants has made a great impact on treatment of sensory deafness. Advanced signal processing and stimulation paradigms have led to continuously improved results in speech understanding. Consequently, indication criteria have been extended to patients with profound and severe-to profound hearing loss and limited speech understanding with conventional acoustic amplification. Aim: The aim of this study was to present speech development in subjects with pre-lingually sensorineural hearing loss implanted with a cochlear implant in Republic of Macedonia. Methods: The study included 31 subjects of both sexes and pre-lingual sensorineural hearing impairment. The average age of the implanted patients was 100.4 ± 74.1 months. The speech perception after cochlear implantation was evaluated using the Monosyllabic-Throche Polysyllabic test (MTP) with closed-set words without the aid of lip-reading. The patients should be able to point-to or clearly repeat the pictured words (or objects). Subjects were followed-up in a period of 6, 12 and 24 month post-implantation. Results: Cochran’s Q-test showed a significant difference in identification of monosyllabic,disyllabic and polysyllabic words in patients with cochlear implant during the analyzed period of 24 months. McNemar’s test confirmed that 24 months after implantation the subjects significantly better identified monosyllabic, disyllabic and polysyllabic words in comparison with the time interval at 12 and 6 months. Also, there was a substantial improvement 12 months after cochlear implantation in comparison with the interval at 6 months.
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    FUNDAMENTAL DIFFERENCES AND BENEFITS OF HEARING BEHIND THE EARS AMPLIFICATIONS AND COCHLEAR IMPLANT WITH HEARING SENSOR NEURAL IMPAIRMENTS
    (Macedonian Association of Anatomists and Morphologists, 2012)
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    Topuzovska Gabriela
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    Jovanovska Mira
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    Gjorgjeska Biljana
    ;
    Delevski Blagoja
    The aimof the hearingamplkification in aperson with impaired hearingis to use the remaining auditory potentials. One of the most important factors affecting the success of the auditoryand speech prcertion in a person with impaired hearing is the time and the quality of the amplification.The main purpose of the hearing aids is to make the sound signal available for the damage ear, to transfer the sound information as accurately as it can , and to adjust the transmission and the quality of the of the sound information to the receptive capacity of the ear to the highest degree. The purpose of this paper is to show the difeerence in the transmission of of the sound signal with the hearing amplifications and the cochlear implants, as wellas their benefits. 31 patients were tested for the purpose of this paper, and their aural condition was measured three times:without a hearing amlification, with a hearing amplification and finally with cochlear implant. The obtained results show that the benefit of the cochlear implants is much larger than the one of the hearing amplifications.
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    CHANGES IN VOICE QUALITY OF THE CHILDREN WITH CLEFT PALATE/LIP IN RELATION TO CHILDREN WITHOUT ANOMALY
    (Институт за јавно здравје на Р Северна Македонија = Institute of Public Health of R North Macedonia, 2021-06-30)
    Mira Jovanovska
    ;
    Mirjana Petrovic-Lazic
    ;
    Children with cleft palate/lip are exposed to risk for verbal communication disorders that include resonance, articulation, voice disorders, and expressive language. The aim of this paper was to evaluate the changes in the voice quality of the children with cleft palate in relation to children without anomaly. The study included 52 participants, 26 with previously corrected cleft palate / lip, and 26 respondents without anomaly who are between 3 and 6 years old. Subjective assessment of voice quality was performed by using the GRBAS scale. Perceptual scales are important in assessing the voice quality, determining the degree and severity of voice disturbance, and deciding on further clinical procedures. Although the instrumental approach to voice examination is relevant because it provides objectivity, the subjective impression in assessing voice quality is crucial. Statistical processing was performed by groups, group structure (gender and age), a certain highest value, as well as percentage participations. The results showed that 50% of the participants were diagnosed with certain changes in the voice. Children aged 3-5 years have a 2.25 times higher incidence of voice changes than children aged 6-8 years. The largest number of participants belong to group 0 - There is no change in voice quality which represents as much as 50% of the total number of patients in the first group. While „3 - Pronounced changes in the voice“ were not identified in the respondents aged 3-5 years. In 50% of the total number of participants there is no change in voice quality and these are located in girls aged 3-5 years