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Mom T, Bachy A, Houette A, Pavier Y, Pastourel R, Gabrillargues J, Saroul N, Gilain L, Avan P. Cochlear implantation through the round window with a straight slotted electrode array: optimizing the surgical procedure. Eur Arch Otorhinolaryngol 2015; 273:853-8. [PMID: 25894503 DOI: 10.1007/s00405-015-3623-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 04/04/2015] [Indexed: 11/29/2022]
Abstract
The question addressed here is how optimizing the quality of insertion through the round window with the lower morbidity, when using a straight and slotted electrode array of regular length. This retrospective analysis includes all cases implanted with a cochlear implant Digisonic SP (Neurelec-Oticon Medical) since 2004. We checked the operative charts, the depth of insertion, and the follow-up. For comparisons, contingency tables were used and a Chi-square test was performed. A p value <0.05 was considered significant. 126 cases of patients with non-malformed cochleas were implanted through the round window. The mean age was 53.8 ± 16.2 for adults and 3.6 ± 2.6 for children (24 cases). The mean follow-up was 33 ± 22 months. The straight electrode array had either a square or a soft pointed tip (n = 84). Full insertion was achieved in 79 out of 84 cases with a soft tip vs. 18 out of 42 square tips (χ (2) = 41.41, DOF = 1, p < 0.0001). Two cases were stuck at the round window niche by a prominent crista fenestrae. In all cases but one, the chorda tympany was preserved. In one case, a misrouting to the vestibule required a revision surgery. Implantation through the round window with a straight and slotted electrode array with a soft tip (Digisonic SP, Neurelec-Oticon Medical) can lead to a full insertion in 94 % of cases. Drilling out a prominent crista fenestrae is recommended.
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Affiliation(s)
- Thierry Mom
- Department of Otolaryngology Head and Neck Surgery, University Hospital Center CHU Gabriel Montpied, Université d'Auvergne Clermont 1, 30 place Henri Dunant, 63000, Clermont-Ferrand, France.
- Laboratory of Biophysics of Sensorineureal Handicaps, Faculty of Medicine, INSERM-UMR 1107, Université d'Auvergne Clermont 1, Clermont-Ferrand, France.
| | - Aurélie Bachy
- Department of Otolaryngology Head and Neck Surgery, University Hospital Center CHU Gabriel Montpied, Université d'Auvergne Clermont 1, 30 place Henri Dunant, 63000, Clermont-Ferrand, France
| | - Aubry Houette
- Department of Otolaryngology Head and Neck Surgery, University Hospital Center CHU Gabriel Montpied, Université d'Auvergne Clermont 1, 30 place Henri Dunant, 63000, Clermont-Ferrand, France
| | - Yoann Pavier
- Department of Otolaryngology Head and Neck Surgery, University Hospital Center CHU Gabriel Montpied, Université d'Auvergne Clermont 1, 30 place Henri Dunant, 63000, Clermont-Ferrand, France
- Laboratory of Biophysics of Sensorineureal Handicaps, Faculty of Medicine, INSERM-UMR 1107, Université d'Auvergne Clermont 1, Clermont-Ferrand, France
| | - Rémy Pastourel
- Department of Otolaryngology Head and Neck Surgery, University Hospital Center CHU Gabriel Montpied, Université d'Auvergne Clermont 1, 30 place Henri Dunant, 63000, Clermont-Ferrand, France
| | - Jean Gabrillargues
- Department of Neuroradiology, University Hospital Center CHU Gabriel Montpied, Université d'Auvergne Clermont 1, 30 place Henri Dunant, 63000, Clermont-Ferrand, France
| | - Nicolas Saroul
- Department of Otolaryngology Head and Neck Surgery, University Hospital Center CHU Gabriel Montpied, Université d'Auvergne Clermont 1, 30 place Henri Dunant, 63000, Clermont-Ferrand, France
| | - Laurent Gilain
- Department of Otolaryngology Head and Neck Surgery, University Hospital Center CHU Gabriel Montpied, Université d'Auvergne Clermont 1, 30 place Henri Dunant, 63000, Clermont-Ferrand, France
- Laboratory of Biophysics of Sensorineureal Handicaps, Faculty of Medicine, INSERM-UMR 1107, Université d'Auvergne Clermont 1, Clermont-Ferrand, France
| | - Paul Avan
- Laboratory of Biophysics of Sensorineureal Handicaps, Faculty of Medicine, INSERM-UMR 1107, Université d'Auvergne Clermont 1, Clermont-Ferrand, France
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Mom T, Djennaoui I, Saroul N, Pavier Y, Khalil T, Gilain L, Avan P. Significance of Postoperative ABRs after Cerebellopontine Angle Surgery. Skull Base Surg 2014. [DOI: 10.1055/s-0034-1384103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pavier Y, Saroul N, Pereira B, Tauveron I, Gilain L, Mom T. Acute prediction of laryngeal outcome during thyroid surgery by electromyographic laryngeal monitoring. Head Neck 2014; 37:835-9. [DOI: 10.1002/hed.23676] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 12/29/2013] [Accepted: 03/06/2014] [Indexed: 11/06/2022] Open
Affiliation(s)
- Yoann Pavier
- Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale; Hôpital Gabriel Montpied, CHU; Clermont-Ferrand France
| | - Nicolas Saroul
- Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale; Hôpital Gabriel Montpied, CHU; Clermont-Ferrand France
| | - Bruno Pereira
- Délégation Recherche Clinique and Innovation, Villa annexe IFSI; Hopital Gabriel Montpied, CHU; Clermont-Ferrand France
| | - Igor Tauveron
- Délégation Recherche Clinique and Innovation, Villa annexe IFSI; Hopital Gabriel Montpied, CHU; Clermont-Ferrand France
| | - Laurent Gilain
- Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale; Hôpital Gabriel Montpied, CHU; Clermont-Ferrand France
| | - Thierry Mom
- Service Diabétologie - Endocrinologie; Hopital Gabriel Montpied, CHU; Clermont-Ferrand France
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Grobost V, Rigal E, Pavier Y, Vidal M, Mrozek N, Beytout J, Laurichesse H, Lesens O. Suppressive therapy using azithromycin in 2 rare cases of recurrent staphylococcal infections. Diagn Microbiol Infect Dis 2014; 79:90-2. [PMID: 24629578 DOI: 10.1016/j.diagmicrobio.2014.01.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 01/08/2014] [Accepted: 01/12/2014] [Indexed: 10/25/2022]
Abstract
Recurrent staphylococcal skin and soft tissue infections may recur despite decontamination and multiple courses of antibiotic therapy and may dramatically impair the patient's quality of life. We report successful use of long-term azithromycin prophylaxis in a recurrent laryngitis and a scalp folliculitis due to methicillin-susceptible Staphylococcus aureus.
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Affiliation(s)
- Vincent Grobost
- Department of Infectious Diseases, Clermont-Ferrand University Hospital, France: CHU Gabriel Montpied, 58 Av. Montalembert 63003 Clermont-Ferrand, France.
| | - Emilie Rigal
- Department of Dermatology, CHU Estaing, 1 Place Lucie et Raymond Aubrac 63100 Clermont-Ferrand, France
| | - Yoann Pavier
- Department of Otorhinolaryngology, Clermont-Ferrand University Hospital, France: CHU Gabriel Montpied, 58 Av. Montalembert 63003 Clermont-Ferrand, France
| | - Magali Vidal
- Department of Infectious Diseases, Clermont-Ferrand University Hospital, France: CHU Gabriel Montpied, 58 Av. Montalembert 63003 Clermont-Ferrand, France
| | - Natacha Mrozek
- Department of Infectious Diseases, Clermont-Ferrand University Hospital, France: CHU Gabriel Montpied, 58 Av. Montalembert 63003 Clermont-Ferrand, France
| | - Jean Beytout
- Department of Infectious Diseases, Clermont-Ferrand University Hospital, France: CHU Gabriel Montpied, 58 Av. Montalembert 63003 Clermont-Ferrand, France
| | - Henri Laurichesse
- Department of Infectious Diseases, Clermont-Ferrand University Hospital, France: CHU Gabriel Montpied, 58 Av. Montalembert 63003 Clermont-Ferrand, France
| | - Olivier Lesens
- Department of Infectious Diseases, Clermont-Ferrand University Hospital, France: CHU Gabriel Montpied, 58 Av. Montalembert 63003 Clermont-Ferrand, France
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Saroul N, Nicolas S, Akkari M, Mohamed A, Pavier Y, Yoann P, Gilain L, Laurent G, Mom T, Thierry M. Long-term benefit and sound localization in patients with single-sided deafness rehabilitated with an osseointegrated bone-conduction device. Otol Neurotol 2013. [PMID: 23202156 DOI: 10.1097/mao.0b013e31827a2020] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Investigation of long-term satisfaction and correlation with audiometric measurements after osseointegrated bone-conduction device (OBCD) surgery for patients with single-sided deafness (SSD). PATIENTS Thirty-six patients implanted with an OBCD for SSD. STUDY DESIGN Retrospective review in a university medical center. INTERVENTION Rehabilitative. The patients were implanted after a test with an OBCD worn on a headband during 15 days in a daily use. The patients were implanted if the test gave us satisfaction. MAIN OUTCOME MEASURES A series of audiometric tests, including speech perception in noise, prosthetic gain, and sound localization measurements, with and without OBCD on headband before surgery and on the transcutaneous implant remote from the surgery. Assessment of benefit and satisfaction using the modified Entific Medical System Questionnaire (EMSQ), the Abbreviated Profile of Hearing Aid Benefit (APHAB), and the Glasgow Benefit Index (GBI). RESULTS The mean follow-up is 2.2 years. Approximately 64% of the patients use their OBCD more than 8 hours per day and 82% more than 4 hours per day. Mean satisfaction score is 7.3/10. The APHAB and GBI show a significant benefit (APHAB ease of communication before and after implantation, +21; GBI total score, +17). These results show an improvement in speech perception in noise with the OBCD, but no differences between the preoperative and postoperative tests. There is no improvement in sound localization. A high level of satisfaction is correlated with good results on the pre operative speech perception in noise. CONCLUSION The OBCD is an effective way of rehabilitation for SSD. The BAHA improves the speech perception in noise but provided no significant improvement in sound localization as revealed in the postoperative test. With 3 questionnaires we noticed an improvement in the quality of life with the OBCD.
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Affiliation(s)
| | - Saroul Nicolas
- Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Hôpital Gabriel Montpied, CHU de Clermont-Ferrand, Clermont-Ferrand, France.
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