Hypothesis-Cochleostomy or round window enlargement techniques for cochlear implant electrode ins... more Hypothesis-Cochleostomy or round window enlargement techniques for cochlear implant electrode insertion result in more abnormal tissue formation in the basal cochlea and are more apt to produce endolymphatic hydrops than round window electrode insertion. Methods-Twelve temporal bones from implanted patients were examined under light microscopy and reconstructed with 3D reconstruction software to determine cochlear damage and volume of neo-ossification and fibrosis following electrode insertion. Amount of new tissue was compared between three groups of bones: insertion through the round window (RW), after enlarging the round window (RWE) and cochleostomy (Cochl). The probable role of the electrode was evaluated in each case with hydrops. Results-More initial damage occurred in the Cochl and RWE groups than in the RW group, and the difference was significant between RWE and RW in cochlear segment I (p<0.026). The volume of new bone in segment I differed significantly between groups (p<.012) and was greater in the RWE group than in either the Cochl or RW groups (post hoc p's <.035 and .019). Hydrops was seen in 5 cases, all in the Cochl and RWE groups. Blockage of the duct was due to new tissue formation in 4 of the 5 hydrops cases. Conclusion-With the electrodes in this serie, implantation through the round window minimized initial intracochlear trauma and subsequent new tissue formation, while the round window extension technique used at the time of these implantations produced the greatest damage. Future studies may clarify whether today's techniques and electrodes will produce these same patterns of damage.
Recurrent vertigo is one of the most common and incapacitating complaints reported by patients in... more Recurrent vertigo is one of the most common and incapacitating complaints reported by patients in a clinical ENT practice. Numerous pathologic diseases can result in vertigo, with or without associated auditory and neurologic symptoms. In 1952, Dix and Hallpike identified vestibular neuronitis (or neuritis) as an association of characteristic signs occurring predominantly in middle age and composed of a sudden severe and prolonged vertigo, with reduced or absent caloric response in 1 ear and preceded or concomitant to an upper respiratory tract infection (1). The presence of any auditory or neurologic symptoms would point to a differential diagnosis such as Meniere’s disease, a cerebellar infarction, or an acoustic tumor. Inflammation has long been thought to be the cause of vestibular neuronitis. However, several temporal bone evaluations have shown histologic changes, which are suggestive of a viral herpetic infection. Moreover, the common association with an upper respiratory infection and the anatomical proximity of the meatal and vestibular ganglions to the upper respiratory tract provides support for the virus theory. After the first contact with a neurotropic virus, the human body cannot rid itself of it, and the virus will remain latent in the ganglion cells, waiting for a reactivation. The contiguity of the meatal and vestibular ganglions can explain, in some cases, the movement of the virus from the meatal ganglion, in the fundal segment of the facial nerve, to the vestibular nerve but not the auditory nerve owing to the lack of continuity of the two. Thus, the neurotropic viruses can spread after an anterograde flow, so that hearing loss does not occur (2).
Multisensory processes include the capacity to combine information from the different senses, oft... more Multisensory processes include the capacity to combine information from the different senses, often improving stimulus representations and behavior. The extent to which multisensory processes are an innate capacity or instead require experience with environmental stimuli remains debated. We addressed this knowledge gap by studying multisensory processes in prematurely born and full-term infants. We recorded 128-channel event-related potentials (ERPs) from a cohort of 55 full-term and 61 preterm neonates (at an equivalent gestational age) in response to auditory, somatosensory, and combined auditory-somatosensory multisensory stimuli. Data were analyzed within an electrical neuroimaging framework, involving unsupervised topographic clustering of the ERP data. Multisensory processing in full-term infants was characterized by a simple linear summation of responses to auditory and somatosensory stimuli alone, which furthermore shared common ERP topographic features. We refer to the ERP ...
BACKGROUND Atypical cries have been identified in infants with neurological dysfunction. The aim ... more BACKGROUND Atypical cries have been identified in infants with neurological dysfunction. The aim of this study was to conduct a systematic review and meta-analysis to appraise existing evidence for associations between acoustic cry characteristics and neurological dysfunction in infants aged 18 months or less. METHODS PubMed/MEDLINE, PsycINFO, CINAHL, and Embase were searched for original, peer-reviewed studies published in English reporting cry variables in infants aged 18 months or less with or at risk of neurological dysfunction. Studies without a nonneurologically impaired control sample were excluded. Pooled effect sizes were estimated using standardized mean difference (SMD) and odds ratio (OR). I2 indicated study heterogeneity, and the risk of bias was assessed using the Newcastle-Ottawa Scale. RESULTS From March 2018 to February 2019, 28,294 studies were retrieved. Eight were meta-analyzed. Infants with or at risk of neurological dysfunction exhibited higher mean (SMD = 0.11 [95% confidence interval, 0.00 to 0.23]) and minimum (SMD = 0.93 [0.64 to 1.23]) fundamental frequency; higher odds of hyperphonation (OR = 13.17 [1.05 to 165.87]), biphonation (OR = 10.62 [1.53 to 73.59]), rise-fall-rise melodies (OR = 4.66 [1.16 to 18.66]), and flat melodies (OR = 4.47 [1.27 to 15.68]); and lower odds of fall-rise-fall melodies (OR = 0.21 [0.05 to 0.83]). CONCLUSIONS Infants with underlying neuropathology have unique cries characterized by higher fundamental frequency, dysphonation, and atypical melodies, although study heterogeneity and imprecision of effect size estimates limited our interpretation. Assessment of acoustic cry characteristics offers the potential for noninvasive, rapid, point-of-care screening for neurologically high-risk infants.
BACKGROUND: This report describes a new strategy for the care of patients with osteogenesis imper... more BACKGROUND: This report describes a new strategy for the care of patients with osteogenesis imperfecta, based on an interdisciplinary team working. Thereby, we aim at fulfilling three main goals: offering thorough coordinated management for all, and improving physical activity and quality of life of the patients. AIM: With rare diseases such as osteogenesis imperfecta (OI), patients and their family often suffer from inadequate recognition of their disease, poor care coordination and incomplete information. A coordinated interdisciplinary approach is one possible solution for providing both comprehensive and cost-effective care, with benefits for patient satisfaction. Poor physical activity and impaired quality of life represent a considerable burden for these patients. To better address these issues, in 2012 we created an interdisciplinary team for the management of OI patients in our University Hospital Centre (CHUV, Lausanne University Hospital,). In this article we describe the implementation of this interdisciplinary care strategy for patients suffering from OI, and its impact on their physical activity and quality of life. METHODS: All patients from the French part of Switzerland were invited to join us. We proposed two complementary evaluations: the initial interdisciplinary evaluation and a yearly follow-up during a special day-the "OI day". This day features specialised medical appointments adapted to each patient's needs, as well as lectures and/or workshops dedicated to patients' and families' education. Our first aim was to propose for each patient the same management, from diagnosis to the bone health evaluation and physical therapy advice. Our second aim was to evaluate the evolution of physical activity, quality of life (measured by EQ-5D, SF-36 and a dedicated questionnaire) and satisfaction of patients and their families. Here we report both the initial and the long-term results. RESULTS: Since 2012, 50 patients from the French part of Switzerland received the personalised medical evaluation. All of the patients included in this study had the same initial evaluation and at least one participation in an OI Day. All patients had an adaptation of their bone acting drugs. Over a 7-year period, 62% of inactive patients started some physical activity, and 44% of patients who were not involved in any athletic activity started participating in sports. The mean EQ-5D increased from 0.73 to 0.75 (p = 0.59). The mean physical SF36 (musculoskeletal function) score was 59.09 ± 22.72 and improved to 65.79 ± 21.51 (p = 0.08), whereas it was 68.06 ± 20.05 for the mental SF36 without alteration during follow-up. The OI day was revealed to be useful, it contributed to improvement in continuity of care and helped families to better understand the OI patients' health. CONCLUSIONS: Our interdisciplinary approach aimed at offering the same thorough management for all patients from the French part of Switzerland, and at improving both the physical activity and the satisfaction of the patients and their family. This report is a basis for future work focusing on the effect of bone fragility and the impact of OI on patients' social relations.
Background: Two non-invasive ventilation strategies, Bubble Continuous Positive Airway Pressure (... more Background: Two non-invasive ventilation strategies, Bubble Continuous Positive Airway Pressure (Bubble CPAP) and standard nasal Continuous Positive Airway Pressure (nasal-CPAP), are commonly used to treat preterm infants in the NICU, differentially impacting their auditory environment and contributing to noise exposure above recommended safe levels. Aim: To compare differences in sound exposure for preterm infants receiving two types of non-invasive CPAP. Method: Prospective observational study of 108 preterm infants, receiving either Bubble-CPAP or nasal-CPAP, using repeated measures of sound exposure in single-patient rooms and semi-private bays. Results: Analyses with repeated measures demonstrated that both types of CPAP increase noise levels above the background of the NICU, and that non-invasive nasal-CPAP produces higher noise pollution compared to Bubble CPAP, regardless of the room type. Conclusion: While CPAP is a necessary treatment for many preterm infants, cumulative noise exposure in extremely preterm infants may also be a care consideration.
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2012
ABSTRACT Dans les tympanoplasties, l’utilisation désormais fréquente de cartilage pour reconstitu... more ABSTRACT Dans les tympanoplasties, l’utilisation désormais fréquente de cartilage pour reconstituer les lyses osseuses du méat auditif externe et pour renforcer la membrane tympanique peut, lorsque le cartilage est en place, gêner la réalisation des ossiculoplasties en masquant la vision de la région stapédienne. Si la tympanoplastie comporte une tympanotomie postérieure, la mise en place de l’ossiculoplastie par la tympanotomie postérieure constitue alors une technique intéressante.
To identify and quantify sources of variability in scores on the speech, spatial, and qualities o... more To identify and quantify sources of variability in scores on the speech, spatial, and qualities of hearing scale (SSQ) and its short forms among normal-hearing and hearing-impaired subjects using a French-language version of the SSQ. Multi-regression analyses of SSQ scores were performed using age, gender, years of education, hearing loss, and hearing-loss asymmetry as predictors. Similar analyses were performed for each subscale (Speech, Spatial, and Qualities), for several SSQ short forms, and for differences in subscale scores. One hundred normal-hearing subjects (NHS) and 230 hearing-impaired subjects (HIS). Hearing loss in the better ear and hearing-loss asymmetry were the two main predictors of scores on the overall SSQ, the three main subscales, and the SSQ short forms. The greatest difference between the NHS and HIS was observed for the Speech subscale, and the NHS showed scores well below the maximum of 10. An age effect was observed mostly on the Speech subscale items, and...
Percent score recognition (PC), for each word, varied from 18% to 92%. Word score increased signi... more Percent score recognition (PC), for each word, varied from 18% to 92%. Word score increased significantly with word amplitude calculated between 500 and 2000 Hz, the highest correlation being observed for 1000 Hz (fig 3, r=0.60). PC rose significantly with word frequency (fig 4, r=0.38, p=0.005). The correlation between PC score and word frequency varied significantly according to age and to the number of educational years (NEY), with significantly stronger correlations for younger subjects and subjects with low NEY (fig 5 ). For the entire population, PC tended to be lower for spondee with large phonological neighborhood (fig 6, p=0.07), word frequency being equivalent. This effect was enhanced for the subgroup of patients with high NEY (fig 6, lower graph) and subgroup of older patients with average hearing loss greater than 60 dB HL (fig 6, upper graph).
École doctorale : Neurosciences et Cognition Équipe de recherche : Neurosciences et système senso... more École doctorale : Neurosciences et Cognition Équipe de recherche : Neurosciences et système sensoriels « Étude de l'encodage des sons de parole par le tronc cérébral dans le bruit »
To validate a French version of the speech, spatial, and qualities of hearing scale (SSQ), a subj... more To validate a French version of the speech, spatial, and qualities of hearing scale (SSQ), a subjective evaluation of patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; hearing disability, and to assess SSQ reproducibility across different language versions. The SSQ was translated in accordance with the principles of the &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;Universalist approach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; of cross-cultural adaptation of patient-reported outcome instruments. Scores from a normal-hearing and a hearing-impaired population were compiled and compared, whenever possible, with data from the literature, collected using other language versions. One hundred normal-hearing subjects and 230 hearing-impaired subjects. Good reproducibility of scores and inter-subject variability were obtained between several language versions, even if scores found using the French version were slightly lower than those obtained using Dutch or English versions. A comparison of factor analysis outcomes between the English and French versions confirmed good conceptual equivalence across languages and robustness of the SSQ for use in international settings. The three main subscales (speech, spatial, and qualities) confirmed their usefulness in assessing different aspects of hearing disability. This study validated a French-language version of the SSQ, and assessed the reproducibility of the SSQ across subject groups, administration modes, and different countries/languages, confirming its potential as an international standard for hearing disability evaluation.
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2013
Glande thyroïde ; Ponction cytologie ; Examen histologique extemporané ; Carcinome thyroïdien Rés... more Glande thyroïde ; Ponction cytologie ; Examen histologique extemporané ; Carcinome thyroïdien Résumé Objectifs.-Les auteurs analysent la pertinence diagnostique prédictive de la ponction cytologique et de l'analyse histopathologique extemporanée chez des patients adultes opérés d'une pathologie nodulaire de la glande thyroïde. Patients et méthodes.-Pour chacune des pièces opératoires, le même médecin anatomopathologiste a effectué une analyse macroscopique, une étude cytologique puis un examen histopathologique extemporané. Les résultats de la cytologie ont été exprimés en trois groupes : cytologie bénigne, maligne ou suspecte avec atypies. L'examen extemporané a été donné en trois catégories : lésion bénigne, maligne ou suspecte car ne possédant pas tous les critères de malignité. Résultats.-Sur 202 patients inclus, 166 sont des femmes (82 %). La moyenne d'âge est de 51 ans. Vingt-deux pour cent des femmes et 25 % des hommes de la population sont porteurs d'un carcinome thyroïdien sur l'histopathologie définitive. La cytologie montre 85 % de lésions bénignes, 9 % de lésions malignes et 6 % de cellules suspectes ou atypiques. Sa spécificité est de plus de 99 % ; sa sensibilité en incluant et excluant les microcarcinomes est respectivement de 36 % et 48 %. Sa pertinence diagnostique est de 84 et 89 % en excluant les microcarcinomes. L'histopathologie extemporanée révèle 85 % de lésions bénignes, 13 % de lésions malignes et 2 % de lésions suspectes. Sa spécificité est de plus de 99 % ; sa sensibilité en incluant et excluant les microcarcinomes est de 56 et 68 %. Sa pertinence diagnostique est de 89 et de 90 % en excluant les microcarcinomes. La pertinence diagnostique de l'association des deux examens est de 94 % en excluant les microcarcinomes.
Objectives: Objectives: To quantify and illustrate the location of otosclerosic foci using morpho... more Objectives: Objectives: To quantify and illustrate the location of otosclerosic foci using morphologic images, and to evaluate the impact of these otosclerotic foci on hearing loss. Methods: Methods: We investigated our histopathological collection to identify all the temporal bones with: (1) oval window otosclerosis (n=200), (2) oval window and multiple otosclerotic foci (n=35), (3) oval window plus cochlear otosclerosis (n=133), and (4) oval window foci with cochlear and multiple other otosclerotic foci (n=33). Foci were tabulated for each specimen. Cochlear function (hearing) and morphology (otosclerotic foci quantity and location) were compared. Results: Results: Of 401 temporal bones with evidence of otosclerosis, 68 had multiple foci. Ectopic foci were found in the internal auditory canal, the peri-carotid area, semicircular canals and anterior to the cochlea. There was no influence of the number of foci [not involving the cochlea] on hearing loss and cochlear morphology. Conclusion: Conclusion: This is the first systematic evaluation of the number and location of ectopic multiple otosclerotic foci. As previously reported, there is a relationship between cochlear otosclerosis and sensorineural hearing loss, however the addition of other foci does not affect hearing.
European annals of otorhinolaryngology, head and neck diseases, 2014
To compare the results obtained with canal wall up (CWU) tympanoplasty for cholesteatoma using ca... more To compare the results obtained with canal wall up (CWU) tympanoplasty for cholesteatoma using cartilage or an hydroxyapatite (HA) PORP positioned on the head of the stapes and to analyse the impact of malleus removal and total reinforcement of the tympanic membrane with cartilage. Retrospective study of 128 cases (99 adults, 29 children) operated between 2003 and 2012 for cholesteatoma by CWU tympanoplasty with use of a cartilage graft (90 cases) or a PORP (38 cases) on the head of the stapes. Audiometric results were analysed according to the International Bureau for Audiophonology (BIAP) criteria and were submitted to statistical analysis. All ossiculoplasties were performed during the first operation and only 39% of patients required surgical revision. The malleus was preserved in 79 cases and sacrificed in 49 cases. With a follow-up of 2 years, the residual mean air-bone gap was 16.8 dB in the cartilage group (gain of 7.6 dB; P = 0.001) and 15.8 dB in the PORP group (gain of 8....
European annals of otorhinolaryngology, head and neck diseases, 2013
Targeted endoscopic parathyroidectomy without gas insufflation is a relatively non-invasive means... more Targeted endoscopic parathyroidectomy without gas insufflation is a relatively non-invasive means of discovering and resecting parathyroid adenomas in sporadic primary hyperparathyroidism. This standardized technique depends on the quality of the preoperative imaging: cervical ultrasound and sestamibi scintigraphy, and can be optimized by preoperative insertion of an ultrasound-guided "harpoon" and rapid peroperative parathyroid hormone analysis. Failure rates range between 1.7% and 4%.
European annals of otorhinolaryngology, head and neck diseases, 2012
Tympanoplasty now frequently uses cartilage to repair bone lysis in the external auditory canal (... more Tympanoplasty now frequently uses cartilage to repair bone lysis in the external auditory canal (EAC) and to reinforce the tympanic membrane. Once in place, however, the cartilage may complicate ossiculoplasty by obstructing visualization of the stapedial region. Posterior tympanotomy, when included in the tympanoplasty procedure, may provide an interesting means of positioning the ossiculoplasty.
Hypothesis-Cochleostomy or round window enlargement techniques for cochlear implant electrode ins... more Hypothesis-Cochleostomy or round window enlargement techniques for cochlear implant electrode insertion result in more abnormal tissue formation in the basal cochlea and are more apt to produce endolymphatic hydrops than round window electrode insertion. Methods-Twelve temporal bones from implanted patients were examined under light microscopy and reconstructed with 3D reconstruction software to determine cochlear damage and volume of neo-ossification and fibrosis following electrode insertion. Amount of new tissue was compared between three groups of bones: insertion through the round window (RW), after enlarging the round window (RWE) and cochleostomy (Cochl). The probable role of the electrode was evaluated in each case with hydrops. Results-More initial damage occurred in the Cochl and RWE groups than in the RW group, and the difference was significant between RWE and RW in cochlear segment I (p<0.026). The volume of new bone in segment I differed significantly between groups (p<.012) and was greater in the RWE group than in either the Cochl or RW groups (post hoc p's <.035 and .019). Hydrops was seen in 5 cases, all in the Cochl and RWE groups. Blockage of the duct was due to new tissue formation in 4 of the 5 hydrops cases. Conclusion-With the electrodes in this serie, implantation through the round window minimized initial intracochlear trauma and subsequent new tissue formation, while the round window extension technique used at the time of these implantations produced the greatest damage. Future studies may clarify whether today's techniques and electrodes will produce these same patterns of damage.
Recurrent vertigo is one of the most common and incapacitating complaints reported by patients in... more Recurrent vertigo is one of the most common and incapacitating complaints reported by patients in a clinical ENT practice. Numerous pathologic diseases can result in vertigo, with or without associated auditory and neurologic symptoms. In 1952, Dix and Hallpike identified vestibular neuronitis (or neuritis) as an association of characteristic signs occurring predominantly in middle age and composed of a sudden severe and prolonged vertigo, with reduced or absent caloric response in 1 ear and preceded or concomitant to an upper respiratory tract infection (1). The presence of any auditory or neurologic symptoms would point to a differential diagnosis such as Meniere’s disease, a cerebellar infarction, or an acoustic tumor. Inflammation has long been thought to be the cause of vestibular neuronitis. However, several temporal bone evaluations have shown histologic changes, which are suggestive of a viral herpetic infection. Moreover, the common association with an upper respiratory infection and the anatomical proximity of the meatal and vestibular ganglions to the upper respiratory tract provides support for the virus theory. After the first contact with a neurotropic virus, the human body cannot rid itself of it, and the virus will remain latent in the ganglion cells, waiting for a reactivation. The contiguity of the meatal and vestibular ganglions can explain, in some cases, the movement of the virus from the meatal ganglion, in the fundal segment of the facial nerve, to the vestibular nerve but not the auditory nerve owing to the lack of continuity of the two. Thus, the neurotropic viruses can spread after an anterograde flow, so that hearing loss does not occur (2).
Multisensory processes include the capacity to combine information from the different senses, oft... more Multisensory processes include the capacity to combine information from the different senses, often improving stimulus representations and behavior. The extent to which multisensory processes are an innate capacity or instead require experience with environmental stimuli remains debated. We addressed this knowledge gap by studying multisensory processes in prematurely born and full-term infants. We recorded 128-channel event-related potentials (ERPs) from a cohort of 55 full-term and 61 preterm neonates (at an equivalent gestational age) in response to auditory, somatosensory, and combined auditory-somatosensory multisensory stimuli. Data were analyzed within an electrical neuroimaging framework, involving unsupervised topographic clustering of the ERP data. Multisensory processing in full-term infants was characterized by a simple linear summation of responses to auditory and somatosensory stimuli alone, which furthermore shared common ERP topographic features. We refer to the ERP ...
BACKGROUND Atypical cries have been identified in infants with neurological dysfunction. The aim ... more BACKGROUND Atypical cries have been identified in infants with neurological dysfunction. The aim of this study was to conduct a systematic review and meta-analysis to appraise existing evidence for associations between acoustic cry characteristics and neurological dysfunction in infants aged 18 months or less. METHODS PubMed/MEDLINE, PsycINFO, CINAHL, and Embase were searched for original, peer-reviewed studies published in English reporting cry variables in infants aged 18 months or less with or at risk of neurological dysfunction. Studies without a nonneurologically impaired control sample were excluded. Pooled effect sizes were estimated using standardized mean difference (SMD) and odds ratio (OR). I2 indicated study heterogeneity, and the risk of bias was assessed using the Newcastle-Ottawa Scale. RESULTS From March 2018 to February 2019, 28,294 studies were retrieved. Eight were meta-analyzed. Infants with or at risk of neurological dysfunction exhibited higher mean (SMD = 0.11 [95% confidence interval, 0.00 to 0.23]) and minimum (SMD = 0.93 [0.64 to 1.23]) fundamental frequency; higher odds of hyperphonation (OR = 13.17 [1.05 to 165.87]), biphonation (OR = 10.62 [1.53 to 73.59]), rise-fall-rise melodies (OR = 4.66 [1.16 to 18.66]), and flat melodies (OR = 4.47 [1.27 to 15.68]); and lower odds of fall-rise-fall melodies (OR = 0.21 [0.05 to 0.83]). CONCLUSIONS Infants with underlying neuropathology have unique cries characterized by higher fundamental frequency, dysphonation, and atypical melodies, although study heterogeneity and imprecision of effect size estimates limited our interpretation. Assessment of acoustic cry characteristics offers the potential for noninvasive, rapid, point-of-care screening for neurologically high-risk infants.
BACKGROUND: This report describes a new strategy for the care of patients with osteogenesis imper... more BACKGROUND: This report describes a new strategy for the care of patients with osteogenesis imperfecta, based on an interdisciplinary team working. Thereby, we aim at fulfilling three main goals: offering thorough coordinated management for all, and improving physical activity and quality of life of the patients. AIM: With rare diseases such as osteogenesis imperfecta (OI), patients and their family often suffer from inadequate recognition of their disease, poor care coordination and incomplete information. A coordinated interdisciplinary approach is one possible solution for providing both comprehensive and cost-effective care, with benefits for patient satisfaction. Poor physical activity and impaired quality of life represent a considerable burden for these patients. To better address these issues, in 2012 we created an interdisciplinary team for the management of OI patients in our University Hospital Centre (CHUV, Lausanne University Hospital,). In this article we describe the implementation of this interdisciplinary care strategy for patients suffering from OI, and its impact on their physical activity and quality of life. METHODS: All patients from the French part of Switzerland were invited to join us. We proposed two complementary evaluations: the initial interdisciplinary evaluation and a yearly follow-up during a special day-the "OI day". This day features specialised medical appointments adapted to each patient's needs, as well as lectures and/or workshops dedicated to patients' and families' education. Our first aim was to propose for each patient the same management, from diagnosis to the bone health evaluation and physical therapy advice. Our second aim was to evaluate the evolution of physical activity, quality of life (measured by EQ-5D, SF-36 and a dedicated questionnaire) and satisfaction of patients and their families. Here we report both the initial and the long-term results. RESULTS: Since 2012, 50 patients from the French part of Switzerland received the personalised medical evaluation. All of the patients included in this study had the same initial evaluation and at least one participation in an OI Day. All patients had an adaptation of their bone acting drugs. Over a 7-year period, 62% of inactive patients started some physical activity, and 44% of patients who were not involved in any athletic activity started participating in sports. The mean EQ-5D increased from 0.73 to 0.75 (p = 0.59). The mean physical SF36 (musculoskeletal function) score was 59.09 ± 22.72 and improved to 65.79 ± 21.51 (p = 0.08), whereas it was 68.06 ± 20.05 for the mental SF36 without alteration during follow-up. The OI day was revealed to be useful, it contributed to improvement in continuity of care and helped families to better understand the OI patients' health. CONCLUSIONS: Our interdisciplinary approach aimed at offering the same thorough management for all patients from the French part of Switzerland, and at improving both the physical activity and the satisfaction of the patients and their family. This report is a basis for future work focusing on the effect of bone fragility and the impact of OI on patients' social relations.
Background: Two non-invasive ventilation strategies, Bubble Continuous Positive Airway Pressure (... more Background: Two non-invasive ventilation strategies, Bubble Continuous Positive Airway Pressure (Bubble CPAP) and standard nasal Continuous Positive Airway Pressure (nasal-CPAP), are commonly used to treat preterm infants in the NICU, differentially impacting their auditory environment and contributing to noise exposure above recommended safe levels. Aim: To compare differences in sound exposure for preterm infants receiving two types of non-invasive CPAP. Method: Prospective observational study of 108 preterm infants, receiving either Bubble-CPAP or nasal-CPAP, using repeated measures of sound exposure in single-patient rooms and semi-private bays. Results: Analyses with repeated measures demonstrated that both types of CPAP increase noise levels above the background of the NICU, and that non-invasive nasal-CPAP produces higher noise pollution compared to Bubble CPAP, regardless of the room type. Conclusion: While CPAP is a necessary treatment for many preterm infants, cumulative noise exposure in extremely preterm infants may also be a care consideration.
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2012
ABSTRACT Dans les tympanoplasties, l’utilisation désormais fréquente de cartilage pour reconstitu... more ABSTRACT Dans les tympanoplasties, l’utilisation désormais fréquente de cartilage pour reconstituer les lyses osseuses du méat auditif externe et pour renforcer la membrane tympanique peut, lorsque le cartilage est en place, gêner la réalisation des ossiculoplasties en masquant la vision de la région stapédienne. Si la tympanoplastie comporte une tympanotomie postérieure, la mise en place de l’ossiculoplastie par la tympanotomie postérieure constitue alors une technique intéressante.
To identify and quantify sources of variability in scores on the speech, spatial, and qualities o... more To identify and quantify sources of variability in scores on the speech, spatial, and qualities of hearing scale (SSQ) and its short forms among normal-hearing and hearing-impaired subjects using a French-language version of the SSQ. Multi-regression analyses of SSQ scores were performed using age, gender, years of education, hearing loss, and hearing-loss asymmetry as predictors. Similar analyses were performed for each subscale (Speech, Spatial, and Qualities), for several SSQ short forms, and for differences in subscale scores. One hundred normal-hearing subjects (NHS) and 230 hearing-impaired subjects (HIS). Hearing loss in the better ear and hearing-loss asymmetry were the two main predictors of scores on the overall SSQ, the three main subscales, and the SSQ short forms. The greatest difference between the NHS and HIS was observed for the Speech subscale, and the NHS showed scores well below the maximum of 10. An age effect was observed mostly on the Speech subscale items, and...
Percent score recognition (PC), for each word, varied from 18% to 92%. Word score increased signi... more Percent score recognition (PC), for each word, varied from 18% to 92%. Word score increased significantly with word amplitude calculated between 500 and 2000 Hz, the highest correlation being observed for 1000 Hz (fig 3, r=0.60). PC rose significantly with word frequency (fig 4, r=0.38, p=0.005). The correlation between PC score and word frequency varied significantly according to age and to the number of educational years (NEY), with significantly stronger correlations for younger subjects and subjects with low NEY (fig 5 ). For the entire population, PC tended to be lower for spondee with large phonological neighborhood (fig 6, p=0.07), word frequency being equivalent. This effect was enhanced for the subgroup of patients with high NEY (fig 6, lower graph) and subgroup of older patients with average hearing loss greater than 60 dB HL (fig 6, upper graph).
École doctorale : Neurosciences et Cognition Équipe de recherche : Neurosciences et système senso... more École doctorale : Neurosciences et Cognition Équipe de recherche : Neurosciences et système sensoriels « Étude de l'encodage des sons de parole par le tronc cérébral dans le bruit »
To validate a French version of the speech, spatial, and qualities of hearing scale (SSQ), a subj... more To validate a French version of the speech, spatial, and qualities of hearing scale (SSQ), a subjective evaluation of patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; hearing disability, and to assess SSQ reproducibility across different language versions. The SSQ was translated in accordance with the principles of the &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;Universalist approach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; of cross-cultural adaptation of patient-reported outcome instruments. Scores from a normal-hearing and a hearing-impaired population were compiled and compared, whenever possible, with data from the literature, collected using other language versions. One hundred normal-hearing subjects and 230 hearing-impaired subjects. Good reproducibility of scores and inter-subject variability were obtained between several language versions, even if scores found using the French version were slightly lower than those obtained using Dutch or English versions. A comparison of factor analysis outcomes between the English and French versions confirmed good conceptual equivalence across languages and robustness of the SSQ for use in international settings. The three main subscales (speech, spatial, and qualities) confirmed their usefulness in assessing different aspects of hearing disability. This study validated a French-language version of the SSQ, and assessed the reproducibility of the SSQ across subject groups, administration modes, and different countries/languages, confirming its potential as an international standard for hearing disability evaluation.
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2013
Glande thyroïde ; Ponction cytologie ; Examen histologique extemporané ; Carcinome thyroïdien Rés... more Glande thyroïde ; Ponction cytologie ; Examen histologique extemporané ; Carcinome thyroïdien Résumé Objectifs.-Les auteurs analysent la pertinence diagnostique prédictive de la ponction cytologique et de l'analyse histopathologique extemporanée chez des patients adultes opérés d'une pathologie nodulaire de la glande thyroïde. Patients et méthodes.-Pour chacune des pièces opératoires, le même médecin anatomopathologiste a effectué une analyse macroscopique, une étude cytologique puis un examen histopathologique extemporané. Les résultats de la cytologie ont été exprimés en trois groupes : cytologie bénigne, maligne ou suspecte avec atypies. L'examen extemporané a été donné en trois catégories : lésion bénigne, maligne ou suspecte car ne possédant pas tous les critères de malignité. Résultats.-Sur 202 patients inclus, 166 sont des femmes (82 %). La moyenne d'âge est de 51 ans. Vingt-deux pour cent des femmes et 25 % des hommes de la population sont porteurs d'un carcinome thyroïdien sur l'histopathologie définitive. La cytologie montre 85 % de lésions bénignes, 9 % de lésions malignes et 6 % de cellules suspectes ou atypiques. Sa spécificité est de plus de 99 % ; sa sensibilité en incluant et excluant les microcarcinomes est respectivement de 36 % et 48 %. Sa pertinence diagnostique est de 84 et 89 % en excluant les microcarcinomes. L'histopathologie extemporanée révèle 85 % de lésions bénignes, 13 % de lésions malignes et 2 % de lésions suspectes. Sa spécificité est de plus de 99 % ; sa sensibilité en incluant et excluant les microcarcinomes est de 56 et 68 %. Sa pertinence diagnostique est de 89 et de 90 % en excluant les microcarcinomes. La pertinence diagnostique de l'association des deux examens est de 94 % en excluant les microcarcinomes.
Objectives: Objectives: To quantify and illustrate the location of otosclerosic foci using morpho... more Objectives: Objectives: To quantify and illustrate the location of otosclerosic foci using morphologic images, and to evaluate the impact of these otosclerotic foci on hearing loss. Methods: Methods: We investigated our histopathological collection to identify all the temporal bones with: (1) oval window otosclerosis (n=200), (2) oval window and multiple otosclerotic foci (n=35), (3) oval window plus cochlear otosclerosis (n=133), and (4) oval window foci with cochlear and multiple other otosclerotic foci (n=33). Foci were tabulated for each specimen. Cochlear function (hearing) and morphology (otosclerotic foci quantity and location) were compared. Results: Results: Of 401 temporal bones with evidence of otosclerosis, 68 had multiple foci. Ectopic foci were found in the internal auditory canal, the peri-carotid area, semicircular canals and anterior to the cochlea. There was no influence of the number of foci [not involving the cochlea] on hearing loss and cochlear morphology. Conclusion: Conclusion: This is the first systematic evaluation of the number and location of ectopic multiple otosclerotic foci. As previously reported, there is a relationship between cochlear otosclerosis and sensorineural hearing loss, however the addition of other foci does not affect hearing.
European annals of otorhinolaryngology, head and neck diseases, 2014
To compare the results obtained with canal wall up (CWU) tympanoplasty for cholesteatoma using ca... more To compare the results obtained with canal wall up (CWU) tympanoplasty for cholesteatoma using cartilage or an hydroxyapatite (HA) PORP positioned on the head of the stapes and to analyse the impact of malleus removal and total reinforcement of the tympanic membrane with cartilage. Retrospective study of 128 cases (99 adults, 29 children) operated between 2003 and 2012 for cholesteatoma by CWU tympanoplasty with use of a cartilage graft (90 cases) or a PORP (38 cases) on the head of the stapes. Audiometric results were analysed according to the International Bureau for Audiophonology (BIAP) criteria and were submitted to statistical analysis. All ossiculoplasties were performed during the first operation and only 39% of patients required surgical revision. The malleus was preserved in 79 cases and sacrificed in 49 cases. With a follow-up of 2 years, the residual mean air-bone gap was 16.8 dB in the cartilage group (gain of 7.6 dB; P = 0.001) and 15.8 dB in the PORP group (gain of 8....
European annals of otorhinolaryngology, head and neck diseases, 2013
Targeted endoscopic parathyroidectomy without gas insufflation is a relatively non-invasive means... more Targeted endoscopic parathyroidectomy without gas insufflation is a relatively non-invasive means of discovering and resecting parathyroid adenomas in sporadic primary hyperparathyroidism. This standardized technique depends on the quality of the preoperative imaging: cervical ultrasound and sestamibi scintigraphy, and can be optimized by preoperative insertion of an ultrasound-guided "harpoon" and rapid peroperative parathyroid hormone analysis. Failure rates range between 1.7% and 4%.
European annals of otorhinolaryngology, head and neck diseases, 2012
Tympanoplasty now frequently uses cartilage to repair bone lysis in the external auditory canal (... more Tympanoplasty now frequently uses cartilage to repair bone lysis in the external auditory canal (EAC) and to reinforce the tympanic membrane. Once in place, however, the cartilage may complicate ossiculoplasty by obstructing visualization of the stapedial region. Posterior tympanotomy, when included in the tympanoplasty procedure, may provide an interesting means of positioning the ossiculoplasty.
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