Biomedical subjects

Georges Dumas

Publications and source records attributed to Georges Dumas.

3 recordsLinked to original sources

PubMed2005

Hearing results with the titanium ossicular replacement prostheses.

The purpose was to study the hearing results in patients receiving a Kurz titanium Bell partial ossicular replacement prosthesis (PORP) or an Aerial total ossicular replacement prosthesis (TORP). The study was a retrospective chart review in a tertiary otologic referral center. A computerized otologic database was used to identify 111 patients implanted with either a PORP or TORP prosthesis. Audiograms were reviewed and air-bone gaps were calculated for each patient. The improvement of the average air-bone gap (ABG) was 10.2 and 12.7 dB at 3 and 20 months after ossiculoplasty, respectively. Sixty-six percent of patients (73/111) had a postoperative air-bone gap of 20 dB or less. The ABG for the titanium PORP prosthesis was 14.3+/-9.7 dB, compared with 25.2+/-13.7 dB for the TORP prosthesis (P <0.05). The ABG to within 20 dB or less was obtained in the PORP group in 77% of the cases, versus 52% of the cases in the TORP group (P <0.05). Two extrusions of the prostheses were observed at 17 and 20 months after surgery (1.8%). Revision procedures for functional failure were carried out in 20 patients (18%). The rate of sensorineural hearing loss was 3.6%. The major factors influencing good audiometric results were the surgical procedure preserving the external auditory canal and the presence of the stapes. The best hearing results were achieved when a PORP was used in an intact canal wall (ICW) procedure, and the worst hearing results were achieved when a TORP was used in a canal wall down (CWD) procedure. The titanium Kurz prosthesis has been an effective implant at our institution for ossicular reconstruction.

Adolescent↗

PubMed2004

Intraoperative auditory monitoring in vestibular schwannoma surgery: new trends.

OBJECTIVE: To investigate the efficiency of a new method of brainstem auditory-evoked potential (BAEP) monitoring during complete vestibular schwannoma (VS) resection with attempted hearing preservation. MATERIAL AND METHODS: Dedicated software providing near real-time recording was developed using a rejection strategy of artifacts based on spectral analysis. A small sample number (maximum 200) is required and results are obtained within 10 s. Fourteen consecutive patients with hearing class A operated on for VS, in an attempt to preserve hearing, participated in the investigation. Postoperatively, 7 patients (50%) had useful hearing (hearing class A, 4/14; hearing class B, 3/14) on the operated side. Seven patients (50%) were reduced to hearing class D. RESULTS: Drilling of the internal auditory canal (IAC) and tumor removal at the lateral end of the IAC were identified as the two most critical steps for achieving hearing preservation. Intraoperative BAEP monitoring was sensitive in detecting auditory damage with useful feedback but its effectiveness in preventing irreversible hearing impairment was not demonstrated in this study. CONCLUSION: Combined BAEP and direct auditory nerve monitoring using the same equipment will be performed in the future in an attempt to enhance the chances of preventing irreversible hearing damage, and possibly to improve the hearing outcome significantly.

Adolescent↗

PubMed2002

Perception of slow pitch and roll body tilts in bilateral labyrinthine-defective subjects.

The aim of the present study was to examine whether the perception of slow body tilts in total darkness was affected by a complete loss of vestibular function. Four blindfolded bilateral labyrinthine-defective subjects (LDs) and 12 normal subjects (Normals) were seated and immobilized with large straps against the back of a rotating L-shaped platform, and were passively displaced from the upright at 0.05 degrees x s(-1) in the pitch and roll dimensions. Subjects were asked to detect the slow change in their body orientation, by indicating as soon as possible the direction of tilt. After a brief period of practice observed for all LDs at the beginning of the session, results showed no significant difference between LDs and Normals in the mean detection threshold recorded for each direction of tilt. The mean perceptual threshold was 4.4 versus 5.1 degrees in the roll dimension, and 6.1 versus 6.1 degrees in the pitch dimension, for the LDs and Normals, respectively. These findings indicate that the accurate perception of body orientation in quasi-static conditions is mainly allowed by somatosensory information rather than by otolithic inputs.

Adult↗