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Biomedical subjects

J P Bebear

Publications and source records attributed to J P Bebear.

16 recordsLinked to original sources
PubMed1991

Betahistine dihydrochloride versus flunarizine. A double-blind study on recurrent vertigo with or without cochlear syndrome typical of Menière's disease.

This study was designed to compare the efficacy and safety of betahistine dihydrochloride and flunarizine. All patients included in this multicenter, double-blind, randomized trial showed a specific pattern of vertigo, i.e. recurrent paroxysmal vertigo with or without the cochlear symptoms typical of Meniere's disease. Fifty-five patients were treated for 2 months (28 in the betahistine group and 27 in the flunarizine group). Analysis of intra-group symptom changes demonstrated a greater efficacy for betahistine. Statistically significant decreases in duration and severity of attacks, and in the presence of vegetative symptoms were seen in the betahistine group after the first and second months of treatment, whereas in the flunarizine group this was the case only at the end of the first month of treatment. Furthermore in the betahistine group, statistically significant decreases occurred for the other major criteria, including number of attacks, evidence of vestibular dysfunction, and presence of cochlear symptoms. Adverse effects were similar to those reported in previous studies of both products: stomach pains only with betahistine, and drowsiness, asthenia, and depression with flunarizine.

Betahistine↗
PubMed1990

[Trimetazidine and degenerative deafness. Effect on hearing and integration].

This study was conducted in order to assess the activity of trimetazidine dosed at 60 mg/day in patients presenting degenerative loss of hearing. Ten centers participated in this multicenter double-blind placebo-controlled trial which spanned 6 months. Included were 251 patients (118 women, 133 men) presenting with pure perception bilateral symmetrical deafness concerning predominantly the acute frequency range. 228 patients terminated the study, including 115 in the trimetazidine group and 113 in the placebo group. The evolution over a 6-month treatment period was significantly better with trimetazidine as regards the following parameters: audibility as assessed by pure-tone audiometry, namely at the acute frequency range (p = 0.002), intelligibility as assessed by speech audiometry (p = 0.008), subjective evaluation of hearing loss and its impact on the patient's social life. Results confirm the value of trimetazidine hearing loss management, based on clinical, subjective criteria as well as audiometric ones. Parameters reflecting best trimetazidine's efficacy were intelligibility and the psychological/behavioral impact of the impairment, allowing for better social integration of the subject.

Aged↗
PubMed1989

Aesthetic surgery for microtia.

We describe here a technique for reconstruction of the external ear based upon an autogenous costal cartilage graft which is inserted into a cutaneous pocket dissected in the auricular area. Three subsequent procedures are then performed: rotation of the ear-lobe; reconstruction of the tragus; and elevation of the auricle. The ideal age for reconstruction is about 7 years. This technique was originally described by Brent, who has a very extensive experience with this kind of surgery. Skin deficiencies can be overcome by using either a temporo-parietal fascial flap or a skin expander.

Cartilage↗
PubMed1986

Ceravital in ossiculoplasty: experimental studies and early clinical results.

The biocompatibility of the bioactive glass-ceramic Ceravital was investigated experimentally both in vivo and in vitro. In the former, ceramic discs were interposed in 30 rat middle ears for periods ranging from 6 weeks to 12 months. In the latter, Ceravital otological prosthesis were placed in human fibroblast culture. Reactions to the biomaterial were assessed by means of scanning electron microscopy (SEM) with chemical analysis facilities (EDAX, WDAX) and light microscopy. The interface reactions were similar in both in vivo and in vitro studies and confirmed the findings of other authors regarding the implants' biocompatibility and bioactivity. The technique of ion etching, however, enabled clear demonstration of this bioactivity on the implant surface, exposed merely to the middle-ear secretions, thus questioning the necessity of placing bone pâté on the implant head at surgery, in order to encourage bioactive bonding with the overlying drum. A clinical trial of Ceravital in 128 patients with an average follow-up period of 2 years is reported. Forty per cent of these patients underwent a type II tympanoplasty, 60 per cent a type III. Though relatively short-term, the results to date have been encouraging: 88 per cent of the implants have been well-tolerated; 70 per cent of the cases have yielded a satisfactory hearing result; and only 3 per cent of the implanted prostheses have been extruded.

Animals↗
PubMed1976

Hemifacial spasm: importance of a complete investigation.

The authors report the experience of the Clinique d'O.R.L. de l'Université de Bordeaux II in the management of hemifacial spasm. The recent diagnostic and therapeutic progress in otoneurology has revealed an organic etiology for many cases of hemifacial spasm. The recent diagnostic and therapeutic progress in otoneurology has revealed an organic etiology for many cases of hemifacial spasm. From their experience, they propose a complete investigation for all cases of hemifacial spasm. The disorder is labelled as being idiopathic only if the complete investigation is negative.

Adult↗
PubMed1975

[Acoustic neuroma. Apropos of a series of 40 cases].

The authors present statistics of 40 acoustic neuromas operated upon by micro-surgical technique in co-operation with oto-neuro-surgery. As regards clinical picture, all persons presenting with unilateral progressive sensoryneural deafness should be subjected to cochlear vestibular and radiologic examination. They advocated essentially two routes:--translabyrinthine approach for the tumours within the internal auditory meatus, --posterior fossa approach for the other tumours. They reported their results and analysed the major advantages of the microsurgical technique which diminish considerably the risk of this surgery, so that the functional result should be of first importance.

Adult↗
PubMedDate not supplied

Surgery of the anterior skull base: total ethmoidectomy for malignant ethmoidal tumors.

The authors report their 17-year experience of total ethmoidectomy using a combined rhinological and neurosurgical approach. As a result of new imaging methods significant progress has been made in the field of pre-operative topographic diagnosis as well as in the operative procedure itself. The optimal skull base reconstruction, which consists of epicranial graft and cryopreserved bone homograft, seems to reduce operative morbidity and mortality. The combined approach technique is shown to be successful in the treatment of both adenocarcinomas and olfactory bulb tumors. However, epidermoid carcinomas still have a poor prognosis due to frequent local recurrences and visceral metastases.

Adenocarcinoma↗
PubMedDate not supplied

Surgery of the internal acoustic meatus and the cerebello-pontine angle.

Tumoral and functional surgery of the cerebellopontine angle and the internal acoustic meatus has been performed in our department for more than 20 years. Acoustic neurinomas (700 cases operated to date) represent the great bulk of this surgery. Since 1985, we have drastically modified our approach to these tumors (220 cases). Large tumors are now dealt with, regardless of the patient's hearing, through a widened translabyrinthine approach. Small tumors with normal hearing are operated on through a suboccipital or a retrolabyrinthine approach depending on the tumoral extension in the internal acoustic meatus. The facial nerve function was preserved in 83% of the cases. Hearing was saved only 6 times in 45 attempts, despite 23 cases of apparent anatomical conservation of the cochlear nerve. Vestibular neurectomy, carried out through a middle cranial fossa or through a retrolabyrinthine approach, ameliorated vertigo in 95% of cases. The major operative risks are regressive facial paresis and secondary total deafness (10% of cases). Surgical treatment of facial hemispasm by neurovascular decompression is very effective, but not without risk. We now prefer to use botulin toxin therapy.

Cerebellar Neoplasms↗