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Biomedical subjects

J P Diard

Publications and source records attributed to J P Diard.

9 recordsLinked to original sources
PubMed1999

Saccular dysfunction in Meniere's disease.

OBJECTIVE: The aim of this study was to assess any dysfunction of the sacculus in patients with unilateral Meniere's disease by monitoring the vestibular evoked myogenic potentials (VEMPs) evoked by high level clicks on the Stemomastoid muscles (SCMs). STUDY DESIGN: The study was a retrospective analysis. SETTING: The study was performed in the E.N.T. department of the Lariboisière Hospital. PATIENTS: Fifty-nine patients aged 18 to 74 years with well-established unilateral Meniere's disease were included in the study. INTERVENTIONS: Loud monaural clicks were delivered unilaterally, and the VEMPs were recorded with skin electrodes on the ipsilateral SCM. All the patients were also subjected to a pure tone audiometric test and bithermal caloric testing. The postural performances of 39 patients were analyzed using the Equitest. MAIN OUTCOME MEASURE: VEMP results were the main outcome measure. RESULTS: The saccular response was absent on the affected side in 54% of the patients with Meniere's disease. This absence was correlated with the degree of low frequency hearing loss but not with canal paresis. Finally, nonfalling patients with saccular dysfunction had a significantly poorer postural performance than those without such dysfunction in the condition 5. CONCLUSION: Patients with Meniere's disease could have a saccular dysfunction (54% in this series). This saccular impairment correlated with low frequency hearing loss but not with canal paresis. Patients without VEMPs had poorer postural performances in condition 5 than those with normal VEMPs. Therefore, VEMP testing is useful for detecting patients at risk: in patients with saccular lesion, the dynamic postural performances should be assessed on a movable platform to detect visually dependent patients and to orient vestibular rehabilitation.

Adolescent↗
PubMed1999

[Rehabilitation of the paralyzed face by hypoglossal-facial nerve anastomosis. An analysis of 7 cases].

After facial nerve injury, in cerebello-pontine tumors surgery, hypoglossal-facial anastomosis is the most common procedure, to rehabilite a paralysed face, if direct facio-facial graft is not possible. This procedure must be done, in a second time, during the next year and followed with a specific reeducation. In seven patients operated between 1985 and 1996, we performed clinical evaluation and electrophysiological examination. The best evaluation is the clinical evaluation using the G. Freyss's facial testing. Best results are seen in early, specific and continued reeducation. All our patients have a good recovery of facial nerve function, but clinical examination and electrophysiological results are not correled with an objective video performance. The management of such patients needs efficient oto-neurosurgical team and specific trained physiotherapists.

Adult↗
PubMed1997

Posture control after prolonged exercise.

The perturbations of equilibrium after prolonged exercise were investigated by dynamic posturography on nine well-trained subjects (four athletes and five triathletes). A sensory organization test, where the platform and visual surround were either stable or referenced to the subject's sway with eyes open or closed, was performed before and after a 25-km run (average time 1 h 44 min) by the nine subjects. In addition, the same test was performed on the five triathletes only, before and after ergocycle exercise of identical duration (i.e. ergocycle time = running time). The results showed that the ability to maintain postural stability during conflicting sensory conditions decreased after exercise, with some differences depending on the kind of exercise. Sensory analysis revealed that the subjects made less effective use of vestibular inputs after running than after cycling (P < 0.05). Adaptation to prolonged stimulation of proprioceptive, vestibular and visual inputs had probably occurred in the integrating centres during exercise. This adaptation was maintained during the recovery period and could explain the postexercise balance disorders. Other mechanisms such as impairment of motor efferents or haemodynamic changes should not be excluded.

Adult↗
PubMed1997

[Equitest and high performance patients].

The purpose of this study was to verify whether a clinical tool used to assess balance deficits could be used to document the enhanced equilibrium skills of highly trained individuals. A sensory organization test (SOT) based on computerized dynamic posturography (Equitest Neurocom) was administered at two levels of difficulty (sway-reference gains 1.0 and 1.99) to six populations of subjects (n = 81): controls, active duty fighters pilots, former fighter pilots, windsurfers, T-kwando athletes and firemen. The more difficult SOT (gain 1.99) provided the best estimation of performances differences among the six populations. Specifically, performance scores were significantly higher (p > 0.001) for wind surfer and active duty pilots compared to the other groups. Differences between active duty are retired pilots suggest that the enhenced balance of milots is an acquired skill required continued practice. Results furthers suggest that dynamic posturography can be reliable tool for identifying subjects with enhenced equilibrium skills.

Adult↗
PubMed1995

[History of the special surgery department].

The author showed a history of the Special Surgery Department in Val de Grace. The Heads of the Department were celebrated surgeons, otolaryngologists, ophthalmologists and facial-maxillary surgeons.

History, 18th Century↗
PubMed1990

[Tympanoplasty in the treatment of sequelae of blast injuries of the ear].

This study deals with 40 clinical files relating to auricular blast injury patients with ensuing eardrum perforation, managed either by tympanoplasty or by placement of a healing support. An analysis of the functional symptoms, the size and localization of the perforation; determination of the presence or lack of immediate post-injury infection, and of the degree and type of hearing loss suffered, permits to define the characteristics of postoperative ear status. A comparison of the study results with published data provides for specifying surgical indications and sheds light on the long-term evolution pattern in such patients.

Adolescent↗