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Jean-Philippe Guyot

Publications and source records attributed to Jean-Philippe Guyot.

11 recordsLinked to original sources
PubMed2006

[Professional occupation after cochlear implantation].

This study verifies whether cochlear implants helps deaf adults to maintain or develop their professional occupations. Sixty-seven patients received a questionnaire concerning their professional activities before and after implantation. At the time of implantation 34 were professionally active. After the implantation 29 remained active, 4 of them reporting positive developments in their careers. Five patients became inactive. The previously inactive patients remained inactive. There was no difference in auditory performances between professionally active or inactive patients. Cochlear implants enable most implanted adults to maintain and even progress in their professions. However, deafness still represents an obstacle to social integration as inactive patients who searched for a job were rejected after the job interviews.

Adolescent↗
PubMed2006

[Cochlear implant or regular hearing aid?].

A significant number of deaf patients that have received cochlear implants now achieve higher word recognition scores then those with conventional auditory prostheses. This situation makes the choice of which type of auditory rehabilitation to propose a complex matter in patients with remaining auditory function. Our paper aims at providing some arguments to these new questions by presenting the clinical experience and practice of the Centre romand d'implants cochléaires. We also address related legal issues. Clinical tools, such as testing the comprehension of lists of logatoms have proved very useful for the evaluation of these particular patients. The evaluation of cochlear implant candidates remains a highly individualized process, necessitating a case by case approach by an experienced multidisciplinary cochlear implant team.

Cochlear Implants↗
PubMed2006

[Difficulties encountered by old patients wearing a hearing aid].

Presbycusis is a common cause of deafness in the elderly. The histopathology shows degenerative changes of the hair cells in the organ of Corti, and of the auditory nerve fibers. This implies a loss of sensibility for low intensity stimuli, although the perception of loud sounds remains normal. The dynamic range of the cochlea is therefore reduced. In addition, the discrimination is also altered. Hearing aids do not restore a normal hearing. Manufacturers have reduced their size, making them difficult to handle by old patients. This paper reports some of the difficulties encountered by old patients suffering from presbycusis, their family members, doctors, and nurses are not always aware of.

Adult↗
PubMed2006

Transcanal approach to the singular nerve.

OBJECTIVES/HYPOTHESIS: Intractable benign paroxysmal positional vertigo is rare, and surgery is indicated in only a very small number of cases. Transcanal singular neurectomy is considered a difficult and risky procedure possibly leading to hearing loss and vertigo. The objective of this study was to evaluate the feasibility of the singular neurectomy through the external ear canal in an attempt to explain the contradictory results of previous reports of anatomists and of surgeons who abandoned the technique, considering that the singular neurectomy could not be reached via the external auditory canal without damaging the labyrinth. MATERIALS AND METHODS: Anatomical study on 100 halves of human heads in which the canal of the singular nerve (SN) was identified and opened at its extremities, the internal auditory canal and the ampulla of the posterior semicircular canal, via a posterior fossa approach. Next, the canal of the SN was dissected via the external auditory canal, at the floor of the round window (RW) niche. The relation of the SN canal to the ampulla of the posterior semicircular canal was evaluated. RESULTS: In 90 cases, the canal was transected medially to and away from the ampulla of the posterior semicircular canal, and in 8, at its emergence from the posterior ampullary recess. In these 98 cases, the RW membrane and the bony labyrinth were kept intact. In two cases, the canal of the SN could not be reached at the floor of the RW niche. CONCLUSION: Singular neurectomy is feasible via the external auditory canal, without damaging the RW membrane or the labyrinth in 98% of the cases. Because singular neurectomy is indicated in a very small number of cases, it is difficult to master this particular surgical procedure. This may explain why most surgeons abandoned the technique after a few attempts, followed by an unacceptable rate of sensorineural hearing loss.

Aged↗
PubMed2005

Intralabyrinthine haemorrhage following cocaine consumption.

The origin of cochleovestibular deficits remains hypothetical, a viral attack or a circulatory disorder being the two most frequently reported hypotheses. We report the case history of a patient suffering from a cochleovestibular deficit after consumption of cocaine, a drug known for its vascular effects. The MRI scans were compatible with an intralabyrinthine haemorrhage. To our knowledge, this is the first case of cochleovestibular deficit due to an intralabyrinthine haemorrhage following cocaine consumption.

Adult↗
PubMed2005

Measurements of electrode position inside the cochlea for different cochlear implant systems.

CONCLUSIONS: This study demonstrates that the exact location of an electrode inside the cochlea needs to be assessed using two complementary measures, namely the length and angle of insertion, both of which are mandatory if one wants to prevent erroneous outcomes. Knowledge of the contact position may become very useful when tuning a cochlear implant processor in a patient with contralateral residual hearing, or in cases of binaural implants. OBJECTIVE: Multichannel cochlear implants restore useful hearing to deaf patients. However, several types of intracochlear electrodes are presently available, each featuring a specific technology or design. The aim of this study was to determine precisely the intracochlear position of the contacts for different electrode arrays. MATERIAL AND METHODS: Electrode array insertions were estimated using special radiographs. A total of 26 cochlear implantations were included in the study: 6 Ineraid; 5 Clarion HiFocus I; 11 Clarion HiFocus II; and 4 Med-El Combi40+. In each case, a measurable reference or marker ring placed close to the round window (within 2 mm) could be identified. Insertion lengths and angles were measured and then plotted on a graphl based on 3D reconstructions. RESULTS: Both Clarion HiFocus I and II electrode arrays were found to be placed close to the inner wall of the cochlea. Ineraid and Med-El Combi40+ electrode arrays were both placed close to the organ of Corti, the Med-El Combi40+ arrays demonstrating the deepest insertions overall. In spite of marked differences in the positions of the contacts, we did not find any correlation with speech perception performance for the different types of implants studied.

Adult↗
PubMed2004

Anatomic and functional long-term results of canal wall-down mastoidectomy.

The objective of this study was to evaluate, over the long-term, the anatomic and functional outcome of canal wall-down mastoidectomy performed for chronic otitis media with cholesteatoma and chronic otomastoiditis resistant to all conservative treatment. The study was made through a retrospective review of 338 cases of consecutive primary canal wall-down mastoidectomies performed between 1974 and 1998. Included were 259 cases with sufficient data. In all cases, functional reconstruction was performed at the same time as the mastoidectomy. Demographic and clinical data were collected from each file. From the clinical data, the surgical techniques, complications, the number of follow-up visits necessary to ensure cavity cleanliness, details of care provided over the period 1 to 24 years (mean, 7 years) after the operation, and audiometric data from admission and from the latest postoperative follow-up were retained. Canal wall-down mastoidectomies were followed up an average of 10 times during the first 6 months after operation, twice a year over the 6-year period following surgery, and less than twice a year beyond the 6-year period. Care was dispensed for meatal stenosis, scars, infections, polyps, and beads of cholesteatoma. Surgical revisions were performed because of residual or recurrent cholesteatoma in 6.1% of the cases, because of perforation of the tympanic membrane in 7.3% of the cases, and to improve hearing in 12.2% of the cases. At the last consultation, 1 to 24 years after surgery, cavities were found to be dry and self-cleaning in 95% of the cases, and still humid, with otorrhea, in 5% of the cases. Over the long-term, the hearing threshold remained unchanged in 41.3% of the cases. It was improved after surgery by 10 to 19 dB in 15.4% of the cases, by 20 to 29 dB in 11.5% of the cases, and by more than 29 dB in 3.8% of the cases. The hearing threshold was thus improved or at least remained unchanged in 72.0% of cases. Hearing losses occurred in 28% of the cases: by 10 to 19 dB in 11.9%, by 20 to 29 dB in 6.5%, and by more than 29 dB in 9.2% of the cases. A sensorineural hearing loss of more than 60 dB at all frequencies occurred immediately after the operation in 2 cases (0.7%). There was 1 case of facial paralysis (0.3%). Four patients (1.5%) complained of persistent vertigo. Canal wall-down mastoidectomy is an adequate treatment for chronic otitis with cholesteatoma or chronic otomastoiditis. The anatomic and functional results are satisfactory, and the rate of complications is acceptably low. A tympanoplasty can be performed simultaneously. Thus, for the large majority of patients, only a single intervention is required; however, a small minority can benefit from a revision tympanoplasty. In order to obtain these results, both the patient and the surgeon should engage in a long-term follow-up.

Adolescent↗
PubMed2003

Room tilt illusion as a manifestation of peripheral vestibular disorders.

Room tilt illusion is a subjective distortion of verticality with transient paradoxical rotation of the visual field, usually in the frontal plane. It might result from dysfunction of the vestibular pathways with subsequent contradictory vestibular, visual, and proprioceptive inputs and erroneous cortical integration. It has already been described in association with brain stem and cortical lesions, but reports of cases of peripheral origin are scarce. We report here 23 cases of room tilt illusion, all but 2 occurring in patients with either vestibular peripheral abnormalities or normal assessment findings. A review of the literature is presented, as well as a hypothesis addressing this phenomenon.

Adult↗