Biomedical subjects
Publications and source records attributed to M Drira.
Ten typical cases of sideropenic dysphagia over four years reported and clinical, biological, endoscopic and radiological signs are studied. The authors stress the value of oesophagal opacification for diagnosis. The particularities of our study are the relative high frequency of the disease in Tunisia and the unusual attack in two black patients.
A battery of psychophysic tests has been designed through a computerized command of the patient's emitter. Because of the fatigability of these implanted patients, especially in the case of deaf-mute children, and the tedious aspect of these exams only 4 tests are commonly used: the threshold level in a Békésy way, the tone decay test, the 2 channels discrimination at different intensity levels, the lowest intensity discrimination. If the electrode impedances have been per-operatively measured, these tests are useful to understand the particular phonemic discrimination difficulties of each patient.
In order to avoid false and quantitatively unprecise responses the stimulating electrode must be directly placed on the round window membrane. That necessitates a transmeatal approach removing the eardrum, which is commonly achieved under local anesthesia. The positive response is subjectively easy to identify; it may be objectively registered by means of brain stem evoked responses; this registration is indispensable in case of children who need general anesthesia. This positive response signifies that some cochlear nerve fibers are still present, and therefore that the rehabilitation of the cochlear implant is possible. Among the 460 totally deaf, stimulated patients, more than 93% of them presented a positive response. The threshold level voltage value represents a statistically significant representation of the functional value of the electrode nerve interface. The features of the tone decay tests, which may be also subjectively or objectively performed, present important data which may be used to predict the clinical results that can be obtained by the cochlear implant.