Biomedical subjects
Publications and source records attributed to M Nègrevergne.
Peroperative catheterization of the Eustachian tube is an exploratory and management technique enabling a better understanding of the pathological phenomena, resulting in a more effective therapeutic orientation for short term lesions (infection). In the long term, tubal rehabilitation becomes a logical complement.
The authors have studied 70 postmeningitic hearing losses in children. The deafness was acquired before the age of 2 year-old in 71% of the cases. Profound losses were observed in 50% considering the 1000 Hz at +100 dB, on the best ear as a selection criterion, 31 cases/70 (= 44%) could benefit from a cochlear implant. Among these 31 cases, 71% (= 22 cases) are prelingually deafness, that is which have occurred before the age of 2 years old. In 2 profound deafness cases, a late improvement of initial threshold, brings to consider with caution the 6 to 12 months time limit which is recommended by the different teams. In 3 other cases of moderate or severe losses, an improvement of the thresholds has been also observed. Because of psychological disturbances or other after-effects, a very regular medical following of these children is needed.
The choice of a cochlear implant is a difficult one. A given type of implant does not yet correspond to a given type of patient. Our indications have to be refined by acquired experience and through the improvement of tests prior to implanting. The implants available present different features, but they all improve the communication of the profoundly deaf to different degrees, by attenuating their tinnitus.
The authors present a case of a cochleovestibular syndrome with a scanner showing a calcified dolico-ektasis of the basilar truncus and the left vertebral artery. The patient had typical Ménière's disease symptomatology. A retrolabyrinthic diagnosis with substantial recruitment was indicated by the results of the audio-vestibular explorations (stapedius reflex, electroculography, early brainstem evoked response, electrocochleography). The electrocochleography with glycerol test indicated labyrinthic hydrops. Finally, some reflections on the role of neurovascular problems in the pathogeny of some cochleovestibular syndromes are put forward.
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Electrical stimulation of the ear in humans was performed with an extracochlear electrode on the round window. With positive currents, suppression of tinnitus could be induced. With negative currents, auditory sensations were evoked. Since electrical stimulation with DC currents may be hazardous in the long term, it cannot yet be proposed for the suppression of tinnitus. However, electrically evoked hearing sensations with AC currents seem to be of definite interest for some totally deaf patients.
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