Intracochlear schwannoma presenting as diffuse cochlear enhancement: diagnostic challenges of a rare cause of deafness

Intracochlear schwannoma is a rare, treatable, cause of unilateral hearing loss. Due to the small size, position, and variable clinical and imaging features, diagnosis presents a significant challenge and is often delayed. We present a case of a patient with an intracochlear schwannoma presenting as a diffuse enhancement of the cochlea, mimicking an infectious or inflammatory process. The absence of focal nodularity in this lesion on multiple high-resolution MRI examinations led to a delay of over 3 years from the patient’s initial presentation to surgical diagnosis. Clinical history and examination, imaging features, pathologic findings, and surgical management options are described

Macro–micromanipulation platform for inner ear drug delivery

International audienceThis paper describes the pulling and steering of magnetic therapeutic microparticles for drug delivery based on a macro-micromanipulator system. The macromanipulation system is composed of a 6 Degree Of Freedom (6 DOF) serial manipulator while a linear permanent-based actuator (1 DOF) is equipped at the end-effector as a micropart to precisely steer and pull magnetic microparticles. Using the classical mathematical tools of robotics, we developed the global kinematic model of the robot-device assembly, thus defining a reference trajectory to propel the microparticles. A novel actuator-based permanent magnet has been designed and realized as a robot micro end-effector to control the trajectory of a microparticle along a millimeter-sized workspace. Simulations and experiments were conducted to show the ability of the macro-micromanipulator system to steer particles on a viscous fluid simulating a biological media. (C) 2018 Published by Elsevier B.V

Local anaesthesia and conscious sedation for cochlear implantation: experience with 20 patients

International audienceOBJECTIVE: Cochlear implantation is mostly performed under general anaesthesia. This study aimed to evaluate cochlear implantation performed under local anaesthesia and sedation. METHOD: Twenty patients had a cochlear implant fitted under combined local anaesthesia (local anaesthesia group) and 41 patients had one fitted under general anaesthesia (general anaesthesia group) for bilateral profound hearing loss, from 2011 to 2014. Surgical duration, period of post-operative hospitalisation and early post-operative symptoms were compared. In the local anaesthesia group, operative symptoms reported during the surgery and by questionnaire were analysed. RESULTS: Mean surgical duration was significantly shorter in the local anaesthesia group: 87 versus 122 minutes (p \textless 0.001). No significant difference was observed between the local anaesthesia and general anaesthesia groups regarding mean post-operative hospitalisation and early post-operative symptoms. Under local anaesthesia, patients had no particular symptoms in 60 per cent of cases. The remaining patients in this group experienced vertigo (10 per cent), pain (20 per cent) and pain-related movement (10 per cent) during the intervention. These symptoms can be controlled with symptomatic treatment. CONCLUSION: Combined local anaesthesia for cochlear implantation is a good alternative to general anaesthesia for co-operating patients

Self-Assembly of Mesoscale Artificial Clathrin Mimics

Fluidic control and sampling in complex environments is an important process in biotechnology, materials synthesis, and microfluidics. An elegant solution to this problem has evolved in nature through cellular endocytosis, where the dynamic recruitment, self-assembly, and spherical budding of clathrin proteins allows cells to sample their external environment. Yet despite the importance and utility of endocytosis, artificial systems which can replicate this dynamic behavior have not been developed. Guided by clathrin’s unusual structure, we created simplified metallic microparticles that capture the three-legged shape, particle curvature, and interfacial attachment characteristics of clathrin. These artificial clathrin mimics successfully recreate biomimetic analogues of clathrin’s recruitment, assembly, and budding, ultimately forming extended networks at fluid interfaces and invaginating immiscible phases into spheres under external fields. Particle curvature was discovered to be a critical structural motif, greatly limiting irreversible aggregation and inducing the legs’ selective tip-to-tip attraction. This architecture provides a template for a class of active self-assembly units to drive structural and dimensional transformations of liquid–liquid interfaces and microscale fluidic sampling