A view of the first BAHA system implant in Zadar General Hospital

Bone Anchored Hearing Aid ili BAHA sistem danas predstavlja novi i moderan način slušne rehabilitacije i alternativu konvencionalnim slušnim pomagalima. Od prve proizvodnje 1977. godine u Švedskoj (Entific Medical Systems, Goteborg), u širokoj je primjeni i do sada je ukupno u svijetu implantirano oko 100.000 bolesnika. U radu prikazujemo prvi slučaj implanatacije BAHA sistema na Odjelu otorinolaringologije, Opće bolnice Zadar. Ugradnja BAHA sistema učinjena je kod bolesnika s dugogodišnjom kroničnom upalom srednjega uha i kroničnim mastoiditisom, što je dovelo do teškoga oštećenja sluha. Zahvat je učinjen u lokalnoj anesteziji u jednom aktu. Po uredno završenoj osteointegraciji nakon osam tjedana postavljen je i aktiviran BAHA govorni procesor BP110. Tri mjeseca od aktivacije govornoga procesora bolesnik je iznimno zadovoljan postignutom razinom slušne rehabilitacije. BAHA sistem danas je postao opće prihvaćen i suvremen način rehabilitacije sluha. Uz adekvatan odabir kandidata i uz pravilno izveden kirurški zahvat, daje značajno bolje rezultate u rehabilitaciji sluha od konvencionalnih slušnih pomagala.Bone Anchored Hearing Aid (BAHA) today presents a new and modern way of hearing rehabilitation and an alternative to the conventional hearing aids. Since its first manufacture in 1977 in Sweden (Entific Medical Systems, Goteborg), it has been widely used and up to now around 100,000 BAHA systems have been implanted worldwide. In the present case we report on a first BAHA system implantation at the ENT Department of Zadar General Hospital. The BAHA system implantation was performed in a patient with a long term history of chronic suppurative otitis that resulted in severe hearing loss. The procedure was done under local anesthesia as a single act. Upon proper osteointegration after eight weeks, the speech processor BP110 was added and activated. Three months following the activation of the speech processor, the patient is highly satisfied with the level of the achieved hearing rehabilitation. Presently, the BAHA system was a universally accepted procedure of hearing rehabilitation, and with the proper candidate selection and meticulous surgical intervention, it gives significantly better hearing rehabilitation when compared to the conventional hearing device

Effect of Rotating Auditory Scene on Postural Control in Normal Subjects, Patients With Bilateral Vestibulopathy, Unilateral, or Bilateral Cochlear Implants

Objective: The aim of this study was to investigate the impact of a rotating sound stimulation on the postural performances in normal subjects, patients with bilateral vestibulopathy (BVP), unilateral (UCI), and bilateral (BCI) cochlear implantees.Materials and Methods: Sixty-nine adults were included (32 women and 37 men) in a multicenter prospective study. The group included 37 healthy subjects, 10 BVP, 15 UCI, and 7 BCI patients. The average of age was 47 ± 2.0 (range: 23–82). In addition to a complete audiovestibular work up, a dynamic posturography (Multitest Framiral, Grasse) was conducted in silence and with a rotating cocktail party sound delivered by headphone. The center of pressure excursion surface (COPS), sensory preferences, as well as fractal, diffusion, and wavelet analysis of stabilometry were collected.Results: The rotating sound seemed to influenced balance in all subgroups except in controls. COPS increased with sound in the BVP and BCI groups in closed eyes and sway-referenced condition indicating a destabilizing effect while it decreased in UCI in the same condition suggesting stabilization (p < 0.05, linear mixed model corrected for age, n = 69). BVP had higher proprioceptive preferences, BCI had higher vestibular and visual preferences, and UCI had only higher vestibular preferences than controls. Sensory preferences were not altered by rotating sound.Conclusions: The rotating sound destabilized BVP and BCI patients with binaural hearing while it stabilized UCI patients with monaural hearing and no sound rotation effect. This difference suggests that binaural auditory cues are exploited in BCI patients for their balance

3D landmark detection for augmented reality based otologic procedures

International audienceEar consists of the smallest bones in the human body and does not contain significant amount of distinct landmark points that may be used to register a preoperative CT-scan with the surgical video in an augmented reality framework. Learning based algorithms may be used to help the surgeons to identify landmark points. This paper presents a convolutional neural network approach to landmark detection in preoperative ear CT images and then discusses an augmented reality system that can be used to visualize the cochlear axis on an otologic surgical video

Influence of Visual and Vestibular Hypersensitivity on Derealization and Depersonalization in Chronic Dizziness

Objective: The aim of this study was to investigate the relation between visual and vestibular hypersensitivity, and Depersonalization/Derealization symptoms in patients with chronic dizziness.Materials and Methods: 319 adult patients with chronic dizziness for more than 3 months (214 females and 105 males, mean age: 58 years, range: 13–90) were included in this prospective cross-sectional study. Patients underwent a complete audio-vestibular workup and 3 auto questionnaires: Hospital Anxiety and Depression (HAD), Depersonalization/Derealization Inventory (DDI), and an in-house questionnaire (Dizziness in Daily Activity, DDA) assessing 9 activities with a score ranging from 0 (no difficulty) to 10 (maximal discomfort) and 11 (avoidance) to detect patients with visual and vestibular hypersensitivity (VVH, a score > 41 corresponding to mean + 1 standard deviation).Results: DDI scores were higher in case of VVH (6.9 ± 6.79, n = 55 vs. 4.2 ± 4.81, n = 256 without VVH, p < 0.001, unpaired t-test), migraine (6.1 ± 6.40, n = 110 vs. 4.0 ± 4.42, n = 208no migraine, p < 0.001, unpaired t-test), and motion sickness (6.8 ± 5.93, n = 41 vs. 4.4 ± 5.11, n = 277 no motion sickness, p < 0.01, unpaired t-test). Women scored DDI higher than men (5.1 ± 5.42, n = 213 vs. 3.9 ± 4.91, n = 105, respectively, p < 0.05, unpaired t-test). DDI scores were also related to depression and anxiety. DDI score was also higher during spells than during the basal state.Conclusion: During chronic dizziness, Depersonalization/Derealization symptoms seem to be related to anxiety and depression. Moreover, they were prominent in women, in those with visual and vestibular hypersensitivity, migraine, and motion sickness

Diagnostic et prise en charge thérapeutique des Schwannomes intracochléaires solitaires

Le but de ce travail est de présenter et d'analyser une série de 14 Schwannomes intracochléaires pour en souligner les caractéristiques cliniques et radiologiques et pour discuter les modalités thérapeutiques. De 1990 à 2003, 14 patients avec un schwannome intracochléaire solitaire ont été inclus dans cette rétrospective. Les données cliniques, audiovestibulaires, radiologiques et les observations péropératoires ont été collectées. La moyenne d'âge était de 54 ans (extrêmes :25 à 71 ans). Lors de l'examen initial, tous les patients présentaient une surdité profonde. Une atteinte faciale clinique de grades 2 et 4 (House et Brackmann) ont été notée dans deux cas (14 %) ou une atteinte seulement électromyographique dans 2 cas (14 %).L 'IRM a mis en évidence une extension tumorale dans le labyrinthe postérieur dans 7 cas (50 %), dans le conduit auditif interne dans 9 cas (64 %) et dans l'angle ponto-cérébelleux dans 4 cas (29 %). Dans 9 cas (64 %) l'exérèse de la tumeur a été réalisé par une voie transotique. La fonction faciale postopératoire était de grade 1 ou 2 dans 5 cas (56 %), de grade 3 ou 4 dans 3 cas (33 %), et de grade 5 dans un cas (11 %). Le recul postopératoire moyen était de 15 mois (extrêmes : 2 - 36 mois). Une surveillance a été décidée pour les 5 autres patients (36 %). Un a été perdu de vue. Les 4 autres cas n'ont pas montré de croissance sur l'IRM à un an. En conclusion, les schwannomes intracochléaires se caractérisent par une perte auditive importante et peuvent s'accompagner d'une atteinte faciale. Une surveillance simple est justifiée en cas de lésion stable et limitée et une exérèse est indiquée en cas de croissance significative ou d'extension dans l'angle ponto-cérébelleux.PARIS7-Villemin (751102101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Prise en charge du schwannome vestibulaire solitaire avec surdité controlatérale sévère à profonde

PARIS7-Xavier Bichat (751182101) / SudocSudocFranceF

Les cholestéatomes de l'oreille moyenne chez l'enfant

DIJON-BU Médecine Pharmacie (212312103) / SudocSudocFranceF

Effect of Repositioning Maneuver Type and Postmaneuver Restrictions on Vertigo and Dizziness in Benign Positional Paroxysmal Vertigo

Introduction. To compare the efficiency of Epley (Ep) and Sémont-Toupet (ST) repositioning maneuvers and to evaluate postmaneuver restriction effect on short-term vertigo and dizziness after repositioning maneuvers by an analog visual scale (VAS) in benign positional paroxysmal vertigo (BPPV). Material and Methods. 226 consecutive adult patients with posterior canal BPPV were included. Patients were randomized into 2 different maneuver sequence groups (n=113): 2 ST then 1 Ep or 2 Ep then 1 ST. Each group of sequence was randomized into 2 subgroups: with or without postmaneuver restrictions. Vertigo and dizziness were assessed from days 0 to 5 by VAS. Results. There was no difference between vertigo scores between Ep and ST groups. Dizziness scores were higher in Ep group during the first 3 days but became similar to those of ST group at days 4 and 5. ST maneuvers induced liberatory signs more frequently than Ep (58% versus 42% resp., P<0.01, Fisher's test). After repositioning maneuvers, VAS scores decreased similarly in patients with and without liberatory signs. Postmaneuver restrictions did not influence VAS scores. Conclusion. Even if ST showed a higher rate of liberatory signs than Ep in this series, VAS scores were not influenced by these signs

Influence of body laterality on recovery from subjective visual vertical tilt after vestibular neuritis

The subjective visual vertical (SVV) is an indicator of vestibular otolithic function and mainly processed by the nondominant parietal cortex. We investigated the hypothesis that recovery from SVV tilt after vestibular neuritis can be influenced by the body's lateral preference. This prospective cohort follow-up study included 254 consecutive adult patients with vestibular neuritis. The recovery from SVV tilt was faster in patients with a left hand or eye dominance than in those with a right dominance. While in left-handers the side of the neuritis did not affect the speed of recovery, in right handed subjects, the recovery from a right-sided neuritis was significantly slower than from a left-sided affection. These observations suggest that subjects with a left sensorimotor dominance have developed more significant midline-crossing projections to the parietal cortex, allowing them to cope faster with a unilateral vestibular deficit.SCOPUS: ar.jinfo:eu-repo/semantics/publishe