Biomedical subjects

C Fugain

Publications and source records attributed to C Fugain.

At least 37 records · Page 2Linked to original sources

PubMed1991

[The choice between mono- and multielectrode implants in rehabilitation of total deafness in young children].

We underline the necessity to supply a prelingually totally deaf patient with some sound information before the critical age of about 5-8 years, which we had previously experimentally demonstrated on the guinea pig. Multichannel cochlear implant is the most efficient and must be placed most of cases. However, specially in case of total ossified cochlea, single channel cochlear implant is the only usefull. The respective indications of these two different systems are discussed as a function of pronostic preoperative data, cochlear total ossification, and financial considerations. The decision to supply a young totally deaf child with a cochlear implant must be considered as an emergency.

Age Factors↗

PubMed1990

["Monosonic" one canal digital implant].

In order to decrease the gap between the single and multichannel cochlear implant efficacy we tried to improve the speech coding strategy of the Monomac, the constant current single channel system which we designed in 1987. Owing to a research computerized system, different strategies have been successively studied in the laboratory on 12 new implanted patients during the first weeks of the post-operative period to avoid habituation differences. Results led us to design a miniaturized digital emitter, the Monosonic. This emitter allows the speech therapist to program the frequency band wideness (80-1000 Hz) of the transmitted information, and the threshold level and dynamic range of the stimulating square wave as a function of its frequency. Other strategies are discussed, which have not been yet studied, but may be also programmed.

Acoustic Stimulation↗

PubMed1990

[Presentation of a French language protocol for the evaluation of communication improvement in the deaf following implantation].

We have been led to drawing up a procedure of assessment of communication as restored by implantation. This procedure is simple, and can be used by all teams, however complex the material implanted is. It can be implemented for children as well as adults, and for both pre- and post-speech deafness. Our staging allows integrating the implanted patient into the classical description of deafness, while retaining the specific features of electrical stimulation.

Auditory Perception↗

PubMed1990

[Results and indications of cochlear implant in 19 cases of total pre-speech deafness].

From June, 1987, to January, 1900, 19 patients aged 3 to 56 years have been rehabilitated for total deafness occurring prior to the acquisition of speech, ie. before age 2, whatever its cause. Some degree of hearing was achieved in all cases. However, the rate and steadiness of progress in auditory recognition, the daily period of use of the device and the changes in the behavior were inversely proportional to the patient's age. This leads to proposing cochlear implants for all patients, especially children, and all the more largely as they are young.

Adolescent↗

PubMed1988

[The monochannel Monomac and multichannel Minimac cochlear implants].

Monomac monochannel and Minimac multichannel cochlear implants bring to the remaining hearing fibers sound information that is previously converted into adequate electric signals. Both function at constant currents. The Monomac monocanal system possesses only one electrode implanted either inside or outside the cochlea and sends off sound of basic laryngeal rythm to all the nervous fibers. The Minimac is entirely numerical and sends off the whole of the sound information by splitting it into 15 frequency tracks, to 15 electrodes inserted within the scala tympani by means of an electrode-holder. Programming allows for selecting specific values from each frequency track and thus regulating the needed compression individually. Both these implants (Monomac and Minimac) work no conflictlessly but complementarily to each other because they answer different, well-defined clinical needs.

Cochlear Implants↗

PubMed1988

[Operative indications of total deafness].

Rehabilitation of patients with total hearing loss through surgical implantation of intracochlear devices is warranted only in cases for which deafness is absolutely not relieved by conventional hearing prostheses. Furthermore, it is required that the patient respond positively to the electrostimulation test of the round window, be strongly motivated, as well as present a high index of socialization. These three parameters will also determine the type of implant to be used, i.e. mono- or multielectrode, as well as particular indications relating to children.

Acoustic Stimulation↗

PubMed1988

[Changes in the speaking fundamental frequency after cochlear implantation].

Speaking fundamental frequency (Fo) changes have been studied in 12 patients suffering from total post-lingual deafness and having been supplied with the multichannel cochlear implant CHORIMAC-12. Fo is significantly lower after implantation. But Fo variance changes depend on the laryngeal associated pathology.

Cochlear Implants↗

PubMed1988

[Clinical results of the multielectrode cochlear implant in the rehabilitation of 27 cases of acquired total deafness].

Multi-electrode cochlear implants allow verbal discrimination without lip reading in a manner dependent directly on the liminal threshold value during the preoperative electrical stimulation of round window test, and the quality of socialization and motivation of the patient. Overall auditory performances of 27 patients rehabilitated in this way are reviewed and compared with those obtained by other teams and other apparatuses.

Adult↗

PubMed1987

Indications for multi- or single-channel cochlear implant for rehabilitation of total deafness.

Only totally deaf patients who do not experience improvement when using classical hearing aids are candidates for a cochlear implant. Preoperative assessment of potential benefits of a cochlear implant may improve selection of patients with pre- or postlingual total deafness, so that the most appropriate system can be implanted. The psychological status of potential candidates for implantation is particularly important because the results of postoperative re-education depends on motivation of the patient. The Round Window electrical stimulation test supplies us with important and measurable data (electrical threshold level, tone decay test). The duration of deafness, the degree of the deafness, and the cochlear tomodensitometry do not affect the decision to implant a cochlear device, (i.e., since the socialization level of the patient is a considerable factor). Preoperative assessment of the patient is very useful. As a result of our experience in 115 implanted cases suffering from pre- and postlingual deafness, we are now able to predict the good or bad results in our patients. Therefore, in patients who have many adverse factors for recovery, it seems to us more reasonable and cheaper to implant a single-channel system instead of a multichannel system, which must be reserved for patients who should do well. In very young children, the most appropriate system seems to be extra cochlear single-channel implant.

Cochlear Implants↗

PubMed1986

The Chorimac 12. A multichannel intracochlear implant for total deafness.

In all of our cases, phonetic discrimination has been obtained without the help of lip-reading. Speech intelligibility is generally better in postlingual deafness that in prelingual deafness. We believe this method, despite the size of the external transmitter, is best for rehabilitation of totally deaf patients.

Adult↗

PubMed1985

Technique and indications for the French multichannel cochlear implant "Chorimac-12" for total deafness rehabilitation.

To obtain some speech discrimination without lip reading it is necessary to elicit different frequency sound sensations in the totally deaf cochlea. Thus, electrically proofs compartments must be created all along the cochlear keyboard. The placement of twelve intracochlear electrodes is greatly facilitated by using our electrode-bearer, which is introduced through the round window by a posterior tympanotomy approach. However, partial or complete ossification of the cochlea may sometimes necessitate the use of our first technique of placement of electrodes one by one with Silastic pieces through twelve cochlear fenestrations. The indications for implanting depend on certain immutable criteria (total deafness, auditory response to electrical stimulation of the round window, patient's motivation), but other criteria are also described and discussed (socialization level, cochlear ossification, and preoperative electrophysiologic data). Associated handicaps (autism, blindness, tetraplegia) are not contraindications and often represent supplementary reasons for implantation.

Adolescent↗

PubMed1985

The Chorimac-12. A multichannel cochlear implant for total deafness. Description and clinical results.

More than 90% of cases of patients suffering from acquired or congenital deafness may be provided with some sound sensation owing to the electrical stimulation of the few cochlear nerve fibers that are still present in the deaf cochlea. In order to obtain some speech discrimination without lip reading it is necessary to elicite different frequency sound sensations. Thus electrically proofs compartments must be performed all along the cochlear keyboard. The placement of 12 intra-cochlear electrodes is greatly facilitated by using an electrodes-bearer which is introduced through a very simple and classical surgical procedure. The indications for implanting depend on undiscussible criteria (total deafness, auditory response to electrical stimulation of the round window, patient's motivation). Clinical results consist of psychoaffective improvement and auditory possibilities. All patients are able to discriminate homosyllabic words in closed lists without lips reading, but the percentages of these performances greatly vary from one patient to the other. Some patients, generally suffering from acquired total deafness, are able to discriminate words or sentences without reference list and without help of lips reading. These results depend on the patient's socialization level, on the pre or post-lingual status of the deafness, on an eventual cochlear ossification, and on the value of several pre operative electro physiological data. Associated handicaps (autism, blindness, tetraplegia) are not contra indications and often represent supplementary reasons for implanting. The value of these post-operative results may be predicted owing to a series of electrical pre-operative tests and clinical data. Thus it is possible to determine the respective indications of multi and single channel cochlear implants.

Adolescent↗

PubMed1984

Psychophysics of 12 channels implant.

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.

Auditory Perception↗

PubMed1984

Prognostic evaluation of the multichannel cochlear implant.

Preoperative appreciation of the future clinical results of the multichannel cochlear implant is important to assess in the case of pre- or post-lingual total deafness, in order to improve the patients selection. The psychological status of the future implanted is one of the main concerns because the post-operative reeducation efficacity depends on the patient's motivation. The Round Window electrical stimulation test supplies us with important and measurable data (electrical threshold level, tone decay test). The age of the patient, the age and the etiology of the deafness, the vestibular status and the cochlear tomodensitometry only offer non-decisive informations. The patient's socialisation level is a considerable factor. But per-operative observations are sometimes and surprisingly determinant (electrode impedances, ossified cochlea). Moreover immediate post-operative electrical and psychophysic data must also be considered.

Auditory Perception↗

PubMed1984

Clinical results of the French multichannel cochlear implant.

Clinical assessment and results are described in 66 patients (among them 20 were less than 20 years old). Voice changes may be objectively observed on sonograms. Phonetic discrimination depends on the electrical and nervous status of the implanted deaf cochlea. Discrimination of words and sentences with reference list, but without lipreading, is commonly obtained. Discrimination of unknown words is more difficult and varies from one patient to the other. Discrimination with lipreading progress elicited by the device depends on the pre-operative status and the own possibilities of each patient. Psychoaffective improvement is evident in every case, especially in 3 cases of autistic deaf-mute children. We shall try to summarize the efficacity of the French 12-channel cochlear implant regarding the clinical results we obtained in 66 patients who have been implanted between October 1976 and September 1983. Among them, 39 suffered from pre-lingual deafness and 27 from post-lingual deafness.

Adolescent↗

PubMed1983

[Treatment of total deafness. Indications for and results of the multi-electrode cochlear implant].

Most cases of total deafness are due to destruction of Corti's organ leaving some of the auditory nerve fibres untouched. When these fibres are electrically stimulated the patient may perceive sounds the pitch of which depends upon the location of the stimulated nerve-endings along the cochlea. An intracochlear electronic device with 12 electrodes implanted in different areas and driven from outside by a portable radiofrequency emitter provides the patient with new hearing and some speech intelligibility. After several months' training words and sentences can be recognized without having recourse to lip reading. Performances depend upon a variety of factors, many of which can be determined prior to implantation. The long-term results obtained in 54 totally deaf patients are reported.

Cochlear Implants↗

PubMed1983

Long-term results of the multichannel cochlear implant.

Clinical results obtained with the multichannel cochlear implant are described in 48 cases of total deafness (27 cases of prelingual and 21 cases of postlingual deafness). The tolerance for implanted material and the survival of the electrode-nerve interface have not yet been altered after more than 5 years. After some months of training the patients, the percentages of phoneme-, word-, and sentence-recognition vary from one patient to another, but depend approximately on the value of the threshold level of the round-window stimulation test, and the degree of socialization of each patient. These results suggest that the multichannel cochlear implant may now be considered as a useful tool in the rehabilitation of totally deaf persons.

Adolescent↗

PubMed1982

[Electrical stimulation of the middle ear in total deafness: results in 375 cases (author's transl)].

Electrical stimulation of the middle ear can provoke sound sensations in 90 p. cent of patients with total deafness, as shown by auditory evoked potentials brain stem recordings. This signifies that cochlear nerve destruction is not complete, and rehabilitation by multiple electrode cochlear implants is possible. The liminal stimulation threshold level appears to be inversely proportional to the functional quality of the electrode-nerve interface obtained by the implants. The electrical stimulation of the middle ear test is therefore essential for selection of patients for operation, and for predicting the quality of rehabilitation that will be obtained.

Adolescent↗