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Biomedical subjects

J B Causse

Publications and source records attributed to J B Causse.

At least 37 records · Page 2Linked to original sources
PubMed1986

[The development of tinnitus in the postoperative period of otospongiosis].

Correlation between tinnitus and audiometric loss, modification of tinnitus by medical or surgical treatment, allow to suspect the origin of tinnitus due to otospongiosis and to give the patient a practically always confirmed prognosis. Audiometric localization of tinnitus is essential, as it is the best clue to etiology, treatment and prognosis of otospongiosis tinnitus. As far as irreducible tinnitus are concerned, as anxiety is the most pejorative parameter, not discouraging the patient is very important.

Audiometry↗
PubMed1985

[Improvement in hearing as a function of type of platinectomy or platinotomy performed in the surgical treatment of otospongiosis].

The footplate fenestra should be performed in its posterior third part to avoid pressure of the piston on the membranous labyrinth, situated very close to the footplate in 2% of the cases in otosclerotic patients. Gain in bone conduction differs according to the size of the fenestra performed. Low frequencies improve most when the whole posterior third part of the footplate is removed; the audiometric gain is better for high frequencies when a 0.8 mm stapedotomy is performed. These findings demonstrate the interest of a more or less enlarged fenestra according to the language spoken by the patient, since the different languages use mainly high or low frequency phonemes.

Audiometry↗
PubMed1985

[Prognosis for tinnitus after surgery for otospongiosis].

Correlation between tinnitus and audiometric loss and modification of the former by both surgical and medical treatment provide sufficient data to suggest its origin and to give the patient a prognosis confirmed in practically every case. Audiometric localization of the tinnitus is essential, since this allows establishment of the etiology, treatment and prognosis of the symptom. When tinnitus is irreversible, the hope of a possible recovery must be given to the patient to avoid the inevitable anxiety produced.

Adjustment Disorders↗
PubMed1984

[Result and treatment of tinnitus in our clinic].

The authors propose a test consisting in performing injections of Renovaine, a very strong anaesthetic drug, in the external ear duct in order to reduce momentarily severe and decompensated tinnitus. They discuss the usefulness of this test and develop two concepts to explain its action. They make a pragmatic approach of the tinnitus etiopathogeny.

4-Aminobenzoic Acid↗
PubMed1984

Otospongiosis as a genetic disease. Early detection, medical management, and prevention.

Extensive research into the inmost mechanism of otospongiotic disease and an extended study of otosclerotic patients' ancestry have led the authors to a plan for prevention of this disease, which appears to be a genetic deafness with autosomal dominant inheritance and about 40 percent penetrance of genes. Progress in impedance audiometry has permitted early detection of stapedial fixation by means of systematic audiometric investigations, particularly the elicitation of stapedius reflex showing a very special pattern called the "on-off effect." The evidence supporting an enzymatic origin of the sensoringeural component of hearing loss in otosclerotic families has led us to treat otospongiotic children with very low doses of sodium fluoride, with no risk of stunting growt. We have been applying this procedure for four years to the families of stapedectomized otosclerotic patients. We believe it would be advisable to extend this type of prevention to schoolchildren by means of systematic audiometric investigations, including the elicitation of stapedius reflex to detect a possible on-off effect. We also studied sodium fluoride therapy, which derives from the enzymatic origin of the otospongiotic disease. This treatment, based on enzymogenesis inhibitors, should be given to young otospongiotic/otosclerotic patients detected by systematic audiometric investigations. Sodium fluoride could even be prescribed for otospongiotic mothers to prevent disease in their newborn children, exactly as in dental prevention. Otospongiotic/otosclerotic disease can be easily controlled by medical treatment, combined with surgery if needed. This treatment is effective thanks to early detection.

Adult↗
PubMed1984

Technique for otosclerosis.

The surgical technique described in this article consists of performing an 0.8-mm stapedotomy at the posterior third part of the footplate using a large 6 mm square vein graft interposition and performing a vigorous inflation of the middle ear as early as the twenty-fourth postoperative hour. This technique allowed the authors to perform a series of more than 5000 operations over the last five years without any dead ear and with remarkable hearing improvement.

Humans↗
PubMed1984

[Means of fixing a transmission device to the center of a mobile footplate].

The authors present a new fixation device for any bony or prosthetic transmission system to the center of a mobile footplate in the absence of the stapes crura. It is a disc-shaped silicone sponge, with a central hole, fitting the bottom of the oval fossa and thus securing the maintenance of the bony or prosthetic transmission in the center of the mobile footplate, and reducing the risk of shifting of the transmission system, which is always possible in case of tympanic retraction. The silicone sponge allows as well a more physiological transmission, because the footplate will vibrate from top to bottom thanks to a central force vector, thus giving better audiometric results. The biocompatibility of the silicone sponge eradicates any phenomenon of intolerance from the tissues.

Audiometry↗
PubMed1983

Early detection of otosclerosis by impedance-audiometry screening.

The basis of the early detection of otosclerosis is dual: first, a better knowledge of the mechanism of the disease itself, which is of enzymatic origin, and the starting point of which is an antigen-antibody conflict between the otic capsule and the embryonic cartilaginous remnants; - second, the fact that the otospongiotic disease appears to be a genetic deafness with an autosomal inheritance and about 40% of genes penetrance. Consequently an early detection is absolutely essential to combat the disease at its beginning and to assure its prevention. The early diagnosis of the otospongiotic/otosclerotic disease is twofold: first, the early detection of stapedial fixation is given by systematic impedance-audiometry screening on school-children by means of stapedius reflex elicitation in order to detect a possible diphasic impedance change (on-off effect); - second, the early diagnosis of progressive cochlear deterioration is yielded through systematic bone-conducted audiometry testing in young children in families with an otospongiotic/otosclerotic history.

Acoustic Impedance Tests↗
PubMed1983

Complications of stapedectomies.

The authors consider the consequences and treatment of any error during and after stapedectomy, and present the usually less developed complications of stapedectomies: postoperative cochlear drops, tinnitus, vertigo. They also mention the other complications of stapedial surgery, and they particularly advocate the half-posterior stapedectomy technique, associated with a sufficiently large venous interposition. The authors had no cases of severe permanent cochlear loss during the first postoperative month in a series of more than 4000 stapedectomies.

Bone Conduction↗
PubMed1983

[Complications of stapedectomy].

The authors present here the usually less developed complications of stapedectomies: postoperative cochlear drops, tinnitus, vertigo. They also mention the other complications of stapedial surgery. They insist particularly on the interest of half posterior platinectomy technique, associated with a sufficiently large venous interposition.

Audiometry↗
PubMed1982

[Antibacterial therapy in surgery of the inner and middle ear. A study of co-trimoxazole penetration into the perilymph (author's transl)].

Studies of the type presented here have rarely been undertaken and should be useful in surgery and pathology of the inner and middle ear. Samples of perilymph were collected during stapedectomy in patients with otosclerosis. In view of the very small volume of perilymph obtainable from each patient's vestibule (2 to 4 microliter), the only assay method that could be used to measure drug levels was thin layer chromatography on silica gel. Despite pooling of the perilymphs of 5 patients, trimethoprim (TMP) levels could not be measured but the authors were able to demonstrate that sulfamethoxazole (SMZ) does penetrate into the perilymph. Since the TMP-SMZ combination (co-trimoxazole) is active against the pathogens usually encountered in middle ear fluids, it is concluded that the drug could be of benefit in the treatment of middle and inner ear infections or after surgical operations on this area.

Adult↗
PubMed1982

The enzymatic mechanism of the otospongiotic disease and NaF action on the enzymatic balance.

Extensive research on enzymes led to the discovery of the innermost mechanism of the otospongiotic disease. The authors present the results of multiple correlations made from February 1976 to September 1980 on 648 samples of perilymph taken during stapedectomies performed on otosclerotic patients. We studied microdosages of three selected enzymes--trypsin, alpha 1 antitrypsin, and alpha 2 macroglobulin--in each of the samples and their relationship with cochlear deterioration expressed in dBs of bone conduction decrease in pure-tone audiometry testing. This study allowed us a better knowledge of the enzymatic mechanism of the otospongiotic disease, based on the previously reported trypsin-alpha 1 antitrypsin balance, but in which alpha 2 macroglobulin appears to play a role as essential as that of alpha 1 antitrypsin. This enzymatic mechanism explains NaF efficiency, which is due in fact to a double action: not only direct trypsin inhibition, but also an overall reduction in enzymatic values in the perilymph of otospongiotic/otosclerotic patients. Current studies could lead to the possibility of future NaF replacement by proteinase inhibitors either of microbial origin, under study by Japanese researchers, or even of synthetic origin, which should be investigated. In fact, the role of NaF therapy could already be taken over by diphosphonates currently under study.

Audiometry, Pure-Tone↗