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J Bel

Publications and source records attributed to J Bel.

At least 55 records · Page 3Linked to original sources

Tympanometry and fistula test.

The 'fistula test' is performed when an abnormal opening between the vestibule and the middle ear cavity is suspected. The fistula is usually seen after stapedectomy, but may also occur after trauma to a normal ear when the round window membrane may rupture. Tympanometry with an electronystagmographic (ENG) tracing may show a positive result after stapedectomy in the absence of a fistula, and there may conversely be a normal ENG tracing after tympanometry when there is in fact a perilymph fistula. The authors explain the reasons for this paradoxical response. In no way does it detract from the value of the test, which only needs to be interpreted correctly.

Acoustic Impedance Tests↗

[Impedancemetry. Clinical applications].

The authors call attention to the importance of the data provided by impendancemetry, both in its classified applications, by tympanogram, and in impedance-audiometry, by the study of elicited stapedius reflex. They warn against the tendency to consider impedancemetry as a synonym for examination in conductive deafness and to reserve impedance-audiometry exclusively for perceptive deafness. These two techniques must be coupled and their multiple clinical applications are very often intricated. Tympanograms based in their clinic on the study of relative impedance, provide equally interesting diagnostic data in post-otorrhea states with open eardrum as well as closed eardrum for which until now tympanogram was the classic test. Of course tubal disfunctions, serous effusions of the middle-ear, fibro-adhesive otitis and ossicles disruptions are part of the current diagnosis clarified by impedancemetry in conductive deafness. On the other hand, for otospongiosis, the tympanogram is not of absolute value, but impedancemetry permits an extremely interesting diagnosis in three cases: in associated syndroms, where it acts as warning before the operation; in airbone gap reopenings after surgery, where the knowledge of the precise etiology conditions the therapy;-- and in postoperative cochlear drops, where an easy differential diagnosis is allowed between perilymph fistula and labyrinthe hydrops. Impedance-audiometry is based on the elicitation of stapedius reflex. It has numerous applications in perceptive deafness, where the detection of recruitment is very easy and of great value. So the diagnosis between cochlear and retro-cochlear deafness may be made evident. This method also applies to conductive deafness, to crura ruptures, as well as to the diagnosis of the beginning of otospongiotic stapedial fixations by the detection of a typical on-off effect. Besides otospongiosis is one of the most paradoxical applications of impedance-audiometry, which is revealed to be richer in information than the study of compliance, masking problems, diagnosis of associated syndroms and early detection of the disease are easily solved by impedance-audiometry. For these many reasons, the authors insist once more upon the importance and value of the data provided by impedancemetry and impedance-audiometry. They specify that this method is the most interesting complement to classic audiometry since the appearance of the audiometer.

Acoustic Stimulation↗

[Contribution of data processing in otospongiosis. Part I. Statistics on otospongiosis].

The use of data processing in their otology clinic allowed the authors a better approach to otospongiosis and to its treatment, thus completing the knowledge of the otospongiotic disease according to their enzymatic concept. An important material has been gathered since 1959 to the present (June 1, 1974), based on more than 16 000 stapedectomies and nearly 100 000 otology out-patients. It has been studied both through a conventional method and an informatic one on the computer of their clinic. Statistical data, apparently valuable, could be drawn from this mass of information for each patient, starting from his first consultation and following him through his secondary consultations, operation, immediate postoperative follow-up and various postoperative check-ups performed. It also takes into account the general state of the patient and all the accidents which may happen during a remote postoperative period. First of all, the authors give the data for these statistics established according to the systematization of the parameters for otospongiosis they have previously published in 1973. In the first part, they gather statistical data obtained about the otospongiotic disease itself, some of which differ from the classical notions of frequency or importance. These statistical conclusions confirm some percentages stated by other authors (predominance of the woman and of the white race, severity of the disease in the young, etc.), but differ in relation to the number of deafs, the percentage of unilateral otospongiosis in comparison, to the bilateral ones, the importance of pure cochlear otospongiosis, the separate valuation of audiometric stages and that of anatomic types, the relation between age and anatomic type, finally the respective frequency of pre-and postoperative vertigos. In the second part, which will be presented later, the authors will study the postoperative functional results obtained within a period of 15 years by stapedectomy according to three techniques. But the particularity of this study will be the fact that functional results will not be considered only from the operative point of view, but from the whole of the factors acting upon the functional result, i.e.: operative mechanical factor, otospongiotic cochlear component, finally general state of the patient. We will thus have a better knowledge of this very peculiar disease of the otic capsule, hat is otospongiosis, characterized by its two phases: a first lytic phase provoked by an enzymatic factor, then a second rebuilding phase according to a pseudo haversian process. During the long progression of the disease, these two phases intermingle and juxtapose much more than they follow each other in the course of time.

Adult↗

[Dental caries].

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Dental Caries↗