Biomedical subjects

J Causse

Publications and source records attributed to J Causse.

At least 73 records · Page 4Linked to original sources

PubMedDate not supplied

Multifrequency impedance testing in relation to otospongiotic stapedial fixation and other factors.

After reviewing COLLETTI'S research, the authors describe their own experimental work on multifrequency impedance testing in relation to stapedial fixation in otospongiosis, and other factors. Their findings, based on 266 tested ears, lead the authors to the conclusion that : (1) the most useful frequencies, from the clinical point of view, are the low ones (220, 660 and 800 Hz); (2) the research frequencies, range beyond (900 to 2 000 Hz), for a finer diagnosis, but are confused by numerous artefacts and are not always reliable; (3) COLLETTI'S conclusions on the inversion of the peak and on the shifting of M and W, are valuable, but not always reliable in some cases.

Acoustic Stimulation↗

PubMedDate not supplied

[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↗

PubMedDate not supplied

[A biochemical and cytological explanation of cochlear otospongiosis].

Carrying on their study about the enzymatic activity of the otospongiotic micro-foci and the hydrolytic activity of the perilymph, the authors present their work concerning the value of trypsin and alpha-1-anti-trypsin in the perilymph of otospongiotic patients operated on by stapedectomy. They describe the method used and give the obtained results which permit to believe that the values of trypsin, and a contrario of anti-trypsin, appear to constitute an index of the severity of the progression. Moreover, the authors have investigated the eventual toxic action of various trypsin concentrations on the hair cells of the Corti organ in the guinea-pig. This study has been carried through successfully by means of the electron microscopic scanning method which allows to obtain an "electron cochleogramme in situ". They explain the method and come to the conclusion that the intensity and extension of the Corti hair cells alterations in a cochlea receiving a perfusion with trypsin solutions, are tightly related to the trypsin concentration. However, they do not pretend so far that these results reflect exactly the anatomo-pathologic reality during the slow progression of otospongiosis towards cochlear deterioration. These two series of experimentation appear to confirm their enzymatic concept of otospongiosis: the long, slow and extremely capricious progression of the disease is the duplicate of its cytologic progression, the contact between hydroltic enzymes and Corti cells having the same capricious character. These findings perfectly corroborate the previus ones they made in this field, as well as the correlations they have established between hydrolytic activity of the perilymph and audiometric progression. Consequently, they believe that the mechanism of the otospongiotic disease is provoked by the rupture of the balance trypsin/anti-trypsin in the otospongiotic micro-foci and thus in the inner ear fluids.

Animals↗

PubMedDate not supplied

[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↗

PubMedDate not supplied