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Biomedical subjects

P Garin

Publications and source records attributed to P Garin.

At least 19 recordsLinked to original sources
PubMed2002

Linking expert evaluations with public consultation to design water policy at the watershed level.

In view of the increasing demand for public participation in public affairs, the European Water Framework Directive requires public consultation when drawing up watershed management plans. Implementation of this Directive requires the development of methods for linking the scientific and technical knowledge of experts with the viewpoints expressed by local actors. The objective of this paper is to propose a public consultation method that can be used as early as the preliminary assessment of river basin characteristics, defined by the Directive, and at the scale of sub-watersheds that make up the district. A case study of a watershed in southern France illustrates this method.

Community Participation↗
PubMed2002

Belgian experience with the Vibrant Soundbridge prosthesis.

The Belgian Experience with the Vibrant Soundbridge Prosthesis. The authors present the first results obtained with 13 patients implanted with the Vibrant Soundbridge, a semi-implantable electromagnetic hearing device. The first patient was implanted in October 1998. The results show that there were no significant modifications of the hearing thresholds after implantation. The average functional gain was 30 dB in tonal audiometry and 25.6 dB in vocal audiometry. All the patients are satisfied with the device and wear it daily.

Adult↗
PubMed2002

[A simple audiometry test of speech intelligibility in background noise].

We propose a new audiometric test to assess French speakers' speech discrimination in noise. This soundfield test uses a standard cocktail-party background noise superimposed on Fournier's disyllabic word lists. The background noise is CD-recorded at constant 55 dB SPL. The discrimination score is measured at a signal-to-noise ratio of -5 dB, 0, and dB. In comparison with other audiometric tests in noise, our test requires only 5 minutes and is simple for both patient and audiologist. All patients are tested using the same standard condition, one that approaches daily life and uses a noise of moderate intensity. The result is reproducible and easy to calculate and graph. We propose this test for diagnosing in-noise speech intelligibility disorders and for assisting the process of conventional or implantable hearing-aid fitting.

Audiometry↗
PubMed2001

Office-based CO2 laser-assisted tympanic membrane fenestration addressing otitis media with effusion.

OBJECTIVE: To use the CO2 laser-assisted tympanic membrane fenestration in office settings, under local anesthesia, as the sole treatment for patients with chronic otitis media with effusion (OME). BACKGROUND DATA: This new treatment ensures artificial ventilation of the middle ear for several weeks, and provides an intermediate solution between ordinary lancet-made tympanocentesis and transtympanic ventilation tube insertion. The operative technique is already well codified, and preliminary studies have demonstrated that tympanic membrane fenestration does not expose patients to any major hazard. METHODS: We treated 30 ears in 21 children and 29 ears in 24 adults. All patients had presented with OME persistent for more than 3 months. The laser tympanostomy was performed under local anesthesia, as an outpatient procedure, using a CO2 flash-scanning laser in conjunction with a handpiece (OTOLAM). Using a power of 12 W to 17 W, a single laser pulse usually sufficed to create a 2-mm-diameter circular perforation in the anteroinferior quadrant of the eardrum. RESULTS: The tympanic membrane fenestration allows avoiding ventilation tube insertion in 63% of children and 75% of adults. CONCLUSIONS: The CO2 laser-assisted tympanic membrane fenestration seems a valid therapeutic option addressing OME. This study should be pursued on a larger scale to define more precisely the indications of the laser tympanostomy.

Adolescent↗
PubMed2001

Cataract with multifocal AMO ARRAY implants.

We have conducted a retrospective study on three hundred cataract surgeries over one year with insertion of the AMO ARRAY multifocal implant dominant for far vision. Under condition of presurgical selection and postsurgery emmetropia, 80% of patients gains multifocality without glasses.

Astigmatism↗
PubMed1999

Laser-assisted myringotomy combined with adenoidectomy in children: preliminary results.

Adenoidectomy and CO2 laser-assisted myringotomy were performed on 26 children (52 ears) diagnosed with adenoid hypertrophy and chronic otitis media with effusion. The age ranged between 2-15. The CO2 laser and a micromanipulator were adapted on the operating microscope. Repeated pulses of focused laser beam were fired in a roselike fashion in order to create a 2-mm round perforation in the antero-inferior quadrant of the eardrum. Three months after surgery, the tympanic membrane was perfectly healed. There were two cases of recurrence of middle ear fluid. There was no adverse effect and hearing results were good. We discuss the significance of these preliminary results and emphasize the need for further research.

Adenoidectomy↗
PubMed1998

[Schwannoma of the cervical esophagus: case report and clinical and pathological analysis].

Neurogenic tumors fo the head and neck are relatively rare and often mistaken for other disease processes. Schwannoma (neurinoma, neurilemoma, neurolemoma) is a tumour histologically characterized by the proliferation of schwann cells from the neural sheath of autonomic, cranial or peripheral nerves. We describe a case of schwannoma located in the muscular layer of the cervical esophagus. The clinical and radiological findings are highlighted allowing a retrospective preoperative presumption of schwannoma. Esophageal schwannoma is a very rare entity as only nine cases have been reported so far.

Adolescent↗
PubMed1998

[Lasers used by a young surgeon for stapes surgery].

We report the results of the first 38 stapes operations performed by a young surgeon. He achieved a perfect closure of the air-one gap (within 10 dB) in 89% of the patients operated on with the laser, compared with 65% of the patients operated on without laser. We discuss the significance of this difference, taking into account the multiple factors influencing the results. In our opinion, the laser helps a young surgeon to accelerate his learning curve in stapes surgery.

Adolescent↗
PubMed1997

External auditory canal cholesteatoma.

A cholesteatoma originating in the external auditory canal is a rare finding. We report 2 cases illustrating its typical localization in the inferior part of the auditory canal and its marked osteolytic character. The extension of such a cholesteatoma in the depth of the temporal bone is often larger than suggested by clinical examination. Since the purpose of treatment is to achieve the complete eradication of the epidermic matrix, surgical treatment is required in most cases. We discuss herein the follow-up strategies, keeping in mind that local recurrence and bilateral disease are not uncommon.

Adult↗
PubMed1997

The relevance of using tragal cartilage in tympanoplasty.

Chronic endotympanic depression is a pathological situation which leads to tympanic atelectasis, retraction pockets and cholesteatoma. It is also at the origin of tympanoplasty failure. Tragal composite perichondrium-cartilage graft is a procedure which gives good results in these difficult surgical cases.

Humans↗
PubMed1995

Myringoplasty: long-term results in adults and children.

This report presents the long-term results 3 years after primary myringoplasties performed with formolized fascia temporalis autografts. The overall closure rate was 87.7% of cases, with improvement in hearing in 67.2% of cases. The best results were achieved with total perforations, and not with partial posterior perforations, contrary to popular opinion. The anterior perforations were the most difficult to close. Anterior angle blunting was avoided by careful technique. Although the results of myringoplasty are clearly better in adults than in children, there is not a determined "frontier age" before which a child may not undergo operation. The state of the middle ear at the time of operation influences surgical outcome: wet ears have a higher rate of perforation, myringitis, and retraction pocket. Medical treatment is recommended prior to surgery in every discharging ear, as a diagnostic method rather than a therapeutic one. If the ear remains wet, chronic otitis media should be considered rather than simple perforation of the eardrum, and a mastoidectomy should be combined with the myringoplasty.

Adolescent↗
PubMed1993

[Bone and cartilage allografts in microsurgery of the ear].

The authors present there experience with bone allografts and costal cartilage allografts in middle ear microsurgery. A drastic selection of the doners and a careful preparation of the grafts avoid the risk of viral transmission to the receiver. The easy available materials can be used for reconstructing the ear drum, the ossicular chain and the tympanic bony wall. With good anatomical and functional results, even at long-term (3 and 4 years).

Bone Transplantation↗
PubMed1993

[The use of glass ionomer cement in otology and in otoneurosurgery].

The use of glass ionomer cement for mastoid obliteration, reconstruction of the external ear canal, closure of the translabyrinthine approach for acoustic neuroma and fixation of a cochlear implant in the temporal bone is described. Preliminary results are encouraging, although some epithelialisation defects may occur in the external ear canal.

Biocompatible Materials↗
PubMed1992

[Acute vertigo caused by cerebellar vascular accident].

At the beginning, small cerebellar strokes may present only with acute onset of vertigo, unsteadiness and unidirectional nystagmus, like a vestibular neuritis. In some cases, it is associated with tinnitus and hearing disturbance, like an endolymphatic hydrops. Other cases may mimic a benign cupulolithiasis, with only a paroxysmal positioning vertigo. Attention should be focused on transient associated symptoms: headache and blurred vision. One should not wait for classical cerebellar clinical signs: they are subtle and they appear late. Within a few days, the clinical picture will change: vertigo will disappear, while unsteadiness will progress. The electronystagmography confirms the integrity of the vestibular peripheric system. The cerebral CT Scan will show the ischaemic lesions only several days after the onset of the symptoms. A magnetic resonance imaging is far more efficient. Small cerebellar strokes have a good prognosis: complete recovery may be hoped with acetylsalicylic acid treatment and kinesitherapy.

Acute Disease↗
PubMed1991

[Isolated cough and bronchial asthma].

Over an 18-month period 31 patients (27 female and 4 male) were referred to the ENT department of our clinic for a 1-month to 14-year history of isolated non-productive cough. As ENT examination, including posterior rhinoscopy, was normal, these patients were sent to the pneumology department. Physical examination and X-ray films of the chest were negative, and the patients did not take an angiotensin converting enzyme inhibitor that could have induced this cough. Inhalation of acetylcholine lowered vital capacity by 32 +/- 14% and forced expiratory volume by 34 +/- 16%, a test which is the hallmark of bronchial hyperreactivity. Three patients were atopic. We believe that this cough can be the only manifestation of bronchial asthma. In these patients, cough was suppressed or strongly attenuated by the inhalation, 5 times a day, of salbutamol 200 mg puffs and beclomethasone dipropionate 250 mcg. In addition, the atopic patients were prescribed 10 puffs of sodium cromoglycate per day. Complaints of isolated non-productive cough must always suggest that possibility of bronchial asthma, and a bronchial provocation test must be performed to confirm this diagnosis.

Adolescent↗