Many instances of total deafness are due to destruction of the organ of Corti, contrasting with the partial or complete preservation of the function of the cochlear nerve. In such cases, it is possible to restore some hearing by stimulating electrically the fibres of the cochlear nerve with the help of implanted electrodes. By means of several fenestrations, it is possible to construct electrically insulated compartments in the scala tympani of the cochlea, and to implant eight electrodes. This procedure allows discrimination of sound frequencies because the electrical stimulation of each electrode gives a sound sensation which depends on the electrode stimulated. This enabled us to elaborate a map of frequencies of the human cochlea and to make some physiological observations and achieve clinical results in seven cases of total bilateral deafness.

Adult↗

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Indications and results of the multichannel cochlear implant.

In the case of total deafness, the multichannel cochlear implant prosthesis constitutes a substantial improvement. It allows known words to be recognized without lip reading, with a great percentage of good responses. Clinical and phoniatric results are reported in 21 cases of patients with implants.

Acoustic Stimulation↗

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[Our technique of hetero-lateral facio-facial anastomosis by means of nerve autografting in the treatment of permanent peripheral facial paralysis].

The authors describe the technique used in 12 surgical cases of heterolateral facio-facial anastomosis by nerve autograft in the treatment of permanent peripheral facial paralyses. Their main contention is that section of 50 p. 100 of the neurones of the peripheral branches of the facial nerve on the unaffected side does not impair motricity to any extent and that it therefore is possible to anastomose the proximal portion of some healthy branches to the corresponding distal portion of the affected side by placing between them a graft from the external saphenous nerve. The principles for fascicular suture as defined by Seddon and later by Millesi are followed. The technique differs from that made popular by Smith and later by Smii inasmuch as: --the bilateral, hidden face-lift incision makes possible a final passive musculotegumentary suspension of the paralysed side immediately improving the patient's appearance while the nerve re-establishes itself; --retrograde interfascicular dissection on the paralysed side allows precious centimetres to be gained; --pinpointing of the nerve suture area is possible by the placing of a silicone-coated ring with a clip some distance away.

Facial Nerve↗

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[Transethmoido-sphenoidal approach to decompression of the optic nerve].

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Adult↗

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[Physiological assessment of the rehabilitation of total deafness by the implantation of multiple intracochlear electrodes].

Cochelar implantation can only be entertained incases of complete endocochlear deafness and if the nerve fibres which transmit the auditory message to the cerebral centres are relatively unaffected. The electrodes should also be placed so as to follow roughly the spatial arrangement of the cochlear organ: each band of the speech area should have an electrode. It is however clear that a single electrode cannot offer selectivity as far as this spatial arrangement is concerned. The authors therefore decided to use 7 or 8 intra-cochlear electrodes. These were insulated from each other so as not to interfere with selective stimulation of the different groups of fibres.

Adult↗

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[Recent developments in electrical tests applied to the study of facial paralysis].

We have already shown the spontaneous development over a period of time of idiopathic facial paralysis, in relation to the extent of the resulting disfigurement, by means of analytical clinical measurement representing the sum of 19 factors constituting the force of contraction, tonus, coordination and hemispasm. This spontaneous development takes place in 3 stages: --an initial period up to the 15th day; --an intermediate period during which there is clinically total facial paralysis; --a period of recuperation. The duration of this development in relation to the extent of sequelae enables a rough distinction to be made between: a) benign facial paralysis in which disfigurement is nil or very slight (1 to 6 p. 100), incomplete paralysis or complete paralysis in which recuperation starts about the 15th day at the earliest, or at about the 4th month at the latest; c) very serious facial paralysis with moderate (38 to 66 p. 100), or considerable (66 to 100 p. 100) disfigurement and in which recuperation starts at the end of the 3rd month at the earliest. The authors have attempted to indicate how effective very prompt quantitative electrical procedures are in helping to assess the seriousness of ultimate permanent disfigurement (see article).

Electrodiagnosis↗

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