Biomedical subjects

R Charachon

Publications and source records attributed to R Charachon.

At least 37 records · Page 2Linked to original sources

PubMed1993

Indirect immunofluorescence in the investigation of rapidly progressive sensorineural hearing loss and Menière's disease.

Being aware of the conservation of antigenicity, we performed indirect immunofluorescence on non fixed non decalcified frozen hamster's cochlea. Once killed, the heads of the hamsters were immediately dipped into liquid nitrogen and then stored at -20 degrees C until cutting. The sections were done at the same temperature, with Tissue-Tek embedding the heads to avoid breaking, using a sharp tungsten knife. The immunofluorescence itself was performed with the sera of the patients which were revealed through donkey fluorescein-conjugated antiserum to human immunoglobulins. For counterstaining, we used Evans blue. Twenty patients with rapidly progressive sensorineural hearing loss (according to the clinical criteria of MacCabe) and 6 with Menière's disease were tested. Five had a specific fluorescence on the stria vascularis. A correlation with the lymphocyte transformation test on human inner ear antigen has been found (p = 0.055).

Animals↗

PubMed1993

[Extensive cholesteatoma without intrapetrous involvement. Discussion on the surgical approach].

Based on 8 observations, the authors analyze the extension of middle ear cholesteatomas on the anterior attic and the anterior supralabyrinthine cellular groove, the internal retrotympanum and the posterior sublabyrinthine cellular groove, the hypotympanum and the anterior sublabyrinthine groove, the retrolabyrinthine region and the translabyrinthine and posterior supralabyrinthine grooves. Despite progress in imaging and optical instrumentation, exact precision of the lesions sometimes remains impossible. The patient must be warned of a possible enlargement of the operative pathway and its consequences.

Adult↗

PubMed1993

[Primary sclerosing cholangitis and autoimmune cochlear deafness: a new syndrome?].

Association of autoimmune cochlear hearing loss with primary sclerosing cholangitis is reported in two patients. Endocochlear sensorineural hearing loss was associated with the presence of anti-cochlear antibodies in the serum directed against the walls of vessels in the stria vascularis. The hearing loss appeared at the same time or shortly after the diagnosis of cholangitis. This association, which has never been described, may reinforce the theory of the role of immunologic factors in the pathogenesis of primary sclerosing cholangitis, possibly linked to or initiated by vasculitis.

Adult↗

PubMed1992

Chondrosarcomas of the petrous apex.

From 1974 to 1988, four patients with chondrosarcomas of the petrous apex were followed. Average age was 46 years (range, 30 to 61), one man and three women. The mean delay between the first patient's symptoms and the visit was 18 months (range, 15 to 24). The surgical treatment consisted of two infratemporal approaches (type A), one transcochlear approach, and one partial excision by retrofacial route. For the four patients, the surgery was followed by cobalt therapy. Three of four patients are alive and one patient died 5 years later of a cerebrovascular lesion and bilateral acute parotiditis. None presented with a recurrent disease.

Journal Article↗

PubMed1992

New immunobiological tests in the investigation of Menière's disease and sensorineural hearing loss.

The aim of the study was to determine the usefulness of new immunobiological tests using fractioned human inner ear antigen in the investigation of 4 Menière's disease and 12 rapidly progressive sensorineural hearing loss (RPSNHL). Each patient underwent a full ENT examination and a full range of immunobiological tests comprising ESR, electrophoresis, IgG, A, M, circulating immune complexes, cryoglobulins, complement, organ and non-organ auto-antibodies. The two new tests were the lymphocyte transformation test (LTT) and the immunoperoxidase test against total or fractioned human inner ear antigens. Four main bands were found in electrophoresis with the following molecular weights: 130,000, 45,000, 22,000, and 14,000. The heaviest band corresponded to IgG contained in the inner ear extract. Three cases of bilateral RPSNHL had positive LTT against inner ear antigens. No serum of patients showed a characteristics band with the immunoperoxidase test with regard to the serum of healthy subjects. At least four abnormal inflammatory non-specific tests were shown in the cases of positive LTT. Out of 3, 2 patients received steroids and improved their hearing.

Adult↗

PubMed1992

[Congenital cholesteatoma of the middle ear in children].

In a series of 16 middle ear cholesteatomas of a congenital type are reported in children; the youngest (18 months) presented with a bilateral case. Whereas a simple tympanoplasty could cure a localized pearl, typically anterosuperior in the mesotympanum, the stapes is fast eroded (7 cases) if progression goes on. Intact canal wall technique in 2 stages was the typical procedure. Good hearing results were generally achieved (except in one case of fixed footplate): 9 cases/14 with an ABG within 20 dB and an AC level within 30 dB.

Child↗

PubMed1992

Spontaneous retraction pockets in chronic otitis media medical and surgical therapy.

Results of a series of 228 spontaneous retraction pockets in chronic otitis media are reported and a classification is proposed. Under medical therapy, 78 retraction pockets of stage I and II (out of 95) were followed for five years. Sixteen percent deteriorated into stage III and were operated on; the others stabilized or improved towards normal tympanic membrane (23%). Different methods of surgical therapy were used in 150 retraction pockets (all the stages III and many stages II). Even with silastic sheeting and strengthening of the tympanic membrane, a recurrent retraction pocket was observed in 24 cases (16%). Functional results were obviously better when the ossicular chain was rebuilt from an intact malleus to an intact stapes and either from an intact malleus to a mobile footplate or from the tympanic membrane to an intact stapes. Surgery of retraction pockets must be used not only to prevent cholesteatoma formation but also to prevent erosion of the stapes.

Adult↗

PubMed1991

[Lipoma of the internal auditory canal. An anatomo-clinical case study and review of the literature about cranial nerve lipomas].

A 36-year-old female presented with vertigo and worsening of a right hearing loss with tinnitus. Clinical and radiologic investigations revealed a tumor of the right internal acoustic meatus, first diagnosed as a neuroma. Histologic study of surgical samples led to a final diagnosis of lipoma. Cranial nerve lipomas are rare and usually located in the cerebellopontine angle. Lipomas confined to the internal acoustic meatus are much rarer. The review of the literature however, shows that their histologic characteristics and their behavior are identical to those of cerebellopontine angle lipomas, and that a minimal surgical resection is therefore advised.

Adult↗

PubMed1991

Reconstruction of radical mastoidectomy by obliteration technique.

Reconstruction of radical mastoidectomy was performed by obliteration tympanoplasty using Palva flap in 199 ears either in one stage (normal mucosa, normal stapes, no risk of residual cholesteatoma behind the flap) or in two stages. At the 2nd stage, middle ear was reopened and the posterior cavity was checked in 34 cases. Bony pâté or ceramic granules may be added behind the flap, especially at this second stage. The closure of the tympanic membrane was achieved in 97% of cases. Residual cholesteatoma was removed in the middle ear at the 2nd stage in 17% of the ears. Late residual cholesteatoma behind the flap appeared in 5 cases where the posterior cavity had not been checked. Three early retraction pockets were due to technical failures which were more recently corrected by the use of fibromuscular graft placed between the fascia graft an the Palva flap. Three late retraction pockets progressed under the tympanic membrane from above to below. Hearing results were better in the 1st stage procedures, obviously selected: ABG within 20 dB in 83% of the ears with a normal stapes. On the contrary, in 2 stage procedures, ABG within 20 dB was achieved only in 50% of cases with a normal stapes and 29% of the ears where the crura were missing.

Adolescent↗

PubMed1991

[Value of immunobiological tests in Menière's disease and in rapidly progressive sensorineural deafness].

We have looked for abnormal immunobiologic test in 12 cases of Meniere's disease and 11 cases of rapidly progressive sensorineural hearing loss. After ruling out known etiologies, they were screened with non specific tests (sedimentation rate, electrophoresis, immunoglobulins, circulating immune complexes, cryoglobulins, complement system, auto antibodies) and inner ear specific tests (antibodies against human cochlea by indirect immunofluorescent test and lymphocyte transformation test against a pool of human inner ear. A non specific inflammatory syndrome was found in more than 50% of cases, specific tests of the inner ear were positive in 30% of cases. Corticosteroid therapy achieved a significant improvement of the hearing in 100% of the patients with a positive specific test, versus 50% of those with a negative result. A therapeutic protocol is suggested taking into account the results of the immunobiologic tests.

Deafness↗

PubMed1991

[Malformations of the bony labyrinth and deafness].

17 new cases of malformation of the bony labyrinth detected radiologically (tomography, CT) and associated with perceptive or composite deafness are reported. 2 cases discovered in spontaneous or traumatic recurrent meningitis are described, as well as 1 case discovered after the occurrence of total deafness following stapedial surgery. The malformations were unilateral in 7 cases, bilateral in 10. Deafness was of the composite type in 6 cases. An associated malformation of the middle or external ear was noted in 4 cases. 5 cases were included in a context of multiple malformations, including 1 case of otobranchiorenal syndrome, 1 case of Apert's syndrome and 3 cases of craniostenosis. Referring to the classification given by Mrs Vignaud and Jardin, we have encountered 1 case of stage I malformation, 9 cases of stage II, pseudo-Mondini malformation, 1 case of stage III or true Mondini malformation, 1 case of stage IV malformation, 3 cases of malformation of the aqueduct of the vestibule, ie. stage V. We have also encountered 2 isolate cases of stenosis of the internal auditory canal. On the basis of these cases, we report a few physiopathogenetic hypotheses and various classifications currently described in the literature. We also list the various associated external and middle ear malformations and the multiple-malformation syndromes that are commonly described. Stress is laid on the fact that these malformations often go undetected in congenital deafness, as well as on the usual course of these types of deafness for which there is no medical or surgical treatment.

Abnormalities, Multiple↗

PubMed1991

[Comparison between closed and open technique with muscular filling up in surgery of cholesteatoma of the middle ear. Long-term results].

Advantages and disadvantages of closed versus obliteration technique are studied in a serie of 348 ears all operated on by the senior surgeon, from January 1970 to January 1980. Closed techniques were performed in 67% of cases in children and 50% of cases in adults. A follow-up at one year was achieved in 98% of the cases, at 5 years in 50% and at 10 years in 25% of the cases. This study consists of long term results after all the scheduled surgery has been performed. Residual cholesteatomas occurred in 5% of closed techniques in 1 stage and 1% of closed techniques in 2 stages at one year, in 1.2% of closed techniques in 2 stages and 5% of obliteration techniques in 1 stage at 5 years. No other residual cholesteatomas were observed. Retraction pockets on the contrary were very frequent in closed techniques in 1 stage: 15% at 1 year, 11% at 5 years and 22% at 10 years. They were less frequent for closed techniques in 2 stages: 0.9% at 1 year, 6.3% at 5 years and 2.8% at 10 years. The same figure was observed for obliteration techniques in 1 or 2 stages: 1% at 1 year, 5 and 8.9% at 5 years and 5.8 and 5.2% at 10 years. The air-bone gaps were the same for closed techniques and obliteration techniques.

Adult↗

PubMed1990

[The open technique of tympanoplasty with obliteration using the Palva flap: technical details and indications].

Technical details of obliteration tympanoplasty with Palva flap are given with the 2 possibilities: 2 stages and 1 stage tympanoplasty. This technique is very convenient for adult cholesteatomas developed in a sclerotic mastoid with an extension limited to mesotympanum and attic, to the children cholesteatomas developed in the mesotympanum with a sclerotic mastoid, for the correction of retraction pockets after a closed technique, rehabilitation of radical mastoidectomies, fibroadhesive otitis and some idiopathic glue tympanic membrane with a large cholesterol granuloma.

Adult↗

PubMed1990

[Tumors of the petrous apex].

Diagnosis and treatment of petrous apex tumors are difficult. The paucity of their presenting symptoms stands out in sharp contrast with an often massive tumoral spread. Their diagnosis is sometimes of an uncertain nature in spite of M.R.I., requiring a biopsy by the middle fossa approach. Electron microscopy should always be requested. Surgical excresis is always delicate by one of the following approaches: middle fossa, translabyrinthine, infra-temporal, transcochlear. The clinical series presented here consists of 7 cases of cholesteatomas, 4 cases of chondrosarcomas and 1 case of giant-cell fibrous histiocytosis.

Adult↗

PubMed1989

Melanin in the inner ear. An experimental study with control and kanamycin-intoxicated colored guinea-pigs.

Following several studies on the effects of kanamycin toxicity on the inner ears of guinea pigs, we have studied the importance of melanin in this phenomenon. Transmission electron microscopy showed that, under the influence of kanamycin, the intermediate strial cells developed a secretory aspect similar to that seen in skin melanocytes. This aspect as yet has never been described for the inner ear cells. A planimetric, morphometric method was also used to determine the strial cell melanin status in control animals. Additional findings in the study confirmed an increase in the number of melanosomes during kanamycin poisoning. Statistical data are discussed.

Animals↗

PubMed1989

Anatomical and functional reconstruction of old radical mastoidectomy cavities by obliteration tympanoplasty.

One hundred and seventeen patients who had previous radical mastoidectomies, atticotomies or Bondy operations were operated on between 1973 and 1984. An open technique with obliteration and traction meatoplasty was used in one stage in 19 ears (normal mucosa in mesotympanum) and in 2 stages in 98 ears (poor mesotympanum which needed to be dissected and covered with silastic sheeting). The second stage was performed 12 to 18 months later. Closure of the tympanic membrane was achieved in 93% of ears at the first stage. In 6 ears out of 81 second stages, residual cholesteatoma was found in the mesotympanum. No residual cholesteatoma was subsequently observed behind the flap but only 4 ears were checked behind the flap at the second stage. An air-bone gap within 20 dB was achieved in 85% of ears if the stapes was intact and surgery was performed in one stage, and in 55% of ears of the stapes was intact and surgery performed in 2 stages. If the crura were missing, an air-bone gap within 20 dB was achieved in 57% of ears in 2 stages.

Adolescent↗

PubMed1989

[Surgery of acoustic neurinoma. Apropos of a personal series. Development of techniques and results].

Between 1973 and 1987, 125 acoustic neurinomas were operated on in oto-neuro-surgery. The sub-occipital approach route was used for Stages III and IV up to 1982 (30 cases). Subsequently, surgery for all the neurinomas used the translabyrinthine approach route (82 cases), except for those cases where an attempt was made to preserve hearing by a supra-petrosal route (6 cases) or a retrosigmoid route (6 cases). The translabyrinthine approach route provided the simplest sequellae and the best preservation of the function of the facial nerve: grades I and II in 68% of cases (in 80% of cases by excluding Stage IV). Preservation of hearing was perfect in 2 cases, and partial in 2 cases, out of 12 attempts. The use of a facial nerve monitor proved highly satisfactory.

Adolescent↗

PubMed1989

[Natural history of Menière's disease concerning 92 cases from 1971 to 1980].

The author analyzes 92 cases of Ménière's disease seen for the first time between 1971 and 1980 (average duration: 3 years and 11 months). The isolated forms of cochlear and vestibular onset are respectively in the order of 21% with periods of 10 to 13 years before the appearance of the second symptom. In this series, the frequency of bilateral forms appears to be low (7.5%). It is probably much greater in the long term, justifying conservative therapeutic methods for hearing. A total of 22 patients underwent surgery: decompression of the saccus endolymphaticus (10 cases); vestibular neurectomy (11 cases); decompressive plate (3 cases); and sacculotomy operation of Fick (2 cases). Four patients were operated on twice.

Adult↗