Ambulatory vs. in-patient stapedectomy: a randomized twenty-patient pilot study.

A prospective study was undertaken to determine whether stapedectomy can safely be performed in an outpatient setting. Twenty patients with otosclerosis amenable to surgical treatment were divided into two groups; those in the hospitalized group were admitted the day before surgery and discharged 24 hours after the procedure. The patients in the ambulatory group were admitted on the day surgery was scheduled and released 1 or 2 hours after the procedure. We analyzed the intensity and duration of postoperative vertigo, and the hearing gain obtained, studying the speech frequencies(500 to 2000 Hz) separately from the high frequencies (4000 to 8000 Hz). No significant difference was found at 1, 3, and 6 months of follow-up in any of the parameters studied, concluding that small-fenestra stapedectomy can safely be performed as an outpatient procedure.

[General principles of conception of cochlear implants]. / Principes généraux de conception des implants cochléaires.

Cochlear implants have greatly been developed on last ten years. Their diversity makes their use and choice more complex. The authors expose simply the physiopathology of the implanted auditory system and basic principles of cochlear implants. Cochlear implants are caracterised by the number of channels and electrodes (monochannel, multichannel), the strategy of encoding (analogiq, digital), the transmission of signal (per-cutaneous, electro-magnetic induction), the site of stimulation (extra or intra-cochlear), the signal wave (sinusoid, pulse), the diffusion of current (monopolar, bipolar).

Cochlear implants, acquisitions and controversies in the adult patient.

The cochlear implant field is rapidly progressing in the clinical field. This progress has produced new information regarding choice of devices, selection criteria, and surgical techniques. Some of these points remain controversial, and the authors try to determine their real value.

[Ethical and economical considerations on cochlear implants in developing countries]. / Considérations éthiques et économiques sur les implants cochléaires dans les pays en voie de développement.

An important factor that all cochlear implant teams have to deal with one way or another is the coast of the prostheses. This problem takes on very special characteristics in developing countries. This paper is based on the authors' experience in establishing the cochlear implant program of the "Hospital General Manuel Gea Gonzalez", a public hospital in Mexico City, and tries to determine which should be the optimal characteristics of an implant to be used in developing countries.

Long-term effect of acetazolamide and chlorthalidone on the hearing loss of Menière's disease.

A retrospective computerized analysis of the records of patients with Meniere's disease was made to evaluate the effect of acetazolamide and chlorthalidone on the rate of hearing loss. Three groups were compared as follows: (1) 79 patients treated with chlorthalidone for 5 to 13.4 years; (2) 42 patients medicated with acetazolamide between 5 and 7.8 years; and (3) a control group of 71 patients who received only intermittent symptomatic treatment for vertigo, followed for 5 to 24.1 years. In the short term, after 2 to 6 weeks of treatment, a statistically significant decrease of the average hearing loss was observed with both chlorthalidone and acetazolamide. In the long term, more than 5 years, no preventive effect on the deterioration of the hearing loss could be detected. Both acetazolamide and chlorthalidone can be useful for diagnostic purposes by causing a fluctuation of hearing, as well as for the management of the vertigo attacks, but it is not useful for the long-term prevention of the hearing deterioration in Meniere's disease.