Antibodies to myelin protein zero (P0) protein as markers of auto-immune inner ear diseases.

BACKGROUND/AIMS: The inner ear can be the target of autoimmune disorders. Recognition of autoimmune inner ear disease is important, as it is one of the very few forms of sensorineural hearing loss (HL) that can be successfully treated by medical therapy. The aim of this study was to evaluate whether the detection of antibodies to myelin protein P0 (MPZ) could be a diagnostic test for inner ear disease of autoimmune cause. METHODS: This multicentric prospective study included 129 patients: patients with progressive sensorineural HL or with Menière's disease, together with their control group corresponding to patients with similar symptoms, but of presumably known origin. Detection of antibodies to myelin P0 protein was performed by using western blots. NORMAL: The prevalence of antibodies to myelin P0 protein in patients with rapidly progressive HL was not statistically different from that of the control group corresponding to genetic HL patients (30 versus 28%). In patients with Menière's disease, the prevalence was lower than that of the control group corresponding to patients with benign paroxysmal positional vertigo (5.4 versus 18.7%). No patient with auto-immune disease had antibodies to myelin P0 protein. CONCLUSIONS: The sole presence of antibodies to myelin P0 may not be used as a marker of inner ear disease of autoimmune origin.

The binaural digisonic cochlear implant: surgical technique.

The surgical technique of cochlear implantation is currently well established. It is sure and efficient. The results of the cochlear implant concerning speech perception are good and have a favorable cost/efficiency ratio. However, some points remain to be researched. Bilateral implantation allows one to obtain a binaural perception and especially to increase, theoretically, the possibilities of frequency discrimination by reducing interactions between electrodes and therefore improving the patient's performance. Nevertheless, it seems important to caution against placing two implants in one patient, especially for economic reasons. Thus, we have developed, with the MXM Company, a concept of a unique implant able to stimulate both cochleas with a single processor and a single receiver: the Binaural Digisonic cochlear implant. This article describes the Binaural Digisonic system, the surgical technique as developed by postmortem dissection, and the first two implantations in patients.