[Relations between vasculotensional disease, sudden deafness and benign paroxysmal postural vertigo: value of anticochlear antibodies]. / Relations entre la maladie vasculotensionnelle, la surdité brusque et le vertige positionnel paroxystique bénin: intérêt des anticorps anticochléaires.

Some vasculotensional diseases may be associated, at a certain point of their evolution, with occurrences of sudden deafness or of benign paroxysmal positional vertigo. It seems that the efficiency of the treatments of sudden deafness and benign paroxysmal positional vertigo is not modified by those associations of pathologies. On the other side, the search for anticochlear antibodies gives a positive result in 45% of the vasculotensional diseases. When the vasculotensional disease is associated with sudden deafness, this percentage increases. On the contrary, it is lower when the vasculotensional disease is associated with benign paroxysmal positional vertigo. The presence of anticochlear antibodies may lead to a corticotherapy in case of failure of the classical treatments.

[Somatosensory evoked potentials in peripheral diseases of the facial nerve: a new investigation method]. / Les potentiels évoqués somesthésiques dans la pathologie périphérique du nerf facial: nouvelle méthode d'investigation.

In 1988, at the Facial Nerve Congress in Rio de Janeiro, results of facial nerve somatosensory evoked potentials (SEPs) by electrical stimulation of the Ramsay-Hunt zone were presented. In the clinical phase of this work, we have tested 8 normal subjects and 5 patients with unilateral peripheral facial palsy by the SEP method. Significant and reproducible responses were obtained in the normal nerves; general wave-form and different parameters are described: latency of different activities, differences inter and intra-subjects. In one case, we performed a brain mapping by stimulation of the Ramsay-Hunt zone to improve the localization of the different activities and to differentiate them from a possible auditory response to the electrical stimulation. In the pathological nerves, we observed significant changes in the morphology of the cortical waves with regards to the healthy nerves. Detailed results are presented in two cases with a long-term follow-up. We concluded that the electrical stimulation of the Ramsay Hunt zone evokes a cortical response like the electrical stimulation of other cutaneous zones. This response is significantly altered in peripheral facial palsy. Following studies should define the prognostic value of such modifications.

[Value of evoked somatosensory potentials of the facial nerve]. / Intérêt des potentiels évoqués somesthésiques du nerf facial.

We assessed the somatosensory evoked potentials (SEP) contribution to the evaluation of peripheral pathologies of the facial nerve. SEPs to electrical stimulation of the internal face of the auricle (Ramsay-Hunt zone) were recorded in 8 normal subjects and in 6 patients with unilateral peripheral facial palsy. Significant and reproducible cortical responses were obtained in all normal subjects and to stimulation of the healthy facial nerve in all patients. Brain mapping performed in one normal subject allowed us to locate the different activities on the cortex and to differentiate those from a possible auditory nerve response to electrical stimulation. When stimulating the pathological side, the cortical activities were altered when compared with those obtained by stimulation of the healthy side. In conclusion, the stimulation of the Ramsay-Hunt zone evokes a cortical response like those obtained by somatosensory stimulation of other cutaneous territories. These responses are significantly altered in peripheral facial palsy. Additional studies are needed to establish the prognostic value of these abnormalities.

[Techniques of uvulopharyngoplasty for snoring]. / Techniques d'uvulopharyngoplastie pour ronflement.

Snoring is considered abnormal even in children. Breathing difficulties can modify the development of the face and provoke upper respiratory dysfunction. Some surgical techniques are presented.

New perspectives on lyophilized bone allografts.

In 1987, at the Congress of Implants in Otology in Venice, Italy, we first presented our experiences with stored lyophilized bone allografts for reconstruction of the tympano-ossicular chain. Since then, we have extended our experiences to include reconstruction of the external bony ear canal, the filling of defects in the mastoid bone, reconstructive nasal surgery and rehabilitation of major bony defects of the face. Additionally, we have tried to improve the preparation of the bony implants used clinically and have started a multicenter collaboration with other European universities.

[Lyophilized homologous bone grafts in middle ear surgery: new perspectives]. / Les homogreffes osseuses lyophilisées dans la chirurgie de l'oreille moyenne: nouvelles perspectives.

The authors share their experience of the use of allografts in the reconstruction of the tympano-ossicular chain. The implants were cut from the cortical substance of the long bone in patients deceased for a maximum of six hours; the donors were tested for syphilis, hepatitis, AIDS, systemic diseases or a neoplasm. These bone allografts were cut to size, degreased, demineralized, frozen and then lyophilized in order to be presented to the surgeon in a sterile container (Bone Bank). The implants were all tolerated well. The anatomical results were satisfactory. Optical microscopic studies showed that the implant was: a) covered with mucosa, b) full of osteoblasts and c) the site of a bone neoformation. Experimental research is currently underway in order to perfect the implant preparation methodology.

Bone allografts in reconstructive middle ear surgery.

The authors present their current experience with stored bone grafts, using allografts shaped from the cortices of long bones for reconstructing the tympano-ossicular chain. The materials and the methods are described. The anatomical results have been good in 97% of the cases, while the functional results are as satisfactory as those obtained with bioceramics. In addition to ossiculoplasty, the bone allografts can also be used in otology for reconstructing large bony defects of the temporal bone.

Comparative study of the clinical results obtained by means of Plastipore and ceramic ossicular prosthesis and bone allografts.

We present a comparative study of the clinical and audiologic results obtained by means of Plastipore and ceramic ossicular prostheses and bone allografts in reconstructive middle ear surgery. We stress the excellent tolerance for ceramic and bone allografts in comparison to Plastipore. Functionally, the best results were obtained with partial prostheses using bone allografts and with total ceramic ossicular prostheses. Air-bone gaps less than 10 dB (37%) and 20 dB (69%) were achieved in patients with partial prostheses; in patients with total prostheses, 38% had an air-bone gap of less than 10 dB and 62% of less than 20 dB.

[Our experience in the study and treatment of medullary carcinomas of the thyroid. Apropos of 2 familial cases]. / Notre expérience dans la mise au point et le traitement des carcinomes médullaires de la thyroïde. A propos de deux cas familiaux.

Between July 1976 and July 1984, 1106 cold thyroid nodules have been operated on UCL. Teaching Hospital; 128 were diagnosed as carcinoma (11,5%) and 15 were diagnosed as medullary carcinoma of the thyroid gland (1,3% of all the cold nodules and 12% of all carcinomas of the thyroid). This article presents the case of two families exhibiting a characteristic clinical history of Medullary Carcinoma of the thyroid or CMT. The authors describe briefly the clinical signs; they point out that it is absolutely necessary to ask for a blood calcitonine level control in case of cold thyroid nodule or cervical lymphadenopathie. Once the diagnosis of Medullary Carcinoma of the thyroid gland is reached, screening of the Family, at least the first degree relatives should be undertaken, in order to reveal subclinical cases, which could be detected by laboratory investigations at an early subclinical stage. The treatment of the CMT is always surgery; it consists of total thyroidectomy with a modified neck dissection or a radical neck dissection, if lymph nodes are more than 3 cm or are fixed. Any way the recurrent nerve nodes have to be looked for, and if positive a Mediastinal lymph node dissection should be carried out. A control of the calcitonine hormone blood level should be asked for twice a year to detect any metastases or recurrence.

[Controversy--open technic--closed technic. Critical review of the literature and our personal experience]. / Controverse--technique ouverte--technique fermée. Revue critique de la littérature et notre expérience personnelle.

The authors have made a comparative study of the functional and auditory results, as well as an appreciation of the eradication of disease, in 64 patients having undergone open technic surgery for cholesteatoma (66 operations) and in 136 patients treated by closed technic (197 operations). The closed technic would appear to be the one of choice as regards the functional hearing results, most particularly in cases of absence of the stapedial crura. Concerning eradication of middle-ear disease, they believe there to be reason for a somewhat less categorical position towards the accepted fact of the semi-open technic (modified radical mastoidectomy) being strikingly safer than the closed technic. They deplore the difficulty of being unable validly to compare the published results obtained by various authors, due to the diversity of the surgical technics and a lack of uniformity in evaluating and presenting the results.