[Laryngeal sarcoidosis: case report]. / Une sarcoïdose laryngée: cas clinique.

Sarcoidosis is a chronic disease characterized by non-caseating granulomatous inflammation in one or multiple organs. The most commonly involved sites are the lungs and the skin. Involvement of the larynx is rare but significant. We present here a case of biopsy-proven of laryngeal sarcoidosis with favourable evolution without specific treatment.

Rehabilitation of high-frequency hearing loss with the RetroX auditory implant.

The RetroX is a new semi-implantable hearing aid which does not occlude the external ear canal. It consists of an electronic unit that plugs into a titanium tube which is implanted under the pinna so as to connect the retroauricular sulcus with the inside lumen of the external ear canal. Implantation requires minor surgery which can be performed under local anesthesia. Moreover, a pre-implant simulator exists and allows patients to try the device before deciding on definite implantation. The RetroX auditory implant is indicated in case of high-frequency sensorineural hearing loss with a steep slope (ski-slope audiogram). We implanted 25 adults suffering from such a hearing loss, and we report their hearing measured after 2.5 to 15 months of use. Four patients developed a persistent granulomatous reaction which disappeared after explantation. Two patients complained of acoustic feedback and needed supplementary fitting. Twenty three of our 25 subjects are satisfied or even extremely satisfied with the hearing improvement provided by the RetroX; they wear the implant daily, from morning until evening. Audiometrically, we observed a statistically significant improvement of the pure-tone thresholds at 1, 2, 4 and 8 kHz. In quiet, the speech reception thresholds decreased by 10 dB SPL and in noise, speech intelligibility increased by 15% for signal-to-noise ratios between -5 dB and +5 dB. Up till now, our patients were implanted monaurally because of financial considerations and our initial inexperience with this new implant. The overall results, however, are promising and nowadays, we advise bilateral implantation for patients who tolerate the first implant. By doing so, we hope to improve hearing in noise and spatial sound perception.

The RetroX auditory implant for high-frequency hearing loss.

OBJECTIVE: The objective of this study was to analyze the subjective satisfaction and measure the hearing gain provided by the RetroX (Auric GmbH, Rheine, Germany), an auditory implant of the external ear. STUDY DESIGN: We conducted a retrospective case review. SETTING: We conducted this study at a tertiary referral center at a university hospital. SUBJECTS: We studied 10 adults with high-frequency sensori-neural hearing loss (ski-slope audiogram). INTERVENTION: The RetroX consists of an electronic unit sited in the postaural sulcus connected to a titanium tube implanted under the auricle between the sulcus and the entrance of the external auditory canal. Implanting requires only minor surgery under local anesthesia. MAIN OUTCOME MEASURES: Main outcome measures were a satisfaction questionnaire, pure-tone audiometry in quiet, speech audiometry in quiet, speech audiometry in noise, and azimuth audiometry (hearing threshold in function of sound source location within the horizontal plane at ear level). RESULTS: : Subjectively, all 10 patients are satisfied or even extremely satisfied with the hearing improvement provided by the RetroX. They wear the implant daily, from morning to evening. We observe a statistically significant improvement of pure-tone thresholds at 1, 2, and 4 kHz. In quiet, the speech reception threshold improves by 9 dB. Speech audiometry in noise shows that intelligibility improves by 26% for a signal-to-noise ratio of -5 dB, by 18% for a signal-to-noise ratio of 0 dB, and by 13% for a signal-to-noise ratio of +5 dB. Localization audiometry indicates that the skull masks sound contralateral to the implanted ear. Of the 10 patients, one had acoustic feedback and one presented with a granulomatous reaction to the foreign body that necessitated removing the implant. CONCLUSION: The RetroX auditory implant is a semi-implantable hearing aid without occlusion of the external auditory canal. It provides a new therapeutic alternative for managing high-frequency hearing loss.