CT-scan contouring technique allows for direct and reliable measurements of the cochlear duct length: implication in cochlear implantation with straight electrode-arrays.

OBJECTIVES: The advent of hybrid electro-acoustic implants requires precise positioning of the electrode-array (EA) within the cochlea. The cochlea size, that is, the length of the cochlear scala tympani, is often indirectly estimated from distance A by Escudé's method. This technique has been confirmed by anatomical studies, in a bunch of cadaveric specimens, but it is not yet widely established in the field of computed tomography (CT). We compared cochlear duct length obtained by Escudé's method to those directly acquired on CT images. MATERIALS AND METHODS: The lengths of cochlear scala tympani were directly measured on CT scans by contouring the external cochlear wall (contouring technique-CoT). In fifteen patients implanted with a straight EA, the length of the EA and the measured length of the cochlea by the CoT were compared, to check the reliability of the CoT. Then, in 200 CT-scans, the length of the cochlear duct was measured by the CoT then compared to Escudé's method. RESULTS: In the 200 CT-scans which served for cochlear length measurements, a significant variability between the cochleae were observed, as expected. At 360°, the correlation between the measurements of the length of the cochlear scala tympani between the two techniques differed, with a difference of 0.2 ± 0.7 mm at 360° (extreme: 2 mm; p < 0.001) and 2.2 ± 1.2 mm at 540° (extreme: 5.6 mm; p < 0.001). CONCLUSION: The CoT can predict with accuracy the length of EA-insertion depth, more precisely than estimation methods such as Escudé's.

Decrease in the Photosynthetic Performance of Temperate Grassland Species Does Not Lead to a Decline in the Gross Primary Production of the Ecosystem.

Plants, under stressful conditions, can proceed to photosynthetic adjustments in order to acclimatize and alleviate the detrimental impacts on the photosynthetic apparatus. However, it is currently unclear how adjustment of photosynthetic processes under environmental constraints by plants influences CO2 gas exchange at the ecosystem-scale. Over a 2-year period, photosynthetic performance of a temperate grassland ecosystem was characterized by conducting frequent chlorophyll fluorescence (ChlF) measurements on three primary grassland species (Lolium perenne L., Taraxacum sp., and Trifolium repens L.). Ecosystem photosynthetic performance was estimated from measurements performed on the three dominant grassland species weighed based on their relative abundance. In addition, monitoring CO2 fluxes was performed by eddy covariance. The highest decrease in photosynthetic performance was detected in summer, when environmental constraints were combined. Dicot species (Taraxacum sp. and T. repens) presented the strongest capacity to up-regulate PSI and exhibited the highest electron transport efficiency under stressful environmental conditions compared with L. perenne. The decline in ecosystem photosynthetic performance did not lead to a reduction in gross primary productivity, likely because increased light energy was available under these conditions. The carbon amounts fixed at light saturation were not influenced by alterations in photosynthetic processes, suggesting photosynthesis was not impaired. Decreased photosynthetic performance was associated with high respiration flux, but both were influenced by temperature. Our study revealed variation in photosynthetic performance of a grassland ecosystem responded to environmental constraints, but alterations in photosynthetic processes appeared to exhibit a negligible influence on ecosystem CO2 fluxes.

Long-term measurements of chlorophyll a fluorescence using the JIP-test show that combined abiotic stresses influence the photosynthetic performance of the perennial ryegrass (Lolium perenne) in a managed temperate grassland.

Several experiments have highlighted the complexity of stress interactions involved in plant response. The impact in field conditions of combined environmental constraints on the mechanisms involved in plant photosynthetic response, however, remains understudied. In a long-term field study performed in a managed grassland, we investigated the photosynthetic apparatus response of the perennial ryegrass (Lolium perenne L.) to environmental constraints and its ability to recover and acclimatize. Frequent field measurements of chlorophyll a fluorescence (ChlF) were made in order to determine the photosynthetic performance response of a population of L. perenne. Strong midday declines in the maximum quantum yield of primary photochemistry (FV FM ) were observed in summer, when a combination of heat and high light intensity increased photosynthetic inhibition. During this period, increase in photosystem I (PSI) activity efficiency was also recorded, suggesting an increase in the photochemical pathway for de-excitation in summer. Strong climatic events (e.g. heat waves) were shown to reduce electron transport between photosystem II (PSII) and PSI. This reduction might have preserved the PSI from photo-oxidation. Periods of low soil moisture and high levels of sun irradiance increased PSII sensitivity to heat stress, suggesting increased susceptibility to combined environmental constraints. Despite the multiple inhibitions of photosynthetic functionality in summer, the L. perenne population showed increased PSII tolerance to environmental stresses in August. This might have been a response to earlier environmental constraints. It could also be linked to the selection and/or emergence of well-adapted individuals.

Cochlear implantation through the round window with a straight slotted electrode array: optimizing the surgical procedure.

The question addressed here is how optimizing the quality of insertion through the round window with the lower morbidity, when using a straight and slotted electrode array of regular length. This retrospective analysis includes all cases implanted with a cochlear implant Digisonic SP (Neurelec-Oticon Medical) since 2004. We checked the operative charts, the depth of insertion, and the follow-up. For comparisons, contingency tables were used and a Chi-square test was performed. A p value <0.05 was considered significant. 126 cases of patients with non-malformed cochleas were implanted through the round window. The mean age was 53.8 ± 16.2 for adults and 3.6 ± 2.6 for children (24 cases). The mean follow-up was 33 ± 22 months. The straight electrode array had either a square or a soft pointed tip (n = 84). Full insertion was achieved in 79 out of 84 cases with a soft tip vs. 18 out of 42 square tips (χ (2) = 41.41, DOF = 1, p < 0.0001). Two cases were stuck at the round window niche by a prominent crista fenestrae. In all cases but one, the chorda tympany was preserved. In one case, a misrouting to the vestibule required a revision surgery. Implantation through the round window with a straight and slotted electrode array with a soft tip (Digisonic SP, Neurelec-Oticon Medical) can lead to a full insertion in 94 % of cases. Drilling out a prominent crista fenestrae is recommended.