ABSTRACT
Single sided deafness diminishes speech understanding in noise and sound localization and thereby globally auditory performance. Most patients also suffer from tinnitus and indicate reduced quality of life. Patients have the choice to adapt to the new situation without treatment, to restore pseudostereophonic hearing by contralateral routing of signal (CROS) hearing aids or to restore binaural hearing using a cochlear implant in the deaf ear. This article summarizes the physiological base of binaural hearing and treatment options for single sided deafness with a special emphasis on the cochlear implant.
La surdité unilatérale diminue la compréhension dans le bruit et la capacité de localiser les sources sonores affectant ainsi globalement la performance auditive. De plus, la qualité de vie est souvent impactée par la présence d'un acouphène dérangeant. Les patients ont le choix de s'adapter à la situation sans traitement ou de reconstituer une pseudo-stéréophonie à l'aide d'un appareillage qui transmet l'information auditive arrivant sur l'oreille sourde à l'oreille saine (Contralateral Routing of Signals (CROS)). L'implant cochléaire est une alternative récente qui permet de « réactiver ¼ l'oreille atteinte et de redonner ainsi une audition binaurale. Les différentes options de réhabilitation auditive en cas de surdité unilatérale en mettant l'accent sur l'implant cochléaire sont discutées à l'aide d'un cas clinique.
Subject(s)
Cochlear Implantation , Deafness , Humans , Quality of LifeABSTRACT
The purpose of the study was to compare the accuracy of computer-assisted surgery (CAS) and the traditional freehand technique for fibular free flap mandibular reconstruction as well as to evaluate the accuracy of the CAS planning. The medical records of 18 patients who underwent mandibular reconstruction with fibular free flap were reviewed. The CAS group (n = 7) benefited from virtual surgical planning and custom patient-specific plates and surgical cutting guides. The Control group (n = 11) was treated by conventional surgery. Morphometric comparison was done by calculating the differences in specific linear and angular parameters on pre- and postoperative CT-scans for both groups by using ProPlan CMF® software. Symmetry was also assessed by calculating the ratio of the affected versus the nonaffected side. In the CAS group, planned and postoperative CT-scans were compared to evaluate accuracy. The morphometric comparison showed no statistically significant differences between the groups except for the axial angle on the nonaffected side (mean difference 1.0° in the CAS group versus 2.9° in the Control group; p = 0.03). Ratios of the affected side over the nonaffected side showed no differences between the two groups. In the CAS group, the accuracy assessment showed a mean distance deviation of 2.3 mm for mandibular osteotomies and 1.9 mm for fibular osteotomies. Our results indicated that CAS and the conventional freehand techniques were comparable in their ability to provide a satisfactory morphological fibular free flap mandibular reconstruction. Moreover, the accuracy of the CAS technique was within the range reported in the literature.
Subject(s)
Free Tissue Flaps/surgery , Mandible/diagnostic imaging , Mandible/surgery , Mandibular Reconstruction/methods , Surgery, Computer-Assisted/methods , Adult , Aged , Female , Fibula , Humans , Male , Mandible/pathology , Middle Aged , Osteotomy/methods , Patient Care Planning , Retrospective Studies , Software , Tomography, X-Ray ComputedABSTRACT
Galectins, a family of endogenous lectins, are multifunctional effectors that act at various sites and can be used in immunohistochemical localization studies of diseased states. Since they form a potentially cooperative and antagonistic network, we tested the hypothesis that histopathological fingerprinting of galectins could refine the molecular understanding of naso-sinusal pathologies. Using non-cross-reactive antibodies against galectin-1, -3, -4, -7, -8 and -9, we characterized the galectin profiles in chronic rhinosinusitis, nasal polyposis, inverted papillomas and squamous cell carcinomas. The expression, signal location and quantitative parameters describing the percentage of positive cells and labeling intensity were assessed for various cases. We discovered that inverted papillomas showed a distinct galectin immunohistochemical profile. Indeed, epithelial overexpression of galectin-3 (p=0.0002), galectin-4 (p<10-6), galectin-7 (p<10-6) and galectin-9 (p<10-6) was observed in inverted papillomas compared to non-malignant diseases. Regarding carcinomas, we observed increased expression of galectin-9 (p<10-6) in epithelial cells compared to non-tumor pathologies. Our results suggest that galectin-3, -4, -7 and -9 could be involved in the biology of inverted papillomas. In addition, we observed that the expression of galectin in naso-sinusal diseases seems to be affected by tumor progression and not inflammatory or allergic phenomena.