Guidelines of the French Society of Otorhinolaryngology-Head and Neck Surgery (SFORL) and the French Society of Audiology (SFA) for Speech-in-Noise Testing in Adults.

OBJECTIVES: This document presents the fundamentals of speech audiometry in noise, general requirements for implementation and criteria for choice among the tests available in French according to the health-professional's needs. MATERIAL AND METHODS: The recommendations are based on a systematic analysis of the literature carried out by a multidisciplinary group of doctors, audiologists and audioprosthetists from all over France. They are graded A, B, C or expert opinion according to decreasing level of scientific evidence. RESULTS: Eight tests of speech audiometry in noise can be used in France. CONCLUSION: To be complete, evaluation of hearing status requires testing understanding of speech in noise. The examination must begin with a minimum of two measurements familiarizing the subject with the test procedure. For initial diagnosis, adaptive procedures establishing the 50% speech reception threshold (SRT50) in noise are to be preferred in order to obtain a rapid and standardized measurement of perception of speech in noise. When the aim is to measure real-life speech comprehension, tests based on sentences, cocktail-party noise and free-field stimulation are to be preferred. Prosthetic gain is evaluated exclusively in free field. This is the only way to evaluate the contribution of binaurality and to measure perception in noise in an environment as close as possible to real life. In order to avoid acoustic interference in free field, at least five loudspeakers should be used, in particular for evaluating the effectiveness of directional microphones, CROS devices enabling sounds picked up in the damaged ear to be rerouted to the functional ear, or bimodal fitting (i.e., when hearing is enabled by two modalities: for example, hearing aid for one ear, cochlear implant for the other).

Guidelines of the French Society of Otorhinolaryngology-Head and Neck Surgery (SFORL) and the French Society of Audiology (SFA) for Speech-in-Noise Testing in Adult [Pré-print]

This document presents the fundamentals of speech audiometry in noise, general requirements for implementation and criteria for choice among the tests available in French according to the health-professional's needs. The recommendations are based on a systematic analysis of the literature carried out by a multidisciplinary group of doctors, audiologists and audioprosthetists from all over France. They are graded A, B, C or expert opinion according to decreasing level of scientific evidence. Eight tests of speech audiometry in noise can be used in France. To be complete, evaluation of hearing status requires testing understanding of speech in noise. The examination must begin with a minimum of two measurements familiarizing the subject with the test procedure. For initial diagnosis, adaptive procedures establishing the 50% speech reception threshold (SRT50) in noise are to be preferred in order to obtain a rapid and standardized measurement of perception of speech in noise. When the aim is to measure real-life speech comprehension, tests based on sentences, cocktail-party noise and free-field stimulation are to be preferred. Prosthetic gain is evaluated exclusively in free field. This is the only way to evaluate the contribution of binaurality and to measure perception in noise in an environment as close as possible to real life. In order to avoid acoustic interference in free field, at least five loudspeakers should be used, in particular for evaluating the effectiveness of directional microphones, CROS devices enabling sounds picked up in the damaged ear to be rerouted to the functional ear, or bimodal fitting (i.e., when hearing is enabled by two modalities: for example, hearing aid for one ear, cochlear implant for the other).

Determination of hydrocarbon types in petroleum and coal-derived products by thin-layer chromatography/densitometry.

Different methodologies based on thin-layer chromatography (TLC)/densitometry were used to separate and quantitate hydrocarbon types in middle distillates (gas oil), heavy distillates (lubricant) from petroleum, and coal-derived products. Thus, petroleum products were separated into saturates and aromatics by development, using n-hexane (9 min) followed by dichloromethane (4.5 min), of silica gel plates impregnated with berberine sulfate. Detection of saturates and aromatics was performed by fluorescence scanning using 365 nm as the excitation wavelength. Alternative detection of aromatics can be performed on either silica gel or berberine-impregnated plates by using ultraviolet (UV) densitometry at 250 nm. On the other hand, polar coal-derived products were separated into aromatics, polar compounds, and uneluted components by using silica gel plates and development with toluene (12 min), followed by dichloromethane-methanol (95 + 5, v/v), with detection by UV densitometry at 250 nm. In all cases, external standard calibration was used for quantitation. Results were validated by using standard methods or well-established techniques of the petrochemical industry. The potential usefulness of TLC/densitometry is discussed.

Enhancement of fluorescence in thin-layer chromatography induced by the interaction between n-alkanes and an organic cation

Fluorescence enhancement of a broad variety of solutes has been used extensively in TLC although no thorough explanation has been proposed. In this work, we try to understand it and explore new applications to which it can be put. In this way, alkanes can be quantitatively determined by fluorescence scanning densitometry using silica gel plates impregnated with berberine sulfate. Molecular simulation and analysis of molecular orbitals allows this phenomenon to be explained in this case and lays the groundwork to explain fluorescence enhancements produced by other molecules. A ion-molecule interaction between alkanes and berberine sulfate is responsible for the enhancement of fluorescence produced by alkanes. Computational results suggest that the surrounding alkane molecules provide an apolar environment to the berberine cation, thus enhancing the intensity of the fluorescence signal. This proposed explanation has been tested by extending the fluorescence determination to other compounds. These include biologically interesting saturated and unsaturated fatty acids, steroids and derivatives, prostaglandins, ceramides, galactocerebrosides, as well as terpenes, and polypropylene glycols. In addition, according to the proposed explanation, the properties required for alternative impregnants to berberine are discussed.

[Severe iatrogenic complications of surgery of the middle ear and their medicolegal aspects]. / Complications iatrogènes graves de la chirurgie de l'oreille moyenne et aspects médico-légaux.

The authors analysed 62 cases of severe iatrogenic complications occurring after middle ear surgery (death, cophosis, PFP) between 1976 and 1986. They compared their results to those of a similar study conducted between 1950 and 1975. They observed an increase in the number of legal proceedings, probably due more to the increased demand by patients than to a higher incidence of these complications. Civil proceedings are much more frequent than penal proceedings. The authors stress the importance attributed by judges to the expert report and to the obtaining of informed consent.

[Inappropriate secretion of antidiuretic hormone (ISADH) after head injury (author's transl)]. / Sécrétion inappropriée d'hormone antidiurétique (SIADH) après traumatisme crânien.

Two new observations of ISADH following head injury are described. A review of the medical literature is presented. Reports of ISADH after head injury are rare in comparison to the frequent occurrence of hydroelectrolytic disorders in the same situation. Attention is drawn to misleading clinical pictures, suggestive of neurosurgical conditions. Intracranial hematoma is frequently associated with ISADH and should be looked for in patients who fail to respond to therapy.