[The prevention of voice disorders in the actor: protocol and follow-up nine months of professional theater]. / La prévention des troubles vocaux chez le comédien: protocole et suivi sur neuf mois de professionnels de théâtre.

In July 2009, at the beginning of this work, 26 theses addressing professional principles of voice were listed in the database of SUDOC (Système Universitaire de Documentation): 9 related to voices of teachers (about 900,000* professionals in France), 14 theses relating to singers (7500** professionals), and only 3 about the voice of actors (20 000*** professional actors in France in 2006). The latter pertaining to concerning rookie actors (sensibilisation vocale auprès du comédien débutant Bichet, Linda, Bordeaux II, 2006), the mechanical larynx (étude des mécanismes laryngés dans la voix projetée: cas particulier des comédiennes Guerin, Mélanie, Paris VI, 2009), vocal fatigue (Fatigue vocale après une tâche d'utilisation prolongée de la voix chez le comédien Canaan Baggioni, Brigitte, Aix-Marseille II, 2009). Professional actors are plentiful; their training in vocal technique is very heterogeneous, or non-existent: it is not a prerequisite to have a degree to work as an actor! This lack of vocal technique is associated with risk factors specific to the acting profession: numerous travels in air-conditioned vehicles, unsuitable workplaces; dusty or poorly heated, irregular working patterns, excessive demands from directors... All this makes the actors highly susceptible to voice disorders. The protocol for the prevention of voice disorders presented here is holistic and ecological. This work also examines the effectiveness of such a preventive protocol aimed at theatre comedians.

[Study of a case of cochlear implant with recurrent cutaneous extrusion]. / Extrusion cutanée à répétition d'un implant cochléaire.

OBJECTIVE: An observation of a difficult-to-diagnose complication of the cochlear implant: recurring cutaneous extrusion of a cochlear implant is reported. PATIENTS AND METHODS: The history of an adult patient with total deafness is reported. She received an implant in her right ear in 1988, which was then explanted because of absence of hearing results. She received a second implant in her left ear in 2002, which was then explanted in 2007 because of cutaneous extrusion. In 2008, a second implant of a different brand was placed in her left ear, with the central part placed away from the first site, but extrusion recurred. A new attempt to encapsulate the central part with a hydroxyapatite box also ended in extrusion and was explanted in 2008. RESULTS: Various diagnoses to explain these cutaneous problems were suggested during this clinical progression: infection, allergy, and a reaction to a foreign body. No hypothesis could be clearly ruled out. CONCLUSION: Cutaneous complications after cochlear implant are exceptional. As soon as cutaneous disorders appear, a rigorous diagnostic process must be followed so that the patient can be recommended a long-lasting solution to restore quality hearing.

[Clinical application of synchronised multimedia scanning for the objectification of laryngeal events in stuttering: preliminary study and first results]. / Utilisation des explorations multimédia synchrones dans l'objectivation des événements larynges lors des bégayages.

OBJECTIVE: We have tried in this preliminary work to observe what kind of mechanical laryngeal events were corresponding to the disfluencies heard while stuttering, especially in the pre-phonatory and phonatory blocks. Basing our observations upon numerised and synchronised multimedia recordings (videonasofibroscopic long duration recordings synchronised to the acoustic recordings of speech corpus) we also tried to figure what happened when an adult speaker used a fluency enhancing method such as the Erasm. Authors advanced the hypothesis of a closed larynx in two or three folds while the stuttering blocks and some even described those folds. MATERIAL AND METHOD: We have recorded the stutterers and non-stutterers (N= 3) as well during speaking tasks as in cough, snuffling (N= 2), swallowing and sustaining a vowel. Secondary, the patients had to use the Erasm method, for the productions they had first stuttered. We wanted to focus rather on the supraglottal components movements. RESULTS: In our study we haven't visualised any laryngeal double or triple folding while the blocks. But we did observe abnormal laryngeal behaviours, which recall spasmodic or myoclonic type of movements with: Tremors of the base of the tongue, a strong lateral pharyngolaryngeal constriction, quick successive up and down involuntary movements of the larynx, anarchic and paradoxal attempts of opening the vocal folds, at the moment of the intention of speaking. We did also objectify a real improvement in those aberrant movements by using the Erasm method.

[Evaluation of the fundamental voice frequency during the day]. / Evaluation de la fréquence fondamentale de la voix au cours de la journée.

As know by the singers, the possibilities of the voice vary during the day. The study aims to determine whether the mean pich of the voice can be a valuable chronobiological index of this variability.

[Signal processing in contour implants]. / Le traitement du signal dans l'implant contour.

Signal processing by cochlear implants is aimed at transmitting all the acoustic information carried by the human voice, whether in its semantic, esthetic or affective aspects, as an electrical signal. The "translating" approach, which encodes the signal according to the characteristics of the sounds, can only be ideally used in multiple-canal implants. On the contrary, our experience with various single-canal prostheses shows that our patients choose one of these according to the comfort of the signal and to its reliability rather than to the complexity of signal processing: all prostheses produce approximately the same results, whatever the method implemented. The contour implant allows an easy, effective and well-tolerated fitting at low costs.

[Trends in clinical research for one canal cochlear implantation]. / Orientations de recherche clinique en matière d'implantation mono-canale.

Like any modality of perception, the processes of hearing can be divided up into two levels: modular or primary, and symbolic or central. Multiple-canal implantation is rather applied to the former mechanism, single-canal implantation to the latter. A bank of electrical signals recognizable from each other is being built up. It may be utilized in single-canal systems using this vocabulary to form sentences. The proper phonetic feature to be matched will then have to be selected.

[Electrophysiologic studies in patients with cochlear implants]. / Les explorations électrophysiologiques chez les patients implantés cochléaires.

The insertion of reliable extracochlear single-canal cochlear implants in cophotic and subcophotic patients allows the electrical stimulation of the acoustic nerve for rehabilitation, as well as audiovestibular explorations that are no longer possible in the acoustic mode. The authors therefore aim at replacing all these examinations with their Electrical equivalent: --early evoked potentials (E-BERA), --medium-latency evoked potentials (E-MLR), --Event-related evoked potentials (E-P300), for which, to our knowledge, theses are the first recordings, --electrical stapedial reflex, --vestibular stimulations. The method, results and clinical and physiological applications of each method are given, as well as its prospects.

[Grading the voice: pitfalls and advantages]. / Chiffrer la voix: pièges et avantages.

All functional exploration, and that of the voice is not an exception to the rule, calls for "setting values". The need for a quantification fo the human voice is legitimate but may lead to the contrary of the goal sought if a few basic principles are not respected and may supply some erroneous pathological results. The imperatives are linked together by a strict protocol, knowledge of measured parameters and the manner in which the signal treatment supplies them. We shall show, step by step, the utility of applying these principles with a few concrete examples.

[A protocol for the evaluation of the voice and speech of the hearing impaired]. / Protocole d'évaluation de la voix et de la parole des sourds.

This study provides a methodology for the evaluation of the voice and the speech of deaf people (VANFIBR). This protocol uses a subjective multi parameter method, similar as the one used for the "normal-hearing" voice (GIRBAS). We use a global appreciation factor (A), a factor for the control of the pitch of the voice (F), the intensity (I), the extra-vocal noises (B), the rhythm of the speech (R) and the voisement (V). This method wants to be independent of the deafness pathology and the age of the subject. It was tested on a deaf population and a normal hearing one. The analyses by a jury showed the good discrimination between both populations and the pertinence of most of the parameters used.