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Saadoun A, Guigou C, Lavedrine A, Bozorg Grayeli A. Minimally invasive ossiculoplasty via an endoscopic transtympanic approach. Eur Ann Otorhinolaryngol Head Neck Dis 2024; 141:93-97. [PMID: 37620172 DOI: 10.1016/j.anorl.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
INTRODUCTION The aim of this study was to evaluate the feasibility of ossiculoplasty via a minimally invasive endoscopic transtympanic approach (ETTA). CASE SERIES We investigated the exposure of target structures (incus and stapes) on 4 human temporal bones by placing an endoscope into the middle ear cleft through the 4 tympanic quadrants. Then, on 3 additional specimens, we performed an incudostapedial disjunction and repaired it with a drop of hydroxyapatite cement via ETTA. We measured the size of tympanic perforation, and the acoustic transfer function of the middle ear (125-8000Hz) before and after repair by placing an insert in the external auditory canal and recording the acoustic signal in the utricle by a microphone. The acoustic signal gain was estimated in dB μV. Exposure was similar in all four quadrants but ergonomics was better with a posteroinferior myringotomy. Ossicular chain repair was conducted successfully in all cases and the acoustic transfer function of the middle ear was significantly improved. Residual tympanic perforation (n=3) was 2±0.3mm in diameter. CONCLUSION ETTA to reconstruct incudostapedial joint with bone cement was feasible and effective. It opens perspectives for robot-based procedures guided by augmented reality.
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Affiliation(s)
- A Saadoun
- Department of Oto-Rhino-Laryngology - Head and Neck Surgery, Dijon University Hospital, 2, boulevard du Maréchal-de-Lattre de Tassigny, 21000 Dijon, France
| | - C Guigou
- Department of Oto-Rhino-Laryngology - Head and Neck Surgery, Dijon University Hospital, 2, boulevard du Maréchal-de-Lattre de Tassigny, 21000 Dijon, France; ICMUB Laboratory, UMR CNRS 6302, University of Burgundy, 21000 Dijon, France.
| | - A Lavedrine
- Department of Oto-Rhino-Laryngology - Head and Neck Surgery, Dijon University Hospital, 2, boulevard du Maréchal-de-Lattre de Tassigny, 21000 Dijon, France
| | - A Bozorg Grayeli
- Department of Oto-Rhino-Laryngology - Head and Neck Surgery, Dijon University Hospital, 2, boulevard du Maréchal-de-Lattre de Tassigny, 21000 Dijon, France; ICMUB Laboratory, UMR CNRS 6302, University of Burgundy, 21000 Dijon, France
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Schein A, Guigou C, Madkouri R, Bozorg Grayeli A. Intraoperative imaging and navigation of the petrous apex by infralabyrinthine route. Eur Ann Otorhinolaryngol Head Neck Dis 2024:S1879-7296(23)00169-2. [PMID: 38233298 DOI: 10.1016/j.anorl.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Intraoperative imaging during skull-base surgery allows the operator to control surgical dissection and to tailor the approach, reducing morbidity due to inadequate resection or reintervention. The O-arm® (Medtronic, Fridley, MN, USA) navigation system is an intraoperative cone-beam CT device that was first designed for spinal surgery but now has applications in lateral skull-base surgery. In this technical note, we present a patient with petrous apex cholesterol granuloma located medial to the intrapetrous internal carotid artery and in the infralabyrinthine compartment. We report the possibility of natural drainage, using intraoperative imaging to guide resection, through a rapid, safe and minimally invasive approach.
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Affiliation(s)
- A Schein
- Service d'ORL et de chirurgie cervico-faciale, centre hospitalo-universitaire, Dijon, France
| | - C Guigou
- Service d'ORL et de chirurgie cervico-faciale, centre hospitalo-universitaire, Dijon, France; ImVia laboratoire de recherche, université de Bourgogne-Franche-Comté, Dijon, France.
| | - R Madkouri
- Service de neurochirurgie, centre hospitalo-universitaire, Dijon, France
| | - A Bozorg Grayeli
- Service d'ORL et de chirurgie cervico-faciale, centre hospitalo-universitaire, Dijon, France; ImVia laboratoire de recherche, université de Bourgogne-Franche-Comté, Dijon, France
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Ursat G, Corda M, Ryard J, Guillet C, Guigou C, Tissier C, Bozorg Grayeli A. Virtual-reality-enhanced mannequin to train emergency physicians to examine dizzy patients using the HINTS method. Front Neurol 2024; 14:1335121. [PMID: 38249749 PMCID: PMC10796789 DOI: 10.3389/fneur.2023.1335121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 12/05/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Acute vertigo is a frequent chief complaint in the emergency departments, and its efficient management requires thorough training. The HINTS protocol is a valid method to screen patients in the emergency room, but its application in routine is hindered by the lack of training. This study aimed to evaluate the training of emergency physicians for the HINTS method based on a mannequin-based virtual reality simulator (MBVRS). Methods We conducted a monocenter, prospective, longitudinal, and randomized cohort study in an Emergency Department at a regional university hospital. We included 34 emergency physicians randomized into two equal groups matched by age and professional experience. The control group attended a theoretical lesson with video demonstrations and the test group received a simulation-based training in addition to the lecture. Results We showed that the test group had a higher diagnosis performance for the HINTS method compared to the control group as evaluated by the simulator at 1 month (89% sensitivity versus 45, and 100% specificity versus 86% respectively, p < 001, Fisher's exact test). Evaluation at 6 months showed a similar advantage to the test group. Discussion The MBVRS is a useful pedagogic tool for the HINTS protocol in the emergency department. The advantage of a unique training session can be measured up to 6 months after the lesson.
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Affiliation(s)
- Guillaume Ursat
- Emergency Department, Dijon University Hospital, Dijon, France
| | - Morgane Corda
- Otolaryngology Department, Dijon University Hospital, Dijon, France
| | - Julien Ryard
- Institut Image, Ecole Nationale d’Arts-et-Métiers, Chalon-sur-Saône, France
| | - Christophe Guillet
- Institut Image, Ecole Nationale d’Arts-et-Métiers, Chalon-sur-Saône, France
| | - Caroline Guigou
- Otolaryngology Department, Dijon University Hospital, Dijon, France
- ICMUB, CNRS, Université Bourgogne-Franche-Comté, Dijon, France
| | - Cindy Tissier
- Emergency Department, Dijon University Hospital, Dijon, France
| | - Alexis Bozorg Grayeli
- Otolaryngology Department, Dijon University Hospital, Dijon, France
- ICMUB, CNRS, Université Bourgogne-Franche-Comté, Dijon, France
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Tetard S, Guigou C, Sonnet CE, Al Burshaid D, Charlery-Adèle A, Bozorg Grayeli A. Free-Field Hearing Test in Noise with Free Head Rotation for Evaluation of Monaural Hearing. J Clin Med 2023; 12:7143. [PMID: 38002755 PMCID: PMC10672306 DOI: 10.3390/jcm12227143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/06/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
There is a discrepancy between the hearing test results in patients with single-sided deafness (SSD) and their reported outcome measures. This is probably due to the presence of two elements in everyday situations: noise and head movements. We developed a stereo-audiometric test in noise with free head movements to evaluate movements and auditory performance in monaural and binaural conditions in normal hearing volunteers with one occluded ear. Tests were performed in the binaural condition (BIN), with the left ear (LEO) or the right ear occluded (REO). The signal was emitted by one of the seven speakers, placed every 30° in a semicircle, and the noise (cocktail party) by all speakers. Subjects turned their head freely to obtain the most comfortable listening position, then repeated 10 sentences in this position. In monaural conditions, the sums of rotations (head rotations for an optimal hearing position in degrees, random signal azimuth, 1 to 15 signal ad lib signal presentations) were higher (LEO 255 ± 212°, REO 308 ± 208° versus BIN 74 ± 76, p < 0.001, ANOVA) than those in the BIN condition and the discrimination score (out of 10) was lower than that in the BIN condition (LEO 5 ± 1, REO 7 ± 1 versus BIN 8 ± 1, respectively p < 0.001 and p < 0.05 ANOVA). In the monaural condition, total rotation and discrimination in noise were negatively correlated with difficulty (Pearson r = -0.68, p < 0.01 and -0.51, p < 0.05, respectively). Subjects' behaviors were different in optimizing their hearing in noise via head rotation. The evaluation of head movements seems to be a significant parameter in predicting the difficulty of monaural hearing in noisy environments.
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Affiliation(s)
- Stanley Tetard
- Department of Otolaryngology-Head and Neck Surgery, Dijon University Hospital, 21000 Dijon, France
| | - Caroline Guigou
- Department of Otolaryngology-Head and Neck Surgery, Dijon University Hospital, 21000 Dijon, France
- ImViA, Laboratory of Imagery and Artificial Vision (EA 7535), Burgundy University, 21078 Dijon, France
| | - Charles-Edouard Sonnet
- Department of Otolaryngology-Head and Neck Surgery, Dijon University Hospital, 21000 Dijon, France
- Amplifon Hearing Aid Center, 21000 Dijon, France
| | - Dhari Al Burshaid
- Department of Otolaryngology-Head and Neck Surgery, Dijon University Hospital, 21000 Dijon, France
| | - Ambre Charlery-Adèle
- Department of Otolaryngology-Head and Neck Surgery, Dijon University Hospital, 21000 Dijon, France
| | - Alexis Bozorg Grayeli
- Department of Otolaryngology-Head and Neck Surgery, Dijon University Hospital, 21000 Dijon, France
- ImViA, Laboratory of Imagery and Artificial Vision (EA 7535), Burgundy University, 21078 Dijon, France
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Taleb A, Guigou C, Leclerc S, Lalande A, Bozorg Grayeli A. Image-to-Patient Registration in Computer-Assisted Surgery of Head and Neck: State-of-the-Art, Perspectives, and Challenges. J Clin Med 2023; 12:5398. [PMID: 37629441 PMCID: PMC10455300 DOI: 10.3390/jcm12165398] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/08/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
Today, image-guided systems play a significant role in improving the outcome of diagnostic and therapeutic interventions. They provide crucial anatomical information during the procedure to decrease the size and the extent of the approach, to reduce intraoperative complications, and to increase accuracy, repeatability, and safety. Image-to-patient registration is the first step in image-guided procedures. It establishes a correspondence between the patient's preoperative imaging and the intraoperative data. When it comes to the head-and-neck region, the presence of many sensitive structures such as the central nervous system or the neurosensory organs requires a millimetric precision. This review allows evaluating the characteristics and the performances of different registration methods in the head-and-neck region used in the operation room from the perspectives of accuracy, invasiveness, and processing times. Our work led to the conclusion that invasive marker-based methods are still considered as the gold standard of image-to-patient registration. The surface-based methods are recommended for faster procedures and applied on the surface tissues especially around the eyes. In the near future, computer vision technology is expected to enhance these systems by reducing human errors and cognitive load in the operating room.
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Affiliation(s)
- Ali Taleb
- Team IFTIM, Institute of Molecular Chemistry of University of Burgundy (ICMUB UMR CNRS 6302), Univ. Bourgogne Franche-Comté, 21000 Dijon, France; (C.G.); (S.L.); (A.L.); (A.B.G.)
| | - Caroline Guigou
- Team IFTIM, Institute of Molecular Chemistry of University of Burgundy (ICMUB UMR CNRS 6302), Univ. Bourgogne Franche-Comté, 21000 Dijon, France; (C.G.); (S.L.); (A.L.); (A.B.G.)
- Otolaryngology Department, University Hospital of Dijon, 21000 Dijon, France
| | - Sarah Leclerc
- Team IFTIM, Institute of Molecular Chemistry of University of Burgundy (ICMUB UMR CNRS 6302), Univ. Bourgogne Franche-Comté, 21000 Dijon, France; (C.G.); (S.L.); (A.L.); (A.B.G.)
| | - Alain Lalande
- Team IFTIM, Institute of Molecular Chemistry of University of Burgundy (ICMUB UMR CNRS 6302), Univ. Bourgogne Franche-Comté, 21000 Dijon, France; (C.G.); (S.L.); (A.L.); (A.B.G.)
- Medical Imaging Department, University Hospital of Dijon, 21000 Dijon, France
| | - Alexis Bozorg Grayeli
- Team IFTIM, Institute of Molecular Chemistry of University of Burgundy (ICMUB UMR CNRS 6302), Univ. Bourgogne Franche-Comté, 21000 Dijon, France; (C.G.); (S.L.); (A.L.); (A.B.G.)
- Otolaryngology Department, University Hospital of Dijon, 21000 Dijon, France
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Al Burshaid D, Corda M, Aho-Glele S, Guigou C, Al Shehabi M, Folia M. The French way of voice rehabilitation post total laryngectomy: current clinical practices and tendencies. Acta Otolaryngol 2023; 143:440-445. [PMID: 37158444 DOI: 10.1080/00016489.2023.2206873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Vocal rehabilitation post total laryngectomy (TL) lacks clinical guidelines, especially with the presence of multiple modalities. OBJECTIVES To describe the tendencies of vocal rehabilitation post TL in France and compare it with other countries. We try to identify the most practiced modalities and recognize statistically significant influencing factors. MATERIALS AND METHODS An electronic anonymous survey was answered by 75 ENT surgeons from France. The survey outlined the common practiced vocal rehabilitation modalities and had two versions depending on if the participant practices the tracheoesophageal speech (TES) or not. RESULTS 96% use TES in their practice. Single modality TES and double modality TES with esophageal speech (ES) are the two most practiced modalities. 99% agreed that there is no age limit for the TES. Single modality ES was offered 92% more when more than 10 TL were performed per year (p < .05). No influencing factors found for single modality TES or double modality TES with ES (p > .05).Conclusion: In line with tendencies from other countries, the TES is the most practiced modality of vocal rehabilitation coupled or not with the ES. TES has no age limit as per our participants. The least practiced modality is the singe modality ALS.
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Affiliation(s)
| | - Morgane Corda
- ENT Department, University Hospital of Dijon, Dijon, France
| | - Serge Aho-Glele
- Department of Epidemiology and Hygiene, University Hospital of Dijon, Dijon, France
| | | | | | - Mireille Folia
- ENT Department, University Hospital of Dijon, Dijon, France
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Toupet M, Guigou C, Chea C, Guyon M, Heuschen S, Bozorg Grayeli A. Delay and Acceleration Threshold of Movement Perception in Patients Suffering from Vertigo or Dizziness. Brain Sci 2023; 13:brainsci13040564. [PMID: 37190529 DOI: 10.3390/brainsci13040564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/08/2023] [Accepted: 03/25/2023] [Indexed: 03/30/2023] Open
Abstract
Background: The objective was to evaluate the delay and the acceleration threshold (AT) of movement perception in a population of patients suffering from dizziness and analyze the factors influencing these parameters. Methods: This prospective study included 256 adult subjects: 16 control and 240 patients (5 acute unilateral vestibular loss, 13 compensated unilateral loss, 32 Meniere diseases, 48 persistent postural-perceptual dizziness (PPPD), 95 benign paroxysmal positional vertigo (BPPV), 10 central cases, 19 bilateral vestibulopathy, 14 vestibular migraine, and 4 age-related dizziness). Patients were evaluated for the sound–movement synchronicity perception (maximum delay between the bed oscillation peak and a beep perceived as synchronous, PST) and AT during a pendular movement on a swinging bed. Results: We observed higher PST in women and in senior patients regardless of etiology. AT was higher in senior patients. AT was not influenced by etiology except in patients with bilateral vestibulopathy who had higher thresholds. AT was related to unipodal stance performance, past history of fall, and stop-walking-when-talking test. Conclusions: Delay and acceleration thresholds appear to be coherent with clinical findings and open insights on the exploration of symptoms that cannot be explained by routine otoneurological tests.
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Diorflar S, Guigou C, Daguet E, Bensimon JL, Toupet M, Bozorg-Grayeli A. Confrontation of endolymphatic hydrops diagnosis on 3-Tesla MRI to clinical and audiovestibular findings in Meniere's disease. Front Neurol 2023; 14:1105461. [PMID: 36779070 PMCID: PMC9909016 DOI: 10.3389/fneur.2023.1105461] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/09/2023] [Indexed: 01/28/2023] Open
Abstract
Objective The aim of this study was to compare different MRI diagnostic criteria for endolymphatic hydrops (EH) and to investigate the relation between audiovestibular and MRI findings in Meniere's disease (MD). Materials and methods Prospective cross-sectional cohort study in 2 referral centers included 76 patients with unilateral (n = 62) or bilateral (n = 14) MD. All patients underwent inner ear 3T-MRI 4 h (n = 52) or >24H (n = 24) following audiovestibular tests. T2-CISS and 3D-FLAIR images 4H after gadolinium were obtained. EH diagnosis was based on saccular morphology on coronal views (T2 and 3D-FLAIR), semi quantitative estimation of endolymphatic space enlargement, and saccule utricle ratio inversion (SURI) on 3D-FLAIR axial views. Results SURI was the best criterion related to the disease side (43 SURI+ on symptomatic ears, n = 77, vs. 6 SURI+ on asymptomatic ears, n = 53, p < 0.0001, Chi-2). Same-day MRI revealed relation between EH, hearing loss and caloric weakness which could not be detected on delayed MRI: SURI was associated with a higher pure-tone average (43 ± 4.1 dB in SURI+ ears, n = 42 vs. 23 ± 2.6 SURI-, n = 62, p < 0.0001, unpaired t-test,), and a higher proportion of vestibular caloric weakness (23/46 SURI+ ears vs. 4/62 SURI-, p < 0.001, Chi-2). Among all criteria, SURI combined to caloric weakness was the best predictor of the affected side in a logistic regression model. Conclusion SURI had the strongest relation to the side the disease and audio vestibular findings for unilateral, probable and definite meniere disease. A short delay between MRI and audio vestibular tests improved the coherence between the findings.
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Affiliation(s)
- Sarah Diorflar
- Department of Otolaryngology, Dijon University Hospital, Dijon, France
| | - Caroline Guigou
- Department of Otolaryngology, Dijon University Hospital, Dijon, France,ImVia, Université Bourgogne Franche-Comté, Dijon, France,*Correspondence: Caroline Guigou ✉
| | | | | | - Michel Toupet
- Department of Otolaryngology, Dijon University Hospital, Dijon, France,Centre d'Explorations Fonctionnelles Otoneurologiques, Paris, France
| | - Alexis Bozorg-Grayeli
- Department of Otolaryngology, Dijon University Hospital, Dijon, France,ImVia, Université Bourgogne Franche-Comté, Dijon, France
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Leterme G, Guigou C, Guenser G, Bigand E, Bozorg Grayeli A. Effect of Sound Coding Strategies on Music Perception with a Cochlear Implant. J Clin Med 2022; 11:jcm11154425. [PMID: 35956042 PMCID: PMC9369156 DOI: 10.3390/jcm11154425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/15/2022] [Accepted: 07/26/2022] [Indexed: 11/21/2022] Open
Abstract
The goal of this study was to evaluate the music perception of cochlear implantees with two different sound processing strategies. Methods: Twenty-one patients with unilateral or bilateral cochlear implants (Oticon Medical®) were included. A music trial evaluated emotions (sad versus happy based on tempo and/or minor versus major modes) with three tests of increasing difficulty. This was followed by a test evaluating the perception of musical dissonances (marked out of 10). A novel sound processing strategy reducing spectral distortions (CrystalisXDP, Oticon Medical) was compared to the standard strategy (main peak interleaved sampling). Each strategy was used one week before the music trial. Results: Total music score was higher with CrystalisXDP than with the standard strategy. Nine patients (21%) categorized music above the random level (>5) on test 3 only based on mode with either of the strategies. In this group, CrystalisXDP improved the performances. For dissonance detection, 17 patients (40%) scored above random level with either of the strategies. In this group, CrystalisXDP did not improve the performances. Conclusions: CrystalisXDP, which enhances spectral cues, seemed to improve the categorization of happy versus sad music. Spectral cues could participate in musical emotions in cochlear implantees and improve the quality of musical perception.
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Affiliation(s)
- Gaëlle Leterme
- Otolaryngology, Head and Neck Surgery Department, Dijon University Hospital, 21000 Dijon, France; (G.L.); (G.G.); (A.B.G.)
- ImVia Research Laboratory, Bourgogne-Franche-Comté University, 21000 Dijon, France
| | - Caroline Guigou
- Otolaryngology, Head and Neck Surgery Department, Dijon University Hospital, 21000 Dijon, France; (G.L.); (G.G.); (A.B.G.)
- ImVia Research Laboratory, Bourgogne-Franche-Comté University, 21000 Dijon, France
- Correspondence: ; Tel.: +33-615718531
| | - Geoffrey Guenser
- Otolaryngology, Head and Neck Surgery Department, Dijon University Hospital, 21000 Dijon, France; (G.L.); (G.G.); (A.B.G.)
| | - Emmanuel Bigand
- LEAD Research Laboratory, CNRS UMR 5022, Bourgogne-Franche-Comté University, 21000 Dijon, France;
| | - Alexis Bozorg Grayeli
- Otolaryngology, Head and Neck Surgery Department, Dijon University Hospital, 21000 Dijon, France; (G.L.); (G.G.); (A.B.G.)
- ImVia Research Laboratory, Bourgogne-Franche-Comté University, 21000 Dijon, France
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Hussain R, Guigou C, Lalande A, Bozorg Grayeli A. Vision-Based Augmented Reality System for Middle Ear Surgery: Evaluation in Operating Room Environment. Otol Neurotol 2022; 43:385-394. [PMID: 34889824 DOI: 10.1097/mao.0000000000003441] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
HYPOTHESIS Augmented reality (AR) solely based on image features is achievable in operating room conditions and its precision is compatible with otological surgery. BACKGROUND The objective of this work was to evaluate the performance of a vision-based AR system for middle ear surgery in the operating room conditions. METHODS Nine adult patients undergoing ossicular procedures were included in this prospective study. AR was obtained by combining real-time video from the operating microscope with the virtual image obtained from the preoperative computed tomography (CT)-scan. Initial registration between the video and the virtual CT image was achieved using manual selection of six points on the tympanic sulcus. Patient-microscope movements during the procedure were tracked using image-feature matching algorithm. The microscope was randomly moved at an approximated speed of 5 mm/s in the three axes of space and rotation for 180 seconds. The accuracy of the system was assessed by calculating the distance between each fiducial point selected on the video image and its corresponding point on the scanner. RESULTS AR could be obtained for at least 3 minutes in seven out of nine patients. The overlay fiducial and target registration errors were 0.38 ± 0.23 mm (n = 7) and 0.36 ± 0.15 mm (n = 5) respectively, with a drift error of 1.2 ± 0.5 μm/s. The system was stable throughout the procedure and achieved a refresh rate of 12 fps. Moderate bleeding and introduction of surgical instruments did not compromise the performance of the system. CONCLUSION The AR system yielded sub-millimetric accuracy and remained stable throughout the experimental study despite patient-microscope movements and field of view obtrusions.
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Affiliation(s)
- Raabid Hussain
- ImVia, Laboratory of Imagery and Artificial Vision, EA 7535, University of Burgundy
| | - Caroline Guigou
- ImVia, Laboratory of Imagery and Artificial Vision, EA 7535, University of Burgundy
- Department Otolaryngology-Head and Neck Surgery
| | - Alain Lalande
- ImVia, Laboratory of Imagery and Artificial Vision, EA 7535, University of Burgundy
- Department of Radiology, Dijon University Hospital, Dijon, France
| | - Alexis Bozorg Grayeli
- ImVia, Laboratory of Imagery and Artificial Vision, EA 7535, University of Burgundy
- Department Otolaryngology-Head and Neck Surgery
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Duret S, Bigand E, Guigou C, Marty N, Lalitte P, Bozorg Grayeli A. Participation of Acoustic and Electric Hearing in Perceiving Musical Sounds. Front Neurosci 2021; 15:558421. [PMID: 34025335 PMCID: PMC8131516 DOI: 10.3389/fnins.2021.558421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 04/12/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction: The objective of our study was to evaluate musical perception and its relation to the quality of life in patients with bimodal binaural auditory stimulation. Materials and Methods: Nineteen adult patients with a cochlear implant (CI) for minimum 6 months, and moderate to severe contralateral hearing loss with a hearing aid (HA), and 21 normal hearing adults were included in this prospective, cross-sectional study. Pure-tone and speech audiometry, musical test evaluating sound perception characteristics and musical listening abilities, Munich questionnaire for musical habits, and the APHAB questionnaire were recoded. Performance in musical perception test with HA, CI, and HA + CI, and potential correlations between music test, audiometry and questionnaires were investigated. Results: Bimodal stimulation improved musical perception in several features (sound brightness, roughness, and clarity) in comparison to unimodal hearing, but CI did not add to HA performances in texture, polyphony or musical emotion and even appeared to interfere negatively in pitch perception with HA. Musical perception performances (sound clarity, instrument recognition) appeared to be correlated to hearing-related quality of life (APHAB RV and EC subdomains) but not with speech performances suggesting that the exploration of musical perception complements speech understanding evaluation to better describe every-day life hearing handicap. Conclusion: Testing musical sound perception provides important information on hearing performances as a complement to speech audiometry and appears to be related to hearing-related quality of life.
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Affiliation(s)
- Sonia Duret
- Otolaryngology Department, Dijon University Hospital, Dijon, France
| | - Emmanuel Bigand
- LEAD Research Laboratory, CNRS UMR-5022, Bourgogne-Franche-Comté University, Dijon, France
| | - Caroline Guigou
- Otolaryngology Department, Dijon University Hospital, Dijon, France.,ImVia Research Laboratory, Bourgogne-Franche-Comté University, Dijon, France
| | - Nicolas Marty
- LEAD Research Laboratory, CNRS UMR-5022, Bourgogne-Franche-Comté University, Dijon, France
| | - Philippe Lalitte
- Institut de Recherche en Musicologie (IReMus), CNRS- UMR 8223, Bourgogne-Franche-Comté University, Dijon, France
| | - Alexis Bozorg Grayeli
- Otolaryngology Department, Dijon University Hospital, Dijon, France.,ImVia Research Laboratory, Bourgogne-Franche-Comté University, Dijon, France
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12
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Guigou C, Lalande A, Millot N, Belharet K, Bozorg Grayeli A. Use of Super Paramagnetic Iron Oxide Nanoparticles as Drug Carriers in Brain and Ear: State of the Art and Challenges. Brain Sci 2021; 11:358. [PMID: 33799690 PMCID: PMC7998448 DOI: 10.3390/brainsci11030358] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/02/2021] [Accepted: 03/05/2021] [Indexed: 12/16/2022] Open
Abstract
Drug delivery and distribution in the central nervous system (CNS) and the inner ear represent a challenge for the medical and scientific world, especially because of the blood-brain and the blood-perilymph barriers. Solutions are being studied to circumvent or to facilitate drug diffusion across these structures. Using superparamagnetic iron oxide nanoparticles (SPIONs), which can be coated to change their properties and ensure biocompatibility, represents a promising tool as a drug carrier. They can act as nanocarriers and can be driven with precision by magnetic forces. The aim of this study was to systematically review the use of SPIONs in the CNS and the inner ear. A systematic PubMed search between 1999 and 2019 yielded 97 studies. In this review, we describe the applications of the SPIONS, their design, their administration, their pharmacokinetic, their toxicity and the methods used for targeted delivery of drugs into the ear and the CNS.
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Affiliation(s)
- Caroline Guigou
- Department of Otolaryngology-Head and Neck Surgery, Dijon University Hospital, 21000 Dijon, France;
- ImVia Laboratory, EA 7535, Université Bourgogne Franche-Comté, 21079 Dijon, France;
| | - Alain Lalande
- ImVia Laboratory, EA 7535, Université Bourgogne Franche-Comté, 21079 Dijon, France;
| | - Nadine Millot
- Laboratoire Interdisciplinaire Carnot de Bourgogne, UMR 6303, CNRS, Université Bourgogne Franche-Comté, BP 47870, 21078 Dijon, France;
| | - Karim Belharet
- Laboratoire PRISME, JUNIA Campus Centre, 36000 Châteauroux, France;
| | - Alexis Bozorg Grayeli
- Department of Otolaryngology-Head and Neck Surgery, Dijon University Hospital, 21000 Dijon, France;
- ImVia Laboratory, EA 7535, Université Bourgogne Franche-Comté, 21079 Dijon, France;
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13
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Hussain R, Lalande A, Girum KB, Guigou C, Bozorg Grayeli A. Automatic segmentation of inner ear on CT-scan using auto-context convolutional neural network. Sci Rep 2021; 11:4406. [PMID: 33623074 PMCID: PMC7902630 DOI: 10.1038/s41598-021-83955-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 02/10/2021] [Indexed: 01/22/2023] Open
Abstract
Temporal bone CT-scan is a prerequisite in most surgical procedures concerning the ear such as cochlear implants. The 3D vision of inner ear structures is crucial for diagnostic and surgical preplanning purposes. Since clinical CT-scans are acquired at relatively low resolutions, improved performance can be achieved by registering patient-specific CT images to a high-resolution inner ear model built from accurate 3D segmentations based on micro-CT of human temporal bone specimens. This paper presents a framework based on convolutional neural network for human inner ear segmentation from micro-CT images which can be used to build such a model from an extensive database. The proposed approach employs an auto-context based cascaded 2D U-net architecture with 3D connected component refinement to segment the cochlear scalae, semicircular canals, and the vestibule. The system was formulated on a data set composed of 17 micro-CT from public Hear-EU dataset. A Dice coefficient of 0.90 and Hausdorff distance of 0.74 mm were obtained. The system yielded precise and fast automatic inner-ear segmentations.
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Affiliation(s)
- Raabid Hussain
- ImViA Laboratory, University of Burgundy Franche Comte, Dijon, France.
| | - Alain Lalande
- ImViA Laboratory, University of Burgundy Franche Comte, Dijon, France.,Medical Imaging Department, University Hospital of Dijon, Dijon, France
| | | | - Caroline Guigou
- ImViA Laboratory, University of Burgundy Franche Comte, Dijon, France.,Otolaryngology Department, University Hospital of Dijon, Dijon, France
| | - Alexis Bozorg Grayeli
- ImViA Laboratory, University of Burgundy Franche Comte, Dijon, France.,Otolaryngology Department, University Hospital of Dijon, Dijon, France
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14
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Thibouw F, Duvillard C, Thibouw D, Bertaut A, Blanc J, Vulquin N, Chevalier C, Guigou C, Folia M. Evaluation of the quality of the information received during head and neck cancer announcement: Prospective two-center study. Head Neck 2020; 42:1800-1810. [PMID: 32091638 DOI: 10.1002/hed.26109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 11/14/2019] [Accepted: 01/28/2020] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Providing patient with cancer with appropriate information following the disclosure of a cancer diagnosis has multiple benefits. The objective was to evaluate the quality of the information received during an announcement for head and neck cancer and to determine predictive factors. METHODS We conducted a prospective two-center study using self-questionnaires to assess the patient's perception of the quality of the announcement. RESULTS Satisfaction scores on the information provided about the overall disease were 7.7/10. The main positive predictors of quality were a satisfactory consultation setting (P = .004), assessment of pain by a physician (P = .04), physician availability (P = .003), accurate information about tumor stage, quality of information regarding the type (P < .0001) and purpose (P = .001) of treatment and its side effects (P = .006), and the interview with the oncology nurse coordinator (P < .05). CONCLUSIONS Patients who received the announcement of head and neck cancer perceived the information received during the pretherapeutic period as satisfactory.
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Affiliation(s)
- François Thibouw
- Department of Otolaryngology-Head and Neck Surgery, University Hospital Center François-Mitterrand, Dijon, France
| | - Christian Duvillard
- Department of Otolaryngology-Head and Neck Surgery, University Hospital Center François-Mitterrand, Dijon, France
| | - David Thibouw
- Department of Radiotherapy, Centre Georges-François Leclerc, Dijon, France
| | - Aurélie Bertaut
- Clinical research center of Methodology and Biostatistics Unit, Centre Georges-François Leclerc, Dijon, France
| | - Julie Blanc
- Clinical research center of Methodology and Biostatistics Unit, Centre Georges-François Leclerc, Dijon, France
| | - Noémie Vulquin
- Department of Radiation Oncology, Centre Georges-François Leclerc, Dijon, France
| | - Cédric Chevalier
- Department of Radiotherapy, Centre Georges-François Leclerc, Dijon, France
| | - Caroline Guigou
- Department of Otolaryngology-Head and Neck Surgery, University Hospital Center François-Mitterrand, Dijon, France
| | - Mireille Folia
- Department of Otolaryngology-Head and Neck Surgery, University Hospital Center François-Mitterrand, Dijon, France
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15
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Leterme G, Guigou C, Oudot A, Collin B, Boudon J, Millot N, Geissler A, Belharet K, Bozorg Grayeli A. Superparamagnetic Nanoparticle Delivery to the Cochlea Through Round Window by External Magnetic Field: Feasibility and Toxicity. Surg Innov 2019; 26:646-655. [PMID: 31478462 DOI: 10.1177/1553350619867217] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Introduction. The objective of this study was to evaluate the feasibility and toxicity of superparamagnetic iron oxide nanoparticles (SPIONs) administered into the cochlea through the round window (RW) by an external magnetic field. Materials and Methods. In 5 Wistar rats, the left RW was punctured. SPIONs suspended in hyaluronic gel (5 mg/mL) were applied in the RW niche and covered by a muscle graft. The nanoparticles were mobilized using a rare earth magnet (0.54 T) held in 4 consecutive positions around the head. The right ear served as control. Hearing function was monitored by auditory brainstem responses (4-32 kHz tone bursts). Results. The auditory thresholds remained unchanged 1 month after the administration. The histological study of the cochleae showed that SPIONs were driven into the scala tympani in the basal turn, the second turn, and the apex. Conclusion. Superparamagnetic nanoparticles can be driven inside the cochlea toward the apex with a preserved hearing up to 1 month in rats.
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Affiliation(s)
- Gaëlle Leterme
- Otolaryngology Department, Dijon University Hospital, Dijon, France.,Laboratoire Imvia, Université Bourgogne-Franche-Comté, Dijon, France
| | - Caroline Guigou
- Otolaryngology Department, Dijon University Hospital, Dijon, France.,Laboratoire Imvia, Université Bourgogne-Franche-Comté, Dijon, France
| | | | - Bertrand Collin
- Centre Georges François Leclerc, Dijon, France.,ICMUB, UMR 6302 CNRS/Université Bourgogne Franche-Comté, Dijon, France
| | - Julien Boudon
- Laboratoire ICB, UMR 6303 CNRS/Université Bourgogne Franche-Comté, Dijon, France
| | - Nadine Millot
- Laboratoire ICB, UMR 6303 CNRS/Université Bourgogne Franche-Comté, Dijon, France
| | - Audrey Geissler
- Plateforme d'imagerie cellulaire CellImaP, Université Bourgogne-Franche-Comté, Dijon, France
| | - Karim Belharet
- Laboratoire PRISME, HEI Campus Centre, Châteauroux, France
| | - Alexis Bozorg Grayeli
- Otolaryngology Department, Dijon University Hospital, Dijon, France.,Laboratoire Imvia, Université Bourgogne-Franche-Comté, Dijon, France
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16
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Hussain R, Lalande A, Guigou C, Bozorg Grayeli A. Contribution of Augmented Reality to Minimally Invasive Computer-Assisted Cranial Base Surgery. IEEE J Biomed Health Inform 2019; 24:2093-2106. [DOI: 10.1109/jbhi.2019.2954003] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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17
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Guigou C, Toupet M, Delemps B, Heuschen S, Aho S, Bozorg Grayeli A. Effect of Rotating Auditory Scene on Postural Control in Normal Subjects, Patients With Bilateral Vestibulopathy, Unilateral, or Bilateral Cochlear Implants. Front Neurol 2018; 9:972. [PMID: 30505289 PMCID: PMC6250812 DOI: 10.3389/fneur.2018.00972] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 10/29/2018] [Indexed: 11/13/2022] Open
Abstract
Objective: The aim of this study was to investigate the impact of a rotating sound stimulation on the postural performances in normal subjects, patients with bilateral vestibulopathy (BVP), unilateral (UCI), and bilateral (BCI) cochlear implantees. Materials and Methods: Sixty-nine adults were included (32 women and 37 men) in a multicenter prospective study. The group included 37 healthy subjects, 10 BVP, 15 UCI, and 7 BCI patients. The average of age was 47 ± 2.0 (range: 23–82). In addition to a complete audiovestibular work up, a dynamic posturography (Multitest Framiral, Grasse) was conducted in silence and with a rotating cocktail party sound delivered by headphone. The center of pressure excursion surface (COPS), sensory preferences, as well as fractal, diffusion, and wavelet analysis of stabilometry were collected. Results: The rotating sound seemed to influenced balance in all subgroups except in controls. COPS increased with sound in the BVP and BCI groups in closed eyes and sway-referenced condition indicating a destabilizing effect while it decreased in UCI in the same condition suggesting stabilization (p < 0.05, linear mixed model corrected for age, n = 69). BVP had higher proprioceptive preferences, BCI had higher vestibular and visual preferences, and UCI had only higher vestibular preferences than controls. Sensory preferences were not altered by rotating sound. Conclusions: The rotating sound destabilized BVP and BCI patients with binaural hearing while it stabilized UCI patients with monaural hearing and no sound rotation effect. This difference suggests that binaural auditory cues are exploited in BCI patients for their balance.
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Affiliation(s)
- Caroline Guigou
- Department of Otolaryngology-Head and Neck Surgery, Dijon University Hospital, Dijon, France.,Le2i Research Laboratory, CNRS, UMR-6306, Dijon, France
| | - Michel Toupet
- Department of Otolaryngology-Head and Neck Surgery, Dijon University Hospital, Dijon, France.,Centre d'Explorations Fonctionnelles Otoneurologiques, Paris, France
| | - Benoit Delemps
- Department of Otolaryngology-Head and Neck Surgery, Dijon University Hospital, Dijon, France.,Audika Auditory Rehabilitation Center, Dijon, France
| | | | - Serge Aho
- Department of Epidemiology, Dijon University Hospital, Dijon, France
| | - Alexis Bozorg Grayeli
- Department of Otolaryngology-Head and Neck Surgery, Dijon University Hospital, Dijon, France.,Le2i Research Laboratory, CNRS, UMR-6306, Dijon, France
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18
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Guigou C, Leterme G, Pasquis B, Martin L, Tourrel G, Bretillon L, Bozorg Grayeli A. Implantation of the Auditory Nerve via the Middle Ear Cavity in Rats with Partial Hearing Preservation. Audiol Neurootol 2016; 21:98-104. [PMID: 27010792 DOI: 10.1159/000444005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 01/14/2016] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to evaluate the residual hearing function and cochlear morphology after auditory nerve implantation via middle ear spaces in rats. A titanium rod (1.5 mm long and 0.3 mm thick) coated with Parylene was inserted in the cochlear apex in the direction of the modiolus in 9 Wistar rats. Auditory brainstem-evoked responses to tone bursts at 2, 8, 12 and 32 kHz were recorded before surgery and on postoperative days 0, 2, 15 and 30. Eight cochleas were examined microscopically. The rod was inside the modiolus in 4, and partly or totally outside the modiolus in 4 animals. Residual hearing was present in all cases. The average threshold shift in cochleas with modiolar implant was 39 ± 11.2, 54 ± 9.7, 48 ± 20.3 and 43 ± 21.3 dB SPL on postoperative days 0, 2, 15 and 30, respectively. The transmodiolar approach allows a minimally invasive cochlear implantation and a partial hearing preservation.
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Affiliation(s)
- Caroline Guigou
- Electronic, Imaging and Computer Science Research Laboratory, UMR 6306, CNRS, Burgundy University, Dijon, France
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Sobhy Afifi WF, Guigou C, Mazalaigue S, Camuset JP, Ricolfi F, Bozorg Grayeli A. Navigation-guided transmodiolar approach for auditory nerve implantation via the middle ear in humans. Audiol Neurootol 2015; 20:128-135. [PMID: 25791165 DOI: 10.1159/000366513] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 08/08/2014] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to assess the surgical feasibility of a transmodiolar approach via the middle ear cavity for an auditory nerve implantation in humans. In the first part of the study, 6 adult human temporal bones underwent a navigator-guided transmodiolar implantation via the middle ear space after a radical mastoidectomy. In the second part, 122 temporal bone CT scans were analyzed for anatomical parameters relevant to this approach. The nerve implantation was feasible in all temporal bones in laboratory conditions, with a mean target registration error of 0.065 ± 0.0583 mm (n = 6). Evaluation of anatomical parameters on CT scans also supported the feasibility. There was a significant interindividual variation of the modiolar axis and the entry point in relation to visible anatomical landmarks, highlighting the necessity for surgical preplanning.
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Béraud C, Andrillat J, Lauras B, David M, Guigou C. [Malignant neonatal osteopetrosis. Apropos of a case]. J Radiol Electrol Med Nucl 1972; 53:567-9. [PMID: 4644357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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