Publications by authors named "Canut Y"

Surgery for otosclerosis means that the sound protection due to the fixation of the footplate does not exist anymore. As the Corti hair cells have been fragilized by proteolytic enzymes, it is absolutely necessary to reconstruct the sound mechanism in order to maintain the vibration of the perilymph absolutely within acoustical physiologic limit of movement. The means to realize this reconstruction are presented in this paper, as well as the results.

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Correlation between tinnitus and audiometric loss, modification of tinnitus by medical or surgical treatment, allow to suspect the origin of tinnitus due to otospongiosis and to give the patient a practically always confirmed prognosis. Audiometric localization of tinnitus is essential, as it is the best clue to etiology, treatment and prognosis of otospongiosis tinnitus. As far as irreducible tinnitus are concerned, as anxiety is the most pejorative parameter, not discouraging the patient is very important.

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Correlation between tinnitus and audiometric loss and modification of the former by both surgical and medical treatment provide sufficient data to suggest its origin and to give the patient a prognosis confirmed in practically every case. Audiometric localization of the tinnitus is essential, since this allows establishment of the etiology, treatment and prognosis of the symptom. When tinnitus is irreversible, the hope of a possible recovery must be given to the patient to avoid the inevitable anxiety produced.

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The footplate fenestra should be performed in its posterior third part to avoid pressure of the piston on the membranous labyrinth, situated very close to the footplate in 2% of the cases in otosclerotic patients. Gain in bone conduction differs according to the size of the fenestra performed. Low frequencies improve most when the whole posterior third part of the footplate is removed; the audiometric gain is better for high frequencies when a 0.

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The authors present a new fixation device for any bony or prosthetic transmission system to the center of a mobile footplate in the absence of the stapes crura. It is a disc-shaped silicone sponge, with a central hole, fitting the bottom of the oval fossa and thus securing the maintenance of the bony or prosthetic transmission in the center of the mobile footplate, and reducing the risk of shifting of the transmission system, which is always possible in case of tympanic retraction. The silicone sponge allows as well a more physiological transmission, because the footplate will vibrate from top to bottom thanks to a central force vector, thus giving better audiometric results.

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The authors propose a test consisting in performing injections of Renovaine, a very strong anaesthetic drug, in the external ear duct in order to reduce momentarily severe and decompensated tinnitus. They discuss the usefulness of this test and develop two concepts to explain its action. They make a pragmatic approach of the tinnitus etiopathogeny.

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To complete their two previous data processing studies on systematization of parameters for otospongiosis and on statistics concerning the otospongiotic disease itself, the authors now develop the study of postoperative functional results obtained over 15 years stapectomies performed according to various techniques. The characteristic of this study is that the functional results are not considered only from the operative technique point of view, but that they also take into account all the factors having an influence upon the functional results, i.e.

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Impedancemetry gives important information in otospongiosis, both for relative compliance and impedance audiometry. The detection of the stapedius reflex is facilitated by recruitment in some audiometric types of otospongiosis and enables us to solve many of the masking problems which are particularly difficult in this disease due to the very important cross-hearing (or cross-over). Diphasic impedance changes (on-off effect) once detected must be systematically investigated since they allow us to detect otospongiosis early on.

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The use of data processing in their otology clinic allowed the authors a better approach to otospongiosis and to its treatment, thus completing the knowledge of the otospongiotic disease according to their enzymatic concept. An important material has been gathered since 1959 to the present (June 1, 1974), based on more than 16 000 stapedectomies and nearly 100 000 otology out-patients. It has been studied both through a conventional method and an informatic one on the computer of their clinic.

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