[Indications for the cochlear implant in partial deafness of the adult].

The last (may 1995) NHI Consensus Development Conference on cochlear implant recommends to extend the use of cochlear implant for adult patient suffering from bilateral acquired severe hearing impairment. Its indications are a severe-to-profound sensorineural hearing loss bilaterally presenting an open-set sentence recognition scores less than or equal to 30 percent under best aided conditions. We report the results of our 4 first implantees responding to these criteria, and discuss the mechanisms of the speech intelligibility improvement which has been obtained.

[Cochlear implant in the aged patient].

Despite the fact that elderly people live frequently alone and frequently have difficulties of vision, is it reasonable to refuse to supply a patient with a cochlear implant only because he is too old? We compare the results of 87 post-lingually implantees as a function of age, less than 60 years (young) and 60 years or more (old). We assessed the implant efficacy using the Protocole Francophone d'Evaluation (PFE), appreciated the speech-therapist's opinion and the patient's satisfaction, and counted the number of hours per day the implant was used (H/D). The PFE score was significantly higher in young than old.

[Cochlear implant and cerebral dominance].

On right handed people the right ear is considered to transmit speech information, and the left ear musical and cognitive information. These dominating ear properties are not exactly symmetrical in the left handed population, and are more consistent in females than in males. CI efficacy assessment is strongly based on speech intelligibility performances, because these criteria allow to measure the social reinsertion and communication possibilities.

[A report of two familial cases of Michel syndrome (bilateral agenesis of the inner ear)].

In two siblings, wearing conventional hearing aid, presenting profound but not total congenital deafness, with no particular antecedents, the imaging destined to confirm the indication of a cochlear implant revealed a total bilateral agenesis of the inner ear. In one of the children, this imaging was confirmed by an exploration of the middle ear performed during a tonsillectomy that was otherwise necessary. We will summarize the literature concerning Michel's Disease, exceptional in its princeps form, and we will discuss the manner of action of conventional devices in these cases which are a priori without any sensorial element.

[Iatrogenic tinnitus and kophosis treated by cochlear implant. Apropos of a case].

A severe iatrogenic tinnitus has been successfully improved by cochlear implant, despite the hearing and intelligibility of the opposite ear were not profoundly impaired. This case report allows to discuss the eventual enlargement of the classic cochlear implant indications.

Supracricoid hemilaryngopharyngectomy in selected pyriform sinus carcinoma staged as T2.

From 1964 to 1985 supracricoid hemilaryngopharyngectomy (SCHLP) was performed at the authors' institution for 34 selected pyriform sinus carcinomas staged as T2. Tumors involved the anterior part of the pyriform sinus, the lateral wall, the medial wall, and the whole aryepiglottic fold in all cases. Tumors with invasion of the apex of the pyriform sinus, of the retrocricoid region, of the posterior pharyngeal wall, or with fixation of the true vocal cord were excluded from the study.

Implantation metastasis following percutaneous endoscopic gastrostomy.

Since it was first described, the original percutaneous endoscopic gastrostomy (PEG) technique has proved to be a valuable adjunct in patients with head and neck tumours. This procedure is being increasingly utilized in the face of swallowing impairment related to head and neck carcinoma. Although generally well tolerated, it may be associated with complications.

Cricohyoidopexy in selected infrahyoid epiglottic carcinomas presenting with pathological preepiglottic space invasion.

Nineteen patients who presented with infrahyoid epiglottic squamous cell carcinoma with gross pathological preepiglottic space invasion, not amenable to a partial horizontal supraglottic laryngectomy, were offered a supracricoid partial laryngectomy with a cricohyoidopexy technique; this was an attempt to preserve physiological phonation, respiration, and deglutition while achieving the same local control rate as with a total laryngectomy. Preoperative chemotherapy and bilateral jugulocarotid lymph node dissection were performed in all cases. Patients were monitored for at least 5 years or until death.

[Partial posterior cordectomy with laser CO2 in bilateral recurrent paralysis].

Thirteen patients with bilateral vocal cord abductor paralysis were treated by Carbon Dioxide Laser Posterior Cordectomy. 6 out of 7 patients were decannulated. 92% of patients recovered a physiologic respiration.