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Clinical study of tinnitus
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A specialist tinnitus
clinic has been created by Dr Cécile Nicolas-Puel
within the ENT department directed by Pr. Alain Uziel.
Ethiological and semiological analysis have been already
performed by these clinicians on 900 patients suffering
of tinnitus. Besides a better understanding of the
mechanisms of tinnitus, these clinical studies will
allow us to determine which patients present enough
similarities with our animal models to integrate future
clinical assay based on local therapy. |
Van Gogh painting
known as "Self portrait with the bandaged
ear" (1889). In 1889, the
painter severed his right ear in an attempt to
stop tinnitus (Bridgeman Art Library, London). |
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In addition to clinical studies, we are developing
an objective method to detect tinnitus in humans by recording
the spontaneous noise of the auditory nerve via an electrode
placed on the promontory through the tympanic membrane. |
Epidemiology and genetic of the presbycusis
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Presbycusis is a progressive
hearing loss which appears during aging. This phenomenon
is probably due to a genetic susceptibility but also
to environmental factors such as noise or ototoxic drugs
(cisplatin, quinine and some antibiotics). |
Presbycusis also results from other disease like heart insufficiency,
high blood pressure, vascular problems or diabetes. Consequently,
Dr Catherine Blanchet and Pr. Michel Mondain are studying
the audiogram and the environmental risk factors for hearing
(noise and ototoxic drugs exposure) in a 3-cities cohort (Montpellier,
Bordeaux, and Dijon). Persons composing this cohort are older
than 70 and have been phenotyped (blood pressure, cholesterol…)
and tested for Alzheimer disease (cognitive tests…)
by Dr Claudine Berr (Inserm U888). Until now, data collection
has been performed on more than 800 subjects (clinical records,
audiograms, and DNA collection). This genetic study is directed
by Dominique Hillaire.
Cochlear implants
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Cochlear implants
are used to restore hearing in profoundly deaf patients
by the electrical stimulation of the auditory nerve
fibres. When residual hearing can be preserved, the
implant performance largely surpasses those of a conventional
hearing aid. To date, the use of "soft surgery" techniques
and adapted devices such as soft tip electrodes allows
the preservation of a certain residual hearing in a
large number of patients, thus increasing hearing performance
and the patient quality of life. |
During the last decade, we closely worked with pharmaceutical
companies in order to test neuroprotective molecules. To date,
the better understanding of the molecular mechanisms involved
in cochlear neurons and hair cell degeneration, and the innovative
therapeutic strategies to protect them, attract implant manufacturers
who want to minimize the traumatism of the electrode insertion
and preserve residual hearing after cochlear implantation.
Selected recent references:
Venail F, Wang J, Ruel J, Ballana E, Rebillard G,
Eybalin M, Arbones M, Bosch A, Puel JL. Coxsackie
adenovirus receptor and alpha nu beta3/alpha nu beta5 integrins
in adenovirus gene transfer of rat cochlea. Gene Ther. 2007,
14: 30-37.
Nicolas-Puel C, Akbaraly T, Lloyd R, Berr C, Uziel A, Rebillard
G, Puel JL. Characteristics of tinnitus in a population
of 555 patients: specificities of tinnitus induced by noise
trauma. Int. Tinnitus J. 2006, 12: 64-70.
Uziel A, Mondain M, Hagen P, Dejean F, Doucet G.
Rehabilitation for high-frequency sensorineural hearing impairment
in adults with the symphonix vibrant soundbridge: a comparative
study. Otol. Neurotol. 2003, 24: 775-783.
Nicolas-Puel C, Faulconbridge RL, Guitton M, Puel
JL, Mondain M, Uziel A. Characteristics of tinnitus
and etiology of associated hearing loss: a study of 123 patients.
Int. Tinnitus J. 2002, 8: 37-44.
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