Evelyne Ferrary

Pierre and Marie Curie University - Paris 6, Lutetia Parisorum, Île-de-France, France

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Publications (176)280.03 Total impact

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    ABSTRACT: The aim of this study was to assess the mental representation of the insertion axis of surgeons with different degrees of experience, and reproducibility of the insertion axis in repeated measures. A mastoidectomy and a posterior tympanotomy were prepared in five different artificial temporal bones. A cone-beam CT was performed for each temporal bone and the data were registered on a magnetic navigation system. In these five temporal bones, 16 surgeons (3 experts; >50 cochlear implant surgery/year; 7 fellows with few cochlear implant experience, and 6 residents) were asked to determine the optimal insertion axis according to their mental representation. Compared to a planned ideal axis, the insertion axis was better determined by the experts with higher accuracy (axial: 7° ± 1.5°, coronal: 6° ± 1.5°) than fellows (axial: 14° ± 1.7°, coronal: 13° ± 1.7°; p < 0.05), or residents (axial: 15° ± 1.5°; p < 0.001, coronal: 17° ± 1.9°; p < 0.001). This study suggests that mental representation of the cochlea is experience-dependent. A high variation of the insertion axis to the scala tympani can be observed due to the complexity of the temporal bone anatomy and lack of landmarks to determine scala tympani orientation. Navigation systems can be used to evaluate and improve mental representation of the insertion axis to the scala tympani for cochlear implant surgery.
    Archives of Oto-Rhino-Laryngology 09/2015; DOI:10.1007/s00405-015-3763-x · 1.55 Impact Factor
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    ABSTRACT: Otosclerosis is a complex disease of the human otic capsule with highest incidence in adult Caucasians. So far, many possible etiological factors like genetics, HLA, autoimmunity, viruses, inflammation, and hormones have been investigated but still the development of the disease remains unclear. Currently, the surgical replacement of stapes (stapedotomy) remains the best possible treatment option. In this review, we analyze different etiological factors studied so far in otosclerosis pathophysiology and discuss most recent findings and possible new research pathways. Copyright © 2015 Elsevier B.V. All rights reserved.
    Hearing Research 08/2015; DOI:10.1016/j.heares.2015.07.014. · 2.97 Impact Factor
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    ABSTRACT: Inner ear diseases are not adequately treated by systemic drug administration mainly because of the blood-perilymph barrier that reduces exchanges between plasma and inner ear fluids. Local drug delivery methods including intratympanic and intracochlear administrations are currently developed to treat inner ear disorders more efficiently. Intratympanic administration is minimally invasive but relies on diffusion through middle ear barriers for drug entry into the cochlea, whereas intracochlear administration offers direct access to the colchlea but is rather invasive. A wide range of drug delivery systems or devices were evaluated in research and clinic over the last decade for inner ear applications. In this review, different strategies including medical devices, hydrogels and nanoparticulate systems for intratympanic administration, and cochlear implant coating or advanced medical devices for intracoclear administration were explored with special attention to in vivo studies. This review highlights the promising systems for future clinical applications as well as the current hurdles that remain to be overcome for efficient inner ear therapy. Copyright © 2015. Published by Elsevier B.V.
    International Journal of Pharmaceutics 08/2015; 494(1). DOI:10.1016/j.ijpharm.2015.08.015 · 3.65 Impact Factor
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    ABSTRACT: The aim of this study was to compare a contralateral routing of signal (CROS) hearing aid to a transcutaneous bone-anchored device in the same conditions. This prospective crossover study included 18 adult patients with a single-sided deafness (SSD). After a trial period of 60 days with CROS and 7 days with a transcutaneous bone-anchored device (Alpha 1®, Sophono, Boulder, Colo., USA) on a headband, 13 (72%) patients opted for Alpha 1, 2 patients for CROS, and 3 rejected both rehabilitation methods. Clinical tolerance, satisfaction, hearing performances (pure-tone audiometry, speech test in quiet and in noise, stereo audiometry, sound localization, and Hearing in Noise Test), and quality of life (Glasgow Benefit Inventory, Abbreviated Profile of Hearing Aid Benefit and Glasgow Hearing Aid Benefit questionnaires) were measured at 3 and 12 months after the implantation. Both devices improved equally the hearing in noise and the quality of life. Transcutaneous devices represent an effective option in SSD. © 2015 S. Karger AG, Basel.
    Audiology and Neurotology 05/2015; 20(4):251-260. DOI:10.1159/000381329 · 1.71 Impact Factor
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    ABSTRACT: The aim of this work was to thoroughly study the effect of liposomes on the rheological and the syringeability properties of hyaluronic acid (HA) hydrogels intended for the local administration of drugs by injection. Whatever the characteristics of the liposomes added (neutral, positively or negatively charged, with a corona of polyethylene glycol chains, size), the viscosity and the elasticity of HA gels increased in a lipid concentration-dependent manner. Indeed, liposomes strengthened the network formed by HA chains due to their interactions with this polymer. The nature and the resulting effects of these interactions depended on liposome composition and concentration. The highest viscosity and elasticity were observed with liposomes covered by polyethylene glycol chains while neutral liposomes displayed the lowest effect. Despite their high viscosity at rest, all the formulations remained easily injectable through needles commonly used for local injections thanks to the shear-thinning behavior of HA gels. The present study demonstrates that rheological and syringeability tests are both necessary to elucidate the behavior of such systems during and post injection. In conclusion, HA liposomal gels appear to be a promising and versatile formulation platform for a wide range of applications in local drug delivery when an injection is required. Copyright © 2015. Published by Elsevier B.V.
    International Journal of Pharmaceutics 04/2015; 487(1-2). DOI:10.1016/j.ijpharm.2015.04.019 · 3.65 Impact Factor
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    ABSTRACT: To review indications, anatomical results, and complications of cochlear implant (CI) surgery in adults for which middle ear and mastoid obliterations were performed. Thirty cases (26 patients, 4 bilaterally implanted) of 837 CI surgeries (3.5%) performed between January 2009 and December 2013 have been included in this retrospective study. The mean follow-up was 21 ± 18 months (mean ± SD, range 3-58). There were 11 males and 15 females. The mean age was 59 ± 19 years (range 35-82). All surgeries were performed with a single-stage technique including a canal wall down mastoidectomy with external auditory canal closure and mastoid obliteration with fat. A postoperative CT scan was performed in all cases. Etiologies of hearing loss were mainly chronic otitis with or without cholesteatoma in 24 cases. Other etiologies were meningitis with cochlear ossification in one case, progressive hearing loss in two cases, enlarged vestibular aqueduct in one case, temporal bone fracture with CSF leak in one case, and congenital aural atresia in one case. Four of those 30 cases were revision CI surgery for electrode array misplacement (one case with cochlear ossification) or extrusion from an open cavity (one case) and recurrent cholesteatomas (two cases). All surgeries were uneventful and performed in a single stage. The electrode array was inserted in the basal turn (29 cases) or in the middle turn (one case) of the cochlea. No complications were observed. Two cases of postoperative abdominal hematoma were drained under local anesthesia. A major failure of the CI device occurred 5 months after surgery. CI with mastoid and middle ear obliteration is a safe and effective technique for selected cases of cochlear implantation. Mastoid obliteration prevents from recurrent disease and lowering the facial ridge allows more space to manage extensive cochlear ossification or malformation.
    Ontology & Neurotology 01/2015; 36(4). DOI:10.1097/MAO.0000000000000702 · 1.79 Impact Factor
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    ABSTRACT: Objective . To evaluate the cutaneous and the inner ear tolerance of bioactive glass S53P4 when used in the mastoid and epitympanic obliteration for chronic otitis surgery. Material and Methods . Forty-one cases have been included in this prospective study. Cutaneous tolerance was clinically evaluated 1 week, 1 month, and 3 months after surgery with a physical examination of the retroauricular and external auditory canal (EAC) skin and the presence of otalgia; the inner ear tolerance was assessed by bone-conduction hearing threshold 1 day after surgery and by the presence of vertigo or imbalance. Results . All surgeries but 1 were uneventful: all patients maintained the preoperative bone-conduction hearing threshold except for one case in which the round window membrane was opened during the dissection of the cholesteatoma in the hypotympanum and this led to a dead ear. No dizziness or vertigo was reported. Three months after surgery, healing was achieved in all cases with a healthy painless skin. No cases of revision surgery for removal of the granules occurred in this study. Conclusion . The bioactive glass S53P4 is a well-tolerated biomaterial for primary or revision chronic otitis surgery, as shown by the local skin reaction which lasted less than 3 months and by the absence of labyrinthine complications.
    01/2015; 2015(2):1-6. DOI:10.1155/2015/242319
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    ABSTRACT: Menière's disease, clinically characterized by fluctuating, recurrent, and invalidating vertigo, hearing loss, and tinnitus, is linked to an increase in endolymph volume, the so-called endolymphatic hydrops. Since dysregulation of water transport could account for the generation of this hydrops, we investigated the role of aquaporin 3 (AQP3) in water transport into endolymph, the K-rich, hyperosmotic fluid that bathes the apical ciliated membrane of sensory cells, and we studied the regulatory effect of dexamethasone upon AQP3 expression and water fluxes. The different AQP subtypes were identified in inner ear by RT-PCR. AQP3 was localized in human utricle and mouse inner ear by immunohistochemistry and confocal microscopy. Unidirectional transepithelial water fluxes were studied by means of (3)H2O transport in murine EC5v vestibular cells cultured on filters, treated or not with dexamethasone (10(-7) M). The stimulatory effect of dexamethasone upon AQP3 expression was assessed in EC5v cells and in vivo in mice. AQP3 was unambiguously detected in human utricle and was highly expressed in both endolymph secretory structures of the mouse inner ear, and EC5v cells. We demonstrated that water reabsorption, from the apical (endolymphatic) to the basolateral (perilymphatic) compartments, was stimulated by dexamethasone in EC5v cells. This was accompanied by a glucocorticoid-dependent increase in AQP3 expression at both messenger RNA (mRNA) and protein level, presumably through glucocorticoid receptor-mediated AQP3 transcriptional activation. We show that glucocorticoids enhance AQP3 expression in human inner ear and stimulate endolymphatic water reabsorption. These findings should encourage further clinical trials evaluating glucocorticoids efficacy in Menière's disease.
    Pflügers Archiv - European Journal of Physiology 10/2014; 467(9). DOI:10.1007/s00424-014-1629-5 · 4.10 Impact Factor

  • J. Nevoux · S. Viengchareun · I. Lema · A. Lecoq · M. Lombes · E. Ferrary ·

  • S. Borel · D. Amar · I. Mosnier · E. Ferrary · O. Sterkers ·
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    ABSTRACT: But de la présentation L’objectif est d’améliorer les performances et le confort d’écoute des adultes implantés depuis au moins un an (Advanced Bionics) par une optimisation du réglage proposée par le logiciel FOX® (Fitting Outcoume Expert, Govaerts et al., Eargroup, Anvers). Matériel et méthodes Dix-huit adultes (9 hommes, 9 femmes), dont trois patients implantés bilatéralement (21 oreilles testées), âgés de 54 ± 17 ans (moyenne ± ET) [extrêmes : 28–78 ans] à la date de l’évaluation, et ayant un délai post-implantation de 5 ± 2 ans [2–9], ont participé à l’étude. L’évaluation se déroule en deux sessions d’environ deux heures (1 itération de réglage FOX®), à deux mois d’intervalle. Une audiométrie tonale (250 à 8000 Hz), quatre listes cochléaires de Lafon (40, 55, 70 et 80 dB), deux listes de phrases MBAA dans le bruit (S/B : 5 dB et 10 dB), un test de discrimination de 20 paires de phonèmes et une évaluation de la croissance en sonie (à 250, 1000 et 4000 Hz) ont été proposés en champ libre. Le questionnaire APHAB a également été complété. Résultats Deux mois après le réglage FOX®, les scores moyens de reconnaissance de phonèmes (Lafon) à 40 dB et 55 dB sont améliorés par rapport aux performances initiales : 4 % à la première session versus 14 % (p < 0,05) à la seconde session à 40 dB, et 33 % versus 47 % (p < 0,05) à 55 dB. À 55 dB, parmi les douze oreilles ayant les scores les plus faibles (< 40 %) lors de la première sessions six, soit la moitié, s’améliorent d’au moins 15 %. Par contre, parmi les 9 oreilles ayant des résultats supérieurs à 40 %, seule une s’améliore d’au moins 15 %. Le score global de l’APHAB (58 % vs 53 %, p < 0,05) ainsi que les domaines « facilité de communication » (45 % vs 39 %, p < 0,05) et « bruit de fond » (66 % vs 56 %, p < 0,05) sont également améliorés. Les scores aux autres évaluations ne sont ni améliorés ni dégradés. Conclusion L’utilisation du logiciel FOX® pour le réglage des implants cochléaires Advanced Bionics est possible en routine clinique et permet d’améliorer, chez certains patients, la compréhension de la parole à faible intensité et le confort d’écoute, et cela même à distance de l’implantation. Les patients avec les plus faibles résultats semblent obtenir davantage de bénéfices de cette méthode de réglage que les autres patients.
    Annales Francaises d'Oto-Rhino-Laryngologie et de Pathologie Cervico-Faciale 10/2014; 131(4):A9–A10. DOI:10.1016/j.aforl.2014.07.032
  • S. Borel · V. Colliou · N. Guillot · M. Smadja · E. Ferrary · O. Sterkers ·
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    ABSTRACT: But de la présentation Développer et pré-valider l’ECOMAS, une échelle évaluant la communication de l’adulte sourd. L’ECOMAS évalue huit domaines : « Reconnaissance de la parole », « Fluidité de l’échange », « Attitude dans la communication », « Autonomie de communication », « Intégration à des groupes sociaux », « Communication en environnement bruyant », « Communication en groupe », « Utilisation des médias ». Chaque domaine est coté de 0 à 4, soit un score total allant de 0 à 32. Matériel et méthodes Cent trente-quatre adultes sourds (76 femmes, 58 hommes) répartis en trois groupes indépendants : 39 adultes sourds candidats à l’implantation (62 ± 14 ans, [23–86]), 53 adultes implantés depuis moins d’un an (57 ± 19 ans [17–90], délai post-implant de 7 ± 4 mois, [1–12]), 42 adultes implantés depuis plus d’un an (délai post-implant de 57 ± 47 mois, [18–228]) ont été évalués avec l’ECOMAS, ainsi qu’avec la CAP, l’ERSA, les mots de Lafon/Fournier, les phrases MBAA avec un S/B de 10 dB en condition binaurale appareillée. Résultats Les scores moyens à l’ECOMAS sont respectivement de : 14 ± 7,8 sur 32 pour le groupe pré-implant (n = 39), 19 ± 6,8 pour le groupe post-implant < à 12 mois (n = 53) et 22 ± 5,5 pour le groupe post-implant > à 12 mois (n = 42). La corrélation pour chacun des trois groupes de patients entre le score total et chacun des 8 domaines (r compris entre 0,55 et 0,87, p < 0,0001), ainsi que le coefficient alpha de Cronbach de 0,9 attestent respectivement de la validité et de la consistance internes de cette échelle. La concordance inter-évaluateurs pour un même patient est très bonne entre les orthophonistes du centre référent (n = 43, coefficient Kappa > 0,8 pour les domaines, 0,68 pour le score total) mais faible entre l’orthophoniste du centre référent et l’orthophoniste de ville (n = 14, coefficient Kappa de 0,36 à 0,71 pour les domaines, 0,29 pour le score total). La validité externe entre l’Ecomas et la CAP est très bonne pour les trois groupes (r compris entre 0,69 et 0,79, p < 0,0001). Conclusion La validité interne et externe de l’ECOMAS est confirmée. Une prochaine étude aura pour objectifs d’améliorer la concordance inter-juges en développant une notice d’utilisation de l’échelle et d’évaluer la sensibilité au changement de l’échelle lors une évaluation longitudinale d’un an après l’implantation.
    Annales Francaises d'Oto-Rhino-Laryngologie et de Pathologie Cervico-Faciale 10/2014; 131(4):A12. DOI:10.1016/j.aforl.2014.07.039
  • D. De seta · Y. Nguyen · E. Ferrary · O. Sterkers · I. Mosnier ·

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    ABSTRACT: But de la présentation Les performances cognitives des personnes de plus de 60 ans présentant une perte auditive supérieure à 25 dB sont inférieures à celles des normo-entendants (Lin, 2013). Plus particulièrement, le seuil d’audition des presbyacousiques est relié aux performances exécutives (Gates, 2010). L’objectif de cette étude est de déterminer si les capacités cognitives des patients presbyacousiques, évaluées avec les tests Codex et MoCA, sont différentes de celles des sujets normo-entendants de même âge. Matériel et méthodes Les performances auditives de 40 patients adultes, 21 femmes et 19 hommes, d’âge moyen 61,1 ± 15,36 ans (ES = 2,43) [22–88] présentant une surdité profonde depuis 55 ± 66 mois [2–264] ont été testées avec des listes de syllabes, de mots monosyllabiques de Lafon, de mots dissyllabiques de Fournier et de phrases MBAA proposées en modalité auditive. Les tests cognitifs de dépistage Codex et MoCA ont été proposés en modalité visuelle. Résultats L’analyse des résultats des tests Codex et MoCA chez les patients sourds ne révèle aucune corrélation avec les performances auditivo-verbales. Les résultats sont anormaux chez 10 patients (25 %) pour le Codex et chez 21 patients (53 %) pour le MoCA, 10 patients ayant des résultats anormaux aux deux tests. L’épreuve d’orientation, déterminante dans le Codex pour départager les patients pathologiques ou normaux – et commune aux deux tests, s’avère non discriminante. Par ailleurs, les épreuves du MoCA les moins bien réussies sont celles testant les fonctions exécutives et la mémoire épisodique. Elles sont corrélées à un score total pathologique au MoCA : capacités visuo-spatiales exécutives (r = 0,95, p < 0,0001),catégorisation (r = 0,95, p < 0,0001) et rappel (r = 0,95, p < 0,0002). Ces épreuves apparaissent donc discriminantes chez les patients sourds. Enfin, ces deux tests n’explorent pas les mêmes fonctions. Conclusion Vingt-cinq pour cent des patients sourds de notre étude ont des scores pathologiques au CODEX et 52,5 % au MoCA. Le profil cognitif des sujets presbyacousiques est différent des normo-entendants, le MoCA ayant été étalonné sur 90 sujets contrôles normo-entendants d’âge moyen 72,84 ± 7,03 ans. Les tests cognitifs de dépistage MoCA et Codex,simples et rapides, pourront être utilisés dans le suivi longitudinal des sujets implantés cochléaires afin de confirmer l’amélioration des fonctions cognitives grâce à la réhabilitation auditive.
    Annales Francaises d'Oto-Rhino-Laryngologie et de Pathologie Cervico-Faciale 10/2014; 131(4):A12. DOI:10.1016/j.aforl.2014.07.038
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    ABSTRACT: HYPOTHESIS: Loading otoprotective drug into cochlear implant might change its mechanical properties, thus compromising atraumatic insertion. This study evaluated the effect of incorporation of dexamethasone (DXM) in the silicone of cochlear implant arrays on insertion forces. BACKGROUND: Local administration of DXM with embedded array can potentially reduce inflammation and fibrosis after cochlear implantation procedure to improve hearing preservation and reduce long-term impedances. METHODS: Four models of arrays have been tested: 0.5-mm distal diameter array (n = 5) used as a control, drug-free 0.4-mm distal diameter array (n = 5), 0.4-mm distal diameter array with 1% eluded DXM silicone (n = 5), and 0.4-mm distal diameter array with 10% eluded DXM silicone (n = 5). Via a motorized insertion bench, each array has been inserted into an artificial scala tympani model. The forces were recorded by a 6-axis force sensor. Each array was tested seven times for a total number of 140 insertions. RESULTS: During the first 10-mm insertion, no difference between the four models was observed. From 10- to 24-mm insertion, the 0.5-mm distal diameter array presented higher insertion forces than the drug-free 0.4-mm distal diameter arrays, with or without DXM. Friction forces for drug-free 0.4-mm distal diameter array and 0.4-mm distal diameter DXM eluded arrays were similar on all insertion lengths. CONCLUSION: Incorporation of DXM in silicone for cochlear implant design does not change electrode array insertion forces. It does not raise the risk of trauma during array insertion, making it suitable for long-term in situ administration to the cochlea.
    Ontology & Neurotology 08/2014; 36(2). DOI:10.1097/MAO.0000000000000521 · 1.79 Impact Factor
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    ABSTRACT: Otological microsurgery is delicate and requires high dexterity in bad ergonomic conditions. To assist surgeons in these indications, a teleoperated system, called RobOtol, is developed. This robot enhances gesture accuracy and handiness and allows exploration of new procedures for middle ear surgery. To plan new procedures that exploit the capacities given by the robot, a surgical simulator is developed. The simulation reproduces with high fidelity the behavior of the anatomical structures and can also be used as a training tool for an easier control of the robot for surgeons. In the paper, we introduce the middle ear surgical simulation and then we perform virtually two challenging procedures with the robot. We show how interactive simulation can assist in analyzing the benefits of robotics in the case of complex manipulations or ergonomics studies and allow the development of innovative surgical procedures. New robot-based microsurgical procedures are investigated. The improvement offered by RobOtol is also evaluated and discussed.
    BioMed Research International 07/2014; 2014:891742. DOI:10.1155/2014/891742 · 1.58 Impact Factor

Publication Stats

2k Citations
280.03 Total Impact Points


  • 2015
    • Pierre and Marie Curie University - Paris 6
      Lutetia Parisorum, Île-de-France, France
  • 2014
    • Polytech Paris-UPMC
      Lutetia Parisorum, Île-de-France, France
  • 2013
    • Hôpital La Pitié Salpêtrière (Groupe Hospitalier "La Pitié Salpêtrière - Charles Foix")
      Lutetia Parisorum, Île-de-France, France
  • 2009-2013
    • Paris Diderot University
      • Faculté de Médecine Xavier Bichat
      Lutetia Parisorum, Île-de-France, France
  • 2003-2013
    • University of Paris-Est
      La Haye-Descartes, Centre, France
  • 2008-2012
    • Assistance Publique – Hôpitaux de Paris
      Lutetia Parisorum, Île-de-France, France
  • 2004-2010
    • Unité Inserm U1077
      Caen, Lower Normandy, France
  • 2005-2009
    • The Australian Society of Otolaryngology Head & Neck Surgery
      Evans Head, New South Wales, Australia
  • 1989-2008
    • French Institute of Health and Medical Research
      Lutetia Parisorum, Île-de-France, France
  • 2000
    • Karolinska Institutet
      • Institutionen för fysiologi och farmakologi
      Solna, Stockholm, Sweden
  • 1992
    • University of Bordeaux
      Burdeos, Aquitaine, France
  • 1987
    • French National Centre for Scientific Research
      Lutetia Parisorum, Île-de-France, France