Isabelle Mosnier

Hôpital La Pitié Salpêtrière (Groupe Hospitalier "La Pitié Salpêtrière - Charles Foix"), Lutetia Parisorum, Île-de-France, France

Are you Isabelle Mosnier?

Claim your profile

Publications (69)55.74 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The association between hearing impairment and cognitive decline has been established; however, the effect of cochlear implantation on cognition in profoundly deaf elderly patients is not known. To analyze the relationship between cognitive function and hearing restoration with a cochlear implant in elderly patients. Prospective longitudinal study performed in 10 tertiary referral centers between September 1, 2006, and June 30, 2009. The participants included 94 patients aged 65 to 85 years with profound, postlingual hearing loss who were evaluated before, 6 months after, and 12 months after cochlear implantation. Cochlear implantation and aural rehabilitation program. Speech perception was measured using disyllabic word recognition tests in quiet and in noise settings. Cognitive function was assessed using a battery of 6 tests evaluating attention, memory, orientation, executive function, mental flexibility, and fluency (Mini-Mental State Examination, 5-word test, clock-drawing test, verbal fluency test, d2 test of attention, and Trail Making test parts A and B). Quality of life and depression were evaluated using the Nijmegen Cochlear Implant Questionnaire and the Geriatric Depression Scale-4. Cochlear implantation led to improvements in speech perception in quiet and in noise (at 6 months: in quiet, 42% score increase [95% CI, 35%-49%; P < .001]; in noise, at signal to noise ratio [SNR] +15 dB, 44% [95% CI, 36%-52%, P < .001], at SNR +10 dB, 37% [95% CI 30%-44%; P < .001], and at SNR +5 dB, 27% [95% CI, 20%-33%; P < .001]), quality of life, and Geriatric Depression Scale-4 scores (76% of patients gave responses indicating no depression at 12 months after implantation vs 59% before implantation; P = .02). Before cochlear implantation, 44% of the patients (40 of 91) had abnormal scores on 2 or 3 of 6 cognition tests. One year after implant, 81% of the subgroup (30 of 37) showed improved global cognitive function (no or 1 abnormal test score). Improved mean scores in all cognitive domains were observed as early as 6 months after cochlear implantation. Cognitive performance remained stable in the remaining 19% of the participants (7 of 37). Among patients with the best cognitive performance before implantation (ie, no or 1 abnormal cognitive test score), 24% (12 of 50) displayed a slight decline in cognitive performance. Multivariate analysis to examine the association between cognitive abilities before implantation and the variability in cochlear implant outcomes demonstrated a significant effect only between long-term memory and speech perception in noise at 12 months (SNR +15 dB, P = .01; SNR +10 dB, P < .001; and SNR +5 dB, P = .02). Rehabilitation of hearing communication through cochlear implantation in elderly patients results in improvements in speech perception and cognitive abilities and positively influences their social activity and quality of life. Further research is needed to assess the long-term effect of cochlear implantation on cognitive decline.
    03/2015; DOI:10.1001/jamaoto.2015.129
  • [Show abstract] [Hide abstract]
    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; DOI:10.1097/MAO.0000000000000702 · 1.60 Impact Factor
  • [Show abstract] [Hide abstract]
    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.
    10/2014; 131(4):A9–A10. DOI:10.1016/j.aforl.2014.07.032
  • [Show abstract] [Hide abstract]
    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.
    10/2014; 131(4):A12. DOI:10.1016/j.aforl.2014.07.038
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective To compare the fitting time requirements and the efficiency in achieving improvements in speech perception during the first 6 months after initial stimulation of computer-assisted fitting with the Fitting to Outcome eXpert' (FOX™) and a standard clinical fitting procedure. Method Twenty-seven post-lingually deafened adults, newly implanted recipients of the Advanced Bionics HiRes 90K™ cochlear implant from Germany, the UK, and France took part in a controlled, randomized, clinical study. Speech perception was measured for all participants and fitting times were compared across groups programmed using FOX and conventional programming methods. Results The fitting time for FOX was significantly reduced at 14 days (P < 0.001) but equivalent over the 6-month period. The groups were not well matched for duration of deafness; therefore, speech perception could not be compared across groups. Discussion Despite including more objective measures of performance than a standard fitting approach and the adjustment of a greater range of parameters during initial fitting, FOX did not add to the overall fitting time when compared to the conventional approach. FOX significantly reduced the fitting time in the first 2 weeks and by providing a standard fitting protocol, reduced variability across centres. Conclusions FOX computer-assisted fitting can be successfully used at switch on, in different clinical environments, reducing fitting time in the first 2 weeks and is efficient at providing a usable program.
    Cochlear Implants International 08/2014; 16(2). DOI:10.1179/1754762814Y.0000000093
  • [Show abstract] [Hide abstract]
    ABSTRACT: To analyze predictive factors of cochlear implant outcomes and postoperative complications in the elderly. Prospective, longitudinal study performed in 10 tertiary referral centers. Ninety-four patients aged 65-85 years with a profound, postlingual hearing loss were evaluated before implantation, at time of activation, and 6 and 12 months after cochlear implantation. Speech perception and lipreading were measured using disyllabic word recognition in quiet and noise, and lipreading using disyllabic words and sentences. The influence of preoperative factors on speech perception in quiet and noise at 12 months was tested in a multivariate analysis. Complications, presence of tinnitus and of vestibular symptoms were collected at each evaluation. The effect of age was observed only in difficult noisy conditions at SNR 0 dB. Lipreading ability for words and sentences was negatively correlated with speech perception in quiet and noise. Better speech perception scores were observed in patients with shorter duration of hearing deprivation, persistence of residual hearing for the low frequencies, the use of a hearing aid before implantation, the absence of cardiovascular risk factors, and in those with implantation in the right ear. General and surgical complications were very rare, and the percentage of vestibular symptoms remained stable over time. This study demonstrates that cochlear implantation in the elderly is a well-tolerated procedure and an effective method to improve communication ability. Advanced age has a low effect on cochlear implant outcome. Analyses of predictive factors in this population provide a convincing argument to recommend treatment with cochlear implantation as early as possible in elderly patients with confirmed diagnosis of a severe-to-profound hearing loss and with only limited benefit from hearing aid use in one ear. © 2015 S. Karger AG, Basel.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Most cochlear implantations are unilateral. To explore the benefits of a binaural cochlear implant, we used water-labelled oxygen-15 positron emission tomography. Relative cerebral blood flow was measured in a binaural implant group (n = 11), while the subjects were passively listening to human voice sounds, environmental sounds non-voice or silence. Binaural auditory stimulation in the cochlear implant group bilaterally activated the temporal voice areas, whereas monaural cochlear implant stimulation only activated the left temporal voice area. Direct comparison of the binaural and the monaural cochlear implant stimulation condition revealed an additional right temporal activation during voice processing in the binaural condition and the activation of a right fronto-parietal cortical network during sound processing that has been implicated in attention. These findings provide evidence that a bilateral cochlear implant stimulation enhanced the spectral cues associated with sound perception and improved brain processing of voice stimuli in the right temporal region when compared to a monaural cochlear implant stimulation. Moreover, the recruitment of sensory attention resources in a right fronto-parietal network allowed patients with bilateral cochlear implant stimulation to enhance their sound discrimination, whereas the same patients with only one cochlear implant stimulation had more auditory perception difficulties.
    Archives of Oto-Rhino-Laryngology 11/2013; 271(12). DOI:10.1007/s00405-013-2810-8 · 1.61 Impact Factor
  • 10/2013; 130(4):A73. DOI:10.1016/j.aforl.2013.06.242
  • 10/2013; 130(4):A103-A104. DOI:10.1016/j.aforl.2013.06.330
  • 10/2013; 130(4):A9. DOI:10.1016/j.aforl.2013.06.022
  • [Show abstract] [Hide abstract]
    ABSTRACT: The objective of this study was to measure performance benefits obtained by upgrading recipients of the Cochlear™ Nucleus(®) CI24 cochlear implant to the new CP810™ sound processor. Speech recognition in quiet and in spatially separated noise was measured in established users of the Cochlear ESPrit 3G™ (n = 22) and Freedom™ (n = 13) sound processors, using the "Everyday" listening program. Subjects were then upgraded to the CP810 processor and were re-assessed after a 3-month period, using both the "Everyday" program and the new "Noise" program, which incorporates several pre-processing features including a new directional microphone algorithm ("Zoom™"). Subjective perceptions were also recorded using the abbreviated profile of hearing aid benefit (APHAB) questionnaire. Mean scores for monosyllables in quiet, presented at 50 and 60 dB SPL, increased by 11 % (p < 0.0001) and 8 % (p < 0.001), respectively, after upgrade, for all subjects combined. Significant increases were also recorded for both processor groups. In noise, the mean scores were 60.0 and 67.4 % for the original and CP810 Everyday programs, respectively (difference not significant). With the CP810 Noise programs the mean score increased to 82.5 % (p < 0.01), with significant increases in both processor groups. There was evidence of slightly greater upgrade benefit in users of the ESPrit 3G processor and in relatively poor performers. The APHAB questionnaire also indicated significant reduction in perceived difficulty in the background noise and reverberation sub-scales after upgrade. The findings of the study appear to support the expectation of increased benefit from the new CP810 sound processor.
    Archives of Oto-Rhino-Laryngology 02/2013; 271(1). DOI:10.1007/s00405-013-2381-8 · 1.61 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The objective of this study is to evaluate the anatomical and functional results of rehabilitation of canal wall down (CWD) mastoidectomy using granules of biphasic ceramic. This is a study design retrospective in a tertiary referral centre Fifty-seven patients (59 ears) operated on between 2006 and 2010 of mastoid obliteration with granules of biphasic ceramic (TricOs(®), Maurepas, France) have been included (55 revisions and 4 first surgeries). Forty-six patients presented already a CWD mastoidectomy. The mean pre-operative bone conduction (BC) was 29 ± 3.4 dB (mean ± SEM) and mean air conduction (AC) was 57 ± 3.2 dB. Cholesteatoma was found in 33 cases. All but seven cases had post-operative otoscopy examination at 1, 3, 6 months, and 1 year postoperative with a CT scan and pure tone audiometry. Mean follow-up was 14 ± 1.8 months (3-35). At one-year follow-up (n = 52), 47 cases (90 %) presented well-healed external auditory canal. Five cases (10 %) of uncovered granules without sign of infection of external auditory canal skin were observed. Mean post-operative threshold was 25 ± 1.8 and 46 ± 1.9 dB for BC and AC , respectively (n = 47). CT scan (n = 42) showed no opacity suggesting residual disease within or behind obliteration. Mastoid obliteration with granules of biphasic ceramic is a safe and effective procedure that allows restoration of a near normal external auditory canal.
    Archives of Oto-Rhino-Laryngology 02/2013; 271(1). DOI:10.1007/s00405-013-2393-4 · 1.61 Impact Factor
  • D. Dulon, I. Mosnier, D. Bouccara
    [Show abstract] [Hide abstract]
    ABSTRACT: Varios fármacos tienen una toxicidad potencial para el oído interno que se traduce por síntomas auditivos: acúfenos, hipoacusia perceptiva que afecta a las frecuencias agudas y trastornos del equilibrio. La afectación suele ser irreversible y bilateral, pero se han descrito casos unilaterales. Los principales fármacos son los antibióticos aminoglucósidos y macrólidos, la aspirina y los salicilatos, los diuréticos de asa y algunos antimitóticos (sales de platino). Estos cuadros suelen ser latentes al principio, por lo que deben detectarse en caso de exposición a un fármaco potencialmente ototóxico, sobre todo cuando existan factores agravantes potenciales, en especial una insuficiencia renal. En este artículo se detallarán los mecanismos fisiopatológicos causantes para los antibióticos aminoglucósidos, incluidos los factores genéticos implicados. Varios trabajos recientes se centran en el desarrollo de tratamientos destinados a proteger el oído interno.
    02/2013; 42(1):1–13. DOI:10.1016/S1632-3475(13)64009-6
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Conclusion: Residual hearing could be preserved with various arrays ranging from 16 to 18 mm in insertion length and 0.25 to 0.5 mm tip diameter. Whether array insertion is performed through a cochleostomy or a round window, tip diameter is an essential criterion for the array design to improve hearing preservation results. Objectives: The goal of this study was to report the outcome of patients implanted with electric acoustic cochlear implants with various surgical techniques and array designs. Methods: Thirty-two implanted ears (30 patients) were included in this retrospective study. Three array models were inserted: Contour Advance implant (n = 16), Nucleus Hybrid-L (n = 12), and Med-El Flex EAS (n = 4). Postoperative pure tone audiometry was performed at 3 and 12 months after implantation. Results: Three months postoperatively, hearing preservation within 30 dB was achieved in 50%, 50%, and 84% cases of patients implanted with a Contour Advance, Flex-EAS, and Hybrid-L, respectively. Two patients (Hybrid-L group) had a delayed sudden hearing loss (> 30 dB) 3 months postoperatively and three patients (Contour Advance group) had total hearing loss at 1 year. Best results were achieved using arrays with small tip diameters. Cochleostomy or round window insertion did not affect hearing preservation results.
    Acta oto-laryngologica 12/2012; 133(2). DOI:10.3109/00016489.2012.723824 · 0.99 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To update a 15-year-old study of 800 postlinguistically deaf adult patients showing how duration of severe to profound hearing loss, age at cochlear implantation (CI), age at onset of severe to profound hearing loss, etiology and CI experience affected CI outcome. Study Design: Retrospective multicenter study. Methods: Data from 2251 adult patients implanted since 2003 in 15 international centers were collected and speech scores in quiet were converted to percentile ranks to remove differences between centers. Results: The negative effect of long duration of severe to profound hearing loss was less important in the new data than in 1996; the effects of age at CI and age at onset of severe to profound hearing loss were delayed until older ages; etiology had a smaller effect, and the effect of CI experience was greater with a steeper learning curve. Patients with longer durations of severe to profound hearing loss were less likely to improve with CI experience than patients with shorter duration of severe to profound hearing loss. Conclusions: The factors that were relevant in 1996 were still relevant in 2011, although their relative importance had changed. Relaxed patient selection criteria, improved clinical management of hearing loss, modifications of surgical practice, and improved devices may explain the differences.
    Audiology and Neurotology 10/2012; 18(1):36-47. DOI:10.1159/000343189 · 1.85 Impact Factor
  • 10/2012; 129(4):A49. DOI:10.1016/j.aforl.2012.07.129
  • 10/2012; 129(4):A48-A49. DOI:10.1016/j.aforl.2012.07.128
  • 10/2012; 129(4). DOI:10.1016/j.aforl.2012.07.314
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectifs Stimuler électriquement le nerf récurrent au cours de la chirurgie thyroïdienne ou parathyroïdienne et enregistrer les réponses musculaires ; en déduire, si possible, un pronostic fonctionnel de la mobilité vocale postopératoire. Patients et méthodes Le monitoring peropératoire du nerf récurrent a été effectué au moyen d’une sonde d’intubation endotrachéale équipée de deux paires d’électrodes de surface (NIM Medtronic Xomed, Jacksonville, Flo, États-Unis) et positionnée en regard des cordes vocales. Deux cent quinze nerfs récurrents ont été monitorés de manière prospective chez 141 patients ayant subi une thyroïdectomie totale (n = 74), une hémithyroïdectomie (n = 63) ou une parathyroïdectomie (n = 4). Dans tous les cas, la réponse musculaire a été recueillie après stimulation directe du nerf récurrent par une sonde monopolaire. Résultats Le seuil minimal de stimulation avant (prédissection) et après la dissection (postdissection) du nerf récurrent, entraînant une réponse musculaire supérieure ou égale à 100 μV, variait de 0,1 à 0,85 mA (moyenne à 0,4 mA). L’intensité de stimulation supramaximale a été définie à 1 mA. L’amplitude de la réponse musculaire était très variable d’un individu à l’autre, mais la similitude des réponses à une stimulation supramaximale de 1 mA, entre pré- et postdissection, d’une part, et entre postdissection aux extrémités proximale et distale du nerf exposé, d’autre part, était corrélée à une mobilité laryngée postopératoire normale. À l’inverse, l’altération de la réponse musculaire a témoigné d’un risque substantiel de paralysie récurrentielle, sans pouvoir prédire si celle-ci sera définitive ou non. Conclusions Cette méthode de monitoring est simple, non invasive et aussi sensible que celles utilisant des électrodes de recueil intramusculaires. Le monitoring est une aide précieuse au repérage du nerf et permet, en cours et en fin d’intervention, de s’assurer de son intégrité fonctionnelle et ainsi d’adapter la stratégie chirurgicale.
    04/2012; 129(2):90–97. DOI:10.1016/j.aforl.2011.12.004
  • [Show abstract] [Hide abstract]
    ABSTRACT: Cochlear implant in adults is a procedure, dedicated to rehabilitate severe to profound hearing loss. Because of technological progresses and their applications for signal strategies, new devices can improve hearing, even in noise conditions. Binaural stimulation, cochlear implant and hearing aid or bilateral cochlear implants are the best opportunities to access to better level of comprehension in all conditions and space localisation. By now minimally invasive surgery is possible to preserve residual hearing and use a double stimulation modality for the same ear: electrical for high frequencies and acoustic for low frequencies. In several conditions, cochlear implant is not possible due to cochlear nerve tumour or major malformations of the inner ear. In these cases, a brainstem implantation can be considered. Clinical data demonstrate that improvement in daily communication, for both cochlear and brainstem implants, is correlated with cerebral activation of auditory cortex.
    La Revue de Médecine Interne 03/2012; 33(3):143–149. DOI:10.1016/j.revmed.2011.11.019 · 1.32 Impact Factor

Publication Stats

328 Citations
55.74 Total Impact Points

Institutions

  • 2013–2015
    • Hôpital La Pitié Salpêtrière (Groupe Hospitalier "La Pitié Salpêtrière - Charles Foix")
      Lutetia Parisorum, Île-de-France, France
    • Université de Vincennes - Paris 8
      Saint-Denis, Île-de-France, France
  • 2012–2013
    • Paris Diderot University
      Lutetia Parisorum, Île-de-France, France
  • 2008–2012
    • Assistance Publique – Hôpitaux de Paris
      Lutetia Parisorum, Île-de-France, France
  • 2011
    • Hôpital Louis-Mourier – Hôpitaux Universitaires Paris Nord Val de Seine
      Colombes, Île-de-France, France
  • 2010
    • Centre Hospitalier de Courbevoie - Neuilly – Puteaux
      Neuilly, Île-de-France, France
  • 2007–2009
    • Unité Inserm U1077
      Caen, Lower Normandy, France
  • 2005
    • University of Auvergne
      Clermont, Auvergne, France
    • The Australian Society of Otolaryngology Head & Neck Surgery
      Evans Head, New South Wales, Australia
  • 2003
    • Alexandria University
      • Department of Otolaryngology
      Al Iskandarīyah, Alexandria, Egypt