P Tran Ba Huy

Publications (132)129.53 Total impact

• Article: Vestibular schwannoma and cell-phones. Results, limits and perspectives of clinical studies.

  E Mornet, R Kania, E Sauvaget, P Herman, P Tran Ba Huy
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  ABSTRACT: The widespread development of cell-phones entails novel user exposure to electromagnetic fields. Health impact is a public health issue and a source of anxiety in the population. Some clinical studies reported an association between cell and cordless phone use and vestibular schwannoma; others found none. A systematic review was performed of all published clinical studies (cohort, registry, case-control and validation studies), with analysis of results, to determine the nature of the association and the level of evidence. Cohort studies were inconclusive due to short exposure durations and poor representativeness. Registry studies showed no correlation between evolution of cell-phone use and incidence of vestibular schwannoma. Case-control studies reported contradictory results, with methodological flaws. Only a small number of subjects were included in long-term studies (>10years), and these failed to demonstrate any indisputable causal relationship. Exposure assessment methods were debatable, and long-term assessment was lacking. An on-going prospective study should determine any major effect of electromagnetic fields; schwannoma being a rare pathology, absence of association will be difficult to prove. No clinical association has been demonstrated between cell and cordless phone use and vestibular schwannoma. Existing studies are limited by their retrospective assessment of exposure.
  European Annals of Otorhinolaryngology, Head and Neck Diseases 05/2013;
• Article: Success and failure factors for hearing-aid prescription: Results of a French national survey.

  A Abdellaoui, P Tran Ba Huy
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  ABSTRACT: OBJECTIVES: To identify epidemiological, socioeconomic, audiometric and environmental factors of success and failure of hearing-aid prescription, and to assess hearing-aid efficacy at 6-9 months after prescription. PATIENTS AND METHODS: A prospective nationwide survey was conducted in France on 184 patients with age-related hearing loss. Inclusion data were collected by a questionnaire filled out by the ENT specialist and patient, and with a second questionnaire filled out by telephone contact with the patient 6-9 months later. RESULTS: One-third of patients failed to fulfill the prescription, either for financial reasons or for lack of interest in correcting their disability. For the other two-thirds, the factors favoring consultation with a hearing-aid fitting specialist seemed to be: leisure activity requiring good hearing, living in a couple or family, spontaneous initial ENT consultation, strong motivation, monthly income greater than €1200, longstanding hearing impairment, and difficulty in listening to television and following a conversation in noise. Eighty percent of hearing-aid trials were successful; 60% of prescriptions were thus followed by hearing-aid purchase. The main three criteria determining purchase were the advice of the hearing-aid fitting specialist, and the price and the effectiveness of the apparatus on trial. In the four daily life situations presented in the questionnaire, the hearing-aid was worn for 8hours or more in 90% of cases, found useful in 70% and proved satisfactory in 70%. Age-related hearing loss, whether metabolic or sensorineural, benefited from hearing-aid correction in 86% of cases. CONCLUSIONS: Indications for hearing-aid prescription should take account of the patient's degree of motivation, awareness of disability, and income. The advice of the ENT and hearing-aid fitting specialists plays a key role in the patient's acceptance of the hearing-aid. Hearing-aids seem to enhance quality of life significantly in age-related hearing loss subjects.
  European Annals of Otorhinolaryngology, Head and Neck Diseases 05/2013;
• Article: Glomus jugular foramen tumours. A review.

  P Tran Ba Huy, M Duet
  B-ENT 01/2011; 7 Suppl 17:67-75.
• Article: [The ultra-rapid cinematography of the larynx, its contributions in speech pathology].

  G Chevaillier, E Sauvaget, P Herman, P Tran Ba Huy
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  ABSTRACT: The development in the medical field of high speed cinematography and its dissemination in the field of speech pathology will probably change the way we view the larynx and diagnose its disorders. So far only the stroboscope could inform us about the appearance of vocal cord vibration but with certain limitations. Indeed the wave motion of the vocal cords is really only apparent motion. It is made possible through the phenomenon of retinal persistence of images and light intermittent vocal folds set to the frequency of the voice and out of phase by a few Hertz. This technique has several disadvantages: The need for the voice to trigger the strobe light; a low number of frames per second (25 fps) recorded; frame loss for the period between unlit two flashes; limitation in the study of the upper voice spectrum (gearing). The ultra-rapid cinematography brings a big difference in design since the digital recording can shoot up to 4000 frames per second with permanent lighting of the larynx. The slow reading of short sequences permits us to view the actual movement of vibrating structures, and to analyze the behavior of the vibrator during the transitional phases of the attack, depreciation and termination of sound. The footage in high resolution permits a detailed analysis of the movements of opening and closing of the vocal cords in phonation and respiration, and the diagnosis of lesions.
  Revue de laryngologie - otologie - rhinologie 01/2010; 131(1):23-9.
• Article: Eustachian tube melanoma treated by double surgical approach.

  K Aubry, J Lerat, P Herman, J-P Guichard, P Tran Ba Huy
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  ABSTRACT: We report a case of an eustachian tube melanoma treated by a double surgical approach. A 56-year-old man consulted for a recurrent left serous otitis media. CT-scan and MRI showed a lesion filling completely the middle ear, extending along the Eustachian tube up to the nasopharynx, with enhancement after injection. The biopsy of the lesion confirmed the diagnosis of malignant melanoma. After left internal carotid artery occlusion, the removal of the lesion was performed by a double surgical approach: combination of an endoscopic transnasal and a retroauricular approach. Radiotherapy was adjuvant therapy. Eustachian tube melanoma is a rare occurrence. Surgical treatment must be radical, what represents a challenge considering the localization; it can be obtained with the double surgical approach proposed in our case report.
  Revue de laryngologie - otologie - rhinologie 01/2010; 131(3):221-4.
• Article: [Association of an arachnoid cyst with heterotopic neuroglial tissue in the internal auditory canal].

  K Aubry, M Wassef, J-P Guichard, P Herman, P Tran Ba Huy
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  ABSTRACT: We report a case of an association of an arachnoid cyst with heterotopic neuroglial tissue in the internal auditory canal. A 66-year-old woman consulted for cochleovestibular syndrome. MRI demonstrated a lesion with spontaneous hypersignal on T1- and T2-weighted images, instigating surgical exploration. We discovered a hematic arachnoid cyst associated with heterotopic neuroglial tissue arising in the internal auditory canal. An arachnoid cyst arising within the cerebellopontine angle or the internal auditory canal is a rare occurrence. Clinical manifestations are identical with those produced by a cochleovestibular schwannoma. MRI usually demonstrates a nonenhancing isointense cystic mass with cerebrospinal fluid on all sequences (hypointense on T1-weighted and hyperintense on T2-weighted images). These lesions are usually monitored. Spontaneous hypersignal on T1- and T2-weighted images makes diagnosis difficult, as in our case, leading to surgical exploration.
  Annales d Otolaryngologie et de Chirurgie Cervico-Faciale 06/2009; 126(3):133-7.
• Article: [Endoscopic thyroid surgery using video-assisted and totally endoscopic techniques].

  R E Kania, M Parodi, A Coste, P Herman, P Tran Ba Huy, J-F Papon
  Annales d Otolaryngologie et de Chirurgie Cervico-Faciale 04/2009; 126(2):82-93.
• Article: From animal research to the bed side: detection of unilateral vestibular lesions in patients complaining of unsteadiness.

  P P Vidal, F Mbongo, P Tran Ba Huy, C de Waele
  Journal of Vestibular Research 01/2009; 19(5-6):147-57. · 1.35 Impact Factor
• Article: Role of vestibular input in triggering and modulating postural responses in unilateral and bilateral vestibular loss patients.

  F Mbongo, C Qu'hen, P P Vidal, P Tran Ba Huy, C de Waele
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  ABSTRACT: The aim of this study was to determine whether the greater medial-lateral (ML) instability observed in patients with compensated unilateral vestibular loss (UVL), tested on a seesaw platform with eyes closed, is task-dependent. UVL patients, categorized into three groups according to time since lesion (1 week, 1 month and 1 year), bilateral vestibular loss patients and age-matched healthy control subjects were tested in three dynamic postural tasks. These tasks involved different supports - a seesaw platform (Satel), a platform generating horizontal linear translations (Synapsys) and foam rubber placed on a static platform - each requiring different somatosensory cues to maintain equilibrium. Displacements of the subjects' center of pressure in both the anterior-posterior (AP) and ML directions were recorded by strain gauges within the platforms. Only tests performed with eyes closed were analyzed. Bilateral vestibular loss patients fell during foam and seesaw trials but not on the platform generating translations. We previously reported that UVL patients had greater postural oscillations on the seesaw platform in the ML compared to AP direction. In this study, we show similar ML/AP differences in patient performance on foam when standing with 'feet close together'. In contrast, these differences were not found when patients were tested on linear translation or on foam standing with feet apart. In conclusion, the postural performance of patients with vestibular loss depends on the exact task used to measure postural stability. UVL patients are less stable when subjected to movement in the ML direction because of the biomechanical constraints of the tasks and/or the availability of proprioceptive information.
  Audiology and Neurotology 11/2008; 14(2):130-8. · 2.46 Impact Factor
• Article: [Dilation of the internal auditory canal and intracanalicular vestibular schwannoma: what are the mechanisms involved?].

  R E Kania, P Herman, J-P Guichard, P Tran Ba Huy
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  ABSTRACT: To present a unique case of unilateral widening of the internal auditory canal (IAC) with no significant contact with an ipsilateral intracanalicular vestibular schwannoma (VS), raising the issue of the cause(s) of this IAC widening. The medical record and radiologic data were reviewed of a patient presenting an enlarged unilateral IAC, which led to the diagnosis of an intracanalicular VS that could not account for the dilation. The patient had a unilateral dilation of the IAC that did not match the ipsilateral VS he had. As a result, this case motivated discussion of whether such dilation of the IAC was congenitally asymmetrical or the result of the mechanisms involved in the widening of the IAC. Although asymmetry of IAC is a current notion, this case demonstrates a contrario that increased pressure exerted on the walls of the IAC cannot be the only mechanism in such widening.
  Annales d Otolaryngologie et de Chirurgie Cervico-Faciale 10/2008; 125(5):256-60.
• Article: Endoscopic transsphenoidal surgery for cholesterol granulomas involving the petrous apex.

  C Georgalas, R Kania, J-P Guichard, E Sauvaget, P Tran Ba Huy, P Herman
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  ABSTRACT: Surgery for cholesterol granulomas involving the petrous apex has traditionally been performed via a lateral skull base approach. We present a case-series of four cholesterol granulomas treated through the endoscopic-transsphenoid approach over the last 10 years. Drainage was successful and symptomatic improvement was obtained in all cases (follow-up 6 months-10 years). Primary 'sphenoid' lesions, which can be widely drained and remain marsupialised, should be differentiated from primary 'petrous' lesions that can be removed safely through the sphenoid sinus only in case of extension medial to the internal carotid artery (ICA). We feel that the endoscopic transsphenoidal approach is a safe and effective way to access cholesterol granulomas of the petrous apex.
  Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 03/2008; 33(1):38-42. · 2.39 Impact Factor
• Article: [Seromucous otitis].

  P Tran Ba Huy, E Sauvaget, F Portier
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  ABSTRACT: Otitis media with effusion are defined as the persistence of middle ear effusion for more than 3 weeks. If the diagnostic is easy, questions remain about pathogeny and treatment. Literature was reviewed regarding the pathogeny and the best treatment strategy. Except in the case of middle ear effusion due to trauma, effusion is an exudate due to mucous cell metaplasia. The main causal factor is middle ear inflammation, which is secondary to viral or bacterial infection. Inflammation causes dysfunction of the sodium transports in the middle ear. Responsibility of the otitis media with effusion in the genesis of the various chronic otitis media remains controversial. Treatment is justified when otitis media last more than 3 months, that is to say few months observation is required. The aim of treatment is to reduce local inflammation and to treat effusion. Prevention and treatment of local inflammation is difficult. Indeed, it is difficult to avoid rhinitis that is mainly viral. Effusion must be treated in order to avoid local middle ear deterioration and language deficiency. Insertion of tympanostomy tube is the only effective treatment. It decreases middle ear depression and Eustachian tube obstruction and restores the mucociliary clearance. Adenoidectomy and amygdalectomy are not effective in otitis media with effusion but, in association with tympanostomy tube, could decrease recurrence of acute otitis media. Otitis media with effusion remains a frequent disorder, for which the only effective treatment is the tympanostomy tube.
  Annales d Otolaryngologie et de Chirurgie Cervico-Faciale 08/2007; 124(3):120-5.
• Article: [Idiopathic sudden sensorineural hearing loss is not, at this time, an otologic emergency].

  P Tran Ba Huy, E Sauvaget
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  ABSTRACT: To evaluate the influence of the treatment delay for sudden sensorineural hearing loss (SSHL) on the final hearing recovery and the prognostic value of the audiometric shapes and the hearing recovery at the end of treatment. Prospective study including 321 patients admitted in the emergency care center for a recent idiopathic SSHL. Classification according to the audiometric shape in 5 types. All patients received steroids (1 mg/kg per day) and, in case of ascending shape, steroids and mannitol during 6 days. Hearing recovery was evaluated according to the following parameters: 1) hearing recovery (initial PTA-PTA at D6 or D30); 2) incidence of hearing recovery (initial PTA-PTA at D6 or D30)/initial PTA x 100%). Whatever the audiometric type, delay in initiating treatment did not have any influence on the final outcome. Audiometric classification had a good prognostic value, since the ascending shape had a better hearing recovery than descending shape or the sub or total anacusis. Hearing recovery at D6 is a prognostic factor on the final outcome. Idiopathic SSHL cannot be considered, nowadays, as an otologic emergency.
  Annales d Otolaryngologie et de Chirurgie Cervico-Faciale 07/2007; 124(2):66-71.
• Article: [Idiopathic sudden sensorineural hearing loss: a review].

  J-B Charrier, P Tran Ba Huy
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  ABSTRACT: Idiopathic Sudden Sensorineural Hearing Loss (ISSHL) remains one of the major unsolved otologic emergencies. It is characterized by the onset of an unilateral sensorineural hearing loss developing within 24 hours, and averaging on pure tone audiogram at least 30 dB HL for three subsequent octave steps, with no marked vestibular symptoms and no identifiable cause. ISSHL is a syndrome covering several heterogeneous entities resulting from different pathogenetic mechanisms. At this time, the audiogram is the unique tool which may help clinicians to identify these entities and provide a classification based on 5 types of hearing loss. Numerous experimental and clinical studies have investigated the mechanisms by which infectious, ischemic, mechanic or immunologic insults may induce cochlear dysfunction. However, extrapolation to humans and rationale therapeutic approaches to ISSHL remain uncertain. SSHL being a diagnosis of exclusion, retrocochlear and neurologic etiologies should be eliminated. No argument allows to consider ISSHL a therapeutic emergency. More precisely, the experimental data presently available on cochlear physiology suggests that a treatment could have some chance to be effective if undertaken within minutes following the onset of ISSHL, a condition never encountered in daily practice. Conversely, it is not justifiable to impute the absence of hearing recovery to a delay in therapy. The various therapeutic strategies currently recommended are highly empirical and should be questionned in terms of cost-effectiveness, the most common being high-dose corticosteroids. New investigation tests are required for improving our approach to ISSHL.
  Annales d Otolaryngologie et de Chirurgie Cervico-Faciale 03/2005; 122(1):3-17.
• Article: Enhanced sodium absorption in middle ear epithelial cells cultured at air-liquid interface.

  F Portier, R Kania, C Planès, W C Hsu, S Couette, P Tran Ba Huy, P Herman
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  ABSTRACT: As we demonstrated previously that transcription of alpha-ENaC was correlated with oxygen tension in the culture medium, this study suggests that the increase in alpha-ENaC expression observed under ALI conditions may result from greater oxygenation of ME cells. The physiology of the middle ear (ME) is primarily concerned with keeping the cavities fluid-free, to allow transmission of sound vibrations from the eardrum to the inner ear. ME epithelial cells are thought to play a key role in this process as they actively absorb sodium and water in order to clear any excess fluid present in the cavities. As an air-liquid interface (ALI) model has been shown to improve differentiation and enhance sodium absorption in other respiratory epithelia, we established an ALI model for ME cells. ME cells cultured under ALI conditions exhibited a fourfold increase in sodium absorption, which was not related to either a metabolic effect or to enhanced morphological differentiation, but instead to an increase in expression of the alpha-subunit of the epithelial sodium channel (alpha-ENaC).
  Acta Oto-Laryngologica 02/2005; 125(1):16-22. · 1.08 Impact Factor
• Article: Vertebrobasilar occlusive disorders presenting as sudden sensorineural hearing loss.

  E Sauvaget, S Kici, B Petelle, R Kania, H Chabriat, Ph Herman, P Tran Ba Huy
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  ABSTRACT: Isolated sudden sensorineural hearing loss (SSHL) has been rarely related to vertebrobasilar occlusive disorders (VBOD). This is an important issue for both neurologists and otolaryngologists, since the management and prognosis of this type of hearing loss widely differs from that of hearing loss from other causes. To describe the clinical characteristics and report the incidence of SSHL related to VBOD. Retrospective analysis of clinical charts from 333 patients admitted for SSHL in a large ear, nose, and throat emergency tertiary care center from 1999 to 2002. Four cases (1.2%) of VBOD as the unique cause of SSHL were diagnosed among 333 patients. The most typical features of these cases were the presence of one of the following characteristics: (1) bilateral SSHL, (2) associated occipital or posterior nuchal pain, and (3) the occurrence of delayed neurologic deficits. The underlying vascular disease affected the vertebral arteries: dissection in two cases and atherosclerosis in two other cases. The audiometric features of hearing loss were endocochlear in one case, of both types in one case, and unknown in two cases. Hearing recovered partially or completely. Our results confirm the low incidence of SSHL related to VBOD and show that the observation of endocochlear audiometric features cannot preclude a central cause in SSHL. The clinical presentation of our cases related to VBOD emphasize that a careful follow-up of any patient with SSHL is warranted and that the presence of nuchal pain suggestive of arterial dissection in younger subjects, a past history of atherosclerosis or embolism in older patients, or the occurrence of delayed associated neurologic symptoms should be considered with particular caution in this situation.
  The Laryngoscope 03/2004; 114(2):327-32. · 1.75 Impact Factor
• Article: [Exploration of olfactory difficulties].

  C Eloit, D Trotier, Ph Herman, P Tran Ba Huy
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  ABSTRACT: Sense-of-smell disorders are a frequent occurrence at ORL clinics. The clinical exploration must include a thorough and comprehensive interview to discover the etiology. The clinical examination is easily performed using cold-light endoscopes, which can reveal anatomical or mucous membrane pathologies, even in far- situated anatomical parts. The access to olfactometric examinations is limited by the small number of health centers which have the proper equipment and trained staff. Guided by the initial interview and clinical exploration, the diagnosis of smell disorder can benefit from the conclusive and factual contribution of the CAT scan and MRI.
  European annals of allergy and clinical immunology 10/2003; 35(7):247-51.
• Article: [Vascular complications after acoustic neurinoma surgery].

  R Kania, G Lot, Ph Herman, P Tran Ba Huy
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  ABSTRACT: To report six cases of vascular complications occurring after acoustic neuroma surgery and to discuss the postoperative signs and symptoms that should alert the surgeon, in order to undertake the appropriate treatment as soon as possible. Four hundred thirty-two cases of acoustic tumors operated by the same surgeons between January 1991 and December 2000 were reviewed. Six cases of vascular complications were identified: one case of cerebral vasospasm secondary to persistence of subarachnoid blood after injury to Dandy's vein; three cases of arterial infarction giving rise to a partial anterior inferior cerebellar artery (AICA) syndrome with an unusual nystagmus in two cases (ipsilateral in one patient and strong controlateral in one patient presenting preoperative vestibular areflexia); one case of hematoma of the cerebello-pontine angle (CPA) causing strong ipsilateral nystagmus; and one case of venous infarction of the cerebellar vermis secondary to accidental sinus thrombosis. Vascular complications after acoustic neuroma surgery are potentially devastating and should be identified as early as possible. Rapid extubation is recommended for systematic neurologic assessment. Among abnormal signs and symptoms that should alert the surgeon, marked nystagmus ipsilateral to the operated side or contralateral in patient presenting preoperative vestibular areflexia appears to be of great value.
  Annales d Otolaryngologie et de Chirurgie Cervico-Faciale 05/2003; 120(2):94-102.
• Article: [Endoscopic resection of the frontal sinus floor following the Draf procedure: long term results and therapeutic algorithm].

  B Pételle, E Sauvaget, S Kici, P Tran Ba Huy, P Herman
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  ABSTRACT: Endoscopic resection of the frontal sinus floor is a minimally invasive and functional surgical procedure designed for the treatment of inflammatory sinus diseases, which avoids the side-effects of external osteoplastic obliteration. The aim of the study was to evaluate long term results and to determine computed tomographic criteria predictive of success. Our study reports the results of 20 patients operated for nasofrontal stenosis associated or not with osteitis or secondary mucocele. A successful result was obtained in 90% with a mean follow-up of 3.5 years. Failures (2) were attributed to insufficient resection and to frontal sinus osteogenesis. Endoscopic frontal sinusotomy is a safe and effective procedure for large sinuses with large distance between nasion and cribriform plate, but not in case of osteogenesis and multiple mucoceles. In case of unfavourable anatomy, or for the aforementioned pathologies, the obliteration procedure should be preferred.
  Annales d Otolaryngologie et de Chirurgie Cervico-Faciale 03/2003; 120(1):14-20.
• Article: [Scintigraphy by l'Octreoscan in the management of head and neck paragangliomas].

  M Duet, E Sauvaget, J-P Guichard, B Petelle, S Ledjedel, Ph Herman, P Tran Ba Huy
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  ABSTRACT: To assess the usefulness of somatostatin receptor scintigraphy [Octreoscan] in a series of 18 patients referred for a suspicion of paraganglioma of the head and neck between July 2001 and February 2002. Sixteen patients had one or several paragangliomas of the head and neck diagnosed on conclusive conventional imaging including CT and MR scan. In two patients, radiological data were not conclusive. Planar images were obtained 4 and 24 hr after the iv injection of 148-185 MBq [Octreoscan]. Twenty-two hot spot lesions were detected. Twenty of these lesions corresponded to the twenty known paragangliomas. The volume of the smallest tumor was 0.2 cm(3). In one patient, intense thyroid nodule uptake led to the surgical diagnosis of oncocytoma. In two lesions, where conventional imaging was not conclusive, arteriography showed a typical aspect of meningioma; one patient was operated on and histology confirmed this diagnosis. No evidence of abnormal uptake was seen in site previously operated on (3 patients). Octreotide scintigraphy is a very sensitive method for detection of paraganglioma of head and neck. It provides information on potential tumor sites in the whole body after one single injection. It could be used as a screening test in patients at risk (familial or known paraganglioma) in order to detect paraganglioma at an early stage and, thus to reduce the surgical morbidity, as well as in the follow-up after surgery to detect recurrences.
  Annales d Otolaryngologie et de Chirurgie Cervico-Faciale 01/2003; 119(6):315-21.