Objectives: Multidisciplinary team meetings (MTM) are essential in the choice of a therapeutic strategy in head and neck cancer. In many centres patients attend MTMs and are examined by the team. The ...aim of this study was to assess the influence of the patient's presence on therapeutic decisions.
Study design: Prospective study of 119 consecutive patients.
Methods: Two therapeutic situations were compared: the therapeutic decision taken following discussion of the patient's file in the MTM (D1) and the therapeutic decision taken after examination of the patient during MTMs (D2). Concordance between the two situations was measured.
Results: Concordance between D1 and D2 was 97%. No factors likely to decrease concordance were identified. Decisions taken during MTMs were acted upon for 97% of the patients.
Conclusion: The presence of the patient during MTMs is not essential if the files are thoroughly presented and discussed.
The question addressed here is how optimizing the quality of insertion through the round window with the lower morbidity, when using a straight and slotted electrode array of regular length. This ...retrospective analysis includes all cases implanted with a cochlear implant Digisonic SP (Neurelec-Oticon Medical) since 2004. We checked the operative charts, the depth of insertion, and the follow-up. For comparisons, contingency tables were used and a Chi-square test was performed. A
p
value <0.05 was considered significant. 126 cases of patients with non-malformed cochleas were implanted through the round window. The mean age was 53.8 ± 16.2 for adults and 3.6 ± 2.6 for children (24 cases). The mean follow-up was 33 ± 22 months. The straight electrode array had either a square or a soft pointed tip (
n
= 84). Full insertion was achieved in 79 out of 84 cases with a soft tip vs. 18 out of 42 square tips (
χ
2
= 41.41, DOF = 1,
p
< 0.0001). Two cases were stuck at the round window niche by a prominent crista fenestrae. In all cases but one, the chorda tympany was preserved. In one case, a misrouting to the vestibule required a revision surgery. Implantation through the round window with a straight and slotted electrode array with a soft tip (Digisonic SP, Neurelec-Oticon Medical) can lead to a full insertion in 94 % of cases. Drilling out a prominent crista fenestrae is recommended.
