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This “unprecedented procedure” that allowed treating the auditory and facial paralysis of an AP-HP patient

The 48-year-old man could no longer hear in his left ear and had been paralyzed on the same side of his face since 2020.

“World premiere at the Pitié-Salpêtrière AP-HP hospital,” the Assistance Publique-Hôpitaux de Paris announced in a press release on Friday. Il recounts the “procédure inédite” menée dans l’établissement en avril 2021, qui a permitir à un homme de 48 ans de retrouver l’ouïe de l’oreille gauche et de comencer à guérir de la paralyzie faciale qui bloquait le côté gauche de his face.

The story begins in August 2020 with the dramatic accident suffered by Arnaud Dubois, according to the parisianwhile the farmer tried to repair his car.

“An incandescent metal projectile entered the left external auditory canal, immediately causing ear pain, tinnitus, hearing loss, vertigo, and complete peripheral facial paralysis on the left side,” explain the doctors, who published their work in the journalAmerican Journal of Otolaryngology in December.

The operation that followed was performed by the team from the department of Ear Nose Throat and Cervicofacial Surgery of the hospital and the Sorbonne University, and was coordinated by Dr. Rémi Hervochon and Dr. Ghizlene Lahlou.

Two techniques used at the same time

To cure the 40-year-old, doctors are performing “an unprecedented procedure” by combining two treatments at the same time. On the one hand, we proceed to repair the facial nerve burned in the accident, causing facial paralysis. Doctors cut and excised the damaged nerve and grafted a sensory nerve from the lobe removed from the farmer’s ear to his palate, he explains. the parisian.

On the other hand, a cochlear implant was placed for deafness. This is a “system that will electrically stimulate the output of the auditory nerve and thus return sound sensations to the implant wearer, allowing them to hear,” explains the Hearing Foundation. Part of the system is surgically implanted in the cochlea, that is, in the inner ear, the other part is external and is used to capture sounds.

These two procedures are not new, but “this is the first time that these two sensitive techniques have been performed together,” writes AP-HP, “to date, no patient in the world has benefited from a combination treatment.”

Rehabilitation work afterwards.

The effects were not visible immediately after the operation, “for a long time, several months, there was no improvement in the face. We believed that the operation had been a failure”, explains Rémi Hervochon daily.

But one day, the mouth begins to move slightly and little by little the rest of the face follows. Arnaud Dubois now has a 53% recovery, explains his speech therapist in Parisian, while in April 2021 it was only 9%. To continue recovering, you must comply with daily exercises and massages.

“The patient can now live normally again: he mobilizes his face and has recovered his binaural hearing”, that is, with both ears, says the AP-HP press release.

“Neither the patients who are victims of ear burns, nor the patients who are victims of any other destructive pathology of the ear”, have so far benefited from this double surgery. In this sense, this operation opens “new perspectives of treatment for any otolaryngologist who is faced with one of these medical situations”, rejoices the AP-HP.

Author: salome vincent
Source: BFM TV

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