Yann Nguyen

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Yann Nguyen is an ENT assistant professor at the Otolaryngology Department, Unit of Otology, Auditory Implants and Skull Base Surgery in Hospital Pitié Salpêtrière, in Paris, France. His clinical activities are focused on middle ear surgery, cochlear implantation and lateral skull base surgery. He has a PhD on “robot based surgery for cochlear implantation”. He now continues his research on robotics in the French national health institute laboratory “Minimally Invasive Robot-based Hearing Rehabilitation”.

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DEBASHIS MAJI

Indian Institute of Technology Kharagpur

Rui de Sousa Camposinhos (PhD EUR-ING) with Habilitation

Instituto Politecnico do Porto

naveen noronha

Visvesvaraya Technological University

Richard Crawford

The University of Texas at Austin

Chandramouli Padmanabhan

IIT Madras

mahmoud hafiz

Al-Azhar University

Carlos Lange

University of Alberta

Kazuki Morita

The University of Tokyo

Alex Dommann

University of Bern

Mirabel Rezende

Universidade Federal de São Paulo (UNIFESP)

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Papers by Yann Nguyen

Virtual Simulation of Stapedotomy Surgery

Recent advances in local drug delivery to the inner ear

International Journal of Pharmaceutics, 2015

Inner ear diseases are not adequately treated by systemic drug administration mainly because of t... more 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.

Effect of liposomes on rheological and syringeability properties of hyaluronic acid hydrogels intended for local injection of drugs

International journal of pharmaceutics, Jan 13, 2015

The aim of this work was to thoroughly study the effect of liposomes on the rheological and the s... more 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-th...

Evaluation of insertions forces of an atraumatic array prototype in a model of micro dissected cochlea

by Yann Nguyen and Mathieu Miroir

International Journal of Pediatric Otorhinolaryngology, 2011

Material and Methods: Data from an early intervention program was audited to allow determination ... more Material and Methods: Data from an early intervention program was audited to allow determination of what testing procedures are being employed at specific ages. This will be related to language development pre and post implantation with a specific focus on age of implantation and language delays. Results: Results indicated increased use of electrophysiological methods of audiological testing and limited use of behavioral testing methods. Conclusion: Development of criteria for implantation together with an association to oversee and validate implantation decisions is needed. Further research on implantation and schooling options for these children is needed. This is especially important in a country where resources are limited.

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Simulation virtuelle de la palpation de la chaîne des osselets : développement d’un retour de forces réaliste

by Mathieu Miroir and Yann Nguyen

Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2014

Comparaison des forces d’insertions de trois techniques d’insertions dans un modèle anatomique de scala tympani

by Mathieu Miroir and Yann Nguyen

Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2014

Hyaluronic acid liposomal gel sustains delivery of a corticoid to the inner ear

Journal of controlled release : official journal of the Controlled Release Society, Jan 6, 2016

The inner ear is one of the most challenging organs for drug delivery, mainly because of the bloo... more The inner ear is one of the most challenging organs for drug delivery, mainly because of the blood-perilymph barrier. Therefore, local rather than systemic drug delivery methods are being developed for inner ear therapy. In this work, we have evaluated the benefit of a hyaluronic acid liposomal gel for sustained delivery of a corticoid to the inner ear after local injection into the middle ear in a guinea pig model. The liposomal gel was easily injectable as a result of the shear-thinning behavior of hyaluronic acid. A prolonged residence time at the site of injection as well as in the round window was achieved without any negative effect on the hearing thresholds of the animals. The presence of liposomes in the formulation resulted in sustained release of the drug in the perilymph for 30days and promoted the conversion of the prodrug loaded within the liposomes (dexamethasone phosphate) into its active form (dexamethasone). In this way, therapeutic doses were attained in the perily...

Intratemporal facial nerve schwannoma: clinical presentation and management

European Archives of Oto-Rhino-Laryngology, 2015

Facial nerve schwannoma is the most common facial nerve tumor, but its therapeutic strategy remai... more Facial nerve schwannoma is the most common facial nerve tumor, but its therapeutic strategy remains debated. The aim of this study is to analyze the facial nerve function and the hearing outcomes after surgery or wait-and-scan policy in a facial nerve schwannoma series. A monocentric retrospective review of medical charts of patients followed for an intratemporal facial nerve schwannoma between 1988 and 2013 was performed. Twenty-two patients were included. Data were extracted pertaining to the following variables: patient demographics, tumor localization, clinical and imaging features, facial nerve function and hearing levels, and details of surgical intervention. The majority of tumors were located at the geniculate ganglion. Initial symptoms were mainly facial palsy and hearing loss. The average follow-up was 4.8 ± 4.5 years. Nineteen patients underwent surgery, and three patients were observed. After surgery, 11 patients had a stable or improved facial nerve function (57.9 %), and 8 patients had a worsened facial nerve function (42.1 %). Facial nerve function was in the majority of cases a HB grade III, depending on surgical strategy. No patient presented a postoperative HB grade V or VI. Regarding the hearing, it remained stable after surgery in 52.6 % of cases, and improved in 10.5 % of cases. Among monitored patients, facial nerve function and hearing remained stable. Surgery for facial nerve schwannoma is a safe and effective option in the treatment of these tumors.

Management of epi- and mesotympanic cholesteatomas by one-stage trans-canal atticotomy in adults

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, Jan 4, 2016

Surgical management of cholesteatoma limited to the attic and/or mesotympanum remains controversi... more Surgical management of cholesteatoma limited to the attic and/or mesotympanum remains controversial. The aim of this study is to evaluate the anatomical and the functional results of trans-canal atticotomy in this pathological condition. The records of 27 adult patients treated from 2008 to 2014 who underwent trans-canal atticotomy for primary cholesteatoma surgery were reviewed. Pre-operative physical examination, audiometry, and CT-scan have been analyzed. Intraoperative findings have been described as well as the surgical technique. Anatomical and functional results have been evaluated with a mean follow-up of 24 ± 12.2 months, and the results of a CT-scan performed 1 year after surgery were examined to assess the presence of residual disease. Surgeries were uneventful. During the follow-up, 1 patient (4 %) experienced a retraction of the attical reconstruction; all the other patients had a well-healed tympanic drum with stable attical reconstruction. The mean air-bone gap was 19...

Mesure des forces d’insertions durant l’implantation cochléaire : intérêt pour le chirurgien

by Mathieu Miroir and Yann Nguyen

Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2012

Cutaneous and Labyrinthine Tolerance of Bioactive Glass S53P4 in Mastoid and Epitympanic Obliteration Surgery: Prospective Clinical Study

BioMed research international, 2015

Objective. To evaluate the cutaneous and the inner ear tolerance of bioactive glass S53P4 when us... more 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 pa...

Cutaneous and Labyrinthine Tolerance of Bioactive Glass S53P4 in Mastoid and Epitympanic Obliteration Surgery: Prospective Clinical Study

BioMed Research International, 2015

Variability of the mental representation of the cochlear anatomy during cochlear implantation

European Archives of Oto-Rhino-Laryngology, 2015

The aim of this study was to assess the mental representation of the insertion axis of surgeons w... more 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; &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;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 &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05), or residents (axial: 15° ± 1.5°; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001, coronal: 17° ± 1.9°; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 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.

Mise au point d’un simulateur et d’un modèle mécanique de l’oreille moyenne pour la chirurgie ossiculaire

by Mathieu Miroir, Yann Nguyen, and Stephane Cotin

Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2012

Évaluation De Techniques Chirurgicales Innovantes Pour L’Otospongiose À L’Aide D’Un Simulateur Chirurgical

by Mathieu Miroir, Yann Nguyen, and Stephane Cotin

Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2013

Conception d’un atlas mécanique pour la simulation de la chirurgie de l’oreille moyenne

by Mathieu Miroir and Yann Nguyen

Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, 2013

Protective effect of systemic administration of erythropoietin on auditory brain stem response and compound action potential thresholds in an animal model of cochlear implantation

The Annals of otology, rhinology, and laryngology, 2011

An animal model of cochlear implantation has been developed, and the hearing threshold was evalua... more An animal model of cochlear implantation has been developed, and the hearing threshold was evaluated after different surgical procedures. The effect of perioperative systemic administration of erythropoietin on the hearing loss induced by cochlear implantation was tested. Twenty-nine guinea pigs with normal hearing underwent implantation of a 254-microm-diameter array through a cochleostomy. The effects on hearing of cochleostomy and transient and long-term array implantation (21 days) were assessed by testing of the auditory brain stem responses and compound action potentials. Eleven implanted animals received intraperitoneal administration of erythropoietin. Selected computed tomographic scans and cochlear histologic studies were performed 1 month after implantation to confirm proper placement of the array. The erythropoietin concentration at the time of surgery was assessed in samples of perilymph, cerebrospinal fluid, and blood. The cochleostomy and transient array insertion had...

Middle Ear and Mastoid Obliteration for Cochlear Implant in Adults

Otology & Neurotology, 2015

To review indications, anatomical results, and complications of cochlear implant (CI) surgery in ... more 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.

Haptic Rendering on Deformable Anatomical Tissues with Strong Heterogeneities

by Yann Nguyen, Mathieu Miroir, and Stephane Cotin

Lecture Notes in Computer Science, 2014

This paper is focus on the development of a haptic rendering method to simulate interactions with... more This paper is focus on the development of a haptic rendering method to simulate interactions with heterogeneous deformable materials, such as anatomical components. Indeed, the strong heterogeneities of the biological tissues involves numerical and real-time issues to simulate the deformations and the mechanical interactions between the organs and the surgical tools. In this paper, we propose a new haptic algorithm adapted to the modeling of heterogeneous biological tissues, based on non-linear finite element model. The central contribution is the use of a triple asynchronous approach: one loop at low rate, which computes a preconditionner that solves the numerical conditioning problems; a second at intermediate rate, to update the model of the biological simulation; and the haptic loop which provides the feedback to the user at high rate. Despite of the desynchronization, we show that the calculation of haptic forces remains accurate compared to the model. We apply our method to a challenging microsurgical intervention of the human middle ear. This surgery requires a delicate gesture in order to master the applied forces.

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