Biomedical subjects
Publications and source records attributed to A Banal.
Lingual thyroid is a rare embryologic migration failure. It may undergo goitrous changes and the ensueing complications as well as carcinomatous transformation [1,2]. We describe a case of an infected ossified lingual thyroid goitre with suspicion of carcinomatous transformation.
As laryngeal schwannomas are a threat to breathing, they must be removed. CT and MR provide an accurate pre-operative work-up of these lesions. The clear delineation of the tumoral attachment to the larynx proved to be very useful in the difficult management of our second patient. Our two laryngeal schwannomas exhibited a similar appearance which differed from those of the few other laryngeal nerve sheath tumors reported in the literature The low attenuating outer part correlated with Antoni B areas. The denser enhancing inner part correlated with Antoni A areas containing large vessels. This unusual tumoral appearance, which has been observed in some other peripheral schwannomas, must bring this diagnostic possibility to mind. However, this clearly contrasting distribution of the two components of schwannomas is not the most commonly observed in other locations. More reports are needed to establish whether this special appearance is characteristic of laryngeal location.
A retrospective study of 139 untreated staged III and IV epidermoid carcinomas of the upper aero digestive tract is reported concerning oropharynx, oral cavity, hypopharynx and larynx, all of them received as a first treatment, chemotherapy using a five days course of Cisplatinium (20 mg/m2/D) and 5FU (1,000 mg/m2/D). The aim of the trial was to determine: a) a free of disease survival and a global survival rate's increase, b) a more conservative treatment. The results of chemotherapy were clinically evaluated in two groups: Responders (a total or a more than 50% response), and no responders. The results were: on the tumor site: 64% responders (25% total response)--more in smaller lesion; on the lymphatic nodes: 54% responders (more in N1-N2). The results vary in inverse ratio to the stage of the lesion; usually, 2 cycles of chemotherapy are used but in case of efficiency: 2 to 6 cycles are provided increasing to 20% the rate of the total responders; toxicity of the drugs was neligible: 6 cases, 3 of them were renal insufficiency. The global survival rate at 3 months reaches 56.7%. The median line of survival reaches 32 months in responders reverse 15 months (NR); but there are no significant difference between the two groups concerning the recurrences, or the metastasis. The local treatment (after chemotherapy) decided in the 137 patients was surgery, in 40 cases and radiotherapy, in 97 cases (conservative treatment; 80%).(ABSTRACT TRUNCATED AT 250 WORDS)
The authors reviewing their own experience of blepharoplasty (92 cases) over the last ten years, discuss the principal approaches used depending on the age of the patient, the amount of adipose tissue, the lower lid tarsal and muscular laxity and the quality of the skin excess. In the lower eyelid they emphasize the value of the transconjunctival approach in young and or coloured people and the use of a cutaneo-muscular flap in the classical technique. In the upper eyelid, they combine the skin excision with an orbicularis muscle strip and in old people with suspension of the lateral canthus. A wise selection of these various approaches avoids the rare complications (ectropion and scleral show) because blepharoplasty must be considered to be a "variable geometry" operation.
The authors, reviewing their own experience of Blepharoplasty (92 cases) since ten years, discuss the principal approaches used depending on the age of the patient, the amount of adipose tissue, the lower lid tarsal and muscular laxity and the quality of the skin excess. On the lower eye lid they emphasize the interest of the transconjunctival approach in young an or coloured people and they undermine a cutaneo-muscular flap in the classical technique. On the upper eye lid, they combine the skin excision with an orbicular muscle strip and in old people with a suspension of the lateral canthus. A good choice between these different approaches avoid the rare complications (ectropion and scleral show) because blepharoplasty must be considered like a "variable geometry" operation.
The authors have reviewed their clinical experiences with 92 cases of blepharoplasties treated during the past 10 years and discuss the principal approaches used, depending on the age of the patient, the amount of adipose tissue present, the degree of lower lid tarsal and muscle laxity present, and the quality of the skin excess encountered. On the upper eyelid, skin excision is combined with an orbicular muscle strip and in older patients a suspension of the lateral canthus. On the lower eyelid the transconjunctival approach is emphasized in young and or colored patients, using an undermined musculocutaneous flap in the classical technique. A good choice between these different approaches avoids the rare complications of ectropion and scleral show because the procedure used is considered to be a variable "geometric" operation.
The authors start by recalling the principal histomorphological and physiological characteristics of skin tissues subjected to expansion, in particular their hyper-vascularisation which allows the raising of vast flaps of excellent quality. After presenting the major principles, they then present their clinical experience in the context of reconstructive surgery of the scalp, particularly in the correction of Juri flap scars used in the treatment of baldness. Finally, they emphasise the great potential of this technique in the whole field of reconstructive surgery.
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Patients with head and neck tumours (HNT) have a high risk of early locoregional relapse that is difficult to diagnose. This study evaluated the usefulness of the serum Cyfra 21-1 assay compared to squamous cell carcinoma antigen (SCC) assay for monitoring such patients. Three hundred and twelve HNT patients, including 204 newly diagnosed patients, were followed up for a median of 446 days with serial serum assays for SCC and Cyfra 21-1. Untreated patients showed SCC and Cyfra 21-1 serum levels correlated with each other: concentration was correlated to clinical stage, tumour size (as T1 + T2 vs. T3 + T4) and nodal status. Cyfra 21-1, but not SCC, was related to the presence of metastases and the primary tumour site, with a univariate prognostic value for disease-free survival (p = 0.015). Cox's regression analysis showed that only Cyfra 21-1 was associated with a risk of relapse (p = 0.027). The random coefficient growth curve model applied to serial SCC and Cyfra 21-1 measurements of 111 patients showed that only Cyfra 21-1 exhibited a significant difference between patients with and without relapses. We found Cyfra 21-1 to be more closely related to initial clinical data and disease evolution than SCC, and therefore propose the use of Cyfra 21-1 for monitoring head and neck cancers.
The authors describe the principles relating to the excision of carcinomas involving the opening of the oesophagus. They emphasize the need for low section of the oesophagus, or even total oesophagectomy by virtue of the frequent submucosal spread of the tumour process. The need for resection of this type eliminates the possibility of repair by the Bakamgian flap type and involve the need for a long intestinal segment with a difficult digestive anastomosis in the middle of the thorax if a free intestinal transplant is selected. The authors themselves carry out oesophagoplasty using the transverse colon which in common with the majority of other authors, they feel to be the technique of choice. However, on the basis of their brief experience, they wish above all to discuss the criteria of operability, rarely discussed elsewhere, and concerning spread to the membranous trachea and the possibility of perivisceral tumour spread which cannot be detected by classical techniques. They suggest the use of a prior mediatinoscopy incision in order to attempt to assess any such possible spread.