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Biomedical subjects

A Desaulty

Publications and source records attributed to A Desaulty.

At least 19 recordsLinked to original sources
PubMed1994

[Cholesteatoma in children. Apropos of 104 cases].

Between 1988 and 1993, 94 children from 3 to 15 years of age underwent one or more surgical procedures for cholesteatoma or epithelization of the middle ear space. Ten children had bilateral disease. 94 ears were operated for the first time and 10 ears had had previous surgery at other institutions. A total of 204 procedures were performed: 190 for cholesteatoma and 14 for epithelization of the middle ear space. Preoperative audiometry showed a mean air-bone gap of 30 decibels. 69% of the ears had ossicular osteolysis. The surgical technique was decided at the time of surgery. This was most often a canal-wall-up procedure which was almost routinely followed by surgical revision (92%). Pearl-like masses or recurrent cholesteatoma were frequently found at the second or third operation (73%) but most could ultimately be controlled with a canal-wall-up procedure. A canal-wall-up down procedure was necessary in 20% of the ears at either the second or third operation because of important residual or recurrent cholesteatoma. Post-operative audiometry showed a mean air-bone gap of 30 decibels.

Age Factors↗
PubMed1994

[Section of the facial nerve. Apropos of 40 cases].

From January, 1985 through December, 1992, 40 patients were referred to the Department of Otoneurology of the Lille University Hospital for traumatic facial nerve injury. The injury was located in the intracranial, intratemporal, or extracranial segments of the nerve in 19, 15 and 6 patients, respectively. The trauma was iatrogenic in 30 patients. It was the result of surgery for a tumor of the posterior fossa, of the temporal bone or of the parotid in 19, 2 and 3 patients, respectively. Nerve injury had occurred during surgery for chronic otitis or a parotid fistula in 5 and 1 patients, respectively. Finally, it was the result of temporal bone fracture in 7 patients. We used various techniques for repair of the nerve. Anastomosis, whether end to end or with an interposition graph and with or without rerouting, was accomplished in 17 patients, as often as possible during the first month following injury (12/17 patients). Hypoglossofacial crossovers were used in 23 patients. Evaluation of the results may vary according to the choice and interpretation of an international facial nerve grading system. We define 4 categories of results: satisfactory, moderate poor and no improvement. The results of anastomosis were best when the repair with or without rerouting was undertaken as soon after injury as possible (7 satisfactory results for 16 patients evaluated). Hypoglossofacial anastomosis gave 5 satisfactory results for 17 patients evaluated. Following this operation a spastic tendency is frequent and seems more important in patients operated during the two months following nerve injury.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

[Retrocochlear deafness, acoustic neurinoma and early evoked auditory potentials--apropos of a series of 113 patients].

The results of brainstem evoked response audiometry (BERA) in a series of 113 patients with neurosensory hearing loss from both tumoral and non tumoral origin are reported. In 37 cases of non tumoral pathology, confirmed by CT-scan or NMR (14 cases) a retrocochlear type of evoked response was observed. The tumoral cases were mainly neurinomas (70 cases). There was a kophosis in 14 cases, typical retrocochlear responses in 52 cases, doubtful responses in 2 cases and in another 2 cases no electrophysiological disturbances could be observed. The systematic stimulation at 4 KHz seems to sensitize the BERA method. According to the authors it remains the first choice investigation technique of unilateral hearing loss. The results of this study are compared with those of the literature.

Adolescent↗
PubMed1991

[Surgery of the facial nerve: current trends].

Recent operative variations in the surgery of the facial nerve are discussed through data from the literature and the author's personal experience. The analysis relates to two different situations: on the one hand the approach and preservation of an intact facial nerve in pathologies requiring the baring or freeing of the nerve; on the other hand, the operative attitude with respect to facial palsies requiring a decompression or repair of the nerve. The techniques are studied according to the intracranial, intrapetrosal or extracranial topography of the lesion. Extralabyrinthine transmastoid decompression is increasingly adopted in cases of intrapetrosal palsy. The different types of derouting and suture are discussed in the case of the solution of continuity of the nerve trajectory.

Anastomosis, Surgical↗
PubMed1991

[Contribution of early electromyography in the prognostic assessment of facial paralysis].

26 patients suffering from total facial palsy of different etiologies underwent an electromyography of the facial muscles between the 5th and 15th day, and were followed up for one year. The muscular activity in forced mimetics, the blink reflex, and the electric response latency were studied after stimulation of the stylomastoid foramen. Early EMG with detection of one or several motor units is a decisive factor in the final prognosis. The methodology and advantages of EMG are compared to those of electroneuronography.

Adolescent↗
PubMed1990

[Trimetazidine (Vastarel 20 mg) and electro-acoustic stimulation in the treatment of tinnitus. Apropos of 64 cases].

This open pilot study was carried out with the intent of assessing the pertinence of combining Vastarel 20 mg with electroacoustic stimulation, as opposed to using solely the electroacoustic stimulation method in the management of subjective tinnitus. Enrolled in the study were 64 patients presenting with subjective tinnitus, 50% of which were related to vascular disorders. Following the entry visit (clinical examination, pure-tone audiometry, Metz' test, auditory evoked potentials, CT scans of the internal auditory canal), the patients underwent six 45-minute sessions of electroacoustic stimulation at one-week intervals. Half the patients followed this sole treatment, while the other half was immediately started on Vastarel 20 mg (3 tablets daily) concurrently with the first electroacoustic stimulation session and maintained on this regimen for 3 months. The electroacoustic stimulation (EAS) device used (Tinitop) was operated by emitting a synchronic sound signal mediated by a cask and an electric signal mediated by adhesive electrodes placed in the pretragal area. Results Results were analyzed through history-taking on the 45th and 90th days following the onset of the treatment, subjective improvement of tinnitus being rated from 0% to 100% based on 25% scoring levels (0 = no effect; 100% = complete disappearance of tinnitus spells). At day 45, the proportion of good and very good results (50% improvement or more) was similar (56%), regardless of whether Vastarel 20 mg was or not associated with EAS therapy. On the other hand, the combination of Vastarel 20 mg with masking of tinnitus proved particularly useful in preventing recurrences.(ABSTRACT TRUNCATED AT 250 WORDS)

Acoustic Stimulation↗
PubMed1990

[Isolated ankylosis of the malleus].

Certain cases of apparently isolated conductive deafness, the etiology of which remains uncertain after clinical examination and impedance measurement, can be found in younger patients and adults. Surgical exploration is necessary: this involves, first of all, an inspection of the anatomy of the ossicles and then precise study of their mobility at the level of the tympanic cavity and attic. Various forms of malleus ankylosis, due to blockage or malformation, are presented. Ossiculoplasty gives good auditory results.

Adolescent↗
PubMed1989

[Traumatic lesions of the ossicles].

In 1957, Plester and Thorburn, independently, published their first reports on surgical correction of posttraumatic ossicular lesions. A large number of papers have appeared on this subject. The authors report their experience of 22 cases of traumatic ossicular lesion operated at ENT and Oto-Neurology Department of Lille University.

Adolescent↗
PubMed1989

[Repair of the attic wall by a mastoid osteofibrous graft].

Closed techniques for the management of cholesteatomas often require repair of the external auditory meatus. Small losses of substance around the tympanic membrane or in the attic wall can be repaired by a mastoid cortical autograft. The originality of the procedure described on the basis of the various operative stages is based above all on the preservation of an osteoperiosteal fringe contiguous with the bone graft used. The value of the technique lies in availability of the graft at the operative site and the ease of its insertion into the defect requiring repair.

Cholesteatoma↗
PubMed1989

[Reconstruction of the wall of the canal].

In "intact" canal wall tympanoplasty, recurrent disease and retraction pockets must be avoided by repair of attic or lateral defects. Between 1983 and 1986, the authors used septal cartilage homograft in 38 cases and mastoid bone autograft in 47 cases. The uniqueness of the last technique is the preservation of fibroperiosteum with the cortical bone shaving, allowing a good adaptability in the defect. Histologic studies, clinical follow up and operative evaluation in case of second look intervention allows discussion on advantages and disadvantages of the two materials. The tolerance is good. The two procedures are variable and reliable in 80% of cases.

Cartilage↗
PubMed1987

[Total ethmoidectomy by frontal and transmaxillary approach].

Four patients with cancer of ethmoid with extension to base of skull were treated by total ethmoidectomy through a subfrontal and transmaxillary approach, the complementary paralateronasal approach being necessary in only one case. Apart from the approach routes, particular features of the technique used were essentially the size of the frontal flap extending to orbital roof, and mainly the confection of a pericranial flap formed of epicranial aponeurosis lined with frontoparietal periosteum and pedunculated at the orbital border. Exposure of the tumor by the neurosurgical and sublabial transmaxillary route allows correct excision of cancers extending to cribriform plate. The pericranial plate completes the traditional base of skull plastic operation and appears to reduce risk of cerebromeningeal complications. The technique is proposed for cancer infiltrating meninges: it is valid whatever the age of patients.

Adenocarcinoma↗
PubMed1984

[Partial surgery of laryngeal vestibule cancer].

A retrospective study was conducted of 141 cases of laryngeal vestibule cancer treated by partial surgery between 1968 and 1977. Patients underwent either subglottic laryngectomy (105 cases) or subtotal laryngectomy with cricohyoidoplexy (36 cases). Operative mortality was 6.5 p. 100. Overall survival rate was 63 p. 100 at 3 years, with lymph node invasion in 32 p. 100 of cases, and a 3 year survival rate for group N of 71 p. 100 as against 50 p. 100 for group N+.

Epiglottis↗