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Biomedical subjects

C Guedon

Publications and source records attributed to C Guedon.

At least 55 records · Page 3Linked to original sources
PubMed1987

[Contribution of muscular and musculocutaneous flaps in the early postoperative period in total salvage laryngectomies and pharyngo-laryngectomies. Apropos of 35 cases].

From 1981 to 1985, 35 patients (34 male, 1 female), mean age, 56 years, underwent salvage total laryngectomy and pharyngo laryngectomy after full course radiotherapy. 13 cases have been closed primarily. 22 cases underwent reconstructive surgery using 15 musculo cutaneous and 7 muscular flaps. Complications occurred in 46% of the patients closed primarily and required further reconstruction by musculocutaneous flap. 90.7% of the cases where a flap was used initially had no post operative complications. This study confirms that the use of muscular and musculocutaneous flaps improve healing in salvage surgery.

Adult↗
PubMed1987

[Primary transmaxillary buccopharyngectomy and recovery transmaxillary buccopharyngectomy in giant cancers of the tonsilar region. Apropos of 120 cases].

Based on a series of 120 patients treated by trans-maxillary buccopharyngectomy for tumors (mainly T3, T4) of the tonsillar region, results are compared of primary and recovery surgery, the latter being instituted from 1981 because of the rapid strides made in new reconstructive procedures. This development markedly modified therapeutic indications, with substitution of radiotherapy as primary treatment. After primary surgery, the 3- and 5-year survival rates were globally 59 and 49% respectively. The usual prognostic factors emphasized, size of tumor and glandular involvement, were verified. Results of recovery surgery were less good, 39% survival at 3 years, for two main reasons: a higher level of lack of local control (34%) than that of primary surgery (14%) and a maintained elevated postoperative mortality. These findings indicate that the initial hope that the use of LMC would raise this surgery to the level of the performance of primary surgery has not been fully confirmed. Finally, analysis of all groups in this series demonstrates that prognosis is worse as the involvement of base of tongue increases.

Adult↗
PubMed1987

[Recovery surgery in cancer of the tongue. Apropos of 101 cases].

Results of 101 salvage glossectomies, after unsuccessful treatment of cancer of tongue by radiotherapy, showed a 3-year survival of 39% and a 5-year of 31%. Carcinologic failures represented 81% of causes of death: 17% due to distant metastases, 6% to a second focus and principally 32% to local recurrence. Local recurrence varied as a function of tumor size but also of site and type of surgical treatment. Tumors of the mobile tongue have a relatively good prognosis, even when the total organ is involved, with attachment to floor of mouth if an anterior transverse glossectomy is performed. Inversely, lateralized tumors spreading to base and to the mobile tongue treated by partial longitudinal glossectomy tend to have a high frequency of failure of local therapy, probably partly avoidable by wider excision. These same local failures of treatment are the cause of the worsening prognosis after total glossectomy in patients who had been poorly selected perhaps and presented extralingual spread not controlled by surgery. Finally, the authors emphasize the need for a collaboration of the patient in the choice of therapy, which involves surgery with functional sequelae that risk to be extremely heavy.

Adult↗
PubMed1986

Decreased brush border hydrolase activities without gross morphologic changes in human intestinal mucosa after prolonged total parenteral nutrition of adults.

Animal experimentation with total parenteral nutrition (TPN) has revealed the occurrence of atrophy of the intestinal mucosa and decreased enzyme activities of the brush border, notably the disaccharidases. These findings have heretofore not been confirmed in human investigation. We performed endoscopic biopsies in the third part of the duodenum in 7 adults before TPN, after 21 days of TPN, and after a progressive oral refeeding. We noted a clear-cut decrease of major enzyme activities during TPN (sucrase, maltase, lactase, glucoamylase, acid aminopeptidase, dipeptidyl peptidase) without any morphologic modifications as observed with standard histology. Electron microscopy showed a slight but significant decrease in the height of microvilli. The decreased enzyme activities were rapidly restored after oral refeeding. Thus, the functional consequences of the modifications observed during medium-term TPN in adults are probably limited.

Adult↗
PubMed1986

[Treatment of cerebrospinal fluid otorrhea. A closure procedure using a pretragal flap].

Based on a series of 12 cases of osteo-dura mater breaches (including 11 cases admitted to hospital for meningitis), the authors review the various techniques for closure and propose simple closure by aponeurosis and tissucol in the treatment of breaches of the tegmen and the use of a pretragal flap to exclude the middle ear, in ballistic disruptions or resection cavities.

Adolescent↗
PubMed1985

[Surgery of pericannular recurrence and extensive tumors of the trachea].

Treatment proposed for pericannular recurrence and previously irradiated vast, extensive, subglottotracheal tumors involves the performance of a manubriectomy with reconstruction using a musculocutaneous flap. The former solves the problem of the route of approach and local carcinologic safety and the latter provides a solution to the problem of congruence of trachea and presternal teguments as well as postoperative complications by protecting the brachiocephalic arterial trunk.

Humans↗
PubMed1985

[ORL manifestations reported in AIDS. Apropos of 54 cases].

A review of 54 cases of AIDS established the ORL manifestations of this constantly fatal disease. Simple infections such as sinusitis, otitis and tonsillitis were frequent and quite typical, but buccopharyngeal herpes and particularly buccopharyngo-esophageal candidosis were widespread affections. The onset of candidosis in a subject at risk is a valid diagnostic factor for AIDS. A buccopharyngeal Kaposi tumor is specific and is usually associated with lesions in other, particularly cutaneous localizations. Marked emphasis is placed on the role of specialists in the detection of this disease, currently increasing at a high rate. In the USA, where AIDS is very prevalent and doctors very clearly informed, 40% of cases are detected from cervicofacial manifestations.

Acquired Immunodeficiency Syndrome↗
PubMed1984

[Serous otitis and necrotizing angiitis].

Three cases are reported of necrotizing angiitis of otologic origin (one polyarteritis nodosa and two wegener's disease). Data in the published literature are reviewed and necrotizing angiitis classified. Two features resulting from this review are emphasized. Firstly, form the pathogenic point of view the fact that specific lesions were detected in the ear in one of these patients means that this localization may be a possible visceral manifestation, as are rhinologic and pulmonary lesions. Otologic sites may be an isolated, or in association, further type of pathogenic mechanism. From the practical point of view, any unexpected serous otitis in adults should suggest the need for an erythrocyte sedimentation test, very high values requiring investigation of etiology. This will avoid unnecessary medical and surgical treatments and the institution of immunosuppressant therapy active against all visceral lesions and the only effective means of treating the otitis. Early treatment could avoid the catastrophic prognosis observed short-term in the 3 cases reported.

Adult↗
PubMed1984

[Musculocutaneous flaps in cervicofacial oncology surgery. Experience in 145 cases].

The use of myocutaneous flaps in reconstructive surgery after cancer resection for T3-T4 tumors of the head and neck is reported in 145 clinical cases. In this series, flap viability, proved to be as high as 96%. The use of myocutaneous flaps extends far beyond the limits of tumor resection, improves functional and cosmetic results and permits to operate safely on irradiated patients. This study shows that healing in irradiated patients tends to be comparable to that in non irradiated patients. Survival's conditions, especially the relief of pain are consistently improved, still when no tumor control can be achieved. Most recurrences occurs within a year following surgery, most frequently after salvage surgery.

Cicatrix↗
PubMed1983

[Mandibular reconstruction by composite musculocutaneous flap in glossopelvimandibular excisions].

Results of 14 mandibular reconstruction by a composite muscular flap of the pectoralis major and trapezium muscles during widespread glossopelvimandibular excisions are described. The technique employed is outlined, emphasis being placed on the need to observe strict precautions during removal and application of the bone component, to avoid accidental avulsion during reconstruction which could compromise the musculoperiosteal vascularization of the graft. Results are sufficiently encouraging for this type of reconstructive surgery to be proposed in all cases where mandibular repair is necessary after interruption of continuity.

Glossectomy↗
PubMed1982

[Musculocutaneous flaps of pectoralis major. Anatomical and technical aspects, results, and literature review (author's transl)].

After a review of reports in the published literature on the employ of musculocutaneous flaps of pectoralis major, and a brief historical outline, the techniques employed, indications, advantages, and results obtained are discussed. Surgery for cancer, particularly in the buccopharyngeal region, could be partly transformed by this excellent reparative procedure because of the wide surgical scope it allows, and the spectacular functional results obtained.

Aged↗
PubMed1982

[Recovery total glossectomy with immediate reconstruction by means of a musculocutaneous flap : functional results and perspectives (author's transl)].

A surgical procedure is proposed for treating recurrent or non-sterile cancer of the tongue whenever satisfactory excision of the tumor can be accomplished. The technique involves a recovery total glossectomy associated, as shown to be necessary following its application in 3 cases, with a transmaxillary buccopharyngectomy. This operation has become valid following the use of musculocutaneous flaps, which enable reconstruction of the tongue with good quality functional results.

Glossectomy↗
PubMed1981

Inhibition of experimental esophageal lye strictures by penicillamine.

We describe a new experimental model for the study of caustic stenosis of the esophagus in the rat. Sixty-five Wistar rats were given a standard esophageal lye burn. Animals were divided into two groups: (1) a control group and (2) a treatment group that received penicillamine from the day after the esophageal lye burn. Stenosis developed in only two of the 23 treated rats. Our conclusion is that penicillamine-induced lathyrism inhibits the onset of stenosis in the rat. Double-blind controlled studies of the effect of penicillamine in the prevention of corrosive strictures of the esophagus in man seem warranted.

Animals↗