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Biomedical subjects

D Briche

Publications and source records attributed to D Briche.

10 recordsLinked to original sources
PubMed1993

[Correlations between anatomy and x-ray computed tomography in cancers of the pharyngo-larynx. Apropos of a prospective study of 35 patients].

A prospective study has been conducted in 35 cases of pharyngolaryngeal's carcinoma, between december 1990 and june 1992 in the department of Head and Neck Surgery of Strasbourg. The authors compared, in a statistic analysis, Computed Tomography and histopathologic's correlations. The operative specimen were sectioned in the horizontal plane to correspond with the CT sections. 11 structures were studied more particularly. Results revealed an excellent sensibility for the study of the pre-epiglottic spaces (100%). Inversely, the study of the para glottic space is less good (69% of sensibility). We found that the CT Scan was of no value for the study of the thyroid cartilage, particularly for detection of subclinical lesions. Overall, this study allowed to confirm the value of the CT Scan in the investigation of pharyngolaryngeal tumors but its limits also.

Adult↗
PubMed1992

[Sudden deafness. Analysis of a series of 117 cases].

A retrospective study have been conducted in 117 cases of sudden sensori-neural hearing loss, between 1988 and 1991, int he department of Head and Neck Surgery (Strasbourg). After a brief review of actually treatments, they show, in a statistic and comparative analysis, that efficacy of therapeutics are never significant. This results are compared with international bibliography, and show that treatments of sudden loss remains doubtful.

Audiometry↗
PubMed1991

[Cranio-maxillo-facial fibrous dysplasia].

The fibrous dysplasia of the bones is a big disease, but it has to be considered as an expansive process with local malignancy in the cranio-maxillo-facial localizations. After a review of the literature, 7 cases of fibrous dysplasia are presented. The only curative treatment is surgical, generally mutilating, it has to be completed by a restoring intervention in same time. The abstention and the modeling surgery can be indicated exceptionally, it requires a regular X ray examination, and a clinical follow-up.

Adolescent↗
PubMed1991

[Value of MRI in the visualization of the meniscus in temporomandibular joints].

Modern imaging techniques, among which nuclear magnetic resonance currently ranks first, have made it much easier to understand the internal disorders of the temporomandibular joint. While computed tomography still is the ideal technique for all bony affections in the articular region, especially for injuries. MRI now is an essential first-intention complementary examination. It allows assessing the location of the meniscus and very well defines the pathology being explored: reducible or irreducible dislocation of the meniscus, either purely anterior or anterolateral, the latter being better visible on coronal views (which are not systematically taken). The examination includes T1-weighted parasagittal views perpendicular to the axis of the condyle, taken with a surface coil (knee coil). Two sequences are performed, one with the mouth open and one with the mouth shut. The meniscus appears as a biconcave hypointense signal, which normally lies on the head of the condyle both when the mouth is open and when it is shut. T2-weighted sequences have the advantage of revealing possible effusion or intra-articular adhesion between the capsule and the synovial membrane. They may also better demonstrate a possible myxoid degeneration of the meniscus. The considerable increase in scanning time required for these sequences accounts for their unfrequent use. The condition of the bone can also be assessed, but we find MRI less accurate than direct sagittal CT scans. The future prospects include shorter imaging times owing to fast-imaging sequences (short T1 with partial flip angle).

Cartilage, Articular↗
PubMed1991

[The vallecula: an anatomic reality?].

The vallecula epiglottica is a borderline area between the pharynx and the larynx, though covered by the epiglottis, and a functionally strategic site and breeding ground for epidermoid carcinoma, but it has remained unappreciated by anatomists. The borders of the vallecula within the oropharynx are represented by the anchoring systems of the epiglottic cartilage; the basilingual margin is sometimes inaccurate. We would like to emphasize the topographical relationships in the vallecular region, in particular: --the proximity to the base of the tongue, which is the preferred are of extension of epitheliomas, --and the features of the hyoepiglottic membrane, which is a veritable barrier for neoplastic infiltration. The valleculae epiglotticae are a definite oropharyngeal anatomical entity, and deserve the attention of maxillofacial surgeons, who should be able to suggest a surgical treatment of cancers that would be practicable both from a functional and from an oncological point of view.

Epiglottis↗
PubMed1990

[Role of micro-anastomosed muscular transplantation in corrective surgery of permanent facial paralysis].

Vascularized and reinnervated transfer of a muscle from the body to the face is never a simple procedure. It is important to evaluate the pre-operative state of facial muscles. It is difficult to define the correct indications for the various surgical techniques proposed: muscle selection, selection of recipient vessels, selection of a reinnervation method, the positioning of the transferred muscle. The authors present a series of 12 cases of long standing facial paralysis for more than 3 years. Results are presented. The authors think that the ideal muscular transfer is still unknown. In principle, nothing can replace facial muscles except facial muscles. Currently, the authors prefer the latissimus dorsi flap with partial transfer. For reinnervation, the facial nerve must take the priority, while all other reinnervation technics should take second place. In all cases, great attention must be paid to the positioning of the muscle, the usefulness of conventional palliative procedures and the continuous moral support to all of these patients.

Facial Paralysis↗
PubMed1990

[Evaluation of the use of free flaps of the anterior iliac crest. Review of 49 cases].

Because of the septic environment, the reconstruction of extensive losses of substance of the mandible has always raised numerous problems, especially as in a certain number of cases, concomitant radiotherapy represents an additional difficulty. Free flaps offer an important contribution. Up until now, we have essentially used the anterior iliac crest flap vascularised by the deep iliac circumflex pedicle. After 55 flaps of this type, the authors present an analysis of their results and try to analyse the causes for the failures. On the basis of their experience, they consider: that it is preferable to perform the bone and soft tissue repair by means of two different procedures (or at least by means of two different pedicles); that it is preferable, as far as possible, to perform immediate reconstructions rather than deferred reconstructions, especially in the case of malignant tumours.

Evaluation Studies as Topic↗
PubMed1990

[Osteosynthesis using a screwed plate in fractures of the mandibular condyle].

The surgical treatment of sub-condylar fractures allows rapid reestablishment of the bite, temporo-mandibular joint function and facial appearance. A pre-auricular approach is used involving dissection of the facial nerve and its upper branch. Surgical reduction is performed under direct vision. Fixation is via a plate with 4 screws. The condylar fragment needs to be large enough to accept at least two screws and hence this needs to be confirmed preoperatively by CT scan examination. In the adult we feel that fixation is indicated for low displaced sub-condylar fractures. We do not feel that surgery is indicated for recent trauma in children.

Adult↗
PubMed1990

[A complete intermediate temporomandibular joint prosthesis. Evaluation after 6 years].

Since 1983 we have inserted more than 100 temporomandibular joint prostheses. A review after 6 years allows the respective indications to be listed and the complications to be studied in 72 insertions involving 62 cases suitable for analysis. The prosthesis is a total intermediary prosthesis forming an unsealed cupula composed of 2 halves--a mandibular portion and a temporal portion. Insertion of the prosthesis requires preliminary facial nerve dissection then osteotomy of the mandibular condyle and its subsequent drilling to allow the screwing in of the prosthesis. The prosthesis was used in traumatology, in condylar and high sub-condylar fractures, in the event of failure of functional treatment, in malformation syndromes, in tumors and, finally, in degenerative pathology. 13 prostheses were removed. A study of the probable causes of complications shows a predominance of technical problems related to inaccurate positioning of the prosthesis, in that it was not placed in the axis of the condyle, or that inadequate bicortical support was present. In our opinion, these complications do not question the conception of the prosthesis but rather indicate that it is necessary to perfect the insertion technique while taking advantage of improvements in the prosthesis which are currently under study.

Ankylosis↗