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D Deffrennes

Publications and source records attributed to D Deffrennes.

At least 19 recordsLinked to original sources
PubMed2002

[Hemangiomas and superficial vascular malformations of the face and neck].

Hemangiomas and superficial vascular anomalies of the head and neck form what usually calls the angiomas. Many terms exist in the literature for that reason the classification of the ISSVA, admitted by most of the doctors, helps us in naming the different anomalies. The processing of this pathology needs a multidisciplinary collaboration with doctors of different specialties. The evolution of the radiological, surgical techniques of laser, and who knows, of the research, allows to hope us to cure some of the particularly dangerous anomalies like the arteriovenous malformations. We presented here the different technics used in 2001 in the management of hemangioma and superficial vascular anomalies insisting on a multidisciplinary approach.

Adult↗
PubMed1998

[Vascular "tumors" and the rules of their surgical management].

After defining vascular tumors and malformations, formerly called angiomas, the authors adopt the classification of the International Society for the Study of vascular Anomalies. The various groups of malformations, after definition of the subject and the problems raised, are illustrated by a number of clinical cases and the rules of surgical management are discussed. Capillary malformations, formerly called portwine stains, can be treated by dye laser, but sometimes tissue and orthognathic reconstructive surgery in the presence of a skeletal malformation. Lymphatic malformations (lymphangiomas), optimally assessed by CT or MRI, can be treated by a variety of approaches: sclerotherapy, surgery. Venous malformations raise very different problems in the cervicocephalic region and on the limbs and trunk, but always require a multidisciplinary approach with, according to the site, size and repercussions, Ethibloc percutaneous sclerotherapy, embolization, surgery. Arteriovenous malformations require complete surgical treatment, usually preceded by embolization; reconstruction consists of local flaps or skin expansion in simple cases, and revascularized free flaps in difficult cases. If the malformation is cosmetically and functionally acceptable, the authors propose conservative management. The first-line treatment of haemangiomas is pharmacological (corticosteroids, interferon), but surgery may be indicated in two situations: early and late. There is a renewed interest in early surgery, subtended by several factors including cosmetic concerns and the development of new technologies, including the Cavitron. Late surgery retains its classical cosmetic and functional indications. Two key-words dominate the rules of therapeutic management of all types of vascular malformations: a multidisciplinary approach and modesty.

Adolescent↗
PubMed1995

[The temporomandibular joint meniscus in MRI].

The continuing improvement of the MRI's equipment and software led us to a continuous adaptation of the exam technique. We use today a bilateral coil technique, 3 inches in diameter. Four slices are performed for each articulation (4 mm thick) in the true sagittal plane. A fast spin echo, balanced in proton density, for one minute, allows the study of 15 steps inside a full open/close cycle. Oblique coronal cuts are also performed parallel to the long axis of the condyle in a T1-weighted spin echo sequence in close and half-open positions. The analysis of 350 subjects allows to detail more precisely the meniscal displacement. Beside the classic anterior luxation, the meniscus slips medially, laterally and may rotate. These different situations may be isolated or combined. The dynamic study is specifically useful in the displacement with reduction exams. It enables permits to point out the timing of the disk disturbance: this information may be of great help in therapeutic decisions.

Adolescent↗
PubMed1995

[Primary adenoid cystic carcinoma of the skin. Histologic and ultrastructural study of two cases localized in the external auditory canal].

Primary cutaneous adenoid cystic carcinoma is a rare tumor, even if its frequency has often be underestimated, its localization in the external auditory meatus being generally considered separately. The results of the histological and ultrastructural study of two cases of adenoid cystic carcinoma, arising in the external auditory meatus, are presented, confirming the essential morphological similarity of adenoid cystic carcinoma of the skin and salivary glands. In these two cases, the ultrastructural study revealed two types of unique intra luminal inclusions, composed respectively of parallel straight tubular arrays and paracrystalline quadrangular structures, probably corresponding to a peculiar organization of secretion products or cellular debris. The review of 126 published cases of adenoid cystic carcinoma of the skin, including 89 cases developed in the auditory canal, shows that 78% of the cases were located in areas containing numerous apocrine glands, supporting an apocrine gland origin for this tumor. Contrasting with the low (8%) metastatic potential of cutaneous adenoid cystic carcinomas of other locations, adenoid cystic carcinoma of the auditory meatus present a 30% metastatic risk, similar to those or adenoid cystic carcinoma of salivary glands.

Aged↗
PubMed1994

Intratumoral embolization of intracranial and extracranial tumors: technical note.

A new technique of intratumoral embolization is described. An intratumoral injection of N-butylcyanoacrylate is performed either perioperatively by direct puncture of the tumor or preoperatively through the nose or through the skin. The indications for this technique are hypervascularized tumors, such as juvenile angiofibroma, hemangiopericytoma, or paraganglioma. This technique has been applied in 21 patients with excellent results in terms of devascularization.

Aged↗
PubMed1993

[Iatrogenic complications of paraganglioma of the jugular foramen].

Twenty-eight cases of tumours of the paraganglioma of the foramen jugulare arising from the jugular foramen were treated from 1982 to 1990. The follow-up and the iatrogenic effect of embolization, surgery and radiotherapy were studied. Routine pre-operative embolisation has changed the therapeutic approach to these tumours although a certain number of mainly neurological complications still occur (32% of the cases with 18% of major accidents) especially when the internal carotid component must be excluded. Current oto-neurosurgical techniques allow wider and more complete exeresis of the tumour but often lead to neurological deficits involving the facial nerve (45%), the mixed nerves (32%) and/or the XII (18%). These deficits occur due to unavoidable sacrifice or peroperative manipulation. Radiotherapy is an essential therapeutic possibility with only minor complications and can be proposed in cases of inoperable or relapsing tumours or after an incomplete surgical exeresis. Our critical analysis led us to propose the present indications for surgery. Surgery is indicated in patients with two or more of the following criteria: age less than 55, unilateral tumour, a tumour considered to be inoperable, preoperative otoneurological manifestations, invasion of the posterior fossa. In the other cases, radiotherapy remains the indicated therapy. It is effective and should be used more often for inoperable tumours of the para-jugular lymph nodes, for relapses or after incomplete surgical exeresis.

Adult↗
PubMed1992

[Treatment of epistaxis in Rendu-Osler disease by intramucosal injection of ethibloc].

The authors relate their one-year experience in percutaneous embolization of 12 patients presenting with severe epistaxis because of a Rendu Osler disease. Using Ethibloc a sclerosing substance derived from maize in direct intramucosal injection seems to be a promising technique. Ethibloc is still used successfully in percutaneous treatment of superficial venous angiomas.

Adult↗
PubMed1990

Influence of membrane surface potential and of net charge on aminoglycoside binding to the organ of Corti of guinea pigs.

Gentamicin binding to homogenates of the organ of Corti of guinea pigs was investigated by altering the magnitude of the membrane surface potential and by testing the potencies of various polyamines and polyamino acids with different numbers of amino groups and different net charge to inhibit or displace bound gentamicin. Diminishing or increasing the ionic strength of the milieu resulted in an increase and a decrease in drug binding, respectively. This observation may be accounted for by the negativity of the membrane surface potential which was enhanced or reduced, when the concentration of cations in the milieu was decreased or increased, respectively. Polyamines and polyamino acids displaced bound gentamicin and inhibited gentamicin binding as a function of the number of amino groups present within the molecule and of their cationic nature. These results point out the importance of considering the surface potential of biological membranes and the net positive charge of the drug in estimating its affinity for the binding site.

Animals↗
PubMed1990

[Surgical indications in temporomandibular joint dysfunction].

There has been a renewed interest in diseases of the temporomandibular joint over recent years due to a better understanding of the pathophysiology improvement in surgical techniques and, most importantly, the development of multidisciplinary teams. The indication for surgery is still essentially clinical, although medical imaging is increasingly informative. Arthrotomography provides the most reliable information. However, continuing progress in magnetic resonance imaging will probably provide surgeons with the best indications in the future. In this article, the authors clearly distinguish between intra-articular disk and muscular diseases. The operative indications are discussed in relation to the clinical signs and the condition of the joint.

Adult↗
PubMed1988

Aminoglycoside binding sites in the inner ears of guinea pigs.

With [125I]gentamicin as radioligand, the presence of aminoglycoside binding sites and kinetics of gentamicin binding to homogenates of organs of Corti, vestibular maculae, livers, spleens, and hearts of guinea pigs were investigated. The effects of temperature, osmolarity, 2,4-dinitrophenol, and digitonin on gentamicin binding were assessed. The affinities of several aminoglycosides for binding sites were tested. Gentamicin bound to cochlear and vestibular structures in a rapid and saturable fashion at a single class of noninteracting binding sites with Kds of 1.2.10(-6) and 3.10(-7) M and maximal binding capacities of 1.3 nmol and 43 pmol/mg of protein, respectively. In the liver, spleen, and heart, binding remained low and appeared to be nonspecific. In the organ of Corti, gentamicin uptake was unaffected by alterations in temperature or medium osmolarity or by 2,4-dinitrophenol, indicating that the uptake represented binding and not active transport. Digitonin at 10 nM increased markedly the uptake at 37 and 4 degrees C, suggesting the presence of internal binding sites. Various aminoglycosides compete for a common binding site.

Animals↗
PubMed1987

[Tympanic and jugular paragangliomas. I. Clinical symptomatology and evaluation of extension. Apropos of 25 cases].

Based on a review of 25 cases of tympanic and jugular paragangliomas treated and followed up in the Lariboisière hospital, Paris between 1978 and 1986, clinical aspects and extension of these tumors are studied. The often long delay in making the diagnosis is related to lack of knowledge of presenting symptomatology, frequent discordance between functional and physical symptomatology exists, but remarkable progress has been made in assessment of extension of tumors using new imaging techniques, particularly angiography, which can also guide the preoperative embolization and surgical procedures.

Adult↗
PubMed1987

[Tympanic and jugular paragangliomas. II. Angiographic, surgical and irradiation treatment. Results. Indications. Apropos of 25 cases].

Results of treatment are reviewed in 25 cases of tympanic and jugular paragangliomas treated and followed up in the Lariboisière hospital, Paris between 1978 and 1986. Therapy has been transformed by the use of embolization but its non-negligible neurologic accident risks, whatever the carotid artery territory involved, justify prior weighing of indications for its application. New surgical technics allow more extensive exeresis, but intrapetrous extension to the nerve compartment of the jugular foramen and the anterior pericarotid region still raises difficult surgical problems and appears to be the principal reason for failure of treatment. Radiotherapy is very effective and applicable for inoperable forms, as a complement to incomplete surgical removal and for recurrences.

Cerebral Angiography↗
PubMed1986

[Conservative surgery of cancer of the larynx. Cordectomy, hemilaryngectomy, supraglottic laryngectomy].

Of a total of 219 partial laryngectomies performed, 119 were cordectomies, 30 hemilaryngectomies and 70 supraglottic laryngectomies. Results of each type of operation are presented with emphasis on problems of local recurrences, evidence of validity of procedure selected and of its indications. Analysis of results, with the reservation that indications were sometimes wide but always reasonable, showed an extremely low incidence of recurrences, the quality of the resection (limited or insufficient) having finally little incidence on the latter, except perhaps in the supraglottic laryngectomies. It is suggested, therefore, that no attempt should be made to "recover" a histologically detected insufficient excision by complementary radiotherapy not required in principle. This assists follow up review and allows secondary therapy if an unfavorable course is noted.

Adult↗
PubMed1986

[Tympanic reconstruction by molded grafts. Value and results. Apropos of experience in 158 cases].

Use of a moulded aponeurotic graft, shapened and then made rigid by heat and formalin, is a seductive method of tympanic reconstruction because of its simplicity and availability. Indications for and results of the application of this method are analyzed based on experience of 158 cases, with sufficient follow up in 90. The principal indication for use is large perforations, when it is possible to exteriorize the whole canal and almost all the tympanic remains, while doubt exists as to its advantages for treatment of small perforations. Its essential advantage is in fact the ease with which the graft can be positioned on external surface of malleus and inside the remains of tympanic membrane. Overall anatomical results were very satisfactory (83.5%) if one includes in failures of treatment the apparent lateralizations of graft. Functional results were poorer, with rarely complete recovery of hearing and a certain number of labyrinthizations possibly due to injury to handle of malleus or even perforation of canal. Secondary degradation of favorable results may develop because of some degree of lateralization of the newly formed tympanic membrane. These could perhaps be avoided by the technical artifices proposed by other authors.

Adolescent↗
PubMed1986

[Choice of the 3d portion of the jejunum for reconstruction of the pharynx in circular pharyngolaryngectomies. Indications and advantages].

Many procedures are used for reconstruction of a pharyngeal gutter after circular pharyngolaryngectomy, interrupter of digestive continuity. The operation chosen was used of third part of jejunum for reconstruction, and its indications and limitations are described. The choice was based on anatomic data from dissection of 100 cadavers and values for different measurements performed (length of transplant, height of mesentery, caliber and length of vessels), and more particularly on constancy and reliability of vascularization of this digestive segment. To these advantages are added bacteriologic, technical, histologic and physiologic reasons. Results are analyzed of 11 operations carried out in the same department, from among a larger group comprising now 45 cases. Postoperative course was usually uncomplicated with rapid restoration of deglutition (a mean of 11.77 days in 9 of the 11 cases). Preoperative radiotherapy is not a contraindication and postoperative radiotherapy should be given routinely as a complement to surgery. It is usually well tolerated and transplant necrosis is not provoked. Nevertheless, the seriousness of this type of lesion is underlined by the high incidence of carcinologic failures, with an elevated risk of local and regional recurrence and of distant metastases.

Aged↗
PubMed1985

[Angiographic and surgical control of the vertebral and carotid pedicles supplying giant paraganglioma of the skull base and neck].

Results obtained after excision of large jugular paragangliomas are largely conditioned by the possibility of control of the different vascular pedicles, and existing possibilities are discussed in relation to 6 briefly presented cases. The internal carotid artery can either be occluded radiologically by balloon catheter and then embolized if the artery is surrounded by a tumor, or controlled surgically if the artery is in contact with the tumor only and provides only a small proportion of its vascular supply. Whenever internal carotid artery occlusion is envisaged a clamping test by balloon under local anaesthesia is carried out initially. The vertebral artery pedicles are interrupted during surgical approach to the artery above the atlas. The value of a 2 or even 3 stage operation for excision of very large tumors with posterior fossa extension is discussed.

Adult↗