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Biomedical subjects

E Fossion

Publications and source records attributed to E Fossion.

At least 19 recordsLinked to original sources
PubMed1999

Reconstruction for large defects of the scalp and cranium.

Thirty-one patients with large scalp and cranium defects were reconstructed with free tissue transfer and scalp flaps. Twenty-eight of the defects resulted after tumour resection, two after infection and one after an extensive burn. Thirty-one free flaps (mainly the latissimus dorsi myocutaneous and the radial forearm fasciocutaneous) and five large (> 200 cm2) scalp flaps were used. Major complications occurred in one patient who developed meningitis and finally died (3.2%), and in one patient who lost a latissimus dorsi flap (3.2%). There were no other significant problems with the remaining patients. All other free flaps and scalp flaps survived. Primary reconstruction with free tissue transfer was our first choice of treatment because of the wide spectrum of advantages of free flaps. However, in a limited number of cases there was an indication for large scalp flaps, which, when properly designed, gave satisfactory results.

Adult↗
PubMed1997

Reconstruction of extensive defects of the parotid region: experience with the pectoralis major and free latissimus dorsi flaps.

Large defects of the parotid region resulting from excision of malignant tumours, or necrotic tissue due to radiotherapy, should not always be closed with local tissue, for several reasons. Occasionally, myocutaneous flaps are indicated, giving better results. We describe the problems of such tissue defects and our experience over a 10-year period using 2 different flap reconstruction techniques. A total of 28 cases, 25 with malignant tumours of the parotid or the external ear, 2 with extensive radionecrosis of the parotid region and 1 with a burn, were evaluated. The defects were restored with a pectoralis major flap in 21 cases and with a free latissimus dorsi flap in 7 cases. The follow-up ranged from 18 to 60 months. The flaps were successful in achieving stable wound healing, restoration of tissue volume and in helping patients to return to normal life activities. There were complications in 28.5% of the cases. There were 2 early deaths due to encephalitis. Two pectoralis major flaps (9.5%) failed partially. All latissimus dorsi flaps survived. The pectoralis major proved to be useful, especially in older and medically compromised patients, whereas the latissimus dorsi fared well in younger female patients and in cases of a hemifacial resection defect. Numerous technical points in both methods are emphasized.

Adult↗
PubMed1996

CT findings in osteoradionecrosis of the mandible.

CT scans of ten patients in whom the diagnosis of mandibular osteoradionecrosis was proven pathologically or by clinical follow-up were reviewed. All ten patients had bony abnormalities (cortical interruptions and loss of spongiosa trabeculation) on the symptomatic side. These were predominantly seen in the body of the mandible (premolar and molar region, eight patients), in some of these cases extending into the retromolar triangle (two patients) or mandibular angle (two patients). In the remaining two patients the abnormalities were in the ramus and angle. The two patients treated with iridium implantation showed localized lingual-sided cortical destruction. Three patients had a pathological fracture. The cortical destruction was buccal-sided in two and both buccal- and lingual-sided in three of the other five patients. Contralateral bony abnormalities were present in four patients. Soft tissue thickening on the symptomatic side was seen in nine patients. As the bony abnormalities in mandibular osteoradionecrosis are often associated with a soft tissue mass, CT differentiation from tumor recurrence can be difficult. The association with cortical defects distant from the position of the original tumor (buccal surface or opposite side of mandible) should evoke the possibility of mandibular osteoradionecrosis.

Adult↗
PubMed1995

The role of free pericranium grafts in augmentation rhinoplasty.

Various tissues and materials have been used in augmentation rhinoplasty. This paper presents a retrospective analysis of 14 patients, 8 female and 6 male, in whom free pericranium grafts were used in order to restore postsurgery or posttraumatic nasal defects. There were no complications from either the donor or the recipient site. The early and medium term results were satisfactory. It is concluded that free pericranium, compared with other autografts, is a good alternative due to its several advantages and hardly any disadvantages. In selected cases it can even be the material of choice.

Adolescent↗
PubMed1994

Eosinophilic granuloma of the head and neck: CT and MRI features in three cases.

We report the radiological findings and more specifically the MRI features in three typical cases of Langerhans' cell histiocytosis of the head and neck. All three cases were of solitary eosinophilic granuloma of bone: two mandibular and one temporal bone lesion. Reports on the MRI features of head and neck eosinophilic granulomas are rare.

Adolescent↗
PubMed1994

Surgical management of the osteoradionecrotic mandible with free vascularised composite flaps.

Osteoradionecrosis (ORN) of the mandible is a serious sequel to radiotherapy administered for malignant neoplasms of the head and neck. In a retrospective/prospective study, 28 patients with mandibular defects due to ORN were reviewed. Monocortical and bicortical defects as well as pathological fractures were reconstructed by means of a free serratus anterior/rib (n = 8) or a vascularised iliac crest flap (n = 25). All the former survived; a pathological fracture, however, occurred postoperatively in 2 of the patients (25%). Five iliac crests were lost (20%). The remaining bone struts healed well. The donor site morbidity was very low. Clinical and radiological longterm follow-up showed that a very acceptable functional and cosmetic result was achieved in all cases. Progress of ORN was prevented in ca. 90% of all patients. The radiological follow-up was facilitated with the use of high-resolution CT-scans.

Adult↗
PubMed1994

[Oral cancer: epidemiology and prognosis].

More than 90% of intra-oral malignancies are squamous cell carcinomas. Oral cancer is far more frequent in developing countries than in developed ones. This has probably to do with the differences in the use of tobacco and alcohol and with factors such as oral hygiene, nutrition and general resistance. Through an increased interest for epidemiological studies certain factors are suspected as carcinogenic. They can grossly be divided into chemical, physical and biological. Even though it is often hard to prove the real relation of cause to effect, one can no longer deny the detrimental role of tobacco, of many alcoholic drinks, of poor oral hygiene, of nutritional deficiencies, of short wave irradiation, and possibly of certain viruses. These factors must further be investigated because the overall prognosis of oral cancer is not very good. Determinant in survival are the volume of tumor present (surface and depth), its growth pattern, its localisation, eventual lymph node involvement and general hematogenic metastases, ... The overall five-year survival seems to range between 10% for T4N3 and 95% for T1N0 cases. Early detection and efficient prevention must therefore be encouraged.

Adult↗
PubMed1993

Chromosome abnormalities in cementifying fibroma.

Cementifying fibroma is the most frequent benign fibro-osseous odontogenic tumor. We found chromosome abnormalities in a second case of this type of benign tumor. The chromosome changes in both cases are different. The chromosome bands involved in our case have not been described before in any benign fibroma so far reported.

Adolescent↗
PubMed1993

Carcinoma of the oral cavity in patients over 75 years of age.

The results have been analyzed of a 15-year retrospective study on the presentation and survival of 46 patients aged > or = 75 years with oral carcinoma. All tumors were staged according to the UICC criteria. The presence of other malignant tumors in nine, premalignancy in five, and systemic disease in 15 patients was noted. A large subpopulation of elderly women, nonusers of alcohol and tobacco, usually with advanced disease, was found. In one-quarter of the patients who underwent surgery, a major resection with primary flap reconstruction was judged to be necessary. In general, this type of surgery was well tolerated. Three-year survival was 60%; women, systemically compromised patients, and patients with stage III and IV tumors did worse. A recurrence ratio of 59% was found after 5 years, recurrence usually appearing during the first year. The conversion rate was low (8.5%).

Age Factors↗
PubMed1993

Hormonal therapy in the treatment of mandibular metastasis of breast carcinoma. Report of a case.

We present the clinical history of a 39-year-old woman, who has survived for over 10 years with metastatic breast cancer. After combined surgery and radiotherapy of the primary tumor and the regional lymph nodes, all bone metastases gradually disappeared under chemotherapy and continuing hormonal treatment. This complete remission included a large mandibular metastasis, which had received additional radiotherapy of 21 Gy. Spontaneous reossification was observed in this location.

Adult↗
PubMed1993

Hematic cyst of the orbit.

We describe a case of a 44-year-old man, presenting with progressive proptosis of the right eye. Computed Tomographic (CT)-examination showed a cystic mass in the lacrimal gland fossa of the right orbit. The lesion was removed in toto. Histological examination showed evidence of old and recent bleedings and a chronic inflammatory reaction with numerous foreign-body giant cells without epithelial lining. The diagnosis of an orbital hematic cyst was established. The pathologic and pathogenetic features of this lesion are discussed. The hematic cyst should be borne in mind as a possible cause of proptosis, due to an intraorbitally-situated mass.

Adult↗
PubMed1993

The value of cryotherapy in the management of trigeminal neuralgia.

Cryotherapy to 32 individual branches of the trigeminal nerve in 27 patients, who were followed up for 3 years, resulted in pain relief out-lasting return of sensation. After one year 65% of patients were pain free. In the treatment of trigeminal neuralgia, cryotherapy is an easy method with similar results but lower complication rate in comparison with other peripheral methods.

Adult↗
PubMed1993

Myogenous or arthrogenous limitation of mouth opening: correlations between clinical findings, MRI, and clinical outcome.

The reproducibility and predictive power of MRI diagnosis was evaluated in a group of 70 patients with limited mouth opening. The predictive reliability of the MRI findings was assessed by comparing the images with a final clinical diagnosis that was based on the initial clinical diagnosis, adjusted and refined, when possible, by findings made during the treatment period (conservative treatment in 51 patients, conservative and surgical treatment in 19 patients). The overall reproducibility of the MRI interpretation by the radiologist appeared very good. The predictive reliability was excellent for normal disc position and fair for anterior disc displacement with reduction. For disc displacement without reduction, however, the predictive power was questioned because of false-positive MRI findings.

Adolescent↗
PubMed1992

Surgical treatment of exophthalmos and exorbitism: a modified technique.

A modified surgical technique for the treatment of exophthalmos caused by Graves' disease or meningioma is presented. It is based on the orbital expansion as presented by Tessier (1969). It consisted of a lateral marginotomy with extension to the superior and inferior orbital rim and removal of the great wing of the sphenoid bone. The osteotomised orbital rim segment was advanced and stabilised by interposition of a calvarial bone graft. Concomitant lipectomy was carried out when indicated. Seven patients were operated on. No major complications occurred. The advantages of the method are discussed.

Adult↗
PubMed1992

[Microsurgical reconstruction of the irradiated mandible with deep iliac circumflex flap].

From 1979 to 1988, 30 osteomuscular or osteomyocutaneous free flaps of the iliac crest (revascularized by the deep circumflex pedicle) were used to reconstruct 28 mandibles severely compromised by radiotherapy exceeding 66 Grays. In addition to a perfect graft raising and microsurgical technique, perfect closure of the mucosal plane appears to be an essential factor of success. Over the years, this iliac crest flap appears to improve the radiological appearance of the bone stumps on either side. The procedure therefore appears to be particularly useful in the treatment of advanced radiation osteonecrosis.

Head and Neck Neoplasms↗
PubMed1991

Bilateral blindness in cavernous sinus thrombosis.

An unusual case of bilateral blindness secondary to a cavernous sinus thrombosis is reported. A woman who had undergone reconstructive surgery after tumor resection of the floor of the mouth, was readmitted 1 month later with bilateral proptosis and signs of sepsis. There were no complaints of blurred vision. A CT-scan of the orbits demonstrated a bilateral cavernous sinus thrombosis (CST) secondary to an infection at the skull base behind the myocutaneous flap. A few days later she became blind, due to bilateral central retinal artery occlusion and anterior ischemic optic neuropathy. The general critical condition improved with intensive AB treatment. The patient recovered well without neurological defects apart from her permanent bilateral blindness. There were no signs of tumor recurrence. To our knowledge, this is the first documented case of bilateral blindness in a patient suffering from CST.

Blindness↗