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Biomedical subjects

E Fossion

Publications and source records attributed to E Fossion.

At least 37 records · Page 2Linked to original sources
PubMed1991

Craniofacial resection for anterior skull base tumours.

This study presents a series of 10 patients with anterior skull base tumours, treated by a team of neurosurgeons and head- and neck surgeons. The series included 7 malignant tumours of the nose and paranasal sinuses and 1 retinoblastoma, all with intracranial extension through the lamina cribrosa. There were also 2 patients with an anterior base meningioma, growing into the ethmoid sinus and the nasal cavity. 8 tumours were resected by a combined bifrontal craniotomy and uni- or bilateral rhinotomy. In 2 cases a bifrontal craniotomy alone without facial incision sufficed. The skull base was closed with a pediculated pericranial flap and a split-thickness free skin graft underneath. There were no postoperative problems of wound infection, CSF-leakage or meningitis. Recurrent tumour growth or systemic metastasis occurred in 5 out of 7 patients with malignant tumours, 6 months to 2 years postoperatively. The related literature and especially questions of operative indications and technique, including different possibilities of closure and reconstruction of the skull base, are discussed.

Adenocarcinoma↗
PubMed1991

Nasolabial flap for the reconstruction of defects of the floor of the mouth.

Nasolabial flaps can be used for local reconstruction of moderate defects of the anterior oronasal structures. In a 10-year period 59 flaps were used in 43 patients to cover defects of the nose, lip and anterior structures of the oral cavity (floor of mouth, tongue, alveolar process). The fate of 26 of the flaps used for reconstruction of defects of the floor of the mouth in 16 patients, were reviewed. All flaps, 6 uni- and 10 bilateral, were inferiorly based. Dehiscence, which occurred twice, and loss of one flap were the main complications. The indications and the technique are discussed. The nasolabial flap is a good alternative for the reconstruction of moderate defects of the floor of the mouth, especially in older patients and even after high doses of preoperative radiotherapy.

Aged↗
PubMed1991

[Tumors of the submaxillary gland].

The tumors of the submaxillary gland are rare. The authors are reviewing 23 cases gathered from three Departments over ten years. The tumors of the submaxillary gland are malignant in as many as 50% of all cases! When the lesion is benign, pleiomorphic adenoma is the most frequent possibility. The authors emphasize the necessity of early and complete surgical treatment, requiring at least total submaxillectomy in case of benign tumor. Cervical mode dissection will be considered if the tumor is malignant.

Adenoma, Pleomorphic↗
PubMed1990

Sinus aspergillosis.

The prevalence of Aspergillus sinusitis is often underestimated because the vast majority of cases are classified as "unspecified sinusitis". Two possible aetio-pathogenic mechanisms can be involved in the development of this fungal infection. Traditionally, the literature emphasised the "anglophone" hypothesis which is based on the inhalation of spores. More recently, the "french" model, based on oro-sinusal fistula and/or the perforation of the maxillary sinus by root canal-filling material, is believed to explain the majority of cases in our industrialised environments. Still, neither model explains the totality of cases and several remain beyond comprehension. The disease most commonly presents as a chronic bacterial sinusitis. The process can however become invasive, thus resembling malignancy, with eventually a fatal outcome. Doctors and dentists should know the possible danger, presented by zinc-oxide-eugenol-paste in the sinus. Radical surgery is the treatment of choice, since a prolonged conservative approach (antibiotics, corticosteroids) can only worsen the prognosis. This paper discusses different aspects of the disease, and presents 10 cases, observed at the University Hospitals of Paris (France) and Leuven (Belgium).

Adult↗
PubMed1988

Late loco-regional recurrences after radical resection for mandibular ameloblastoma.

5 cases of mandibular ameloblastoma are described with multiple recurrences after a long period of time. 4 of them were primarily treated by radical resection. 1 was initially treated by enucleation and extensive resection was performed only after its recurrence. The invasive growth of the recurrent tumor into the soft tissues and the cranial base, necessitating extensive ablative and reconstructive surgery, reflects the potential aggressiveness of this tumor. It is therefore recommended, to plan an adequate resection in cases of multicystic ameloblastoma, which includes a margin of at least 1 cm, of apparently non-invaded bone. If the tumor has eroded through the cortical bone and invaded into the soft tissues, wider margins are necessary to eliminate possible tumor extensions that are left behind. Adequate follow-up on a regular basis should enable the clinician to detect early recurrence so as to avoid major surgery.

Aged↗
PubMed1988

The significance of perineural spread in adenoid cystic carcinoma of the major and minor salivary glands.

Patient survival, local recurrence and distant metastasis were studied in relation to the pathological finding of perineural spread in 37 patients with adenoid cystic carcinoma of the major and minor salivary glands. All patients underwent a combined surgical and radiotherapeutical treatment. The overall incidence of perineural invasion in primary resection specimens was 52.6%. The 5-year actuarial survival rate for patients with perineural invasion was significantly lower (p less than 0.001) than for those without (36.9% versus 93.8%). In 26 patients with resection margins free of tumour, recurrences developed in 9/11 (81.8%) of the patients with perineural invasion as opposed to 4/15 (26.7%) of the patients without perineural invasion (p = 0.005). In the same group with resection margins free of tumour, distant metastasis developed after the primary treatment in 4/10 (40.0%) of the patients with perineural invasion, while none of the 14 patients without perineural invasion experienced distant metastasis (p less than 0.0002). The incidence of perineural invasion increased with a higher stage of the primary tumour.

Adult↗
PubMed1987

Arthroplasty for temporomandibular joint ankylosis secondary to ankylosing spondylitis.

Although temporomandibular joint involvement is frequent in ankylosing spondylitis, ankylosis seldom ensues. A patient with a temporomandibular joint ankylosis secondary to ankylosing spondylitis is presented. Treatment consisted of an osteoarthrectomy, followed by a costochondral ribgraft. A follow-up period of 39 months showed a satisfactory result.

Adult↗
PubMed1987

The use of costochondral grafts in arthroplasty of the temporomandibular joint.

Replacement of the condyle with a costochondral graft restores the altered biomechanics after condylectomy or gap-arthroplasty procedures. It avoids the recurrence of ankylosis. In the child, this graft allows harmonious growth of the mandible due to the characteristics of the costochondral cartilage. A case of uncontrolled multidirectional and excessive growth of the graft during pregnancy supports the view that the costochondral junction also carries intrinsic growth properties. Long-term follow-up evaluation shows very satisfactory cosmetic and functional results. In patients neglecting postoperative jaw mobilisation, maximal interincisal opening is acceptable but remains low. If no posterior dental support is provided after restoring the vertical dimension with the graft, some degree of graft resorption is possible.

Adult↗
PubMed1984

Scanning electron microscopy of irradiated recipient blood vessels in head and neck free flaps.

Irradiated and control recipient blood vessels in a similar patient population were studied with scanning electron microscopy. The vessels that were biopsied were then anastomosed to a free flap. Irradiated arteries display a significantly greater wall thickness and higher incidence of intimal dehiscence compared with control arteries. Fibrin deposition, microthrombi, and endothelium cell dehiscence are present more frequently in irradiated vessels than in control vessels. Details of the preparation and anastomotic technique for irradiated blood vessels are discussed. Microvascular surgery in irradiated human blood vessels carries with it a higher risk of thrombosis due to preexisting vessel wall damage. This risk can be minimized by experience and attention to detail.

Arteries↗
PubMed1984

Spontaneous regression of lung metastases of adenoid cystic carcinoma.

Two patients with spontaneous regression of histologically confirmed lung metastases from a classic cribriform adenoid cystic carcinoma are presented. The first case was moribund when multiple small lung metastases were detected, but after a very strict diet, he presented progressive improvement in his general condition and regression of the metastases. In the second case, three large lung metastases and a subcutaneous metastasis regressed after several local recurrences of the primary tumor had been removed.

Adult↗