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E Lescanne

Publications and source records attributed to E Lescanne.

18 recordsLinked to original sources
PubMed2006

[Differenciated thyroid carcinomas with laryngo-tracheal invasion].

OBJECTIVES: Analyze the diagnosis and treatment of differentiated thyroid carcinomas with laryngo-tracheal invasion. MATERIALS AND METHODS: Among the 117 patients operated for a differentiated thyroid carcinoma in the ENT department of Tours Hospital (France) between January 1990 and December 2003, seven presented laryngo-tracheal invasion and were included in this retrospective study. RESULTS: Laryngo-tracheal resection resulted in a thyroid cartilage-shaving in two patients. We performed a resection of one side of the thyroid cartilage in one patient, a thyro-tracheal resection-anastomosis with a partial cricoidectomy in one patient, a partial vertical laryngectomy extended to the first tracheal ring in one patient and a total laryngectomy in one patient. No laryngo-tracheal resection was done in one patient. Early complications were swallowing disorders (n = 2), transitory hypoparathyroidism (n = 1), definitive recurrent nerve paralysis (n = 2), subcutaneous emphysema and hematoma (n = 1) and Claude Bernard-Horner's syndrome (n = 1). Locoregional recurrences (n = 2) and distant metastasis (n = 2) were discovered six months to four years after the laryngo-tracheal resection. With a mean follow-up of 40 month, four patients were alive (two disease free) two patients had died and one was lost of follow-up at three months. CONCLUSION: The frequency of locoregional recurrences and distant metastasis is higher for the differentiated thyroid carcinomas with laryngo-tracheal invasion than the others. In these cases, we performed macroscopic carcinological surgery preserving laryngeal functions as much as possible.

Adult↗
PubMed2006

[Pericochlear hypodensity on CT: normal variant in childhood].

PURPOSE: Evaluation of the prevalence of a pericochlear hypodensity on CT in children. Materials and methods. This study correlates the findings on temporal bone CT to the indications for CT (headache, trauma). Helical CT acquisitions using 0,5 mm, 0,6 mm or 0,75 mm slice thickness according to the material available, with multiplanar reconstructions. Only patients with significant pericochlear hypodensity, larger or equal to 0,4 mm, were taken into account, and the curvilinear or nodular nature of the lesion on axial and coronal sections was recorded. RESULTS: A pericochlear hypodensity was identified in nearly 40% of cases. There was no population predominence according to the indication for the CT. The curvilinear type was more frequent on coronal images, with unilateral and bilateral involvement being equally frequent. There was no significant difference according to the sex. Patients of all ages showed lesions, from newborns to adolescents, with increased frequency in childhood. CONCLUSION: This study confirms a high prevalence of pericochlear hypodensity in a paediatric population, without clinical correlation, which requires prudence when interpreting the significance of this CT sign commonly described in association with pericochlear otosclerosis and the pericochlear form of osteogenesis imperfecta.

Adolescent↗
PubMed2005

["Audio 4": a simple and quick speech audiometry test for moderate hearing loss screening in four-year-old children].

UNLABELLED: The need for repeated auditory screening throughout early childhood faces the obstacle of the lack of objective validated material. OBJECTIVES: The goal of this two-year prospective study was to create and validate frequency-based word/picture lists appropriate for four-year-olds. Words were chosen not on the basis of the acoustic frequency of phoneme production, but on frequencies corresponding to their optimal recognition. Responses thus were to predict pure-tone threshold curves. MATERIAL AND METHODS: First of all, the linguistics laboratory created lists. Next, we proceeded to validate the form of the test: this involved verifying that the words selected on the basis of their frequency characteristics were common and well-known to children of this age. During the first year of the study, the picture boards were tested in a hospital otolaryngology service (66 children) and in a public health service (500 children) and corrected. RESULTS: All of the words and pictures were known during the next year by 5088 children. The second step was the audiometric validation of the test in a paediatric otolaryngology service. We compared classification of normal and impaired ears according to tonal audiograms and according to "Audio 4": 360 children were tested. Results were the following ones: Se: 0.81, Sp: 0.96, PPV: 0.91, NPV: 0.93. "Audio 4" therefore allows for prediction of pure-tone curves. CONCLUSION: This gives us hope that, directly interpretable by physicians, Audio 4, a rapid test which is attractive to children, will be used in diagnostic paediatric examinations whenever necessary.

Age Factors↗
PubMed2005

[Chondrosarcoma of the cricoid].

OBJECTIVE: Chondrosarcoma of the larynx is a rare neoplasm generally observed on the cricoid. The purpose of this study was to define the most appropriate surgical management depending on tumor extension and histological grade. PATIENTS AND METHODS: Three males and one female were treated for chondrosarcoma of the cricoid between 1990 and 2003 in the Ear, Nose and Throat department in Tours, France. There were three grade I tumors and one grade II tumor. Tumor resection by thyrotomy was performed in two patients, total laryngectomy in one and laser desobstruction in one. RESULTS: The patient who underwent total laryngectomy remained in complete remission at five years. Among the two patients who had thyrotomy, one remained in remission at three years and the other experienced recurrence at four years and underwent a second operation. He died five years later due to another disease. Total follow-up was nine years. The patient treated by laser therapy achieved stabilization at twelve months. CONCLUSION: Computed tomography and histological grading enable choosing the best surgical procedure. Partial laryngeal surgery is indicated for small or low-grade chondrosarcomas. For large or high-grade tumors, total laryngectomy must be performed. In the event of patient refusal, laser desobstruction can provide clinical stabilization.

Aged↗
PubMed2004

[Metachronous sinonasal squamous-cell carcinoma after pharyngolaryngectomy].

OBJECTIVE: Three laryngectomized patients developed metachronous sinonasal squamous-cell carcinoma. We reviewed their files to search for clinical features useful for early diagnosis of this localization. CASE REPORTS: Two of the patients, a textile worker and a food processing worker, had occupation exposure risk factors for sinonasal squamous-cell carcinoma. The anatomic modifications created by laryngectomy contributed to late diagnosis of the metachronous tumor at an advanced stage. Surgery was performed in all three patients. Local recurrence was observed at one year in two patients. DISCUSSION: Sinonasal fibroscopy should be part of the surveillance scheme in laryngectomized patients to enable early diagnosis and treatment of metachronous tumors.

Aged↗
PubMed2004

[Extracranial internal carotid artery aneurysm].

INTRODUCTION: Extracranial aneurysm of the internal carotid artery is an exceptional finding. CASE REPORT: An 89-year-old woman consulted for a peritonsillar mass. Physical examination revealed a parapharyngeal pulsatile mass in the oropharynx. Computed tomography (CT) provided the diagnosis of extracranial internal carotid artery aneurysm. Endovascular or surgical treatment were declined. Anticoagulation medication was given. DISCUSSION: We reviewed the CT and magnetic resonance imaging findings and the clinical manifestations of extracranial internal artery aneurysm. Endovascular treatment is an alternative to open surgery.

Aged↗
PubMed2004

[Management of cerebrospinal fluid fistulae: physiopathology, imaging and treatment].

Cerebrospinal fluid (CSF) fistulae can produce leakage through a defect in the bony skull and meninges into the contiguous air-filled cavities at the base of the skull. The major risk is central nervous system infection. When abundant clear rhinorrhea or otorrhea is present, the diagnosis is obvious and imaging is used to localize the fistula. Computed tomography (CT) with millimetric slices and magnetic resonance imaging (MRI) are the most effective diagnostic tools. CT cisternography, an invasive procedure, should only be used when the diagnosis remains uncertain following CT scan and MRI. When CSF leakage is sparse or intermittent, the diagnosis can be made by measuring beta-2 transferrine in the escaping fluid. CT scan followed by MRI are also useful for making the diagnosis and locating the fistula when exterior leakage is absent. CT scan alone is effective for assessing isolated otorrhea. If the diagnosis remains uncertain after all these studies have been used, the patient should be closely followed clinically and isotopic study or surgery should be considered.

Cerebrospinal Fluid Otorrhea↗
PubMed2003

[Acute mastoiditis in children: clinical and bacteriological study of 17 cases].

OBJECTIVE: Acute mastoiditis (AM) represents the most frequent complication of acute otitis media (AOM) in children. In the literature, its incidence is stable but with an impressive increase in pneumococci with reduced sensitivity to penicillin (PRSP). The aim of this study was to assess the incidence of AM in the area of Tours and the prevalence of PRSP. METHOD: This was a retrospective study of children admitted to the regional paediatric centre in the Tours area, between January 1994 and May 2001. The coded AM files were analysed, excluding all the sub-acute forms or those complicating a cholesteatoma. The criteria studied concerned the clinical signs on admission, the imaging data and the bacteriological samples and the results of treatment. RESULTS: Seventeen children (8 boys, 9 girls) were admitted for an AM during the study period. Their mean age was of 3.2 years (range: 6 months to 13 years). In 24% of cases, the mastoiditis existed on admission and in 59% of cases it complicated an AMO already treated with antibiotics. In 3 cases (18%), the AM was complicated on admission with peripheral facial paralysis in one case and thrombosis of the lateral sinus in 2 cases. The germ responsible was identified in 14 cases (82%) with a predominance of pneumococci (11 cases). Eight were PRSP-type. Scan of the pars petrosa identified a subperiosteal abscess in 13 cases. Fourteen mastoidectomies were performed and the mean duration of antibiotic therapy was of 23 days. The outcome was always good. CONCLUSION: Over the past 7 years, the incidence of AM has been estimated at 1.2/100 000 children aged under 15 per year. The prevalence of PRSP is high but does not change the principles or the results of the treatment of AM.

Acute Disease↗
PubMed2002

[Postoperative comfort in pediatric outpatient tonsillectomy].

OBJECTIVE: Evaluate the comfort in children after ambulatory tonsillectomy, disregarding the surgical technique and with a systematic prescription of paracetamol and codeine. The study lasted 4 days including the day of surgery. STUDY DESIGN: [corrected] Prospective study during 5 months. PATIENTS AND METHODS: We performed a prospective study over a five-month period to evaluate the comfort in children after ambulatory tonsillectomy. Opioids were used for analgesia during surgery, morphine and propacetamol in the recovery room, and a systematic prescription of paracetamol-codeine between Day 0 to Day 3 at home. The assessment of pain was made by nurses and the family, considering 6 endpoints: spontaneous pain and when swallowing by verbal scale (0 to 4), occurrence of PONV (0 or 1), quality of sleep (0 or 1), quality of feeding (0 or 1) and play (0 or 1), combined in a global score of 0 to 12, with a score < or = 4 very satisfactory. RESULTS: 78 children were included, 49 tonsillectomy by dissection, 29 by Sluder. The score were < or = 4 at Day 0 and Day 1 in 53 children, but statistical analysis (univariate analysis) showed difference between the two surgical procedures with a global comfort score better and PONV lower with dissection procedure. CONCLUSION: The use of paracetamol-codeine after tonsillectomy offers a reliable analgesia with very satisfactory scores of comfort. Such prescription is effective in ambulatory tonsillectomy if a rigorous selection of patients is made.

Acetaminophen↗
PubMed2002

[Cervical osteophytes and ENT disease: three surgery cases].

Vertebral cervical hyperostosis is frequent in the general population but is rarely symptomatic. Dysphagia is the most frequently encountered symptom. We report three cases of cervical hyperostosis leading to ENT symptoms. Two patients had bilateral laryngeal paralysis, rarely described in the literature. These three cases were treated surgically.

Aged↗
PubMed2001

[Teratoma of the rhinopharynx and the infratemporal fossa in neonates: report of 3 cases].

Teratomas are tumors which develop in childhood or early adulthood, generally in the gonads. More rarely these tumors may be found in an axial localization, notably in cervicofacial forms. We report three cases of teratomas observed in rhinopharynx of three neonates operated at the Clocheville General Hospital. We present the main anatomoclinical features of these tumors, focusing on the cervicofacial forms in neonates. All three cases occurred in female neonates presenting acute dyspnea within the first hours of life, requiring intubation in two cases. The first two tumors invaded the infratemoral region and the third was a pediculated tumor of the velum exteriorized via the mouth. In one case antenatal ultrasound had suggested the diagnosis of a right temporomaxillary tumor. Rapid excision of the rhinopharngyeal component allow extubation for the two intubated infants and pathology diagnosis. In the first infant operated at 2 months, the lateral route was adapted to age, with mandibulotomy with section of the coronoid process but preserving the mandibular condyle. The second infant was operated at the age of 3 weeks using a wide frontotemporoperitonial approach then at the age of 3.5 months for recurrence extending to the floor of the temporal fossa and the middle ear. A type C infratemporal approach was used with lost-bone temporal craniectomy. Per-buccal excision was possible in the third infant with resection at the base of implantation. No recurrence has been observed in the first two cases at 3.5 and 2.5 months follow-up in the first two cases. The third infant was lost to follow-up.

Female↗
PubMed1999

Surgical removal of subglottic hemangiomas in children.

OBJECTIVE: To examine the indications and the results of surgical excision of severe subglottic hemangiomas. DESIGN: Retrospective study and case series. SETTING: Four academic tertiary care centers of pediatric otolaryngology. PATIENTS: Twenty children were included from 1991 to 1997. All presented with severe subglottic hemangiomas resistant to classical treatments such as corticosteroids and/or CO2 laser. INTERVENTION: Six children were operated on using laryngotracheal reconstruction and prolonged stenting by a reinforced Silastic roll and 14 children were operated on by a single-stage laryngotracheoplasty and postoperative intubation in a pediatric intensive care unit. RESULTS: All patients were successfully decannulated or extubated and have been free from recurrent hemangiomas. CONCLUSION: The surgery of severe subglottic hemangiomas is a reliable technique in selected patients and should be considered in corticoresistant or corticodependent, circular, or bilateral hemangiomas.

Child, Preschool↗
PubMed1999

[Otosclerosis surgery: a series of 227 cases. Introduction of CO2 laser].

OBJECTIVES: To evaluate the effects of the size of the footplate opening on the hearing results in surgical treatment of otosclerosis and the use of CO2 laser in this indication. PATIENTS AND METHODS: 190 patients with otosclerosis underwent 227 procedures between 1986 and 1995. Hearing results and symptoms were analyzed to compare the different procedures: 140 stapedectomies, 87 Fisch's stapedotomies, 35 of them with manual perforator, 52 of them with CO2 laser. RESULTS: Air/bone gap closure within 10 dB was obtained in 87, 92 and 97 percent of stapedectomies and in 80, 84 et 90 percent of stapedotomies after 3 months, 1 and 3 years (NS). Bone conduction was improved in 81, 80 et 63 percent of stapedectomies and 87, 97, 60 percent of stapedotomies after the same time (NS). Air/bone gap closure within 10 dB was obtained in 75 and 80 percent of manual perforator stapedotomies and in 84 and 88 percent of CO2 laser stapedotomies after 3 months, and 1 year (NS). Bone conduction was improved in 78 and 96 percent of manual perforator stapedotomies and 95 and 100 percent of CO2 laser stapedotomies after the same time (NS). No facial palsy or prolonged vertigo occurred. There was one case of anucusis following a stapedectomy. CONCLUSION: Although both stapedectomy and stapedotomy produced equivalent air/bone gap closure, reduction of inner ear trauma was noted with Fisch's stapedotomy. CO2 laser technique is a safe procedure, which optimizes the Fisch's stapedotomy.

Adolescent↗
PubMed1998

[Epidemiology of otitis media with effusion].

Acute otitis media (AOM) and otitis media with effusion (OME) are very common in the young children. The relation ship between these two pathologies has not been completely established. The AOM incidence ranges between 22 to 74%. The OME which persists after onset of AOM is more frequent (20% at 2 months) than the chronic OME which concern 4.4 to 10% of the child population before the age of five. The highest age specific incidence for all episodes of AOM is one year of age. AOM and OME are most likely to occur in the winter. The OME risk factors are: the first episode of OMA before 6 month of age, the males sex, no breastfeeding, day-care centers, low socio-economic conditions and familial genetic predisposition. Passive-smoke exposure and allergy are discussed. The epidemiology assesses the actual state of these pathologies to settle, with the family, the optimum choices for the prevention.

Acute Disease↗
PubMed1998

Solitary fibrous tumour of the larynx: report of a case.

Solitary fibrous tumour is a particular kind of mesenchymal tumour, classically arising in the pleura. We report the first case arising in the larynx, associated with a metastasizing adenocarcinoma. The diagnosis is mainly histopathological, especially when strong immunoreactivity for the CD34 antibody is present.

Adenocarcinoma↗
PubMed1998

[Results of vestibular neurotomy from a socio-professional point of view].

Vestibular neurotomy, in addition to the fact that it preserves the hearing, is considered to be the most effective form of treatment for incapacitating unilateral Menières disease which is resistant to medical treatment. The authors have carried out a retrospective study of 20 cases of vestibular neurotomy operated on between 1986 and 1996. They have evaluated the results of the suppression of vertigo and the improvement of quality of life. Each patient was given a questionnaire. The parameters studied were the quality of daily life, professional life and driving ability. The mean follow-up period was 3 years. This study confirms the good results obtained with vestibular neurotomy for vertigo: complete control of attacks of vertigo was obtained in 90% of cases according to the criteria laid down by the American Committee on Hearing and Balance, as modified in 1985 (AAO, 1985). This study has also confirmed that the quality of patients lives is greatly enhanced both for everyday activities, professional activities and driving.

Adult↗
PubMed1997

[Cervicofacial manifestations of tularemia. Apropos of a familial case].

Tularemia is a rare infectious disease, due to Francisella tularensis, a virulent bacterium transmitted by a carrier insect (essentially ticks) or by the meat of an infected animal (generally hares). We report 3 cases that occurred in the same family, showing the various symptoms of this disease. Revealing head and neck manifestations may mislead diagnosis.

Adolescent↗