F Cacès | PubMed Health

PubMed1998

[Fixed mallear head syndrome].

Fixed head malleus syndrome is a rare anatomoclinical entity first described by Goodhill in 1966. We present a series of 9 patients who underwent surgery between 1991 and 1997 and discuss the technical procedures used and functional outcome. Ossicular mobility can be re-established with two surgical methods. The more simple method consists in a classical incus transposition with malleus neck section. The more physiological method consists in drilling the synostosis fixing the malleus without disrupting the ossicular chain; stapedotomy is associated in certain cases (Type III).

Adult↗

PubMed1996

[Results of treatment of hemifacial spasm by surgical and endoscopic neurovascular decompression. Analysis of 60 records].

The notion of a neurovascular conflict in the pathogenesis of hemifacial spasm is now well accepted based on evidence obtained from pre-operative imaging and per-operative videoendoscopy of the pontocerebellous angle. We operated 60 patients, 47 women and 13 men, age range 28-79 years, who had hemifacial spasms for 2 months to 30 years. Neurovascular decompression of the facial nerve via the retrosigmoid access was performed using a minimal invasive technique: limited access of short duration, microsurgery, endoscopic and electrophysiologic techniques, positioning of Teflon microsponges between the nerve and the vessels involved. Surgery led to 90% good long-term results with minimal morbidity limited to auditive sequellae in 3.3% of the cases. The site of compression was at the point where the facial nerve emerged in 95% of the cases. Arteries involved were the posteroinferior cerebellous artery (39 cases), the vertebral artery (23 cases) and the anteroinferior cerebellous artery (16 cases). In a third of the cases, the vascular conflict involved more than one vessel. The facial nerve should be isolated from any nociceptive contact to obtain definitive cure.

Adult↗