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Biomedical subjects

F Legent

Publications and source records attributed to F Legent.

At least 19 recordsLinked to original sources

[Vestibular evoked potentials. Diagnostic trends].

The contribution of short-latency evoked potentials to the exploration of auditory, visual and somatosensory neurosensory pathways is capital. The determination of short-latency vestibular evoked potentials has encountered many difficulties, mainly due to the necessity to find a specific, very short stimulation in order to select and synchronize the vestibular nerve fibers. Recent studies in animals have demonstrated short-latency potentials evoked by angular accelerations, linear accelerations or electric shocks on the round window. The generators of these potentials seem to be located in the vestibular nerve and nuclei. Electric stimulations of the internal ear have the advantage of providing a study of the peripheral vestibular pathways separately on both sides, while accelerations involve both vestibula, which probably makes the interpretation of data very difficult.

Acoustic Stimulation

[Infratemporal region extension of malignant tumors of the parotid with deep development. Hypotheses on deep extension of parotid tumors according to benign or malignant characteristics].

The infratemporal and paratonsillar regions can be the site of propagation of parotid tumors. Our personal experience with 3 cases of malignant parotid tumors extending into the infratemporal region and the study of the literature seem to show that: benign tumors, such as pleiomorphic adenomas, develop in depth towards the paratonsillar regin and not towards the infratemporal region; and conversely, malignant tumors rather invade the infratemporal regin and not the paratonsillar region. This extension occurs along the neurovascular axis through Juvara's retrocondylar buttonhole. If this notion was confirmed, it might have a semiological and therapeutic interest.

Adenoma, Pleomorphic

[Immunohistochemical study of 6 multiple familial cervical paragangliomas with lymph node metastasis in one case].

Cervical localizations of extra-adrenal paragangliomas are infrequently malignant, especially in their familial forms. An immunohistochemical study was performed on 6 cervical paragangliomas which were detected in 3 sisters at the age of 20 20. One had a lymph node metastasis. This study confirmed the diagnosis of paraganglioma with endocrine chief cells and supratentacular cells. It also enabled the hormonal contents of these cervical paraganglioma to be determined. In addition to catecholamine, these tumors may (like pheochromocytomas) produce serotonin and one or more other peptides.

Adult

[Nervous tumors of the infratemporal fossa].

Six cases of neurogenic tumors developing in the infratemporal fossa are reported. These are neuromas or neurofibromas in 5 cases and meningioma in 1 case only. The first 4 cases are primary tumors of the infratemporal fossa, while the last 2 tumors have developed into the temporal fossa from neighboring lesions. Computed tomography and RMI are irreplaceable techniques to assess the extension of such tumors and their connection with the neighboring organs, and to guide the treatment, which must be surgical whenever possible. Complete exeresis of the tumor is difficult. These examinations are also essential for follow-up and for the early detection of possible recurrence.

Adult

[Pneumosinus dilatans. Long-term result of modelling osteoplasties].

Pneumosinus dilatans is a rare disease characterized by an evolutive hyperpneumatization of the sinuses. The frontal sinus is most often involved, but any other sinus of the face can be affected. Three cases of pneumosinus dilatans, including two in the frontal sinus and one in the maxillary sinus, are reported. Modelling osteoplasty without drainage of the sinus was performed in all three cases and yielded satisfactory and stable results with a minimal period of observation of 5 years. The long-term effectiveness of modelling osteoplasty must be taken into account to study the physiopathology of pneumosinus dilatans. The most likely etiopathogenetic hypothesis is a disorder in the local growth of the sinus.

Adolescent

[Anatomical study of the infratemporal fossa].

The infratemporal fossa (ITF) is a hidden, subracranial part of the retrofacial region, which is concealed by the mandible. While its definition corresponds to bony relationships, it goes far beyond these. The classical pyramid with a lateral mandibular base and a superomedial apex, the pterygopalatine fossa, actually is a passage for the neurovascular elements it contains. It also is the hidden aspect of the manducatory apparatus, accommodating the pterygoid muscles. Besides these bony limits, the ITF has fasciomuscular boundaries formed posteriorly by the sphenomandibular ligament and the lateral insertion of the styloidian curtain on the angle of the mandible. The anterior limit, under the maxillozygomatic bones, is formed by the pterygomandibular ligament, on which spread the fibers of the buccinator muscle. The inferior limit is only theoretic and corresponds to the lower margin of the mandible. Within these limits, the ITF is connected with the mandible and the lateral manducatory muscles, the parotid gland, the peripharyngeal spaces, the submandibular region. However, it primarily is a passage into the neighboring regions with which it communicates through openings that are either endo- or exocranial, parotid, pharyngeal, nasal, orbital. Thus this fossa is one of the paths of the expansile processes that arise from the neighboring regions and invade it, being guided by the various anatomical openings we have described.

Humans

[Transzygomatic approach of the infratemporal fossa. Value and limits].

We report about one case of neurofibroma in the infratemporal fossa, which was treated surgically through a transzygomatic approach. Lowering the zygomatic arch with the masseter muscle and raising the coronoid process with the temporalis muscles provides a wide access to the infratemporal region without any mutilation. This way of approach can be widened anteriorly towards the orbital frame in order to reach lateral orbital lesions, and posteriorly towards the mastoideum to resect large tumors extending into the base of the skull. The transzygomatic approach seems to be particularly appropriate for the exeresis of benign tumors in the infratemporal region.

Facial Neoplasms

[Pneumolabyrinth and perilymphatic fistula after stapedectomy].

A case of per-surgery discovery of a pneumolabyrinth referred to the oval window is reported. Such was associated with a post-stapedectomy perilymphatic fistula. Revealing clinical signs were invalidating vertigo, transmission-type hearing loss, and tinnitus. Surgical plugging of the fistula caused the dizziness spells to regress completely, as well as improving tinnitus and restoring hearing markedly. Literature data confirm the fact that pneumolabyrinths are always associated with perilymphatic fistulas. Moreover, pneumolabyrinths seem to play an important role in the genesis of cochlear signs accompanying perilymphatic fistulas.

Adult

[Rhinoplasty with the external approach. Report of 23 cases].

23 external rhinoplasties were carried out over a 4-year period between 1986 and 1989. In 19 cases, they related to major malformations or traumatic sequelae requiring a spindle or columella bone graft. In 14 out of these 19 cases, an iliac graft was used. This approach requires a specific technique but it allows an accurate dissection of all the nose structures and grafting under excellent conditions.

Adolescent

[Value of preserving mandibular continuity in transmandibular bucco-pharyngectomy. Apropos of 11 cases].

84 transmandibular bucco-pharyngectomies were carried out over 6 years between 1983 and 1988. Eleven, i.e. 13%, were performed with preservation of mandibular continuity. Histological examination of resected bone fragments did not demonstrate any bony invasion in 65 cases; in contrast, in 8 cases, extension of the tumour to involve bone was likely due to the topography of the tumour and the results of pre-operative X-ray examination.

Adult

The role of dental canal fillings in the development of Aspergillus sinusitis. A report of 85 cases.

Radiopaque concretions in the maxillary sinus in cases of sinusitis are often observed in infections with aspergillosis. For several authors, such features are considered to be typical of these infections. For us this foreign body in most cases is believed to be related to overfilling of the teeth. We have previously drawn attention to this fact. We report 85 cases of aspergillosis of the maxillary sinus. Cases involving immunosuppressed patients were excluded because of very different clinical conditions. A radiopaque foreign body was seen in 94% of the cases. Of this group, 85% were believed to be related to overfilling of maxillary teeth with dental paste, particularly since evidence for endodontic treatment was found in the premolar/molar region. An image of intrasinus dental paste was demonstrated in 12% of the cases as a direct extension of filling paste from affected teeth. The nature of the dental paste is important because the zinc contained can stimulate the growth of Aspergillus fumigatus. In vitro studies in our laboratory also showed that the growth of A. fumigatus was stimulated with a low concentration of zinc.

Adolescent

The infratemporal fossa: a trial clarification.

The contents of the infratemporal fossa have been studied using CT scans, anatomical dissections and radiography of the anatomical specimens. On the strength of this, 3 distinct regions are discernable: the anterior part of the fossa contains the fat pad of the cheek and this area corresponds to the retromaxillo-zygomatic region; the region of the pterygoid m. contains vascular structures and lies behind the preceding region; the pterygopalatine fossa, formerly considered the deepest part, extends the infratemporal fossa superiorly and medially. These anatomical and radiographic findings could serve as a guide to maxillo-facial surgeons dealing with expanding lesions within the infratemporal fossa, or invading it from adjacent regions.

Adipose Tissue

[Malformation of the facial canal, meningitis and cerebrospinal otorrhea].

CSF fistulas into the middle ear due to labyrinthine or tegmental anomalies are well known. They predispose to recurrent meningitis if they do not receive appropriate surgical treatment. CSF fistulas due to facial canal anomalies are extremely rare and predispose to the same risk of meningitis. The case reported enables a comparison to be made with the three other cases of the same form of anomaly found in the literature, and the diagnostic and therapeutic difficulties are also discussed.

Adolescent

[Dermatologic facial surgery in patients over 70 years of age. Apropos of 166 cases surgically treated in 1986 and 1987].

For patients pass the age of seventy, the facial dermatologic surgery can be often practised, under local anesthesia, during an hospitalisation of one day (111 cases under 121). The technic of repair in two times is systematically applied for the sclerosing basal cell carcinoma; this technic allows a best performance of excision and diminishes the risk of recurrence.

Aged

[Intrapetrous carotid aneurysm and tube prosthesis. Apropos of a case].

The introduction of a tubular prosthesis such as that described by J. Wright in 1976 is sometimes proposeD to ensure ventilation of the ear at the time of tympanoplasty. A case of ruptured intrapetrosal internal carotid aneurysm is reported, apparently related to the presence of such a prosthesis. The occurrence of such an accident should question the use of a tubular prosthesis in an inflamed ear. Endovascular trapping by balloon catheter would appear to be the most effective treatment for this form of ruptured intrapetrosal aneurysm.

Adult