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Biomedical subjects

G Le Clech

Publications and source records attributed to G Le Clech.

At least 19 recordsLinked to original sources
PubMed2006

[Neck dissection for stage N0 oral cavity carcinoma].

OBJECTIVES: The management of N0 neck remains controversial. The purpose of this study was to evaluate the efficacy of selective neck dissection (SND) in managing N0 neck of oral cavity carcinomas. MATERIAL AND METHODS: A retrospective chart review of 77 previously untreated patients with squamous cell carcinomas of the oral cavity with N0 neck from 1988 to 2001 was performed. Cervical treatments were "wait and see" policy in 7 cases, neck dissection in 56 cases, radiotherapy alone in 14 cases. 77 neck dissections were performed in which 62 were selective and 15 were radical modified. RESULTS: On pathologic examination, the average number of lymph nodes was 10.7 per neck. Occult disease (cN0pN+) was detected in 32.5%, and occult extracapsular spread (cN0pN+R+) was detected in 7.8%. The median follow-up was 43 months. The overall neck recurrence rate in patients with controlled primary disease was 2.4%. Recurrent disease developed in 2.9% of the cNOpN0 neck. Regional control rate of the dissected neck was 94%. No cervical recurrence occurred in 11 patients treated with SND alone. There was no survival or recurrence rate difference in T1T2pN0 patients with or without post-operative radiotherapy. Post-operative radiotherapy could be avoided in 27% of the dissected neck. One, 3 and 5 years overall survival rate were 89.3%, 77.7% and 63.2%. CONCLUSIONS: SND is an effective procedure for staging and treating the clinically negative neck of oral cavity cancer.

Adult↗
PubMed2005

[Treatments of hereditary hemorrhagic telangiectasia of the nasal mucosa].

UNLABELLED: Hereditary Hemorrhagic Telangiectasia is a systemic autosomal dominant disorder involving blood vessels. The most common symptom is recurrent epistaxis. The treatments of these epistaxis are numerous but such treatments are often symptomatic and their effects are often not sustained. Some of these treatments may be complicated by visceral vascular malformations. The aim of this study is to propose a treatment plan for these patients with hierarchical organisation of therapeutic options taking into account of their previous therapy. METHOD: H. Plauchu organized in Paris, december 2002 a meeting with any medical specialists of this disease. They have analysed variety of therapies that have been proposed for epistaxis control in Hereditary Haemorrhagic Télangiectasia. RESULTS: Most common use packing of nasal fossa and then hyperselective embolization of the internal maxillary and facial arteries for severe epistaxis. For chronic epistaxis, best treatment use sclerotics products (Ethibloc) and laser. After discussion, primary embolization could be useful to reduce vascularization of nasal fossa. CONCLUSION: Treatment of epistaxis in Hereditary Haemorrhagic Telangiectasia could increase in few years. Use of an index card of for epistaxis in the disease of Rendu-Osler could help to find treatment of choice.

Acute Disease↗
PubMed2003

[Myospherulosis of the maxillary sinus].

BACKGROUND: We present a case of a myospherulosis, describe the underlying cause and discuss ways of preventing its development. CASE REPORT: A 35-year-old man presented myospherulosis of the maxillary sinus caused by an antibiotic ointment placed in the sinus three years earlier during a Caldwell Luc procedure. The patient underwent a second Calwell Luc procedure. Outcome was uneventful and no recurrence was noted. DISCUSSION: Histological examination should be ordered at reoperation and petroleum-based ointments and packings should be avoided in sinus surgery.

Adult↗
PubMed2002

[Exercise-induced laryngomalacia].

Exercise-induced laryngomalacia is a rare differential diagnosis of exercise-induced asthma. We report the case of a previously fit 14-year-old female patient who presented with dyspnoea on intense exertion and whose condition had not improved with treatment prescribed for a misdiagnosed exercise-induced asthma. A diagnosis of exercise-induced laryngomalacia was eventually made when a variable extra-thoracic airway obstruction on the flow-volume loops was obtained after an incremental exercise test. Flexible fiberoptic rhinolaryngoscopy confirmed this abnormality and demonstrated an anterior prolapse of the arytenoid region, partially obstructing the airway. The patient therefore underwent laser aryepiglottoplasty which produced a satisfactory anatomical outcome in the larynx but which only resulted in a partial functional improvement. Laryngomalacia is rare and its pathophysiology is not well understood. However, it should be considered in patients presenting with exertional dyspnoea, particularly if there is inspiratory embarrassment, who fail to improve with beta-2-adrenergic agonists. The diagnosis can be made from the flow-volume loop and direct laryngoscopy, before and after exercise.

Adolescent↗
PubMed1999

Pituitary adenomas with infra-sellar extension into the nasopharynx.

Three cases of pituitary adenomas with infra-sellar extension into the nasopharynx and the nasal cavities are reported. The clinical signs were epistaxis, nasal obstruction, painful sinuses and purulent rhinorrhoea. The initial diagnostic hypothesis was that of a carcinoma of the nasopharynx or the sinuses in all three cases. The diagnosis was made by histological examination and measurement of plasma hormone levels. These cases highlight the difficulty in the diagnosis of such tumours due to their misleading clinical, radiological and histological features.

Adenoma↗
PubMed1999

[Long-term results of swallowing after horizontal sub-glottic laryngectomy].

This is a retrospective study of 80 patients who have had a horizontal subglottic laryngectomy. The functional results were assessed by means of clinical findings at follow-up and a questionnaire. The mean time to decannulation was 32 days, and to removal of the nasogastric tube 25 days. 45% of patients had no fistula. Of the remaining 55%, there was a false passage for fluids in 90%. These fistulae remained patent for an average of 12 weeks. At one year and beyond, 40% of patients were on a normal diet, 33% were on ground food, 10% on a soft paste diet, 6% on a semi-liquid diet, and 10% were fed by tube. The factors militating towards poor function are age above 65 years, and previous radiotherapy.

Adult↗
PubMed1998

Primary aspergillosis of the larynx and squamous cell carcinoma.

Primary laryngeal aspergillosis is exceptionally rare, and only five cases have been reported in the literature. We present here two cases of invasive laryngeal aspergillosis without tracheobronchopulmonary extension and without any generalized immune deficit. Aspergillosis developed after local radiotherapy for a squamous cell carcinoma and preceded a recurrence of the tumor. The relationships between the clinical features, the histopathology, and the etiology of laryngeal aspergillosis and squamous cell carcinoma are discussed. We recommend that following treatment of laryngeal aspergillosis, these rare patients should systematically be investigated for a squamous cell carcinoma or a recurrence thereof.

Aspergillosis↗
PubMed1996

[Diving goiter. Apropos of 139 cases].

Between 1976 and 1994, 139 cases of diving goiter were operated. Hyperthyroidism is a factor in compression. Morbidity is low for surgery for diving goiters, but increases if performed in emergency situations. Cervicotomy was used alone in more than 99% of the cases.

Female↗
PubMed1996

[Extemporaneous anatomo-pathological test in surgery of thyroid cancers. Values and limitations].

We report our experience in surgical treatment of thyroid cancer; 2470 total or partial thyroidectomies were performed for a thyroid nodule, 205 were primitive thyroid carcinoma (8.3%). Intraoperative frozen sections diagnoses were performed in 100% of the patients. In this study, a 100% specificity and 74% sensitivity were found. Data for each histological type were compared with the previous studies. Each false negative macroscopic aspect carcinoma's size, differenciation, plurificality were studied in order to understand the limits of frozen sections diagnoses. The higher rate of false negative was found with small, well differenciated vesicular carcinoma. This study shows that high accuracy of frozen sections diagnoses allows to improve the intraoperative management of thyroid cancer. The high specificity of frozen sections diagnoses strengthens our reliance upon this examination.

Evaluation Studies as Topic↗
PubMed1995

[Malformation of the internal ear and recurrent meningitis: radio-surgical correlations].

Authors report one case of bilateral inner ear malformation in a 3 years-old child with congenital sensorineural hearing loss, recurrent meningitis and cerebro-spinal fluid leakage. This anomaly is a pseudo-Mondini's malformation with a meningocele through the oval window and a fistula of C.S.F. of the round window. A close radiological and surgical correlation support some physiopathological hypothesis about fistula between sub arachnoid space and middle ear. Authors discuss the place of high resolution computed tomography in case of congenital sensorineural learning loss.

Child, Preschool↗
PubMed1994

[Latent forms of parathyroid cysts. Report of two cases].

The authors report two cases of non functional parathyroid cyst both found by a systematic clinical examination in two women of 56 and 67 years. In the first case, the cyst was associated to a thyroid dystrophy; the other patient had a history of thyroid dystrophy but also of pituitary prolactin adenoma.

Aged↗
PubMed1993

[Cell culture in thyroid cancers].

The authors studied the diagnostic interest of cell cultures in thyroid tumors. They cultivated 10 tumours (4 papillary carcinomas, 5 medullary carcinomas and 1 sarcoma-looking tumour). In 7 cases, cultures yielded nothing more than pathologic examination. Nonetheless the study allowed to detect a double secretion (calcitonin and thyroglobulin) in 2 medullary carcinomas which turned out to be mixed proliferations. It also detected a production of thyroglobulin by the sarcoma. They think that cell cultures may have a diagnostic interest besides pathologic examination, allowing precise study of secretory features of the tumors.

Adult↗
PubMed1992

[Acquired tracheobronchial stenosis of the premature infant under artificial respiration. Value of bronchography and endoscopic balloon dilatation. Apropos of 7 cases].

The authors report about a series of 7 cases of acquired tracheobronchial stenosis in premature infants who were intubated as soon as they were born and ventilated. Two important points can be pointed out: the merits of bedside bronchography, which allows diagnosing the lesions, the merits of balloon dilatation during tracheobronchoscopy on the ENT operating theatre to treat the stenosis. This technique allowed improving ventilation and removing the tube in 6 of 7 cases.

Bronchography↗
PubMed1991

[Intrinsic congenital stenoses of the trachea].

The authors report about one case of intrinsic congenital stenosis of the trachea in a newborn. The prognosis of tracheal stenosis in infants is poor, more so when it is congenital and intrinsic, because it is often extensive and associated with other malformations, especially of the right mainstem bronchus and of the right lung. The prognosis of such extensive stenoses, for which surgery constantly resulted in death, has been improved by a new type of tracheoplasty (Kimura-Tsugawa, 1982). However, these children can only be operated with this procedure once they are through intensive care and acute respiratory distress, often in the neonatal period.

Humans↗
PubMed1990

[Post-traumatic infections of the frontal sinus].

Post-traumatic infectious complications of the frontal sinus occur more frequently after multiple fractures than after isolated fractures. The greatest frequency is found with open traumas of the sinus, due to the presence of foreign bodies and to bone and mucosal destruction. Such infectious complications are curatively treated both medically and surgically, to eliminate the bony and mucosal infection and to restore the normal physiology of the frontal sinus. Stress is laid on the preventive treatment, especially on the quality of the initial surgical treatment, either by restoring the sinus with gauging of the nasal-frontal canals, or by eliminating the sinusal function by a canalization which appears preferable to exclusion by obliteration.

Bacterial Infections↗
PubMed1990

[The value of pharyngo-esophageal manometry in the study of deglutition disorders].

Pharyngoesophageal manometry is an excellent tool for the study of pharyngeal swallowing disorders, and allows quantifying the various anomalies. The comparison of pre- and postoperative results allows better differentiation of the indications for myotomy or myectomy of the cricopharyngeal muscle. On the basis of a series of 10 cases with sufficient distance in time, the operation can be regarded as even more beneficial as the manometric anomalies are confined to the sole upper esophageal sphincter.

Adult↗
PubMed1987

[Results of a multicenter study of an amoxicillin-clavulanic acid combination in sinusitis in children and adults].

Efficacy and safety of Augmentin were evaluated in 79 patients, 64 adults and 15 children, treated for sinusitis during a multicentric hospital trial. Pre-treatment meatal pus samples were examined for bacteriology: 37 of 39 strains (95%) isolated from adults were sensitive to Augmentin, and two beta-lactamase producing Haemophilus strains sensitive to Augmentin were isolated from the children. Adult dosage was usually 2 g per day as two divided doses over 8 to 10 days. Recovery was obtained at end of treatment in 92% of cases, side effects being reported in 56 patients, including 8 with benign digestive disorders. Usual dosage in children was 25 to 50 mg/kg/d over 8 to 10 days and treatment was effective in 13 cases. One child developed a skin rash, and there was no report of digestive disturbance.

Adolescent↗