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Biomedical subjects

G Sénéchal

Publications and source records attributed to G Sénéchal.

At least 19 recordsLinked to original sources
PubMed1991

[Esthetic rhinoplasty in the elderly].

The classical refusal to perform rhinoplasty in elderly subjects needs to be revised. In fact, this operation gives satisfactory results provided the patients are well selected on the basis of psychological and anatomical criteria. Apart from the repair of accidental or surgical skin defects, the delayed request from rhinoplasty candidates should be carefully assessed and, when in doubt, the patient may require psychiatric consultation. The major technical problem is that of the lack of elasticity of the skin requiring very moderate modifications of the osteocartilaginous skeleton in every case and occasionally skin resections to allow skin cover of the revised structures. Various techniques for the root of the nose have been proposed. The classical difficulty for elderly people to assume their new body image is more theoretical than real provided "minimal" rhinoplasties are performed. This operation warrants a place in the surgery of ageing.

Aged↗
PubMed1991

[The mongoloid nose].

The more precise term "mongoloid" should be used in the place of "oriental" and "asian". The nose of the Han race constitutes the most typical example. The description of "intermediary", usually used to describe this nose is insufficient, as it has a very particular type which contributes to the "Asian triad". A study conducted by Chengdu tries to overcome this deficiency. This information is particularly useful in that aesthetic rhinoplasty, performed increasingly frequently for this type of nose, raises specific problems and requires particular caution to avoid excessive correction which may be disastrous in a small face.

Asian People↗
PubMed1991

[Critical study of surgical approaches in esthetic rhinoplasty].

Not only the approach is the first but also one of the most important steps of every surgical operation. This is specially true about the nose, which is a cavernous, complex and inextensible structure. Nevertheless these difficulties it is possible to have a good exposure allowing to make the greatest number of aesthetic rhinoplasties, from endonasal incisions. In spite of a recent vogue external incisions seem to be reserved for few special and difficult cases or secondary corrections.

Esthetics↗
PubMed1989

[Decompression of the optic nerve through the trans-ethmoid-sphenoidal approach in orbital injuries. Technic and results apropos of a new series].

An orbital injury can be responsible for compressing the optic nerve in the optic canal. This compression leads to a syndrome of physiological division with homo-lateral blindness and absence of pupillary reaction of light during stimulation of the injured eye, whereas the light reflex is present with contralateral stimulation. Computed tomography studies show the compression site directly: optic canal fracture, or indirectly: hematoma of posterior ethmoidal cells and sphenoidal sinus, fracture of the posterior part of the orbit. This type of injury can be improved by surgical decompression of the optic nerve via a trans-ethmoid-sphenoidal approach. The surgical technique will be first described. Then, the authors will report a series of 13 cases. In 6 cases, surgical decompression allowed recovery of visual acuity. The authors emphasize the uncomplicated post-operative course. Indeed, no complication was recorded and the hospitalization time was very short.

Adolescent↗
PubMed1989

[For or against rhinoplasty in children?].

The correction of nasal malformations in children divides surgeons into two groups: those who prefer to operate in order to rapidly restore the altered anatomical structures, and those who prefer to wait and see, to avoid aggravating the initial lesions by operating during the growth period. Clinical findings and animal experiments fail to clearly support either one of these approaches, at least in the case of very young children, but as recent embryological studies have demonstrated the important role of the septum in the growth of the nose, it still seems legitimate to recommend great caution before performing rhinoplasty in children: caution concerning the indications which should take into account major functional problems, caution in deciding the time of operation, which can frequently be delayed, caution in the technique which should be ultraconservative with preservation of the mucoperichondrium, reposition of the displaced fragments and reinclusion in the case of resection, caution in the desired goal of the operation as it is better to obtain a partial result with the possibility of subsequent revision rather than risk serious problems of growth. Rhinoplasty in young children is always difficult and should therefore remain an exceptional procedure.

Adolescent↗
PubMed1988

[A controversial procedure: rhinoplasty in children].

Confronted with nose malformations in children, surgeons experience at the same time a legitimate desire to rapidly attend to the altered anatomical structures, and a fear to aggravate the lesions existing initially by operating during a period of growth. Numerous animal experiments have not been conclusive as far as these two contradictory theses are concerned. In all cases, prudence remains mandatory, that is prudence towards the operational indications (important functional impairment), the date of the intervention (risk minimization with age), assessment of expected results (secondary malformations occurring even very late postoperatively).

Adolescent↗
PubMed1988

[Treatment of acquired stenosis of the external auditory canal].

Often difficult surgical problems are encountered during treatment of acquired stenosis of external auditory canal. Theses stenoses can be of tumoral, inflammatory or traumatic origin and are the cause of infectious complications related to epidermal retention. Even with the assistance of modern imaging procedures, preoperative investigation is not simple, precise details of lesions being obtained in greater detail during surgical exploration. Four stages are involved in surgical treatment: excision of lesion, reaming of bony canal and enlargement of auditory meatus, providing cover and maintaining graft in place. The CO2 laser can be useful for excision of lesion or possible postoperative recurrence, and adjacent pedicle flaps are best for covering site. Postoperative inflammatory episodes can be treated by infiltration of local corticoids. Whatever the result of these different techniques, long-term surveillance of these patients is essential.

Constriction, Pathologic↗
PubMed1988

[Treatment of sequelae of basedowian exophthalmos].

Treatment of sequelae of ophthalmopathy of Basedow's disease, essentially exophthalmos, oculomotor disorders and upper eyelid retraction, is of particular importance because of the functional and esthetic problems presented. Improvement in the different symptoms can be obtained by surgical treatment, but patients must have been perfectly stable with respect to both the thyroid and ophthalmologic plan for at least 6 months. It marked exophthalmos exists this is treated initially by orbital enlargement. Oculomotor problems are then resolved and finally treatment is terminated by surgery to eyelids. Very satisfactory functional and esthetic results are obtained.

Exophthalmos↗
PubMed1983

[Complications and failures of otoplasty].

Hematoma and infection are particularly serious true complications of otoplasty because of the fragile nature of the cartilage. Perichondritis and chondritis are happily extremely rare sequelae as they may provoke veritable disasters. In contrast, imperfect results due to poor evaluation of protrusion factors or an unadapted technique are encountered less rarely. Schematically they can be divided into anomalies of the external ear in relation to the skull and morphological alterations. The former include overcorrections, or more usually insufficient corrections which may be uni or bilateral, global, or sectorial, particularly affecting the lobe. Among the latter are found poor reconstructions of the anthelix, which constitutes one of the most important elevations on the external ear, but also of the concha or helix. Corrective treatment consists mainly of procedures that were omitted or poorly performed during initial operations. Repeat surgery is always a delicate procedure, and the comments in this report should contribute to avoiding its necessity in the majority of cases.

Bacterial Infections↗
PubMed1983

[Rare tumor of the cavum (mycosis fungoides)].

A case of mycosis fungoides initiating in the cavum is reported. Results of biopsy of specimens taken from this region were negative, and diagnosis was established only after the appearance of lymph node and cutaneous lesions. The etiology is discussed, particularly in relation to the possible viral nature of the acquired immunodeficiency sundromes and more especially the "gay syndrome".

Adult↗
PubMed1983

[Riedel's thyroiditis. Apropos of a case with acute massive fibrous development].

Before a brief historical review of the disease, including its classical diagnostic criteria, the authors present a true case of Riedel's thyroiditis. After an initial operation involving virtually complete excision of the affected lobe, the course was particularly rapid with very extensive cervical fibrosis which resulted in death from tracheal and oesophageal complications. Such rapidly progressive secondary fibrosis has not been described before and did not have the histological characteristics of a recurrence. The authors liken it to phenomena of fibrosis frequently described as being associated with Riedel's disease (retroperitoneal fibrosis, fibrosing cholangitis, orbital pseudotumour, etc.). Bearing in mind that glucocorticosteroids have a beneficial action on such sites, the authors wonder whether routine preoperative corticosteroid therapy might not have avoided such an early fatal outcome in this patient.

Aged↗
PubMed1983

[Injuries of the nose in the newborn and young infant].

After having emphasized the frequency of the newborn's and young child's nasal fractures, the authors insist on the difficulty of: - a precise outcome of the lesions, - the complications due to nasal obstruction, - the impossibility to anticipate the evolution of these lesions, which is being precised by a brief embryological recall. The traumas are deliberately presented according to the age of the patients: 1) the newborn's fractures: - the prenatal fractures, which generally have a favorable evolution. - obstetrical traumas, with nasal obstruction and feeding difficulty, both being indications to surgery. 2) The young child's fractures: often misknown, and relatively frequent, the nasal wall's hematoma is a dreadful complication. 3) During school years: (sports, car accidents, Silverman's syndrome) Nasal fractures are here generally associated to other facial lesions. Indications to surgery: Always: If it is a recent fracture, provoquing nasal obstruction with respiratory and feeding problems. Sometimes: Septoplasty as minima in case of respiratory difficulties. Never perform true rhinoplasty and/or osteotomies.

Age Factors↗
PubMed1982

[Palliative surgery for facial paralysis].

Palliative surgery in patients with facial paralysis can be a useful temporary measure before nerve recuperation occurs, or a definitive procedure in cases with permanent loss of the effector muscle. Valid results can be obtained in the periorbital region by performing an external blepharorraphy, together with various static or dynamic procedures for louvering of the upper eyelid. The fascia lata is usually employed to obtain suspension, reequilibrium of soft tissues being ensared by lifting and localized cutaneous resections. Marked hyperactivity on the apposing side can be reduced by selective neurectomies.

Eyelids↗
PubMed1981

[Hypoglosso-facial anastomosis. Results in 10 cases (author's transl)].

The authors present the results of 10 hypoglosso-facial anastomoses performed according to the technique of J.M. Sterkers and J.M. Pelisse. In 9 cases regularly followed up: - Muscle tone reappeared between 4 and 5 months and was symmetrical in all cases. - Motility of the half of the face was visible between 4 and 7 months after the anastomosis. In 8 cases out of 9 the definitive result was good with muscle testing varying between 17 and 23/30. In one case palpebral occlusion was incomplete with testing at 13/30. Paralysis of one half of the tongue was invariably well tolerated. Hypoglosso-facial anastomosis has the value of reliability superior to other techniques, in particular facio-facial anastomosis.

Facial Muscles↗