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Biomedical subjects

H Lacombe

Publications and source records attributed to H Lacombe.

At least 19 recordsLinked to original sources
PubMed1994

[Unilateral paralysis of the lower cranial nerves caused by lesion of the internal carotid artery].

We report two cases of unilateral, isolated lower cranial nerves (IX, X, XI and XII) palsy: both were due to a lesion of the internal carotid artery in the para-pharyngeal space (a dissection and a pseudoaneurysm). The diagnosis was based upon magnetic resonance imaging and selective angiography. The normality of the external carotid artery on angiography led to the hypothesis of a direct compression of the lower cranial nerves in the para-pharyngeal space, rather than an ischemia of these nerves.

Carotid Artery Diseases↗
PubMed1994

[Fixed retraction pockets and cholesteatoma in children. Authors' experience with 199 cases].

Cholesteatoma is more destructive in the child than in the adult, but few studies have examined the outcome as a function of age. The authors evaluated retrospectively their experience in 199 cases of cholesteatomas or uncontrollable fixed retraction pouches in children under the age of 15. Mean follow-up was 2 and a half years and the anatomic and functional results are detailed. Reasons for performing first intention or second intention canal wall up or down procedures were analyzed as a function of age. Residual cholesteatomas were particularly frequent in whatever the initial surgical procedure. Cholesteatomas and retraction pouches in the child under 5 (n = 24) were particularly aggressive and destructive, often requiring a canal wall down operation. Residual cholesteatomas were also very frequent and involved both bony and functional element of the petrus. The clinical course of cholesteatoma in the young child appears to be very different, becoming less destructive as the child reaches adulthood.

Adolescent↗
PubMed1994

[Value of the monitoring of the facial nerve in the evaluation of facial function in translabyrinthine surgery for acoustic neuroma].

Amongst the 62 patients operated for acoustic neuroma using a translabyrinthine approach, the authors study post operatory results at one month of the facial function according to the "House-Brackmann" classification. The analysis consists in 2 homogeneous and comparable series of 34 and 28 patients having benefited or not of a per operatory monitoring of the facial nerve with "NIM 2" neuro monitor. Without distinction of the tumoral sizes 76% of patients show a good facial result when monitorized against 60.7% when not. According to the tumoral size monitoring becomes more interesting: also you will find better results in the monitorized serial (71%) against 29% without. Other factors concerning the facial post operatory functions are also analysed by authors. To the very important part of per operatory monitoring, the anatomical status, microvascularization and physiological state of the nerve al as well as the operator's experience are to be added. All above factors must be considered when evaluating the final post operatory facial result.

Adult↗
PubMed1994

[Painful ophthalmoplegia caused by chronic sphenoid sinusitis. Contribution of imaging].

Sphenoid sinusitis is a rare, often misdiagnosed, potentially lifethreatening infection. We report two cases of chronic sphenoid sinusitis presenting as painful ophthalmoplegia. We emphasize the difficulty of the diagnosis due to the deep-seated position of the cavity. The availability of CT and MRI should allow an early diagnosis. Attention has to be paid to the sphenoid sinus on every cranial image. In the chronic as well as in the acute form, the treatment is an emergency. Surgery procedures should be considered when antibiotics are inefficient. Sphenoid sinusitis must be considered in the diagnosis of painful ophthalmoplegia.

Adult↗
PubMed1990

[Congenital sensorineural deafness and associated syndromes].

The etiology of perceptive deafness, especially the congenital variety, requires investigation. The presence of a variety of signs associated with deafness constitutes an "associated syndrome" and helps to define a possible genetic origin. These syndromes only represent a small percentage of overall causes of deafness in children, since at most they account for only 10% of cases. Certain syndromes are encountered more often or are well known, others are extremely rare or have only been described recently. The authors report six of these very rare syndromes discovered among their patients: a KID syndrome, a Leopard syndrome, a Norrie syndrome, a Jervell and Lange Nielsen syndrome, a recently described entity called CEE with deafness and an External Neuro-Cochleo-Pancreatic syndrome which would not appear to have been previously described.

Abnormalities, Multiple↗
PubMed1990

[Development of tone curves in sensorineural deafness in children].

The authors reviews 239 cases of child sensorineural deafness (478 ears studied both separately and in correlation with the controlateral ear) to try and identify the evolutionary trend of the tone curves throughout the follow-up period, which spanned nearly 20 years in some cases. The difficulties encountered in this study were due to several factors, namely the problem involving very accurate assessment in very young children, the high incidence of tubotympanal disease in the very young, the hard to obtain definition and quantitative evaluation of the notion of progressiveness, as well as the need to analyze the evolutionary patterns in global terms (mean hearing loss), from one frequency to the next and from one ear to the other, since such tone loss patterns are not always symmetric. The authors state their opinion derived from a large number of cases regarding a situation, which characterizes a relatively frequent (over 25% of cases) aggravation of perceptive hearing loss in children.

Adolescent↗
PubMed1990

[Protracted otitis and subacute mastoiditis in children. A prospective study apropos of 118 cases].

Antibiotherapy has lead to a substantial decrease in the number of infants with acute mastoiditis or complications thereof. However, the non-negligible incidence of protracted otitis currently observed has caused one to raise several pathogenid hypotheses, among which subacute mastoiditis figures as one needing to be detected early. This prospective study was conducted on 118 children treated for protracted otitis in the ENT Service at Hopital Trousseau, during the period from january 1987 to december 1988. It allowed us to develop diagnostic and therapeutic strategies to cope with the difficult problem of protracted otitis, taking into account bacteriologic findings and risk factors, among other things.

Adenoidectomy↗
PubMed1990

[Emergency tracheobronchoscopy in children with burns].

Smoke inhalation affects the upper airways and lung parenchyma, causing the burn victims' death rate to increase substantially. Early diagnosis is hard to obtain, as clinical signs of complications will be delayed. However, both improved chances for survival and a lower incidence of sequelae depend on how soon treatment is initiated. The smoke inhalation syndrome suspectacle from the case history cannot be confirmed without due paraclinical investigations. The authors retrace their experience with 42 children hospitalized at the Hôpital Trousseau Burn Unit. They stress the importance of emergy ENT endoscopic assessment for obtaining the diagnostic and therapeutic data necessary for taking adequate measures.

Bronchial Diseases↗
PubMed1989

[The carbon dioxide laser in tracheobronchial diseases in children. A prospective study of 11 cases].

Carbon dioxide laser has been used in bronchology for over 15 years, primarily in adults and older children. With the recent development of appropriate bronchoscopes, one has now been able to extend its application to infants and small children. 11 patients, aged 10 months through 7 years, were treated by this technic at the ENT Service of the Hôpital Trousseau (Paris). Indications for broncholaser management at this age and the particularities thereof are specified, as well as the results obtained and the complications linked with its use. This new therapeutic tool appears to be reliable and effective in a certain number of cases, representative of which are circumscribed bronchostenoses, granulomas resulting from trauma or associated with tuberculosis, and benign tumors.

Bronchial Diseases↗
PubMed1989

[The dilated vestibular aqueduct syndrome].

The authors analyse the clinical, radiological and audiometric findings in a population of 89 ears of 49 patients. There was no correlation between bone malformation and auditory deficit which was often profound. This anomaly occurs during the 7th week of embryogenesis and represents one facet of the dysplasia of Mondini.

Adolescent↗
PubMed1988

Acute myeloblastic leukemia presenting as apparent acute otitis media.

Three cases of acute myeloblastic leukemia of FAB-M2 type revealed by an isolated otitis media are reported. This mean of revelation is valuable for early diagnosis and treatment of the disease. A karyotype was performed in two cases and showed an 8;21 translocation. As far as we know, these are the first acute myeloblastic leukemia cases with otitis media reported in which an 8;21 translocation was detected.

Acute Disease↗
PubMed1988

[Effect of the surgical treatment of cleft palate on pathology of the middle ear. Apropos of 49 cases].

The presence of middle ear disease was analyzed in 49 patients with soft palate cleft, and more particularly the influence of surgical repair and early therapy. Clinical examination, impedancemetry and audiometry carried out preoperatively and at follow up more than 3 months after surgery showed that although surgical closure of cleft provokes some improvement (40% of cases) some degree of seromucous otitis persisted in most patients, with a very partial positive influence of early surgery. Other physiopathologic factors are involved in the genesis of seromucous otitis, which cannot be cured by early surgery for soft palate cleft alone.

Acoustic Impedance Tests↗
PubMed1985

[Reduction of bleeding during microsurgery of the middle ear by amiodarone].

Operative bleeding was reduced in 47 patients undergoing middle ear microsurgery by means of an intravenous infusion of Amiodarone. Total doses of the order of 1 mg.kg-1 were remarkably effective without adverse effects. This result is attributed to the capacity of Amiodarone to reduce the increase in blood pressure and particularly the tachycardia induced by release of endogenous (operative stress) and exogenous (local adrenaline infiltrations) catecholamines.

Adolescent↗
PubMed1984

Surgical procedure and implanted material description.

The 12 intracochlear electrode placement is greatly facilitated by using our electrode-bearer which is introduced through the round window via a posterior tympanotomy approach. However, partial or complete ossification of the cochlea may oblige us to use again our first technique of one-by-one electrode placement, using Silastic pieces through 12 cochlear fenestrations. The microconnectors and the receptor are also described.

Cochlea↗