Biomedical subjects
Publications and source records attributed to J Desnos.
The authors recall their experience about 42 cases of island flaps for surgical defects after dermatologic epithelioma of the face. Surgical technic is described, the design, implementation and anatomy of subcutaneous flap are discussed and illustrated.
Congenital tracheoesophageal fistulas (CTOF) without esophageal atresia are uncommon and exceptional when multiple. Authors report a new personal case treated in two times. Others eight cases in literature are studied. Only one pre-operative diagnosis was made. Two old no-operated cases were discovered at autopsy. For five, no clinical modification was noted after the first CTOF surgical care. In them two no-reoperated died and the second fistula was seen after. For the others, the same radiological or endoscopic exams that have not marked the second fistula were positive after surgery. No explanation was done. For a better result, systematic complete investigation of trachea and esophagus are necessary even if first fistula is diagnosed. Luckily per-operative discovery of second fistula (one case) do not allowed initial extensive surgery. To support a second congenital tracheoesophageal fistula after a surgical time, many criterias are necessary: 1. a undoubted fistula recognised during the first intervention; 2. recurrent symptoms after surgery with no free interval; 3. identification by radiology or endoscopy of a new tracheoesophageal shunt in other place that the first; 4. its surgical discovery in no previous dissected area. In all cases where fistulas are described, the aspect is not the same: the upper fistula is a "H" type and the lower is shorter and larger ("X" type). To note a case of three simultaneaous fistulas in the same patient.
Dubreuilh's melanosis or circumscribed melanosis is a current disease of the old patient's face. The therapeutical attitude should be surgical and as earlier as possible. A 5 millimeter cutaneous margin must be resected around this lesion. A review of 30 cases is made.
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A case of facial palsy first unilateral then bilateral, due to Lyme disease, is reported. This disease, transmitted by ticks, is caused by a spirochete (Borrelia burgdorferi) known as the etiologic agent since 1982.
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It is widely accepted that the cause of congenital deafness is genetic in one third of cases roughly, is due to acquired affections during pregnancy or delivery in another third and remains unknown in the last third. It is possible that the cytomegalovirus (CMV) plays an important role in the latter group. The CMV is thought to be involved in 10 to 30% of cases of auditory sequelae from fetal infection, either severe neonatal CMV-induced disease, which is rare, or the frequent subclinical infections affecting an average of 1% of newborn infants. The only certain way to determine the importance of the role of CMV in deafness of unknown etiology is large-scale neonatal biologic screening followed by long-term audiologic surveillance: currently available documented data suggest that this role is very important.
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Five further cases of subglottic stenosis after intubation are reported. Lesions were due to chondrolysis of the cricoid cartilage: associating an Evans type anterior laryngotracheoplasty (the principle of which is recalled) with the posterior cricoid incision of the Rethi-Aboulker type produced a marked improvement in the results of posterior laryngoplasty performed alone.
High quality of anesthesia and efficiency of light sources and optical systems now allow safe examination of upper respiratory tract and ability to give very precise informations in neonates and infants. Endoscopy now is then an essential procedure for diagnostic of congenital anomalies of respiratory tract. The necessary conditions for a safe examination and the necessity of complete exploration (Polyendoscopy) are exposed as well as endoscopic aspects of various congenital anomalies.
Laryngeal diastema or laryngeal or posterior laryngotracheal cleft is a rare congenital malformation producing an aerodigestive communication of abnormal location which leads to severe or even fatal respiratory and infective complications. Findings in 16 cases are presented and the characteristics and particular problems of treatment of this malformation discussed. Diagnosis is presently based on results of microlaryngoscopic examination. Details are given of therapy of the commonest forms of the affection (cricoidal and upper cricotracheal), operations being performed in 9 such cases, and the place and course of forms limited to the interarytenoidal space discussed. Frequency and effect on prognosis of associated malformation are outlined. Considerable improvement has been obtained in the postoperative prognosis of cricoidal (I) and upper cricotracheal (II) forms during the last few years, and these forms must now be considered as curable.
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In a case of profuse and persistent traumatic haemoptysis uncontrolled by thoracotomy, haemostasis was achieved by introducing a Fogarthy's catheter under bronchoscopy into the bronchus involved. Some practical details facilitating the procedure are given, e.g. a rigid bronchoscopic tube should be used instead of a fiberoscope; the catheter should be introduced between the vocal cords along the tube and not inside it.
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Explore the source record for details and available documents.