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Biomedical subjects

J J Daele

Publications and source records attributed to J J Daele.

10 recordsLinked to original sources
PubMed2005

Cancer of the nasal vestibule, nasal cavity and paranasal sinuses.

The usual clinical presentation of sinonasal tumours includes symptoms that are indistinguishable from inflammatory sinus disease, namely nasal airway obstruction, pain, and epistaxis. Abnormal V1 and/or V2 sensations are a strong indication of the possibility of tumour. Computed tomography is the most reliable and informative imaging tool for evaluating the cancers of the paranasal sinuses. Magnetic resonance imaging is essential for tumour mapping because of the excellent tissue characterisation and the possibility of differentiating between neoplasms and retained secretions. A wide variety of histologies may be encountered, although squamous cell carcinoma (SCCA) is the most common. Radiation is a common adjuvant to surgery. The response of sinonasal tract tumours to radiation therapy varies with the stage and histology of the tumour. Rehabilitation after surgical resection may be accomplished with prosthodontics or reconstructive flaps. Bony erosion of the orbital walls does not constitute an indication for orbital exenteration. Patients with tumour involvement of the skull base, either in the infratemporal fossa or at the fovea ethmoidalis and cribriform plate, should be considered for craniofacial resection. Management of these tumours requires a multimodal approach, involving surgery, radiation therapy and, increasingly in recent years, chemotherapy. Management should therefore be entrusted to multidisciplinary teams only.

Chemotherapy, Adjuvant↗
PubMed2003

The yellow nail syndrome.

The yellow nail syndrome is a rare clinical entity which combines three main features: yellow discolouration of the nails, chronic lymphedema, and pleural effusion. Since 1994, chronic rhinosinusitis is associated in this syndrome. A lot of other pathologic conditions are often present. The most frequent are: bronchiectasis, recurrent pneumonia, pericardic effusion, humoral immunity deficiencies. Among the etiopathogeneses advocated, the more credible ones deal with changes of the lymphatic network with hypoplastic vessels leading to inadequate adaptation, after local damage of the tissues. When this syndrome is suspected on the basis of the examination of the nails, an extensive investigation (dermatologic, pneumologic, lymphographic, biologic) has to be launched to exclude underlying neoplasma, or autoimmune disease, frequently associated with this syndrome. The treatment is controversial and poorly effective. Vitamin A and E, Zn sulfate and itraconazole are drugs the most often advised. Spontaneous healing is reported in 30% of the cases. Endoscopic endonasal surgery in such cases, when the sinusal mucosa is involved, is controversial and its outcome is not yet documented.

Aged↗
PubMed2000

Endoscopic endonasal ligation in treatment of severe posterior epistaxis.

The technique and indications of an endonasal endoscopic technique for treatment of posterior epistaxis are presented. Three cases were successfully treated in our department in 1999. The posterior vascularisation of the nose is reviewed with emphasis on surgical anatomy. Endoscopic endonasal ligation of posterior nasal arterial vascularisation is compared with other treatment choices in posterior epistaxis. The technique is save and efficient. Since it is also a minimally invasive technique, it has become our first choice surgical procedure for posterior epistaxis.

Adult↗
PubMed1997

Chronic sinusitis in children.

In children, sinusitis is a common, generally uncomplicated, and self limiting disease which drops with age. The diagnosis is difficult because of relatively non specific signs and symptoms that overlap with viral upper respiratory infection and allergy. Plain paranasal sinus radiographs are not adequate, in determining the extent of involvement in recurrent or chronic sinusitis and so CT scan has become the standard. Viral illness appears to be the most common predisposing factor. Immune defects (mainly IG2 and IGA) may exist in a significant percentage of children. The role of allergy seems less important. With advances in the genetic field of cystic fibrosis, genetic factors are advocated in chronic or recurrent sinusitis. The most common bacterial pathogens in pediatric sinusitis patients are SP (Streptococcus Pneumoniae), HI (Hemophilus Influenza) and MC (Moraxella Catarrhalis). Other less frequent bacterial species include group A streptococcus, group C streptococcus, streptococcus viridans, peptostreptococcus, moraxella species and Eikenella corrodens. Respiratory anaerobes are not common. Antibiotics resistant to the action of the beta-lactamase are the cornerstone in medical treatment. In recurrent acute sinusitis prophylactic antimicrobials may be helpful. The indication for surgery remains controversial. To date, we have no prospective studies comparing surgical to medical therapy in order to guide us in deciding surgical indication. It is therefore recommended to follow a conservative track and to limit surgical procedures in children with suppurative complications, nasal obstruction from polyposis or refractory sinusitis aggravating chronic pulmonary disease such as asthma.

Anti-Bacterial Agents↗
PubMed1993

[Surgical treatment of nasal obstruction in children].

Three principles about pediatric nasal surgery should be borne in mind. 1) Surgical resection may not interfere with nasal growth. 2) Aesthetic defects without functional impairment should be corrected at the end of adolescence. 3) When classical treatments fail, functional endoscopic procedures (F.E.S.S.) intended to ensure drainage and ventilation of the sinuses as well as to improve nasal conductivity, by partial inferior turbinate resection have to be proposed.

Adenoidectomy↗
PubMed1991

Second branchial cleft-pouch set fistulae, sinuses and cysts in children.

A perfect understanding of the embryology of the branchial apparatus and the cervical anatomy is absolutely essential for the classification and treatment of branchial fistulae, sinuses and cysts, particularly with respect to those of the second cleft-pouch set. Some of our recent cases provide evidence of the need for precise dissection, a condition sine qua non to avoid surgical failures.

Adolescent↗
PubMed1980

Some statistical data about anterior rhinomanometry.A comparative study between passive anterior rhinomanometry and active anterior rhinomanometry.

The authors studied the value of the passive anterior rhinomanometry. In a first group of 28 patients it was possible to determine by a confidence interval test if the type of the airstream was mainly laminar or turbulent . In a second group of 15 test subjects the type of airstream was graphically determined. At the same time, the values of nose resistance obtained with the P.A.R. were compared to the values obtained with active anterior rhinomanometry.

Airway Resistance↗