Asymptomatic nasal mass.
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Child, Preschool↗
Biomedical subjects
J J Pessey
Publications and source records attributed to J J Pessey.
[Parotid tumors. Diagnostic orientation].
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Biopsy, Needle↗
Randomized trial of induction chemotherapy in larynx carcinoma.
We conducted a randomized study in patients with previously untreated advanced (T3) larynx carcinoma to compare total laryngectomy followed by radiotherapy to induction chemotherapy, followed by radiotherapy in good responders, and by total laryngectomy plus radiotherapy in poor responders. A total of 68 patients were included in the study, 36 in the induction chemotherapy group and 32 in the no chemotherapy group. 15 of the 36 patients in the induction chemotherapy group did not have a laryngectomy. Survival and disease-free survival were significantly worse in the induction chemotherapy group than in the no chemotherapy group (P = 0.006 and P = 0.02, respectively). The 2-year survival rates were 69% in the induction chemotherapy group and 84% in the no chemotherapy group. Larynx preservation for patients, selected on the basis of having responded to induction chemotherapy, cannot be considered a standard treatment at the present time.
Aged↗
Mucoceles of the paranasal sinuses: uncommon location.
Mucoceles are the most common lesions causing expansion of the paranasal sinuses. The sinuses most commonly involved are, in decreasing order of frequency, frontal sinus, ethmoid sinuses, maxillary sinus and sphenoid sinus. We reviewed 46 cases of surgically proven mucoceles and the purpose of this study was to report five cases of mucoceles in an uncommon location.
Adult↗
Evaluation of some velar functions before and after surgical treatment of snoring.
The aim of this prospective study was to evaluate velar function before and after uvulopalatopharyngoplasty for isolated snoring and for sleep apnoea. It is based on the analysis of oral and nasal airflow during phonation by an EVA workstation of 24 patients before and after the surgical intervention. The results show (1) quantitative and qualitative airflow abnormalities before the operation, (2) an increase in the percentage of nasal airflow flow after the operation, and (3) a change in the airflow sequence, which is improved after the surgical procedure. In conclusion, this work confirms a modification of velar function after uvulopalatopharyngoplasty and raises the problem of contra-indications to this intervention.
Adult↗
[Three-dimensional facial reconstruction of computerized tomography images by computer-aided design: example of an anthropologic study].
Thanks to the medical scanning techniques and the reliability of some applications programs in 3D reconstruction, we are now able to explain an observation methodology based on the example of an anthropology study on Egyptian mummies'heads through a non-destructive proceeding. We have managed to demonstrate the exploration of the cervicofacial anatomy in the three dimensions of space and the possibility of dissociating the different anatomical tissues. The authors would like to point out the various consequences such a methodology may engender in any field.
Adult↗
The holmium:YAG laser for treatment of inferior turbinate hypertrophy.
Chronic hypertrophic rhinitis is sometimes refractory to local, as well as general, medical treatment. Before undertaking surgical reduction of the inferior turbinates, there is indisputably a place for cauterization or laser vaporization of the inferior turbinate mucosa. The authors present a study of 46 patients treated by the holmium:YAG laser for chronic hypertrophic rhinitis. The results after only one laser session are satisfactory in 89.1% at 6 months' follow-up and in 52.2% with mean follow-up of 16.2 months. No major secondary effects were observed.
Adolescent↗
[Bilateral closure of the nasal cavity. An original surgical technique of treatment of severe recurrent epistaxis in Rendu-Osler disease].
In the Rendu Osler disease, epistaxis are seen in 80 to 90% of patients, and the multiple treatments that have been proposed have each shown their failure to achieve satisfactory results. We propose, in the case of abundant epistaxis, a bilateral closure of the nasal cavity. This technique has been initially described by Young in 1967 in the treatment of chronic atrophic rhinitis. This operation was carried out in two patients who presented with serious daily epistaxis, poorly tolerated, and refractory to several treatments. Neither of these patients has presented a post-operative bleeding episode with a one year and six months follow-up respectively. Anatomically, the results are satisfactory in both patients, with total closure of the nasal cavity. Functionally, both patients are satisfied, with an appreciable improvement in the quality of life despite total nasal obstruction.
Aged↗
[Adenoid cystic carcinoma of the larynx. A case report and review of the literature].
Laryngeal adenoïd cystic carcinoma (ACC) is a rare disease due to the poor distribution of the accessory salivary glands in this area. The authors describe a case of ACC arising from the sus glottic area and underline the difficulty of such a diagnosis, which is in fact an histologic finding. The signs of discovery of a laryngeal ACC are not different from other tumors of the area, except pain frequently evoked in these tumors. Laryngeal ACC arises exceptionally before the age of 20 years and no risk factor is known. The most frequent localization is in the sub-glottic area, but sus glottic and glottic localizations have been reported. Evolution is marked by the onset of cervical lymph adenopathies and systemic metastasis most often located in the lung. The treatment comprises wide surgical exerisis followed by radiotherapy. Other reports seem to indicate that the pronostic of the laryngeal location of this disease is worse than in other areas of the head and neck.
Aged↗
Functional endoscopic sinus surgery and 109 mycetomas of paranasal sinuses.
Mycetomas of paranasal sinuses are more frequently diagnosed with the widespread use of nasal endoscopy and computed tomography (CT). We present a series of 109 cases treated by functional endoscopic sinus surgery (FESS) with a mean follow-up of 29 months. All localizations were seen, and contrary to what was initially thought, seven cases presented in multiple sites. Several clinical presentations were found, from a pansinusal involvement to a simple mycetoma hanging in a superior meatus. A heterogeneous sinus opacity with microcalcifications on CT scan is very suggestive of the diagnosis, but a homogeneous opacity may be encountered even with bone lysis. FESS was performed in all cases to obtain a wide opening of the affected sinuses, permitting a careful extraction of all fungal material. In the postoperative period, no medical treatment is prescribed. With a mean follow-up of 29 months, only four recurrences were seen. This study reinforces the interest in FESS for cases of mycetoma of the paranasal sinuses.
Adult↗
[Role of nocturnal oximetry in screening for sleep apnea syndrome in pulmonary medicine. Study of 329 patients].
Nocturnal oximetry can show nocturnal oxygen desaturation. This examination was proposed as an investigation for the early detection of the sleep apnoea syndrome (SAS). We have compared the results of nocturnal oximetry and polysomnography in 329 consecutive patients seen in the department of thoracic medicine for the early detection of the SAS between June 1990 and June 1995. The diagnosis of SAS was confirmed at the time of polysomnography using an hypopnoea/apnoea index (IAH) greater or equal to 15 per hour. Two parameters of oximetry were well correlated with IAH less than 15 per hour: if the mean oxygen saturation is greater than 92% and for less than five per cent of the time of the examination there was a saturation of less than 90%. The sensitivity was 89.7% and the specificity was 57.8%. Among the 48 false positive cases on oximetry 17 patients were found to be suffering from COPD and 31 patients were probably suffering from a syndrome of upper airways resistance or possibly from the hypoventilation obesity syndrome. Amongst the 22 false, negatives to oximetry 10 non COPD patients with an IAH of greater than 30 per hour and diurnal somnolence had important anomalies of the oro-pharyngeal pathway as the origin of their nocturnal apnoea. The 12 other false negatives were patients with moderate SAS with an IAH of between 15 and 20 per hour. Logistical analysis has shown the association of the two oximetric criteria (mean oxygen saturation or percentage of time with a saturation of less than 5%) with clinical criteria (body mass index and formation on diurnal somnolence from a questionnaire) would enable a probable diagnosis of SAS in 75% of cases. Our study shows that nocturnal oximetry used an early diagnosis test, associated with clinical and respiratory function data enables the number of requests for polysomnography to be reduced.
Female↗
[Is laryngeal papillomatosis always juvenile?].
After recording an increased frequency of adult-onset recurrent respiratory papillomatosis, the authors propose a multicentric investigation. The aim of the investigation is to determinate the frequency of the new cases and their clinical form. The preliminary results confirm the increased frequency of the adult-onset form and show the possibility of a clinical form change.
Adolescent↗
Deglutition after supracricoid laryngectomy: compensatory mechanisms and sequelae.
This study is based on the videofluorographic exploration of deglutition in 14 patients who were treated by supracricoid laryngectomy. The choice of this population rests on two criteria: a 1-year postoperative delay, and absence of residual deglutition disorders elicited by patient history. Asymptomatic aspiration was seen in 6 cases. In the cricohyoidoepiglottopexies (CHEP), aspiration occurred uniquely in patients who did not recuperate satisfactorily from epiglottic dynamics. The deglutition sequelae are less invalidating relative to the cricohyoidopexies (CHP), with a possible recuperation of the dynamic sequence of the pharyngeal swallow. On the other hand, in the CHP, a complete reorganization of the stepwise sequence of the different neuromuscular events is necessary.
Adult↗
[Introductory chemotherapy in epidermoid carcinoma of the head and neck. Apropos of a retrospective study of 293 patients].
The authors present a retrospective study of 293 patients treated by neoadjuvant chemotherapy for squamous cell carcinoma of the head and neck without metastases. The results are globally analyzed for all localizations, as well as separately for each localization (larynx, hypopharynx, oropharynx). The aims of this study are to evaluate the results of neoadjuvant chemotherapy in the different tumor sites of the upper aerodigestive tract, to identify the predictive factors of a complete response, and to ascertain if neoadjuvant chemotherapy allows to alleviate the locoregional treatment without compromising survival. In laryngeal cancers, the organ conservation rate was 20.8%. If chemotherapy does not improve survival in patients with laryngeal cancer, it should be noted that survival of patients who had a total response of their tumor to chemotherapy is better than that of non-responders. In hypopharyngeal cancers, the organ conservation rate was 30% and no statistically significant difference in survival was noted as a function of the different parameters studied. As for oropharyngeal cancers, chemotherapy obtained, in our series, a total clinical response, and thus avoiding oropharyngeal surgery, in 46.2% of cases. In this localization, the survival of totally-responding patients is greater in a statistically significant manner at 5 years than in non-responding patients. Globally, chemotherapy does not improve survival, but does allow for a gain in the quality of survival, permitting a non-negligible rate of organ preservation as a function of tumor site. The tumor stage, the lymph node status, as well as the initial performance index represent predictive factors of total response to neoadjuvant chemotherapy. Analysis of our results had led us to reserve neoadjuvant chemotherapy in T3 laryngeal and hypopharyngeal cancers, in T3 cancers of the tonsil and the tonsiloglossal fold, as well as T2-T3 tumors of base of the tongue and soft palate.
Adult↗
[Paranasal sinus aspergilloma. A propos of 45 cases].
The authors report a retrospective study of 45 cases of paranasal sinus aspergillomas to justify the endonasal endoscopic approach and define its limitations. The maxillary form was found in 40 cases (89%). 61% of the patients had dental care in the past. Radiographically, calcifications were seen in 43% of the cases and heterogenous sinus opacification in 38% of the cases. Mycologic study was positive in 94% of the cases. Fungal hyphae were observed in 83% of the cases on pathologic examination. During the follow-up, 3 recurrences appeared. The following points are emphasized: predictive factors, diagnosis and the different surgical procedures and their respective indications.
Adolescent↗
[Metastatic cervical adenopathies of unknown primary site. Long-term course].
We conducted a retrospective study of 34 patients treated by radical neck dissection followed by radiotherapy for one or several cervical adenopathies without a primary tumor. Mean follow-up was 48 months. During follow-up, 6 patients developed a presumed primary tumor, and 11 patients presented with recurrent lymph nodes. We found no statistically significant predictive factor, as to either clinical characteristics or the histological nature of the adenopathies. On the other hand, the number of metastatic lymph nodes found on the surgical specimen was correlated with the risk of lymph node recurrence. Among the prognostic factors with an unfavorable effect on survival, the dimensions of the adenopathy, its fixed characteristic and its TNM status, were identified. In this series, the appearance of a primary tumor did not seem to worsen the prognosis. On the other hand, the appearance of lymph node recurrence predicted poorer survival rates. The results are discussed and compared with those found in the literature.
Adult↗
[The voice of the child, morphological evolution of the larynx and its acoustic consequences].
From a review of the literature, the authors analyze the role of laryngeal modifications in the evolution of a child's voice. The modifications found are topographic (laryngeal descent in the neck), morphologic (increase in volume modification of laryngeal shape), and histologic (lamina propria differentiation), each responsible for acoustic modifications. The chronological evolution of the voice integrates these modifications in a global context of development, where the central nervous system is of primary importance.
Adolescent↗