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J L Poncet

Publications and source records attributed to J L Poncet.

34 records · Page 2Linked to original sources
PubMed1995

[Surgery for meningioma of the posterior skull base. 135 cases. Choice of approach and results].

One hundred and thirty-five patients with posterior skull base meningiomas were seen and treated by a neurosurgical-neurotological team over the last 12 years. Ten tumors were "true" clival meningiomas and 125 were posterior petrous meningiomas: 25 were located anterior to the internal auditory meatus (IAM) (zone A); 29 were located around the IAM (zone M) and 18 were posterior to the IAM (zone P). 53 tumors had a larger zone of implantation and are accordingly called AM (31 cases), MP (15 cases), AMP (7 cases). The choice of routes was guided by a radiological anatomy classification system (17). Transpetrous approaches, alone or in combination with subtemporal transtentorial or retrosigmoid approaches were the surgical routes of choice for posterior petrous meningiomas, making it possible to reach the tumoral osteodural implantation, reduce the tumoral mass and perform a subarachnoidal dissection of the tumor poles. A retrolabyrinthine (RL) approach allows access to zone P and a translabyrinthine approach to zone MP. Zones A, M and P can be reached via the anterior extended translabyrinthine (AETL) approach. Anterolateral transclival approaches with apex petrectomy were used to reach the clival meningiomas with a wide implantation zone. Standard microsurgical techniques were used in 32 cases and 103 procedures included the use of a microscope-guided laser. Complete tumor removal was accomplished in 88% of cases (120/135). Overall mortality was 3.7% (2 cases at 30 days and 3 cases between 31 days and 1 year).

Aged↗
PubMed1995

[High resolution T2 weighted MRI sequence and diagnosis of neurinoma of the VIII].

OBJECT: To assess the value of high resolution fast spin echo T2 weighted (HR-FSE T2w) sequence for the diagnosis of acoustic neuroma. Two criteria for normality of the HR-FSE T2w examination are defined. PATIENTS AND METHODS: 114 patients underwent MR imaging at 1.5 T. The protocol included: axial images; 2 overlapped sequences focused on the internal auditory meatus (IAM), HR-FSE T2w acquisition (512 matrix, 3 mm sections with 1.5 mm overlapping); pre and postcontrast T1 weighted sequences focused on IAM. We defined two criteria for a normal HR-FSE T2w image: cerebellospinal fluid visible throughout the IAM, cochleo-vestibular and facial nerves visible in the IAM. RESULTS: 31 examinations were abnormal with HR-FSE T2w sequence, 25 lesions were found on postcontrast T1 weighted sequence (i.e. 6 false-positive results and none false-negative). The sensitivity, specificity and negative predictive value of this HR-FSE T2w sequence were 100%, 97% and 100% respectively. CONCLUSION: the HR-FSE T2w sequence is the first-line method for detecting tumoral lesions of the IAM. If the 2 normality criteria are present on the HR-FSE T2w images, the T1w sequence with gadolinium injection is of no use; the injection of gadolinium remains necessary if only one of these criteria is lacking.

Adult↗
PubMed1994

[Imaging protocol in salivary pathology].

Numerous techniques have been used for imaging salivary glands including standard radiography, scintigraphy, sialography, echography, computed tomography and finally NMI. These different techniques each have their own indications or complementary role. We therefore developed a protocol for using the different imaging techniques according to the different salivary pathologies encountered. This protocol is given as an examination flow chart to be used in light of clinical findings. A large number of images selected by P. Laudenbach illustrate the typical pathologies encountered. Special emphasis is placed on sialography, an important imaging technique, unfortunately somewhat neglected.

Acute Disease↗
PubMed1993

[Cervical cystic lymphangioma in adults].

Cystic hygromas, infrequent in children, are even rarer in adults where they once were generally an unexpected operative findings. Now, with the progress in modern medical imaging the diagnosis can be suggested before operation. Analysis of the embryogenesis helps to explain the different anatomical and clinical forms and the relations of the cystic hygroma with neighboring tissues, particularly of renous origin, grases of cystic hygroma of the neck in adults are reported and discussed with 26 other well documented cases from the literature. The diagnosis can be confirmed only after operation and histological examination. Surgical removal is technically less difficulté in adults than in children and recurrences are rare.

Adolescent↗
PubMed1992

[Maxillary Aspergillus sinusitis. Comments apropos of 20 cases].

About a series of 20 aspergillus maxillary sinusitis, the correlation between this pathology and previous dental treatments is emphasized. In some cases such as sinusitis can occur without any dental pathology and/or in absence of foreign body on the X-rays. C.T. findings are the basis of the diagnosis. Surgical treatment, using endonasal micro surgery, has been performed in all cases.

Aspergillosis↗
PubMed1992

[Petrous surgical approaches in tumors of the cerebellopontine angle].

Three petrous incisions, performed by an ENT-neurosurgery team, can be used for the resection of tumours of the cerebellopontine angle: transpetrosal incisions (posterior translabyrinthine and transcochlear) which provide large access to the IAM and the posterior surface of the petrous bone, but they sacrifice hearing. The suprapetrosal incision (reserved for tumours in the meatus) and the mastoidoretrosigmoid incision (for tumours less than or equal to 20 mm) preserve the labyrinth in an attempt to preserve hearing. The principal objectives of surgical resection of tumours of the cerebellopontine angle (85% of which are acoustic neuromas) are total resection (to preserve the vital prognosis) and preservation of facial nerve function. Attempts to preserve hearing must be confined to cases selected by a complete clinical otological and audiometric examination.

Cerebellar Neoplasms↗
PubMed1991

[Surgery of the parotid gland. Indications. Review of the anatomy].

The surgical division of the parotid gland in three parts or "lobes" in relation to facial nerve is a practical custom. After revising the surgical anatomy, the indications and operative technique of total parotidectomy with preservation of the facial nerve (TPP) are described. The discussion is open for pleomorphic adenomas of the superficial lobe, between some authors in favour of a superficial parotidectomy and others who perform a systematic TPP. Other surgical operations are total parotidectomy (TP) without preservation of the facial nerve, TP associated with a neck dissection, at lastly extensive or partial parotidectomies. Trans-parotid surgery uses the parotid region as an approach to neighbouring structures or regions.

Humans↗
PubMed1990

[Isolated sphenoidal aspergillosis presenting as an optic neuropathy].

Aspergillosis fixation in the sphenoidal sinus is an exceptional occurrence when isolated. The clinical feature is misleading and the diagnosis often difficult; local and regional complications are dreadful. The authors report a case, presenting as an optic neuropathy, and the literature data.

Aged↗
PubMed1990

[Preservation of auditory function in the excision of acoustic neuroma].

Selection criteria for the preservation of auditory function during excision of acoustic neurinoma have been defined for a long time, and the means for a successful achievement of such a goal are widely known. Recruitment of special patients, for whom maintenance of an even deeply altered hearing capacity constitutes a requisite for continuation of professional work has lead us to extend indications for the pre- and retrosigmoid approaches recommended by J.M. Sterkers. The authors present a series of 16 patients, in which a single case of cophosis was deplored.

Audiometry↗
PubMed1990

[Tympanoplasty in the treatment of sequelae of blast injuries of the ear].

This study deals with 40 clinical files relating to auricular blast injury patients with ensuing eardrum perforation, managed either by tympanoplasty or by placement of a healing support. An analysis of the functional symptoms, the size and localization of the perforation; determination of the presence or lack of immediate post-injury infection, and of the degree and type of hearing loss suffered, permits to define the characteristics of postoperative ear status. A comparison of the study results with published data provides for specifying surgical indications and sheds light on the long-term evolution pattern in such patients.

Adolescent↗
PubMed1990

[Effects of loud music on the Garde Républicaine musicians].

The authors report their observations on the auditory status of 76 musicians belonging to a Republican Guard brass band, and give their interpretation of abnormal findings, as they compare percussion with wind instruments and make reference to literature data. Accompanying signs, such as ear fatigue, noise intolerance, tinnitus, ear-aches, disturbance of sleep, psychic disorders, and disturbances of equilibrium are also taken into account as predisposing factors. Lastly, an attempt is made to bring out some of the characteristics that are specific to each instrument.

Audiometry↗
PubMed1986

[Blast injuries of the ear. Current status and study of 200 cases].

Clinical case-reports of 200 patients with blast-induced lesions are used as a basis for a review of physical and physiopathologic factors. Otologic aspects of injuries due to high-intensity shock waves are discussed and clinical and histopathologic features described. The place of post-traumatic pressure induced injuries to ear in catastrophy medicine is emphasized.

Adolescent↗
PubMedDate not supplied

Fine alterations of distortion-product otoacoustic emissions after moderate acoustic overexposure in guinea pigs.

Guinea pigs were exposed to a pure tone at 6 kHz and 80 dB SPL for 30 minutes in order to induce mild reversible auditory fatigue over the 4 hours following exposure. Cochlear monitoring aimed to compare the shifts in round-window compound action potentials (CAP) thresholds to those of 2f1-f2 distortion-product otoacoustic emissions (DPOAE, frequency of stimuli f1 and f2). Both responses were evaluated every 1/10th octave between 6 and 12 kHz for CAP thresholds, and from 4 to about 14 kHz for DPOAEs in response to 50- and 70-dB SPL stimuli. The auditory fatigue turned out to be sufficiently mild that DPOAEs remained present, so that their microstructure could be followed up while the stimulus frequency ratio f2/f1 was swept from 1.06 to 1.30 (fixed f2) so as to derive DPOAE level profiles against f2/f1 and group latencies. CAP thresholds decreased by about 10 dB above 7.2 kHz, whereas DPOAE amplitudes decreased at most f2 frequencies from 6.6 kHz to 15.2 kHz, with the range of decrease being slightly narrower at higher stimulus intensities. While the mean DPOAE shift after 1 hour was around 5 dB irrespective of stimulus intensity, it tended to increase slightly after 2 hours despite stable CAP thresholds. DPOAE profiles against f2/f1 were slightly modified by the auditory fatigue, so that the maximum tended to be reached at lower ratio. No significant variation of DPOAE latencies was found after acoustic overstimulation. These experiments show that complex DPOAE changes were induced by auditory fatigue and their relationship to CAP threshold changes does not seem to be straight-forward. Nonetheless, fine DPOAE recordings might be useful to detect early changes in cochlear mechanics.

Acoustic Stimulation↗
PubMedDate not supplied

[Cervical cystic lymphangiomas in adults].

Cystic hygromas, infrequent in children, are even rarer in adults where they are generally unexpected operative findings. Now, with the progress in modern medical imaging, the diagnosis can be suggested before operation. Analysis of the embryogenesis helps to explain the different anatomical and clinical forms and the relations of the cystic hygroma with neighboring tissues, particularly of venous origin. 9 cases of cystic hygroma of the neck in adults are reported and discussed with 26 other well documented cases from the literature. The diagnosis can be confirmed only after operation and histological examination. Surgical removal is technically less difficult in adults than in children and recurrences are rare.

Adolescent↗