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J M Juvanon

Publications and source records attributed to J M Juvanon.

11 recordsLinked to original sources
PubMed1989

[The posterior pharyngeal wall in pharyngo-laryngeal cancer. Spontaneous healing after excision].

Malignant lesions arising from the posterior pharyngeal wall, or spreading to involve it, present a therapeutic problem in cancer surgery as witnessed by the number of techniques proposed and used. In general, they require longer operating time, sometimes need a double team of surgeons and sometimes specialised training. There is an increased risk of complications. The experience with pharyngoplasty using mucosal or musculo-mucosal flaps, which leave the donor site bare, raised the possibility of partial repair in circular pharyngo-laryngectomy. A myocutaneous flap is sutured in "gutter" fashion anteriorly opposite the posterior pharyngeal wall which in fact consists of the prevertebral aponeurosis laid bare. Repair was not performed in certain partial posterior pharyngectomies. Seven patients underwent surgery using this technique. Four circular pharyngo-laryngectomies, including 2 as second stage procedures were performed. Healing occurred in all cases. No breakdown of sutures occurred. Oral feeding was possible from D12 on average and patients were discharged on D18. Three posterior pharyngectomies, including 1 as a second stage procedure, were performed. Feeding was possible in 2 patients on D15 and discharge on D18. These encouraging results suggest that this reliable, rapid single stage procedure technique should be adopted.

Follow-Up Studies↗
PubMed1989

[Results and indications of curietherapy of the eustachian tube with iridium 192 in chronic otitis in the adult].

Between January 1985 and January 1988, 56 patients received radioactive implant therapy of the Eustachian tube with Iridium 192 in the context of tympanoplasty for chronic otitis with tubal dysfunction. After reviewing the method used, we present the results by category of chronic otitis and attempt to propose its indications. Tubal dysfunction was assessed on clinical and otoscopic data and tubal manometry in each patient. A randomised study would appear to be necessary to confirm the interesting results obtained in chronic mucous otitis, in the sequelae of chronic otitis, in evolving retraction pockets and finally for certain manifestly discharging cavities.

Adolescent↗
PubMed1989

[Failure and complications of esthetic rhinoplasty. Apropos of 30 reoperations].

Out of 150 rhinoplasties carried out over 3 years in a Surgical Department. 20% of cases had previously undergone one or several surgical procedures. Based on these cases, the authors analysed the principal factors producing failure in cosmetic rhinoplasties and proposed a preventive strategy. The osteocartilaginous dorsum and point of the nose are considered separately in this paper.

Cartilage↗
PubMed1987

[Curietherapy of the eustachian tube with Ir-192].

An essential success factor for tympanoplasties is effective aeration of middle ear, lack of tubular permeability being a factor for failure. The anti-inflammatory effect of curietherapy with Iridium 192 introduced into the tube during middle ear surgery was studied in 38 patients. Tubular dysfunction was evaluated by clinical and manometric examinations. During operation, a sealed plastic tube 1.6 mm in diameter was introduced into the Eustachian tube, an Iridium wire inserted on the following day, and a dose of 1.5 and 3 Gy applied to two groups respectively. Tubular function was assessed as normal or almost normal in 61% of cases. Results were compared with a group of 30 patients not receiving curietherapy.

Adolescent↗
PubMed1987

[Update on exclusive radiotherapy of T1 and T2 of the faucial arch].

From April 1971 to October 1984, 71 patients with T1 or T2 tumors of the faucial arch were treated according to the following protocol: Telecobalt therapy to the primary site and to the neck nodes to a dose of 45 Gy. Brachytherapy to the primary site to a dose of 25 to 30 Gy using iridium 192. For node positive patients, boost dose to involved neck nodes with electrons, or radical neck dissection. Seven patients with T1N0 tumors were treated exclusively by 60 Gy iridium implantation. The crude disease free survival is 66% for the group of patients with tumors of the tonsillar region and 41% for those with tumors of the soft palate or uvula. Local control of tonsillar tumors was 98% while that of tumors of the soft palate was 85%. Regional control was 98% for the N0 group and 87% for the N1-3 group. Five cases of soft tissue ulceration were observed, all of which healed spontaneously within a few months. Less salivary impairment was seen than after treatment by external irradiation alone. While these promising results have encouraged the use of this protocol, the introduction of the plastic tube technique has expanded the indications to include almost all T1 and T2 tumors of the faucial arch without obvious extension to the base of tongue or retromolar trigone.

Adult↗
PubMed1987

[Evaluation of low-dose cobalt teletherapy in the treatment of oropharyngeal cancers of moderate extension].

Comparative efficacy of treatment with irradiation of 20 Gy, either conventionally fractionated (33 cases) or by semi-continuous low-dose irradiation (32 cases) was studied in 65 patients with oropharyngeal cancer with moderate extension (T2b and T3a). Survival rate was 44% in the low-dose group as against 24% in the conventionally treated group at 2-year follow up review. More particularly, however, there were 4 times fewer recurrences in the low-dose group (16% as against 61% in conventional group). This suggests the need for continuing study of the time factor in radiotherapy, although a few cases of necrosis (16%) were observed in the low-dose group.

Cobalt Radioisotopes↗
PubMed1987

[Critical study and role of partial vertical reconstructive laryngectomies with epiglottoplasty by the Tucker method. Apropos of 18 cases].

Two groups could be distinguished in a series of 18 patients with glottic lesions: one with pure glottic tumors (12 cases) and the other with tumors extending beyond the glottic region (6 cases). All patients but one were operated upon by first intention for epidermoid carcinoma, but also for associated pronounced dysplasia. The so-called Tucker technique was used with slight modifications (less extensive resection of thyroid cartilage, conservation of the two arytenoid cartilages). The postoperative course was satisfactory with decanulation and ablation on the 13th day, and a mean hospital stay of 22 days. Two postoperative deaths due to vascular complications occurred and one patient developed a swinging epiglottis after 2 years. The remaining 16 patients are all alive, including 8 after less than 3 years. Analogous results were noted in an analysis of a total of 93 case-reports from 5 different series of patients. This method provides an elegant and satisfactory repair of pure cordal surgery, but adds nothing from the oncologic point of view since other better adapted and currently well defined operations have to be envisaged for lesions extending beyond this region.

Adult↗
PubMed1987

[Severe nasosinus aspergillosis in immunosuppressed patients. Apropos of 3 cases].

Nasosinusal lesions due to Aspergillus rarely occur during immunosuppressive chemotherapy, but are extremely grave, and often fatal due to the extensive necrotizing mucoperiostitis of facial bones provoked under these conditions. Three cases are reported, with recovery in one case only, after exenteration of orbit and denudation of dura mater in orbital roof.

Adolescent↗
PubMed1985

[Myringoplasty in children].

An anatomical success rate of 81% was obtained in 150 children 2 to 15 years of age operated upon by myringoplasty in the hospital Bretonneau, Paris between 1977 and 1984. Results were unrelated to age the season or the condition of the mucosa. Adverse factors were a previous history of a transtympanic aerator, a velar cleft or bilateral perforations. Mean functional gain after 1 year was 14 dB. It was not related to age or the technique used.

Adolescent↗
PubMed1985

[Congenital glottic-subglottic stenoses].

One particular form of congenital stenosis of larynx that should be considered as a separate entity is the combination of a glottic stenosis with subglottic retraction. The salient features of this malformation are analyzed in 15 cases: laryngeal dyspnea with dysphonia in 2 of 3 patients and the possible detection of a subglottic anomaly on lateral radiography of larynx. However, confirmation of diagnosis can only be by laryngotracheoscopy. It is important to establish a diagnosis of subglottic stenosis associated with a palmation, since treatment and prognosis are very different from those of an isolated glottic palmation: all attempts at endoscopic treatment resulted in failure that intubation or tracheotomy was necessary in 7 cases. One of the 3 fatal cases was directly related to lack of detection of the subglottic stenosis. A successful laryngoplasty was performed in 10 children.

Adolescent↗