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Biomedical subjects

J M Thomassin

Publications and source records attributed to J M Thomassin.

At least 19 recordsLinked to original sources
PubMed1994

[Value of hyomandibulopexia in the surgical treatment of snoring in patients with sleep apnea].

The authors report their experience with hyomandibulopexia for lingual repositioning in patients with the sleep apnea syndrome. The technique was used 12 times in 11 men and 1 woman and a maximum follow-up of 3.4 years. Hypomandibulopexia was performed as first intention therapy 7 times with or without uvulo-palato-pharyngoplasty. Video-fibroscopy of the pharynx and cephalic magnetic resonance imagery revealed retrobasilingual narrowing in all 7 of these cases. Hyomandibulopexia was performed 5 times for recurrent sleep apnoea syndrome after prior surgery. In two cases, pre-operative evaluation did not reveal any topographic abnormality. Polysomnography studies showed clear improvement with a decreased apneic index and desaturation values. A second fixation of the hyoid was success fully in one case. Hyomandibulopexia is a simple and reliable technique which is useful in patients with sleep apnea syndrome with good to excellent medium term results.

Adult↗
PubMed1994

[An unusual cervical tumor: meningioma. Apropos of a case of petrous origin. Review of the literature of meningioma presenting as cervical mass].

Primary ectopic meningiomas are uncommon. The authors report a case of a 12-year-old boy with a meningioma presenting as a neck mass. The conclusion of the initial biopsy was chemodectoma, but on surgical resection, the tumour was found to have invaded the petrous bone. Post-operative follow-up was uneventful but magnetic resonance imagery revealed extension to the cerebello-pontine angle, the cavernous sinus, the tentorium and the falx. The authors discuss the main pathogenic hypotheses and the classification of ectopic meningiomas. Based on 62 similar cases reported in the literature, primary ectopic meningiomas are found most often in young subjects, with no female predominance, neurofibromatosis is often observed and angioblastic or malignant features are frequent. These tumours can be divided into 6 localizations (jugulo-carotid space, lymph nodes, parotid gland, thyroid gland, soft paravertebral tissues, skin) and into 3 pathogenic groups (solitary ectopic tumour of the neck, tumour of the neck connected to a cranial or spinal meningioma, metastasis). Meningioma of the jugulo-carotid space with connection to the skull base is the most frequent entity. Solitary ectopic meningiomas of the neck occur in only 1 out of 5 cases. In 2 out of 3 cases, the neck localization involves a connection to a cranial or spinal meningioma. In a few cases the neck mass is a metastasis. These findings suggest that a complete neuroradiological work-up is required. Prognosis depends on the completeness of the surgical resection and the histologic aggressiveness frequently encountered.

Child↗
PubMed1992

[Asthma and polyposis. Efficacy and adverse effect of endonasal ethmoidectomy. Results apropos of 70 patients].

The authors report the efficacy and adverse effects of intranasal ethmoidectomy in 70 patients with asthma and persistent severe symptoms from nasosinal polyposis despite repeated prior treatment. The efficacy was defined according to the evolution of symptoms and endoscopic findings. Adverse effects were evaluated according to subjective clinical and therapeutic data in all 70 patients. In addition, 25 patients had complete pre and post-operative pulmonary function tests. The results confirm that intranasal micro-surgery does not increase the severity of asthma. On the other hand, no significant improvement in bronchial function was noted after ethmoidectomy. Finally, the authors emphasize the poorer results obtained in Widal's disease and the importance, after the failure of medical treatment, of using of sufficiently extensive surgical procedure in order to decrease the incidence of recurrences.

Adolescent↗
PubMed1992

[Vocal dysfunctions: bases for rehabilitation].

Based on our observations of vocal dysfunction modes, we set up a classification of dysfunctions. Most often, we encounter a "prolonged and usual vocal forcing on an anatomically normal larynx". This forcing often essentially predominates breathing, but it may predominate the larynx, in the posterior glottis or on the vibrating area of the vocal cords. We individualized the very specific group of dysphonias with limited tone where the forcing in located, especially in the resonators. We reviewed the dysphonias with modified larynx, by secondary lesions or primitive pathologies. Analysis of the vocal dysfunction mode makes it possible to establish a therapeutic programme adapted to each case with a functional aim.

Humans↗
PubMed1992

[Pharyngeal video-fibroscopy: value in the management of apneic snoring].

The pharyngeal video fibroscopy (P.V.F.) should complete the classical diagnostical management of each snoring associated with obstructive sleep apnea. Easily made on a seated awake patient the P.V.F. is the one dynamical pharyngeal procedure. It also let see the snoring and reproduce the upper airway obstruction. The Müller test seats the level of this obstruction, helps the surgeon in the choice of the procedure and should reduce the failure rate.

Adult↗
PubMed1991

[Functional anatomy of the pharynx].

The pharynx, as the junction of the aero-digestive pathways, is situated in the centre of the cervico-facial region. The description of its anatomic components will be complemented by a study of the muscular-aponeurotic features, that the pharynx forms with its surrounding regions, presenting a complex velo-pharyngo-facial structure, the anatomic unity of which will be confirmed by a functional unit.

Humans↗
PubMed1991

[Nasosinusal polyposis. Indications. Results. Apropos of 222 ethmoidectomies].

From 1984 to 1990, we carried out 222 endonasal ethmoidectomies in 116 patients with invalidating nasosinusal polyposis who had undergone multiple treatments. Out of these, 49 suffered from asthma and 17 from Widal's disease. We were able to follow up 109 patients with an average time lapse of 14.2 months, the extreme values being 3 months and 6 years. Complete ethmoidectomy was performed in all case, using a combination of surgical microscope and 30% rigid optics. The low number of complications, the high percentage of good results and the absence of respiratory functional aggravation currently give endonasal ethmoidectomy a place of choice for the management of patients with polyposis, in the absence of any true etiological treatment. We associate non-intolerant asthmatics, for whom we have obtained the best results, to the conventional indication. Conversely, Widal's disease is a more disputable indication, and its high percentage of failures justifies the continuation of basic research.

Adult↗
PubMed1991

[Residual cholesteatoma: its prevention by surgery with endoscopic guidance].

In comparing two series of 72 operated cholesteatomas covered by a systematic surgical second look between 12 and 18 months, the authors have observed a distinct regression of residual cholesteatomas since oto-endoscopy came into use (from 47.7% to 10.7%). This new approach, with a minimum amount of practice, makes it possible to perform true endoscopy-guided surgery of the entire tympanic cavity, and reduces the indications of later tympanotomy.

Cholesteatoma↗
PubMed1991

[Benign adenoma of the middle ear].

Starting from one case, the authors review the recent literature data on this very rare lesion. Elements of clinical and histological diagnosis are discussed. Treatment is surgical and must be complete to prevent recurrence.

Adenoma↗
PubMed1991

[Tumors of the cerebellopontine angle. Fortuitous association of meningioma and neurinoma].

The authors report the case of a totally accidental meningioma/neuroma association in the same internal auditory meatus, although no Recklinghausen's disease seems to be involved. In relation with this case and with the literature data, the authors review the frequency and diagnosis of meningiomas of the cerebellopontine angle. Lastly, this case helps avoiding a diagnostic error, since the imaging may lead to diagnose one tumor only.

Cerebellar Neoplasms↗
PubMed1991

[Extraskeletal pharyngolaryngeal Ewing's sarcoma. Apropos of a case].

The authors report on one case of pharyngolaryngeal extraosseous Ewing's sarcoma. This is a very rare tumor which preferentially has a paravertebral or retroperitoneal location. The difficult histological diagnosis is greatly facilitated by the use of tumoral markers. The treatment implemented consisted of a "conventional" Cisplatin 5 FU chemotherapy, which allowed an almost complete clinical recession after 3 courses, then of external radiation therapy. The evolution of these tumors still remains unpredictable. Regional metastases to the lymph nodes are rare, and they are usually remote and mainly pulmonary. Lastly, the merits of computed tomography for the follow-up of these intramural lesions of the larynx must be emphasized.

Adult↗
PubMed1990

[Endoscopic ear surgery. Initial evaluation].

The authors describe an endoscopic procedure of surgery of the ear and report on their experience in surgery for cholesteatoma with a closed procedure in the first step and the systematic second-look. The use of such a system is an essential complement for the surgical microscope to control some regions of the middle ear such as the sinus tympani. The study deals with 72 cases of cholesteatoma operated successively. The number if residual cholesteatomas is analyzed. The merits of controlling assemblies in some ossiculoplasties with an endoscopic system are discussed.

Adult↗
PubMed1990

[Otoendoscopy: application in the middle ear surgery].

Oto-endoscopy is already of considerable value not only for the diagnosis of otological disorders, but also in peroperative use for access to areas that are difficult to see even under an operating microscope (sinus tympani, anterior attic, protympanum). The authors present an endoscopic operation, and report on their experience in cholesteatoma surgery using a closed technique.

Cholesteatoma↗
PubMed1990

[A scapular osteo-cutaneous flap in mandibular reconstruction].

The authors report their experience with 6 cases involving the scapular T.O.L.V. technique described by Swartz et coll. They review the anatomy of the vascularisation of the flap together with the possible operative techniques. The 6 cases involved mandibular reconstruction following transmandibular bucco-pharyngectomy, either as first or second line surgery. In all cases the osteo-cutaneous flap gave a good quality reconstruction both in terms of oro-bucco-pharyngoplasty and in terms of repair of the horizontal portion of the mandible. The vascular pedicle was of satisfactory quality. Primary closure of the donor site was possible. No functional complications occurred at shoulder level. Combined reconstruction of the loss of bony and mucosal substance following this type of surgery considerably improves swallowing and phonation in these patients who previously had to undergo hemi-mandibulectomy.

Bone Transplantation↗
PubMed1990

[The scapular osteocutaneous flap. Technic, indications in cervicofacial surgery].

The authors describe 10 cases of mandibular reconstruction following transmandibular buccopharyngectomy, using scapular osteocutaneous flaps. Repair of mandibular substance loss due to neoplastic surgery becomes a problem. Composite bone resections are associated with mucous and muscular defect formation. There is dual advantage in using this type of flap: on the one hand, reliability is great, independently of the case (revisions or other types of surgery) because of the presence of constant elements in the vascular pedicle; on the other hand, the cutaneous flap and the bone transplant are independent from each other, such plasticity affording equally successful symphyseal and lateral repair.

Bone Transplantation↗
PubMed1990

[Trimetazidine and degenerative deafness. Effect on hearing and integration].

This study was conducted in order to assess the activity of trimetazidine dosed at 60 mg/day in patients presenting degenerative loss of hearing. Ten centers participated in this multicenter double-blind placebo-controlled trial which spanned 6 months. Included were 251 patients (118 women, 133 men) presenting with pure perception bilateral symmetrical deafness concerning predominantly the acute frequency range. 228 patients terminated the study, including 115 in the trimetazidine group and 113 in the placebo group. The evolution over a 6-month treatment period was significantly better with trimetazidine as regards the following parameters: audibility as assessed by pure-tone audiometry, namely at the acute frequency range (p = 0.002), intelligibility as assessed by speech audiometry (p = 0.008), subjective evaluation of hearing loss and its impact on the patient's social life. Results confirm the value of trimetazidine hearing loss management, based on clinical, subjective criteria as well as audiometric ones. Parameters reflecting best trimetazidine's efficacy were intelligibility and the psychological/behavioral impact of the impairment, allowing for better social integration of the subject.

Aged↗
PubMed1990

[Dysphonia in children].

Numerous cases of early dysphonia in children are due to congenital lesions of the vocal cord. Others, developing later, appear within a context of maltreatment of the vocal cords, and become part of the child's psychological and psychomotor developmental disorder. Hearing and seeing dysphonia are the two parts of our diagnostic stage, assisted by the use of optic fibres and audiovisual methods. Treatment must be global, putting dysphonia back into its proper context, leaving a substantial part to vocal re-education, as laryngeal microsurgery only comes into play when the result is inadequate, or when the vocal imperatives of a child musician lead to that choice.

Child↗