[Apert-Gallais syndrome. Apropos of 2 cases].
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Biomedical subjects
Publications and source records attributed to J Y Barbin.
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An investigation on the external laryngeal nerve is carried out from cadeverous material (24 thyroid glands). Various origins of the nerve are reported. The relationships are investigated. They are particularly important on the superior pole of the thyroid gland. The nerve may pass at a variable distance of the superior pole of the thyroid gland. The size of the gland and particularly the more the more or less early intramuscular course of the nerve through the fibers of the inferior pharyngeal constrictor muscle determine the relationships. Those relationships will be made closer if the nerve is adherent to the thyroid sheath, passes forward of the superior thyroid artery or between the supra polar branches. The collateral nervous branches for the thyroid gland or for the thyroid vessels, the arterial branches which passed into the pharyngeal constrictor muscle with the nerve may also change the relationships. Practical applications in thyroid surgery are made through this investigation.
Study on the superficial circumflex iliac vascular pedicle. The artery can take its origin separately from the common trunk of the common femoral artery. The decisive element is shown by the variations in course and diameter of the artery, which, in nearly 40% of the cases, seems relatively slender. In thoses cases, the sub cutaneous abdominal artery seems be the essential vascular element. Concerning the veins, they steadily join a principal vein, subjacent to the artery, sometimes doubled by a subordinate vein, satellite of the artery. All these notions incite to some prudence in using flaps that depend for their vascularisation on the superficial circumflex iliac pedicle.
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In 1989, we reported our thoughts on the neurophysiological and anatomic aspects of pudendal nerve involvement in certain types of perinal pain. Since that time, the surgical approach has been modified. Here we report our follow-up of 40 patients with 48 operated nerves. Follow-up ranged from 6 months to 7 years and outcome revealed improvement in 67% and no change in 33%. Thus surgery had been useful in two-thirds of the cases; in 44% of the patients, there was either a frank improvement or no change. Early diagnosis appears to be the determining factor in improving results. Operating for the canal syndrome must be performed before lesions to the nervous trunk become too important.