Biomedical subjects

Johann Peltier

Publications and source records attributed to Johann Peltier.

4 recordsLinked to original sources

PubMed2006

Superior approach to the inferior laryngeal nerve in thyroid surgery: anatomy, surgical technique and indications.

GOALS OF THE STUDY: To describe the anatomical bases of the surgical access to the higher part of the thyroid lobe, with first location of the inferior laryngeal nerve at its laryngeal penetration, to discuss the advantages and disadvantages of this surgical technique and to determine the operational indications. POPULATION AND METHOD: A prospective study of surgical anatomy performed over a period of 18 months was conducted. A total of 25 (22 women and 3 men) patients with cervicothoracic goitre underwent total thyroidectomy. Thyroid lobectomies were performed using the technique of "capsular thyroidectomy", with first location and complete dissection of the inferior laryngeal nerve. A neurostimulator was systematically used for the location of the inferior laryngeal nerve and also the external laryngeal nerve. RESULTS: The first detection of the inferior laryngeal nerve at the top of the thyroid lobe was positive in 49/50 cases. A superior parathyroid gland was found in 75% of cases and an inferior parathyroid gland in 37.5% of cases. The external laryngeal nerve was stimulated and respected in 12,5% of cases. No voice trouble, no laryngeal palsy and no definitive hypoparathyroidism occurred after surgery. CONCLUSION: Safeguarding of the inferior laryngeal nerve is the principal and obligatory stake in thyroid surgery. Locating the inferior laryngeal nerve at the level of its laryngeal penetration at the superior pole of the thyroid region is necessary in cases of particular situations: huge cervicothoracic goitres, re-operative procedures and various anatomical variations. The use of a neurostimulator secures this technique.

Adult↗

PubMed2006

Optic radiations: a microsurgical anatomical study.

OBJECT: In this study, the authors used a fiber-dissection technique to describe the optic radiation. They focused on the morphological characteristics (length and breadth) of this structure, its course, and its relationships with neighboring fasciculi and the lateral ventricle. METHODS: The authors dissected 10 previously frozen, formalin-fixed human brains with the aid of an operating microscope by following the fiber dissection technique described by Klingler in 1960. Lateral, inferior, and medial approaches were made. The optic radiation, also known as the Gratiolet radiation, extended from the lateral geniculate body to the calcarine fissure. The average distance from the tip of the anterior Meyer loop to the calcarine sulcus was 105 mm (range 95-114 mm). The breadth of the optic radiations, one on each side of the brain, averaged 17 mm at the level of the inferior horn (range 15-18 mm). This tract could be divided into three main segments: the anterior or Meyer loop, the body, and the end of the optic radiation. Adjacent anatomical structures included: laterally, the inferior longitudinal fasciculi; medially, the tapetum of the corpus callosum; and the ependyma of the inferior horn of the lateral ventricle. CONCLUSIONS: Various practical surgical approaches are discussed. The knowledge gained by studying this particular anatomy will help prevent injury to the optic radiations during neurosurgery.

Adult↗

PubMed2005

The duodenal fossae: anatomic study and clinical correlations.

The aim of this study was to present anatomic macroscopic aspects and the relationship between the duodenum and the posterior abdominal wall. The authors describe anatomic types of peritoneal duodenal fossae and stress some points of surgical importance. Twenty-four cadavers, fixed in formalin, were dissected. Ten peritoneal fossae were given prominence and the authors show the anatomical structures topographically, from a superficial plane to a deep viscerae level. There is usually a complete fusion of the duodenal loop with the posterior parietal peritoneum except the duodenojejunal flexure. The study reveals three right retroduodenal fossae, three left retroduodenal fossae, two inferior duodenal fossae, one left paraduodenal fossa and one superior duodenal fossa. These peritoneal recesses mostly result from an incomplete adhesion of the Treitz's fascia. This work provides some explanation of paraduodenal hernias that represent a rare case of intestinal obstruction. Two cases of these internal hernias are illustrated and their pathophysiology and embryologic basis are discussed.

Abdominal Wall↗

PubMed2004

Cerebral venous angioma of the pons complicated by nonhemorrhagic infarction. Case report.

The authors emphasize an unusual complication of venous angiomas in the brain: venous infarction. The patient in this case is a 32-year-old man who presented with a clinical history of headache followed by a worsening of his neurological status. Neuroimaging studies demonstrated a brain infarct in the posterior fossa, which was related to thrombosis of the draining vein of a cerebral venous angioma. A conservative treatment approach without anticoagulation therapy was followed and the patient completely recovered. Nonhemorragic venous infarction caused by thrombosis of a venous angioma is exceptional and only nine previous cases have been reported in the literature.

Adult↗