Some hemostatic and hemorheological disorders in auditory and vestibular impairments.
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Adult↗
Biomedical subjects
L Traissac
Publications and source records attributed to L Traissac.
[Subglosso-epiglottectomy: carcinologic and functional results].
The authors report on 26 cases of patients treated by subglosso-epiglottectomy from 1978 to 1989. Whilst as far as survival and local oncological control are concerned the results are encouraging, the functional results are disappointing.
Actuarial Analysis↗
[Surgical rehabilitation of deglutition after partial surgery of the pharyngo-larynx].
The authors report four cases of severe deglutition disorders after partial laryngectomy. Three had collagen injection and one had a plastic reconstruction. They propose to use dynamic imagery in order to have a better selection of the patients.
Aged↗
[Leiomyosarcoma of the larynx: presentation of a case].
The authors report a new case of laryngeal leiomyosarcoma. The patient was a 43-year-old-man. The tumor extended to the left vocal cord, the paraglottic space and the deep layers of the left false vocal cord. Histologically, the lesion showed the typical pattern of a grade-3 leiomyosarcoma. Immunochemical studies revealed a strong positive staining with the actin smooth muscle antisera. A partial laryngectomy was performed. There was no evidence of recurrent or metastatic disease 10 months after surgery.
Adult↗
[Our experience with percutaneous endoscopic gastrostomy in pharyngo-laryngeal surgery].
Percutaneous endoscopic gastrostomy (PEG), is an enteral feeding procedure, easy to tolerate and simple to perform. PEG appears to be an alternative to surgical gastrostomy. Used in ten patients with E.N.T. cancer, we only observe two minor complications. Advisable in a first time for the feeding of patients with palliative treatment, we propose PEG for patients in position to have a long and difficult rehabilitation of swallowing.
Adult↗
[Melanoma of the ORL mucosa].
The study of ENT mucous melanomas (ENT MM) was performed retrospectively, based on 20 patients treated in Bordeaux and 156 detailed files taken from the international literature. Each paragraph is followed by a review of the general literature. The ENT MM, a rare form of melanomas, presents a majority of nasal locations. The mean age is 63 years old. The sex ratio trend is towards one. The aspecific call signs partially explain the delayed diagnosis. The difficult pathological examination is assisted by tumoral markers. Mean survival is two and a half years without any clear prognostic factors as for cutaneous melanomas. Treatment is essentially surgical, but adjuvant radiotherapy may have a significant effect. The other treatments are palliative.
Aged↗
[Evaluation of the efficacy of the combination amoxicillin-clavulanic acid-tobramycin for the prevention of infections after surgery for ORL cancers].
The clinic and economic evaluation of a probabilist antibiotherapy Augmentin/Nebcine administered until the wound healing was studied in 60 patients, operated of upper aerodigestives tracts cancer. The antibiotherapy efficiency was estimated at the end of 6 days in terms of clinic and bacteriologic results. In case of therapeutic failure, the treatment was adapted according to antibiogram results. The association Augmentin/Nebcine was effective in 93% of cases. Antibiotherapy was to be modified for five patients (one for allergy and four for bacteriological unsuccessful). The bacteriologic sample shows the predominance of Gram(-) germs. 83% of them were sensitive to one of these antibiotics in vitro. The daily mean cost of antibiotherapy was about FF 71. The overcost, due to antibiotherapy failures, represented only 1% of the whole cost of the 60 treatments. These results justify the use of a large spectrum antibiotherapy reaching Gram(-) germs.
Aged↗
[Role of radiotherapy in cancer of the ethmoid. Retrospective study of a series of 24 cases].
From april 1978 to december 1988, 24 patients were treated were by radiotherapy at the Bergonié Foundation cases were for ethmoidal cancer cases. Twenty two for initial treatment and two refermed for local recurrence. The mean age was 51.4 years and the sex ratio was 5.2 (21 men/4 women). Histologically there were 15 adenocarcinomas, 3 squamous carcinomas, 4 undifferentiated carcinomas and 2 esthesioneuroblastomas. According to the classification of the University of Florida, they were retrospectively classified as stage I = 9 pts, stage II = 5 and stage III = 10. Twenty one patients had postoperative radiotherapy and 3 had exclusive radiotherapy. The average dose was 55.3 Gy. Local control was obtained in 12 pts. Seven patients have recurred locally (within an average period of 12 months) and 5 patients showed progression of disease after treatment. The overall actuarial survival and the disease free survival at 5 years were respectively 50% and 53%. The actuarial survival by stage at 2 years and 5 years was: stage I (88% and 61%), stage II (100% and 50%), stage III (0%). The prognosis of ethmoidal cancer is strictly correlated to local control. For this reason, radiotherapy (with or without surgery) remains important in the treatment of this disease.
Adult↗
[Evaluation of voice quality. Experimental approach and modeling of the prosthetic voice of laryngectomized patients].
The authors describe their initial results with the parametric assessment of voice quality, which still is mainly subjective. This analysis will be used both in audiology and phonology. A first approach is made on the experimental model of a laryngectomee with a Bordeaux-type phonatory implant. Such patients allow a simpler analysis of voice production both incoustics and with an electromyographic control. The analysis of the data and their statistical validation is based on the use of original computer software.
Acoustics↗
[Cavum tuberculosis. Apropos of 2 cases].
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Aged↗
[Local approaches to extensions of laryngeal cancers: implications for anatomo-pathological testing of surgically removed specimens after laryngectomy].
The pathological examination of partial or total laryngectomy specimens for primary laryngeal cancer presents some difficulties that are related to the complex anatomical configuration of this organ. Moreover, the local spread is depending on the primary location of the lesion. The pathological findings are of special importance because they are used for planning postoperative treatment and for predicting prognosis. The gross study is the most important time but it needs to be completed by histopathological study on whole organ serial sections or on selected parts. This last event is often the only appropriate one for routine examination but it needs to know as well as possible the usual modes of invasion in accordance to the primary location. This work presents the results of the pathological topographic study in 251 partial or total laryngectomy specimens that were removed because of primary laryngeal cancer.
Humans↗
[Electromyography of the larynx in the diagnosis of spontaneous or post-thyroidectomy laryngeal paralysis].
Electromyographic assessment (EMG) of the larynx is very important for diagnostic and prognostic in cases of unmoving larynx: definition that authors like better than larynx palsie or recurrent nerve palsie because it is impossible to know why the larynx do not move in many cases (15f for 20 cases in the experience of the authors). EMG must be realized on several muscles and not only on the vocal fold muscle. It is necessary to realize several EMG to have a good follow up. If we have the proof that it is a case of definitive recurrent palsie the authors think that it is now, indication of nervous selective anastomosis by micro-surgery.
Electromyography↗
[Current techniques of pharyngo-velar reconstruction after excision for cancer].
Carcinological surgery of the pharyngo-velar region poses delicate problems of reconstruction in exereses exceeding the midline. To avoid false alimentary pathways through the nose and phonatory problems (open rhinolalia), we propose the use, with or without the combination of a muscular cutaneous flap, of a free antecubital flap or of a latter is apparently fully satisfactory on the functional plane with the additional advantage of not leaving any aesthetic sequellae.
Humans↗
[Technical indications and results of reconstructive laryngectomies].
The results of a series of 164 patients operated on using reconstructive laryngectomy, gives satisfaction for this type of operation if the indications are respected after a very specific endoscopic, radiological and per-operative loco-regional and local check-up. The functional results are clearly improved by a pluridisciplinary treatment associating a nursing team, orthophonists and physical therapists.
Adult↗
[Radiotherapy of carcinoma of the nasopharynx].
Cancer of the cavum is a rare condition in France. These tumors have, however, a poor prognosis and in general occur in young subjects. While radiotherapy would appear to be the best mean of ensuring local control, life expectancy depends solely on distant metastases. Analysis of a series of 58 cases treated at the Fondation Bergonié from 1975 to 1985 demonstrated a 30% five year survival rate. Among the 25 cases of recurrence, 1 was exclusively local and 6 were loco-regional (T and N), while 18 patients presented metastatic progression, either exclusively, or with local or lymph node failure. The prognostic factors found in this series were: age, extension beyond the cavum, the dose of radiotherapy. Results in the literature in terms of survival remain poor, especially in advanced stages and the future perspectives for better control of this disease remain early diagnosis and other forms of therapy such as combined chemotherapy and radiotherapy.
Adolescent↗
[The value of cellulo-adenectomy in the treatment of pharyngolaryngeal cancers without clinical adenopathy].
The term cellulo-adenectomy involves dissection of all the neck jugulo-carotid lymph nodes below the digastric muscle and above the omo-hyoid muscle. From the study of 133 cases treated by primary surgery, it can be said that this technique is essentially diagnosis to verify the actual integrity of the jugulo-carotid lymph trunk in patients who are clinically NO and who present a lymphophile ENT tumour. Such a technique necessitates a macroscopic lymph examination with an extemporaneous anatomical and pathological examination. Subsequent therapy depends on the result; for N+ patients, further surgery and/or irradiation, irrespective of the site; for a confirmed N- patient, additional therapy depending on the site of the tumour. Our experience has shown that this approach is safe and enables the treatment of the lymph glands to be better adapted to the reality of the neoplastic invasion.
Humans↗
[Complementary tests in the evaluation of velar insufficiency].
In order to assess the degree of velar deficiency as accurately as possible, three tests can be made: a nasofibroscopy, X-rays, and notably xeroradiography, a radiography made under brightness amplification. This check-up indicates the course of action to be undertaken: orthophonic rehabilitation followed, depending on the results, by a surgical operation. These tests are incorporated into a pluridisciplinary treatment.
Deglutition↗
[Rehabilitation of the abduction of the vocal cord by selective nerve anastomosis in dogs].
Laryngeal reinnervation procedures were performed on 15 dogs. Anastomosis was performed between a selected motor branch of the ansa hypoglossi and the posterior crico-arytenoid nerve. The results were analyzed endoscopically, electromyographically, and histologically. Results were satisfactory in 12 cases. The methods and results have been compared with those obtained using other reinnervation techniques.
Anastomosis, Surgical↗