Biomedical subjects

M Bruzzo

Publications and source records attributed to M Bruzzo.

8 recordsLinked to original sources

PubMed2000

[Our current results with acoustic neurinoma surgery].

Out of 130 CPA tumors operated on between 1993 and 1997, 91 were vestibular schwannomas less than 25 mm with preoperative hearing and normal facial function. The pre and postoperative facial and hearing functions were analyzed prospectively. The surgical technique applied was the complete tumor removal via retrosigmoid approach under facial nerve monitoring and CPA endoscopy. Clinical features were analyzed to determine postoperative facial grading (House-Brackmannn) and tonal and vocal audiometrical datas (PTA-SDS) at 8 days, 90 days and 1 year. We achieved 96 % of good facial results (Grade I and II/HB) and 46,5 % of postoperative conserved hearing. For tumors less than 25 mm in the CPA, good preoperative hearing level, preoperative AOE and BER seem to be predictive factors for hearing preservation. Early diagnosis associated with the advances in minimal invasive otoneurological techniques leads to perform complete removal of this type of tumors with respect of facial and hearing functions.

Adult↗

PubMed1998

[Fixed mallear head syndrome].

Fixed head malleus syndrome is a rare anatomoclinical entity first described by Goodhill in 1966. We present a series of 9 patients who underwent surgery between 1991 and 1997 and discuss the technical procedures used and functional outcome. Ossicular mobility can be re-established with two surgical methods. The more simple method consists in a classical incus transposition with malleus neck section. The more physiological method consists in drilling the synostosis fixing the malleus without disrupting the ossicular chain; stapedotomy is associated in certain cases (Type III).

Adult↗

PubMed1998

[Intact ossicular chain cholesteatoma: aspects and results of conservative surgery].

We present a 24 case-study of intact ossicular chain cholesteatomas among 158 first-look procedures performed between august 93 and april 96 (15%). The eradication of the disease was achieved via canal wall up technique without disrupting the ossicular chain in 20 cases (84%). Technical procedures are described. This new surgical attitude has enabled us to achieve better functional results. Second look procedures have not been necessary in all cases and occurrence of residuals has not been increased on a 14 months follow up period (2 cases out of 24 patients: 8%). Therefore, a longer follow up period is necessary to validate the results obtained using this recent concept.

Adolescent↗

PubMed1996

[Neuro-vascular decompression in hemifacial spasm: anatomical, electrophysiological and therapeutic results apropos of 100 cases].

Hemifacial spasm is a neurological disorder due to abnormal hyperactivity of the facial nerve. The most common cause of hemifacial spasm is a neuro-vascular conflict in the cerebellopontine angle between a vascular loop and the root of the facial nerve (96% of cases). Tumors are the cause of hemifacial spasm in only 1% of cases). The authors present their results in 100 patients who underwent microvascular decompression for essential hemifacial spasm between 1990 and 1995. They used microsurgical and endoscopic procedures by a minimal retrosigmoid approach in all cases. The most common offending vessels were the posterior inferior cerebellar artery (70%), the vertebral artery (41%) and the anterior inferior cerebellar artery (28%). An aberrant vein was found in 2 cases. There were 38% of multiple artery-nerve conflicts. Physiopathology of hemifacial spasm is explained by two principal theories: in the ephaptic theory, hyperactivity and an abnormal nervous impulse pathway are due to a short demyelinated area on the nerve trunk caused by the offending vessel, inducing short circuiting between adjacent nerve fibers. In the nuclear theory, hyperactivity of the facial nerve is due to an abnormal and automatic activity of the facial nerve nucleus itself, induced by the vessel. The authors used pre and postoperative electromyographic tests and intraoperative electromyographic tests. Their results tend to prove the nuclear theory. Ninety per cent of the patients had a good result, with a mean follow-up time of 30 months in 60 cases. In 82% of the cases, there was a total recovery after a single procedure. There was no mortality and no facial palsy. Hearing loss occurred in less than 5%.

Electromyography↗

PubMed1995

Canal wall prosthesis--new devices.

In our experience, management of the troublesome mastoid cavity a "rehabilitation" of the middle ear, usually involves post canal wall reconstruction. The purpose of the long canal wall reconstruction is to restore the anatomy as perfectly as possible in order to induce satisfactory wound healing of both epidermal a mucosal layers. The numerous materials and different surgical procedures to date, demonstrate the difficulty of reconstruction of the ear canal. Over twenty years we have performed 386 cases using various materials: cortical bone, ear canal allograft, ceravital, porous and dense hydroxylapatite. More recently to improve the anatomical results we have used a new titanium prosthesis. The pros and cons of each device are discussed.

Biocompatible Materials↗

PubMed1994

[Role of endoscopy and vascular decompression in the treatment of hemifacial spasm].

Although it has long been hypothesized that hemifacial spasm could arise from a conflict between the nerve and the artery, it is very difficult to distinguish between a normal arterial loop and a pathological conflict leading to facial symptoms. Several new elements would help in the definition of the cause and allow less traumatic treatment of idiopathic hemifacial spasm. They include magnetic resonance imagery with CISS sequences, limited retrosigmoid approach, endoscopy of the cerebellopontine angle and monitoring the facial nerve. In our experience with 20 cases, retrosigmoid approach with a combined surgical and endoscopic procedure has led to total involution of the spasms in 80% of the cases.

Adult↗

PubMed1993

[Contribution of endoscopy of the cerebellopontine angle by retrosigmoid approach. Neuroma and vasculo-nervous compression].

An endoscopic approach to the cerebellopontine angle has been suggested by several authors over the last 20 years but it is only recently that the technical and operative conditions for successful endoscopy could be met. The retrosigmoid approach provides simple and direct access to the cerebellopontine zone. The endoscope, with its distal light source, provides excellent illumination of a wide visual field within an anatomical site particularly rich in neurovascular structures. Endoscopic and microsurgical techniques may be combined for the surgical management of acoustic neuroma with the advantage of assuring better exposure of structures adjacent to the tumor and better control of the quality of dissection of the fundus of the internal auditory canal. The addition of endoscopic techniques, during surgery for trigeminal neuralgia or unilateral facial spasm, makes it possible to accurately locate the site of neurovascular compression without either retraction of the cerebellum or unnecessary dissection.

Arteries↗

PubMed1992

[Hemichorea-hemiballismus and toxoplasmosis in AIDS].

The authors report two cases of hemichorea-hemiballism revealing a toxoplasmic abscess in the subthalamic nucleus during AIDS. Despite the great frequency of this opportunistic infection such cases are exceptional. This rarity seems to be explained by the frequent association of other lesions of the basal ganglia which may prevent the movement disorders. Nevertheless an hemichorea-hemiballism in young people must suggest a cerebral toxoplasmosis. Finally a symptomatic treatment is often necessary; in these cases the use of sodium valproate must be considered, this drug being able to induce a clinical improvement.

AIDS-Related Opportunistic Infections↗