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Biomedical subjects

M Decat

Publications and source records attributed to M Decat.

At least 19 recordsLinked to original sources
PubMed2005

Metastatic renal cell carcinoma to the temporal bone: case report.

We report an extremely rare case of metastasic renal cell carcinoma to the temporal bone which presented initially as a jugulotympanic paraganglioma. The clinical and radiological appearances were misleading.Investigations of concomitant high blood pressure revealed a tumour of the right kidney. Biopsy of the mastoid mass was histologically compatible with a metastasis from a clear cell renal carcinoma. The patient underwent a radical nephrectomy and local external radiotherapy to the head. He also received adjuvant treatment with interferon-_ and interleukin 2. The clinical presentation, the radiological and histological features, the patterns of spread, the treatment options and the prognosis of these tumours are discussed. A review of the literature confirms the extremely unusual occurrence of this localisation.

Adult↗
PubMed2003

Tragal cartilage in tympanic membrane reconstruction.

INTRODUCTION: Management of chronic perforation and severe posterior and/or attic Retraction Pocket (RP) or atelectasis of the tympanic membrane continues to be one of the most difficult problems for otologists. AIM OF THE STUDY: To analyse the usefulness of the tympanic membrane reconstruction with tragal cartilage. MATERIALS AND METHODS: The study included 27 patients with chronic perforation or severe RP operated by the same surgeon, using tragal cartilage tympanoplasty. Seven supplementary procedures were required for recurrent cholesteatoma (second-look surgery). RESULTS: There has been no recurrence of the retraction and the perforation. Nineteen ossicular reconstructions were necessary with acceptable hearing results. CONCLUSIONS: Tragal cartilage has made a significant improvement in the tympanic membrane reconstruction procedure. A large thin cartilage combined with a titanium prosthesis can provide an excellent anatomical result, perfect stability and good functional outcome. When the eardrum is intact, we still use allografts of costal cartilage for the management of the retraction pocket or titanium prosthesis.

Adolescent↗
PubMed2002

Imaging in sensorineural deafness.

In this paper, the authors describe, in details, the techniques and the indication of CT scanner and MRI for the evaluation of neurosensory deafness. CT scanner allows to study bony and pneumatized structures of the ear. CT scanner is mostly indicated for the study of congenital deafness, post-trauma deafness and unilateral progressive deafness for which the otoscopy is normal. MRI allows the study of fluid compartments, nerves, vascularization and tissue. MRI will be chosen to evaluate sudden sensory neural deafness and unilateral deafness. However, it is worth to mention that CT scanner and MRI are complementary and that precision of the imaging system as well as a strong collaboration between the otolaryngologist and the radiologist are mandatory.

Adult↗
PubMed2000

Tinnitus and otosclerosis.

Fifty patients with otosclerosis and tinnitus were studied for the course of the tinnitus after stapes surgery. Tinnitus disappeared in 64% of the cases, improved in 16%, was unchanged in 14%, and worsened in 6%. The reduction in tinnitus was more favorable after a small fenestra stapedotomy than after a partial stapedectomy with removal of the posterior half of the footplate. An unfavorable postoperative course of tinnitus did not appear to be linked to the postoperative audiometric result. In our study the subjective evaluation of pitch and loudness of the tinnitus did not provide significant information regarding its prognosis.

Adult↗
PubMed2000

Labyrinthine fistula after cholesteatomatous chronic otitis media.

OBJECTIVES: To report on cases of labyrinthine fistula diagnosed in an ear, nose, and throat department and to study the incidence, location, pre- and postoperative symptoms (hearing loss, tinnitus, vertigo, facial palsy), preoperative diagnostic imaging, and surgical treatment of two types of cholesteatomatous labyrinthine fistulae-the extensive fistula that erodes both the bony and membranous labyrinths and the bone fistula that affects only the bony labyrinth. STUDY DESIGN: Retrospective case review. PATIENTS: Fifty-four patients with cholesteatomatous chronic otitis media with labyrinthine fistulae. SETTING: Tertiary referral center. INTERVENTIONS: Diagnosis and treatment. MAIN OUTCOME MEASURES: Clinical, imaging, and surgical correlation of extensive fistulae and bone fistulae. RESULTS: The incidence of labyrinthine fistulae was 7% in all patients who underwent surgery for chronic otitis media. The bone type (66%) is more common than the extensive type (33%). Compared with bone fistulae, the outcome for extensive fistulae is more severe in terms of hearing loss, vertigo, and facial palsy. In terms of preoperative diagnosis, computed tomography imaging ensured early diagnosis in 89% of extensive cases and in 28% of bone cases. For extensive fistulae, the surgical technique was more radical, requiring an open technique in 66% of cases versus 22% of the bone fistulae cases. The most common location is the lateral semicircular canal (61%). CONCLUSIONS: The breach in the membranous labyrinth is consistent with a more aggressive pathology, causing more severe pre- and postoperative symptoms. Preoperative computed tomography is more sensitive for diagnosing extensive fistulae, which also require a more radical treatment.

Adolescent↗
PubMed2000

Results of cerebellopontine space imaging by magnetic resonance during one year.

The authors present the results of a retrospective study concerning 231 magnetic resonance imaging (MRI) of the cerellopontine space requested by the otologists of the department between September 1996 and September 1997. The motives of imaging were sensorineural hearing loss (44%), vertigo and unsteadiness (25.5%), tinnitus (16.5%) and other (13%). The MRI was abnormal in 18% of the cases and the diagnosis of acoustic schwannoma was made in 10% of the cases.

Belgium↗
PubMed1998

Our classification of tympanic retraction pockets.

A classification of tympanic retraction pockets is indispensable in order to standardise their evaluation. In this manner, the evolution of the pathology can be carefully followed and the most appropriate therapy chosen. The authors propose adapting their classification to endoscopy which permits the inspection of the depths of certain pockets, otherwise invisible to examination under microscope, thus ensuring a better follow-up.

Ear Diseases↗
PubMed1997

Use of costal cartilage in middle ear surgery.

Use of costal cartilage in middle ear surgery. Tympanic membrane retraction often occurs in otologic pathology. In an effort to reduce this pathology, the surgical procedure considered incorporates the use of a new material which diminishes retraction and allows freer movement of the eardrum. Since 1991, we have been using costal cartilage allograft obtained from donors and treated to prevent disease transmission. The allografts were used for tympanoplasty, retraction pockets and attic reconstruction. More than 150 patients were treated and the results evaluated in order to determine the indications of this new material.

Cartilage↗
PubMed1997

The relevance of using tragal cartilage in tympanoplasty.

Chronic endotympanic depression is a pathological situation which leads to tympanic atelectasis, retraction pockets and cholesteatoma. It is also at the origin of tympanoplasty failure. Tragal composite perichondrium-cartilage graft is a procedure which gives good results in these difficult surgical cases.

Humans↗
PubMed1997

[Objective tinnitus and velar myoclonus: apropos of a case of a child].

The syndrome in which velar myoclonus is associated with objective tinnitus is rare, and in the adult corresponds most commonly with a lesion in the dentato-rubro-olivary tract. In the child, no lesion can usually be found. The disorders of function resulting from this syndrome are very disabling. Many forms of treatment have been proposed, and the results have been found to be disappointing. The authors report the case of a child in which muscle relaxants were used to very good effect, and emphasize the fact that the natural history of the condition in childhood is one of spontaneous remission, so that aggressive treatment is not appropriate.

Child↗
PubMed1996

Intracochlear schwannoma.

In the case reported evaluation of unilateral endocochlear deafness in a 44-year-old man led to a diagnosis of a small intracanalicular neurinoma of the cochlear nerve which had invaded the first turn of the cochlear spiral.

Adult↗
PubMed1995

Myringoplasty: long-term results in adults and children.

This report presents the long-term results 3 years after primary myringoplasties performed with formolized fascia temporalis autografts. The overall closure rate was 87.7% of cases, with improvement in hearing in 67.2% of cases. The best results were achieved with total perforations, and not with partial posterior perforations, contrary to popular opinion. The anterior perforations were the most difficult to close. Anterior angle blunting was avoided by careful technique. Although the results of myringoplasty are clearly better in adults than in children, there is not a determined "frontier age" before which a child may not undergo operation. The state of the middle ear at the time of operation influences surgical outcome: wet ears have a higher rate of perforation, myringitis, and retraction pocket. Medical treatment is recommended prior to surgery in every discharging ear, as a diagnostic method rather than a therapeutic one. If the ear remains wet, chronic otitis media should be considered rather than simple perforation of the eardrum, and a mastoidectomy should be combined with the myringoplasty.

Adolescent↗
PubMed1994

Treatment of lingual tonsillitis by transoral CO2 laser endoscopy.

The authors report on their clinical experiences concerning 100 cases of chronic lingual tonsillitis. The surgical treatment employed was endoscopic vaporization of affected tissues with the CO2 laser. Prior to surgical intervention, predisposing conditions such as allergy, rhinosinusitis, and gastroesophageal reflux were identified and treated. The surgical technique consisted of progressive vaporization of the lymphoid tissue at the base of the tongue until the lingual fascia was reached. A slightly defocused (700 mm) continuous 10-15 W laser beam was used at a working distance of 400 mm. Following surgery, no dyspnea was observed secondary to epiglottic edema and only one patient required postoperative hemostasis. Symptoms related to tonsil or tongue inflammation were eliminated or alleviated in 87 patients, remained unchanged in 12 patients and were worse in 1 patient.

Chronic Disease↗
PubMed1993

[Bone and cartilage allografts in microsurgery of the ear].

The authors present there experience with bone allografts and costal cartilage allografts in middle ear microsurgery. A drastic selection of the doners and a careful preparation of the grafts avoid the risk of viral transmission to the receiver. The easy available materials can be used for reconstructing the ear drum, the ossicular chain and the tympanic bony wall. With good anatomical and functional results, even at long-term (3 and 4 years).

Bone Transplantation↗
PubMed1993

[The use of glass ionomer cement in otology and in otoneurosurgery].

The use of glass ionomer cement for mastoid obliteration, reconstruction of the external ear canal, closure of the translabyrinthine approach for acoustic neuroma and fixation of a cochlear implant in the temporal bone is described. Preliminary results are encouraging, although some epithelialisation defects may occur in the external ear canal.

Biocompatible Materials↗