PubMed Health⌕ Search

Biomedical subjects

N Julien

Publications and source records attributed to N Julien.

12 recordsLinked to original sources
PubMed1992

Postlaryngectomy voice restoration. A prospective study in 83 patients.

From July 1985 until May 1990, 83 patients underwent a total laryngectomy. We prospectively studied voice restoration in 81 of them (two died postoperatively). Esophageal voice was used by 19 patients; a tracheoesophageal procedure (myomucosal shunt, primary or secondary puncture with Blom-Singer prosthesis) by 41; and 21 patients had no voice restoration. Results were assessed according to voice quality and usage. Tracheoesophageal speech had a success rate of 73% (good voice, daily use) after 1 month, while esophageal voice proved to have only a 5% success rate. Thirty patients (37%), however, remained without a substitute voice. The reasons for their exclusion are presented; they include a high rate of refusal.

Adult↗
PubMed1992

[Hemangioma of the petrous bone. Diagnosis and treatment].

Hemangiomas of the temporal bone are benign, vascular and are tumors. The diagnosis is in most cases made during the operation because the symptoms are non conclusive. Two cases were recently observed: one simulating a Meniere disease while the tumor was developed close to the jugular bulb and the endolymphatic sac; the second invaded the geniculate area and the petrous apex and was revealed by a progressive facial palsy.

Facial Paralysis↗
PubMed1991

[Infratemporal extension of tumors of the skull base].

The tumors of the middle and posterior portion of the skull base may extend extracranially. The spread of the tumors towards the infratemporal fossa is rare. Among 23 skull base tumors with extracranial extension which were diagnosed during the last 5 years, only two middle ear epidermoid carcinomas extended into the infratemporal fossa. Subtotal surgical removal of tumors was obtained in both cases through a subtotal petrectomy with an ultrasonic aspiration of the extracranial extension followed by transcutaneous irradiation. One case is followed free of disease 2 years and a half after the beginning of the treatment. The spread of the tumor into the infratemporal fossa might not be of poor prognosis.

Aged↗
PubMed1991

[Contribution of magnetic resonance imaging in the evaluation of chronic otitis].

Thirty four patients with a chronic otitis were evaluated prospectively by magnetic resonance imaging (MRI) to delineate its contribution in the diagnosis of middle ear masses. The results were correlated to the CT and the surgical and pathological findings. MRI permitted to differentiate the inflammatory tissues from either cholesteatoma, cholesterol granuloma and cerebromeningeal hernia.

Chronic Disease↗
PubMed1991

[Meningocerebral hernia and defects of the tegmen. Diagnosis and surgical treatment].

Eight defects of the tegmen tympani or antri have been operated on during the last two years. Among these cases, 4 brain herniae were associated with the defect of the tegmen. Magnetic resonance imaging permitted to evaluate accurately the space occupying lesions into the mastoid cavity and disclosed the brain and/or meningeal herniations. The defect of the tegmen was oblitered through a middle fossa approach whereas the hernia was resected through a mastoid approach when necessary.

Adult↗
PubMed1991

[Vocal restoration by tracheo-esophageal fistula. Evaluation of a 5 years' experience].

Between december 1985 and august 1990, 70 patients with total laryngectomy had their voice restaured by creation of tracheo-esophageal fistula. The tracheo-esophageal fistula was created during laryngectomy in 33 cases (20 punctures with Blom Singer prostheses, 13 surgical shunts), a few weeks later after surgery of radiotherapy in 17 cases or when production of esophageal voice feld in 20 cases. No major complication was observed. Results following voice recovery were satisfactory in 78.5% of cases (normal voice), one month after the procedure. Results are better when tracheo-oesophageal fistula was used initially (88%), than performed secondary (55%). After one year, results were satisfactory in 75.5% of cases.

Esophagus↗
PubMed1989

Cholesterol granulomas of the middle ear cavities: MR imaging.

Symptomatic cholesterol granuloma developed in the middle ear cavities in three cases. At computed tomography (CT) after the administration of contrast material, the granulomas appeared as nonspecific, nonenhanced soft-tissue masses with variable bone erosion. These features are indistinguishable from those of other similar clinical entities, especially cholesteatoma, paraganglioma, and endaural brain hernia. At magnetic resonance (MR) imaging, cholesterol granulomas had a more characteristic appearance. In two cases, the granulomas were depicted as areas of high signal intensity with both T1- and T2-weighted sequences. In the third case, an expansile mastoid cholesterol cyst exhibited medium signal intensity on T1-weighted images, with only a small hyperintense area and a hypointense area located in the cystic wall. Correlations between CT, MR, and microscopic findings show that MR imaging is far superior to CT in tumoral characterization, which is crucial for planning surgical approaches. MR imaging has limitations, however, particularly its inability to depict subtle bone abnormalities.

Adult↗
PubMed1989

[Cholesterol granuloma of the middle ear. Apropos of 3 cases].

Cholesterol granulomas arise scarcely within the middle ear cavities revealed by a conductive deafness. They appear on the CT scan as a non specific mass developed in the middle ear cavities with bone defects. MRI allow the diagnosis as cholesterol granulomas is defined by hyperintensity on all sequences.

Adult↗
PubMed1989

[Voice restoration after total laryngectomy by tracheoesophageal fistula].

Between December 1985 and December 1988, 34 patients with total laryngectomy had their voice restored by creation of tracheoesophageal fistula. A shunt was created in 13 cases of total laryngectomy. In 21 others, the technique used was tracheosophageal puncture with placement of a Blom-Singer prosthesis. This puncture was carried out either at the time of the laryngectomy or a few weeks later, or when production of esophageal voice failed. Results were assessed on the basis of criteria such as quality of voice, its use and the patient's autonomy. Indications for both procedures, their respective limits and difficulties are exposed. Immediate results following voice recovery were satisfactory in 82% of cases.

Esophagostomy↗