PubMed Health⌕ Search

Biomedical subjects

P Beutter

Publications and source records attributed to P Beutter.

At least 19 recordsLinked to original sources
PubMed2001

[Teratoma of the rhinopharynx and the infratemporal fossa in neonates: report of 3 cases].

Teratomas are tumors which develop in childhood or early adulthood, generally in the gonads. More rarely these tumors may be found in an axial localization, notably in cervicofacial forms. We report three cases of teratomas observed in rhinopharynx of three neonates operated at the Clocheville General Hospital. We present the main anatomoclinical features of these tumors, focusing on the cervicofacial forms in neonates. All three cases occurred in female neonates presenting acute dyspnea within the first hours of life, requiring intubation in two cases. The first two tumors invaded the infratemoral region and the third was a pediculated tumor of the velum exteriorized via the mouth. In one case antenatal ultrasound had suggested the diagnosis of a right temporomaxillary tumor. Rapid excision of the rhinopharngyeal component allow extubation for the two intubated infants and pathology diagnosis. In the first infant operated at 2 months, the lateral route was adapted to age, with mandibulotomy with section of the coronoid process but preserving the mandibular condyle. The second infant was operated at the age of 3 weeks using a wide frontotemporoperitonial approach then at the age of 3.5 months for recurrence extending to the floor of the temporal fossa and the middle ear. A type C infratemporal approach was used with lost-bone temporal craniectomy. Per-buccal excision was possible in the third infant with resection at the base of implantation. No recurrence has been observed in the first two cases at 3.5 and 2.5 months follow-up in the first two cases. The third infant was lost to follow-up.

Female↗
PubMed1999

[Otosclerosis surgery: a series of 227 cases. Introduction of CO2 laser].

OBJECTIVES: To evaluate the effects of the size of the footplate opening on the hearing results in surgical treatment of otosclerosis and the use of CO2 laser in this indication. PATIENTS AND METHODS: 190 patients with otosclerosis underwent 227 procedures between 1986 and 1995. Hearing results and symptoms were analyzed to compare the different procedures: 140 stapedectomies, 87 Fisch's stapedotomies, 35 of them with manual perforator, 52 of them with CO2 laser. RESULTS: Air/bone gap closure within 10 dB was obtained in 87, 92 and 97 percent of stapedectomies and in 80, 84 et 90 percent of stapedotomies after 3 months, 1 and 3 years (NS). Bone conduction was improved in 81, 80 et 63 percent of stapedectomies and 87, 97, 60 percent of stapedotomies after the same time (NS). Air/bone gap closure within 10 dB was obtained in 75 and 80 percent of manual perforator stapedotomies and in 84 and 88 percent of CO2 laser stapedotomies after 3 months, and 1 year (NS). Bone conduction was improved in 78 and 96 percent of manual perforator stapedotomies and 95 and 100 percent of CO2 laser stapedotomies after the same time (NS). No facial palsy or prolonged vertigo occurred. There was one case of anucusis following a stapedectomy. CONCLUSION: Although both stapedectomy and stapedotomy produced equivalent air/bone gap closure, reduction of inner ear trauma was noted with Fisch's stapedotomy. CO2 laser technique is a safe procedure, which optimizes the Fisch's stapedotomy.

Adolescent↗
PubMed1998

Bacteriology of chronic purulent secretions in chronic rhinosinusitis.

The aim of this work was to study the bacterial flora of purulent secretions during chronic rhinosinusitis. We studied a total of 533 patients divided into two groups. The control population consisted of 139 adults (> 16 years) of both sexes seen in the community or hospitalized for less than 72 hours for non-rhinological conditions. The rhinosinusitis group consisted of 394 patients referred to the ENT clinic with chronic rhinosinusitis. All the patients with rhinosinusitis had had a post-nasal discharge for at least three months, associated with purulent or mucopurulent secretions originating from the involved sinus cavity. All samples were obtained endonasally under endoscopic guidance from the sinus ostium or from the sinus cavity during surgery. Cultures were positive in 81.3 per cent of the control subjects and 83.1 per cent of the patients with rhinosinusitis. Corynebacteria, coagulase-negative staphylococci, propionibacteria and peptostreptococci were the main commensal organisms, while Haemophilus influenzae, streptococci, Streptococcus pneumoniae, Prevotella spp and Fusobacterium spp were probable causative pathogens. Anaerobes were isolated from approximately 25 per cent of the patients in the rhinosinusitis group. Betalactamase producers represented 27.5 per cent of H. influenzae and 28 per cent of Prevotella spp isolates. Diminished susceptibility to penicillin was found in 13 per cent of S. pneumoniae isolates. The amoxycillin-clavulanate combination was the most active oral antibiotic tested against the pathogenic species in vitro.

Adult↗
PubMed1998

Solitary fibrous tumour of the larynx: report of a case.

Solitary fibrous tumour is a particular kind of mesenchymal tumour, classically arising in the pleura. We report the first case arising in the larynx, associated with a metastasizing adenocarcinoma. The diagnosis is mainly histopathological, especially when strong immunoreactivity for the CD34 antibody is present.

Adenocarcinoma↗
PubMed1998

[Esophageal morphology with ultrasound imaging after laryngectomy: effect on quality of esophageal speech].

PURPOSE: In patients with aerodigestive cancer, laryngectomy places the esophagus in a superficial position, allowing easy ultrasound examination of this organ. The purpose of the present study was to assess oesophagus morphology after laryngectomy using echotomography and to compare this morphology with voice quality. MATERIAL AND METHODS: In the present study, ultrasonography was performed in 28 patients (delay from surgery: 3 +/- 3 years): 15 were operated using laryngectomy technique (LT) and 13 with pharyngolaryngectomy technique (PLT). On transversal echography, antero-posterior and latero-lateral diameters, esophagus area and dilatation during phonation were systematically measured. These data were compared to the voice quality assessed by two independent observers. RESULTS: A smaller latero-lateral diameter and area were found in the PLT group than in the LT group (p < 0.05) with a flat aspect in group LT. This was associated with faster and better voice acquisition in the PLT group. CONCLUSION: Morphologic study of the esophagus after laryngectomy using ultrasound is in favor of pharyngolaryngectomy technique which allows better conditions for acquiring esophageal voice in better conditions. This could be due to the small area, circle shape and tonicity of the esophagus after this type of surgery.

Esophagus↗
PubMed1998

[Results of vestibular neurotomy from a socio-professional point of view].

Vestibular neurotomy, in addition to the fact that it preserves the hearing, is considered to be the most effective form of treatment for incapacitating unilateral Menières disease which is resistant to medical treatment. The authors have carried out a retrospective study of 20 cases of vestibular neurotomy operated on between 1986 and 1996. They have evaluated the results of the suppression of vertigo and the improvement of quality of life. Each patient was given a questionnaire. The parameters studied were the quality of daily life, professional life and driving ability. The mean follow-up period was 3 years. This study confirms the good results obtained with vestibular neurotomy for vertigo: complete control of attacks of vertigo was obtained in 90% of cases according to the criteria laid down by the American Committee on Hearing and Balance, as modified in 1985 (AAO, 1985). This study has also confirmed that the quality of patients lives is greatly enhanced both for everyday activities, professional activities and driving.

Adult↗
PubMed1996

Bacteriology of the adult middle meatus.

The aim of this work was to assess the commensal flora in the adult middle meatus. Thus, 139 samples were taken from subjects of both sexes, over 16 years of age, seen in the community or hospitalized for less than 72 hours for non-rhinological conditions. They had had no nasal or sinus conditions in the previous three months. One hundred and thirteen samples contained at least one aerobic or anaerobic bacterium. Fifty-nine samples yielded a single organism in culture. A maximum of five organisms were isolated from a given patient. These results show that the adult middle meatus contains a mixed commensal flora and should prove useful in interpreting endonasal swab cultures during acute and chronic sinus infection.

Adolescent↗
PubMed1995

[Lateral efferent system and evoked auditory potentials. Response in tinnitus].

The effects of ipsi- or contralateral masking have been studied in 45 normal hearing subjects and in 49 tinnitus patients. With normal subjects, ipsilateral masking during auditory stimulation involves--in opposition to contralateral masking which does not alter any latencies--a significant lengthening of all the latencies in the brainstem, except that of the first wave (right and left), and a significant decreasing of the amplitudes of the waves I L and R. It was important to know whether the lengthening of the latencies in the brainstem--which we suppose to be due to the stimulation of the lateral efferent system--was not in fact due to a preferential stimulation of the auditory cells from the basis of the cochlea. Yet experiments have shown that continuous masking of 40 dB at 750 Hz or 4000 Hz added to stimulation, involved no significant modification of the latencies in normal subjects. Therefore the lengthening of the latencies obtained with white noise masking, belonged to an other sphere. The second problem concerned the responses of tinnitus patients. Ipsilateral masking in white noises does not alter any latencies in the patients' brainstem. They seem to have lost the possibility of reacting to any additional noise coming from the outside. As we have already noticed, their latencies before masking were different from those of normal subjects. With masking the patients, latencies remained unchanged whereas the latencies of normal subjects lengthened and caught up the patients. To conclude, we suppose the lateral efferent system can be explored by the adjunction of white noise masking, ipsilateral to the stimulation. The expected response is a lengthening of interpeak I-V latency, without any modification of the latency of the first wave. Tinnitus patients generally do not have that type of response to white noise masking. Their lateral efferent system may not be operating.

Adult↗
PubMed1995

[Tracheal carcinoma infiltrating the thyroid gland and mimicking subacute thyroiditis. Contribution of Doppler to differential diagnosis].

In the present case Color Coded Doppler showed a marked increase in vascularization in the right lobe of the thyroid with high systolic velocities (1 m/s). This sign was only doubtful compared with clinical, biological and isotopic data. Because of dramatic laryngeal dyspnea, surgery was conducted which allowed the final diagnosis of thyroid invasion by tracheal epidermoid carcinoma. This demonstrates the particular role of Color Coded Doppler in the management of inflammatory thyroid diseases.

Adult↗
PubMed1995

[Contribution of echography in the detection of lymph node diseases in epidermoid carcinoma of the larynx: therapeutic implications].

Based on a clinical, echographic and histologic study of 80 lymph node dissection, correlations were made by dissection and lymph node localization. The literature and the results of this study suggest that preoperative echography could have an effect on the surgical procedure, especially in cases with a clinically detected lymph node enlargement and if complementary radiotherapy is planned.

Carcinoma, Squamous Cell↗
PubMed1993

Perfusion response during electrical stimulation of the auditory nerve in profoundly deaf patients: study with single photon emission computed tomography.

Brain activation procedures associated with single photon emission computed tomography (SPECT) recently have been developed in healthy controls and in diseased patients to help in their diagnosis and treatment. We investigated the effects of an electrical stimulation of the auditory nerve on the cerebral distribution of 99mTc-HMPAO in seven profoundly deaf adults. The promontory test was positive (PT+) in six patients and negative (PT-) in one. A count increment of the temporal cortex was observed in all patients, and was higher in all patients with PT+ (right 20%, left 19%) than in the patient with PT- (right 9%, left 3%). These results led us to consider 99mTc-HMPAO brain SPECT imaging as a potential preoperative test for cochlear implant. It might be helpful for the evaluation of cortical perfusion response to an electrical stimulation. Sensitivity tests for the method are requested before this clinical application.

Adolescent↗
PubMed1992

Cortical perfusion response to an electrical stimulation of the auditory nerve in profoundly deaf patients: study with technetium-99m hexamethylpropylene amine oxime single photon emission tomography.

Brain activation procedures associated with single photon emission tomography (SPET) have recently been developed in healthy controls and diseased patients in order to help in their diagnosis and treatment. We investigated the effects of a promontory test (PT) on the cerebral distribution of technetium-99m hexamethylpropylene amine oxime (99mTc-HMPAO) in 7 profoundly deaf patients, 6 PT+ and one PT-. The count variation in the temporal lobe was calculated on 6 coronal slices using the ratio (Rstimulation-Rdeprivation)/Rdeprivation where R = counts in the temporal lobe/whole-brain count. A count increase in the temporal lobe was observed in all patients and was higher in all patients with PT+ than in the patient with PT-. The problems of head positioning and resolution of the system were taken into account, and we considered that the maximal count increment was related to the auditory cortex response to the stimulus. Further clinical investigations with high-resolution systems have to be performed in order to validate this presurgery test in cochlear implant assessment.

Adult↗
PubMed1992

[Septic erosion of the internal carotid artery and retrostylian phlegmon. Apropos of a case].

The vascular complications of peritonsillar phlegmons have become exceptional. On the basis of a recent case, the authors sum up the criteria of severity, including: white puncture sample, paralysis of the 9th, 10th, 11th, 12th cranial nerves and of the cervical sympathetic nerve. Computed tomography allows not only refining the topographic diagnosis, but even sometimes diagnosing a pseudoaneurysm before it is fissured. At this stage, intraoperative radiology may probably prevent the unavoidable secondary rupture. If it cannot be used, preventive ligation must be proposed. In the absence of cataclysmic hemorrhage, this easier procedure usually does not cause any irreversible neurological deficit. If performed in emergency, it may entail a major risk, not only a neurological risk, but a vital risk as well.

Carotid Artery Diseases↗
PubMed1991

Increment of brain temporal perfusion during auditory stimulation. Preliminary study with technetium-99m HMPAO SPET.

A study on the dynamic exploration of the auditory pathway is presented, in which technetium-99m hexamethylpropylene amine oxime single-photon emission computed tomography (SPET) was used in volunteers with normal hearing. Changes in 99mTc-HMPAO distribution were calculated using a region of interest/whole-brain count ratio. The results showed a temporal perfusion increment of 17% (right) and 19% (left) during tonal supraliminar stimulation, which was significantly different from the control ROI. Sensitivity tests for the method were requested before any clinical application.

Acoustic Stimulation↗
PubMed1991

[Can the efferent auditory system be explored via early evoked potentials? Preliminary results in normal hearing subjects and people with tinnitus].

The use of masking in brainstem auditory evoked potential technic remains one of the important issue regarding the evaluation of different auditory control systems. Brainstem auditory evoked response wave form latencies and amplitudes have been studied on 14 normal hearing subjects. On one hand the contralateral masking which theoretically stimulates the medial contralateral efferent bundle did not modify the responses. On the other hand, the ipsilateral masking stimulating the lateral bundle reduced the amplitude of wave I and lengthened the latency of interwave I to V. The same protocol has been applied to 21 tinnitus patients. In these subjects before masking, the waves amplitude was lower and inter wave I-V latency was lengthened. The ipsilateral did not modify the responses as in the normal population. Comparing brainstem responses obtained in masking and no masking condition offers the possibility of evaluating the lateral efferent system function but we can conclude that the contralateral masking is of no use studying the medial system and that dysfunctions of the lateral efferent system could be one mechanism responsible for tinnitus.

Adult↗