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P Beutter

Publications and source records attributed to P Beutter.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1991

[HMPAO radionuclide of temporal cortex in the study of deafness].

A new method of dynamic exploration of central auditory pathway is presented, using measurement of cortical temporal perfusion variations, during auditory stimulation (tonal stimulation in normal hearing patients, electrical stimulation with promontory test in profoundly deaf patients). This study shows a perfusion increment in normal hearing and deaf patients with positive promontory test, which doesn't exist in a patient with negative promontory test. Further development of this study could help for optimization of post implantation auditory results.

Acoustic Stimulation↗
PubMed1990

Oropharynx carcinoma: irradiation alone versus induction chemotherapy plus irradiation--5 year results.

Induction chemotherapy (CT) has demonstrated overall response rates of 80% for oropharynx carcinomas, but no overall survival benefit has been reported. In order to determine the value of induction CT for such patients, we conducted a retrospective study: 121 patients were treated with CT and radiotherapy (RT) (Group 1). This group was compared with a historical group of 84 patients treated by RT alone (Group 2). The CT used was Cisplatinum associated with Bleomycin and Vincristin or Vindesin and with 5 Fluoro-uracil. An objective response to CT was observed for 41% of patients. The 5 year actuarial survival rate was 19% for Group 1 and 24% for Group 2. Patterns of failure were identical in the two groups. The only difference observed was for patients with N3 nodes (26% of 5 year survival rate in Group 1 versus 9% in Group 2) (p = 0.05). The results did not depend on the histological differentiation, the tumour site or the type of CT. We conclude that this retrospective study failed to demonstrate an advantage for induction CT in oropharynx carcinoma except for patients with N3 nodes.

Actuarial Analysis↗
PubMed1990

[Modification of precocious evoked auditory potential amplitudes observed in tinnitus].

Brainstem evoked response audiometry has been performed in 139 patients complaining of tinnitus, unilateral or bilateral. Amplitudes of I, III, V waves and the amplitude relations I/III, I/V, III/V have been compared with those obtained in a normal population (n = 20). Amplitudes of waves I and III decreased according to their localization: decrease of left I and III for left tinnitus, decrease of left I and right III for right tinnitus, and for I and III both left and right for bilateral tinnitus. Recording of brainstem evoked response before any therapeutical treatment, especially study of amplitudes, could therefore provide information an localization of tinnitus.

Adult↗
PubMed1990

[Normovolemic hemodilution in the treatment of sudden deafness].

Of a series of 23 patients presenting sudden deafness, treatment by normovolemic hemodilution yielded good results in 17 cases (74%), including 14 excellent results (61%) with constant efficacy on the tinnitus aurium (100%). These results appear overall superior to the 40 to 65% improvements reported in the literature. Nevertheless, comparisons in this area must take into account the very different assessment criteria applied from one series to another. The authors propose using the formula established to assess professional deafness, but taking the other ear as a reference.

Adult↗
PubMed1990

[Otogenic thrombosis of the lateral sinus].

Otogenic thrombosis of the lateral sinus, which has become rare since the use of antibiotics, nevertheless still poses diagnostic and therapeutic problems. Based on 4 cases treated at the University Teaching Hospital in Tours since 1982, the authors study the various clinical and paraclinical elements in the diagnosis, stressing the value of CT examination using contrast. Management is then proposed in diagramatic form: the indication for surgery depending on the efficacy of antibiotic therapy and internal jugular vein ligation being required in the event of septic emboli manifest cervical signs.

Adult↗
PubMed1990

[Value of the administration of trimetazidine associated with hemodilution in the treatment of sudden deafness. Report of a multicenter study].

Sudden deafness is a medical emergency, for which etiopathology is ill-known and no therapeutic consensus exists. This study is aimed at demonstrating that a greater audiometric gain can be achieved if trimetazidine, a major cellular anti-ischemia agent, is associated with hemodilution, than when the treatment is based on hemodilution only. 42 patients suffering from sudden deafness were all treated with hemodilution before their 7th day of deafness, half of them being given 3 tablets of trimetazidine daily in addition and the other half placebo, during one month. The results of this double-blind trial demonstrate an additional audiometric gain of 10% in the trimetazidine group for all frequencies, as well as a higher percentage of total recovery, ie. 63% vs. 47% in the placebo group. No particular sensitivity to treatment was noted according to the shape of the audiometric curve or in the case of initial cophosis, known to be of poor prognosis. The statistic significance was not established due to the small number of cases. The association of trimetazidine and hemodilution therefore seems to be an interesting therapeutic approach for sudden deafness, owing to the clinically appreciable audiometric improvement we have noted.

Adult↗
PubMed1990

[Pure primary retroperitoneal seminoma in a woman. Apropos of a case].

The authors report a case of a stage IV retroperitoneal seminoma in a patient of 43 years of age diagnosed after histological examination of a biopsy specimen from the left sub clavicular lymph mode showed metastatic seminomatosis. After complete assessment including and abdominal and pelvic ultrasound, a CT scan of the abdomen and pelvis, an intravenous urogram, a lymphogram and serial estimations of tumour markers (alpha feta protein and beta HCG) a laparotomy was carried out. This made it possible to take a retroperitoneal biopsy as well as to carry out a total hysterectomy without conservation of the ovaries. From all this we concluded that we were dealing with a straightforward very large retroperitoneal seminoma. The treatment was continued with large doses of chemotherapy using Vinblastin, Cisplatin and Bleomycin (V.C.B.). She received 5 treatments of this and then had radiotherapy. The authors report this first case described in the literature (because they found no other in women) and what made them decide on the therapy.

Adult↗
PubMed1990

[Results of radiotherapy of carcinomas of the tonsillar area. Study of 137 cases].

In our center, carcinomas of the tonsillar region are most often treated by radiotherapy. The aim of this retrospective study was to assess the therapeutical results obtained for such tumors over a period of ten years. From 1976 to 1986, 137 patients with carcinoma of the tonsillar area were exclusively treated by radiotherapy. The mean age of the patients was 54.3 years. 120 male and 17 female patients were included in the study. 63% of the patients had T3 or T4 tumors, while 53% had N2 or N3 adenopathies at enrollment (1979 TNM classification). All the patients had transcutaneous irradiation done either exclusively (121 cases) or in combination with curietherapy (16 cases). 61 patients had induction chemotherapy. Local control of the tumor was obtained in 59% of patients (79/137), and attained 92%, 71%, 58% and 16% for the T1, T2, T3 and T4 groups, respectively. The 5 year survival rate was 34%. 12 patients developed distal metastases. 9 patients developed another type of cancer. Elements of prognosis were tumor size and nodal status. Age, sex and histological differentiation were not determinant prognostic factors.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

[Auditory evoked potentials in distinguishing between peripheral and central tinnitus].

Brainstem evoked response audiometry has been performed in 164 patients complaining of tinnitus, unilateral or bilateral. The latency of every wave and the latency between the peak of every wave have been compared with those obtained in a normal population (n = 57). The latency of the first wave is increased significantly at the same side of the tinnitus. But I-V latency is shorter at the side of the tinnitus. When this increase is absent, the I-V latency is prolonged the side of the tinnitus. It is possible to differentiate between tinnitus of peripheral origin and that of central origin, although the existence of unilateral deafness is constant. The same results have been obtained in the deaf patients with bilateral symmetric deafness, in accordance with Maurizi et al., 1985.

Adult↗
PubMed1989

[Otoneurosurgery in the elderly].

An oto-neuro-surgical experience on patients older than 65 years is reported. 25 patients have been operated: 9 meningiomas, 5 trigeminal neuroglia, 2 vestibular neurectomies, 9 acoustic neuromas. The assessment, the indication, the surgical techniques are discussed. Are also evaluated the anesthetic technique, the patient drugs, position, and the post-operative survey.

Aged↗
PubMed1989

[Cancer of the tonsillar region. Role of irradiation in treatment].

In our center, carcinomas of the tonsillar region are usually treated by radiotherapy. This study presents the results of our treatment experience over ten years. Between 1976 and 1986, we treated 137 patients with carcinoma of the tonsillar area. The mean age was 54.3 years. The UICC TNM staging of 1979 was used: 63% of the patients had T3 and T4 tumours and 53% had lymph nodes at the first examination. All patients were treated by radiotherapy, alone for 121 patients and associated with brachytherapy for 16 patients. 61 patients received induction chemotherapy with Cisplatinum. Local control rate at the primary site was 56%, and was respectively 92%, 71%, 57% and 11% for T1, T2, T3 and T4 tumours. Local control rate in the neck was 72%. The 5-year actuarial survival rate was 34%. Distant metastasis occurred in 12 patients. 9 patients had a second primary tumor. Node status and stage were the main prognostic factors. Age, sex, histological subtype were not prognostic factors.

Carcinoma, Squamous Cell↗
PubMed1989

[Radiotherapy of carcinoma of the oropharynx. Results of 10 years' experience at the University Hospital Center, Tours].

In our centre, the vast majority of patients with oropharyngeal tumours are treated by irradiation. Over a period of 10 years, between 1976 and 1986 we treated 305 patients with squamous carcinomas of the oropharynx. The mean age was 58.2 years. There were 24 women and 281 men. 59% of the patients had advanced tumours, classified as T3 or T4, 54% of the patients showed the presence of adenopathy at the first examination. All patients received radiation therapy. 69 patients had surgical treatment of the tumour or glands. 21 patients had implant therapy (most often combined with transcutaneous irradiation). 165 patients had induction chemotherapy. Local tumour control was obtained in 124 patients (41%), i.e. 82, 56, 31 and 4% for T1, T2, T3 and T4 respectively. The 5 years survival rate of the overall population was 28%. The principle causes of failure were local progression for T3 and T4 tumours and metastases and second cancers in patients with T1 or T2 tumours. The prognostic factors were gland involvement and general health. The site of the tumour, sex and histological type were not prognostic factors. Induction chemotherapy did not improve the results of treatment.

Carcinoma↗
PubMed1989

[Carcinomas of the base of tongue: analysis of treatment results in 115 patients].

Between 1976 and 1986, we have treated 115 patients with base of the tongue carcinomas. The mean age was 53.8 years. Staging system used was the UICC TNM classification of 1979. 70% of the tumors were T3 or T4 and 42% had N2 or N3 lymph nodes. Loco-regional treatment was irradiation alone (98/115) or surgery and post-operative radiotherapy (17/115). 67 patients received an induction chemotherapy. 3 and 5 years actuarial survival was 25% and 23%, and 42, 48, 20 and 17% at 3 years for T1, T2, T3 and T4 lesions respectively. Local control rate at the primary sites was 55%, local control rate in the neck was 78%. Distant metastases occurred for 10% and 8% had a second primary. Nodal status was the only other prognostic factor. Local control rate obtained with irradiation alone was not good. For limited tumors T1 and T2, a better local control rate can be obtained with interstitial therapy or surgery.

Carcinoma, Squamous Cell↗
PubMed1988

[Carcinoma of the soft palate and uvula. An analysis of the results and the reasons for failures. A study of 76 cases].

The treatment of carcinomas of the soft palate most often involves radiotherapy. In order to assess the value of irradiation, notably in the treatment of limited T1 or T2 tumours, a retrospective study was carried out of 76 case records suitable for analysis of patients treated in our hospital for this type of tumour between 1974 and 1987. There were 70 men and 6 women. The mean age was 54 years. Fifty-four patients had limited T1 or T2 tumours (including 40 without lymphadenopathy). Treatment methods varied but 48/76 were treated by radiotherapy only (transcutaneous irradiation and/or local interstitial implant). Local tumour control was obtained in 87% of patients with T1 tumours, in 77% with T2 and in 50% with T3 tumours. Lymph node control was obtained in 68% of patients. None of the patients initially classified NO showed any subsequent lymph node involvement. The actuarial five-year survival rate was 67% for T1, 38% for T2 and 22% for T3. Lymph node involvement was the only other prognostic factor. Fourteen patients developed distant metastases and 13% had at least one other tumour site. Radiotherapy as tumour treatment is thus felt to be the method most widely used apart from tumours strictly limited to the uvula, where surgery is preferred. Cervical lymph nodes are treated surgically when there is a palpable lymphadenopathy and by radiotherapy for N0 patients. Induction chemotherapy before radiotherapy is used in addition at stages T3 and T4.

Adult↗
PubMed1988

[Advanced carcinoma of the oropharynx: the value of induction chemotherapy before locoregional treatment. A retrospective study of 138 cases].

Induction chemotherapy in oropharynx carcinomas had demonstrated overall response rates of 80%, but no overall survival benefit have been reported. In order to determine the value of induction chemotherapy for these patients, we conducted a retrospective study: 86 patients were treated with chemotherapy (CT) and RT (group 1) and 52 patients were treated by radiotherapy (RT) alone (group 2). All patients had T3 or T4 tumors. CT used was cisplatinum based associated with bleomycin and vincristine or vindesine and actually with 5 fluoro-uracil. Objective response to the CT was observed for 34% patients. Five years actuarial survival rate was 18% for group 1 and 17% for group 2. Patterns of failure were identical in the 2 groups. A difference was observed only for patients with N3 nodes (24% 5 years survival rate in group 1 versus 6% in group 2) (P = 0.05). According to the histologic differentiation, the tumor site or the type of CT, no difference was observed. We concluded that this study failed to demonstrate an advantage for induction chemotherapy in advanced oropharynx carcinoma excepted for patients with N3 nodes.

Actuarial Analysis↗
PubMed1988

[Surgical correction of saddle nose. Apropos of 23 cases].

Choice of graft for repair of a saddle nose in 23 patients, usually late sequelae of nasal fracture, varied with degree of concavity : moderate anomalies usually by cartilaginous graft, major lesions by iliac bone graft. Postoperative course was always simple. The Rethi approach was used when a bone graft was necessary, with a minimum esthetic ransom, and a skin flap of V-Y advancement at the expense of the white labrum when there was insufficiency of columellar height. Although results were assessed as satisfactory by the patients, the difficulties in obtaining excellent results in this type of rhinoplasty are emphasized, imperfections being frequent : filling of nasofrontal angle, asymmetry of naries orifices and fixed nose appearance.

Adolescent↗