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P Bordure

Publications and source records attributed to P Bordure.

At least 19 recordsLinked to original sources
PubMed2005

Hyrtl's fissure: a case of spontaneous cerebrospinal fluid otorrhea.

Spontaneous CSF otorrhea is a relatively rare entity. Adequate diagnosis and treatment are needed to avoid life-threatening complications such as meningitis. Because diagnosis is based on CT findings, identification of the different pathways of congenital fistulas requires detailed knowledge of embryology and anatomy. The facial canal, petromastoid canal, and tympanomeningeal (Hyrtl's) fissure can be responsible for CSF fluid otorrhea in the absence of any abnormality of the adjacent membranous labyrinth. We report the first documented and imaging case of Hyrtl's fissure and its treatment.

Cerebrospinal Fluid Otorrhea↗
PubMed2004

[Treatment of functional signs of acute maxillary rhinosinusitis in adults. Efficacy and tolerance of administration of oral prednisone for 3 days].

OBJECTIVE: Acute maxillary rhinosinusitis (AMRS) is a pathology in which the pain is often severe and requires appropriate treatment. Although the use of antibiotics is widely documented, the interest of short cycles of corticosteroids in the treatment of the functional manifestations of AMRS is based on professional experience. The aim of this study was to assess the efficacy and tolerance to prednisone administered for 3 days in addition to antibiotherapy in patients presenting with an AMRS. METHOD: This was a double blind, randomised study in parallel groups and controlled versus a placebo, involving patients aged over 18, presenting with an AMRS confirmed by X-ray and endoscopy, having developed less than 5 days and complaining of spontaneous pain assessed as >or=50 millimetres on a visual analog scale (VAS). Together with cefpodoxime, the patients received either prednisone (0.8 to 1.2 mg/kg) for 3 days or a placebo. The primary efficacy endpoint was the mean of the differences versus the baseline value of pain (MPID - mean pain intensity difference) assessed on the VAS from Day 1 to Day 3. The secondary endpoints assessed were the mean of the differences in intensity of nasal obstruction, assessed in the same way as the MPID, the time lapse before the orally expressed relief of the pain (PRID - pain reflief intensity difference) and the administration of paracetamol during the first 3 days. RESULTS: 289 patients (placebo 147, prednisone 142) were assessable for analysis in intent-to-treat (ITT). The global spontaneous pain on inclusion, measured by a VAS was of 73.0 +/- 14.1 mm. The assessments made during the first 3 days of treatment showed a statistically significant difference in favour of the prednisone group regarding MPID: - 4.82 mm (CI 95% -9.25; -0.40) (p=0.03), nasal obstruction - 5.0 mm (CI 95% -9.1; -0.8) (p=0.02) and consumption of paracetamol (p=0.03). There was no difference between the two groups after the end of the antibiotherapy. The tolerance measured throughout the study was comparable between the two groups. CONCLUSION: This study clearly showed the efficacy of a short course of oral prednisone (3 days), versus a placebo, in the treatment of the functional signs of acute maxillary rhinosinusitis with severe pain in adults in addition to an appropriate antibiotic treatment.

Acetaminophen↗
PubMed2003

What is the arcuate eminence?

A study was made of 100 homogeneous CT scans of the petrous part of the temporal bone to determine whether or not the arcuate eminence (AE) is a good landmark for the superior semicircular canal (SSCC) in the suprapetrous approach to the internal acoustic meatus which is used in the extirpation of acoustic neuromas. Direct measurements were made on consecutive coronal sections, 1 mm thick. The AE was absent from the petrous surface in 15% of cases. It corresponded to the relief of the SSCC in 37% of cases; laterally, however, it was separated from the petrous cortex by bone whose thickness varied from 0.5 to 5 mm. Finally, in 48% of cases, the AE was not a good landmark for the canal although nonetheless it participated in the development of this bulge in 46% of cases, always lying towards the medial border of the pneumatized eminence. In addition, study of the coronal sections with MRI allowed us to confirm that the AE does not routinely correspond to the imprint of a temporal sulcus. The AE, whose presence on the petrous surface is due to the combined effects of the SSCC, the air cells of the petrous part of the temporal bone and the temporal sulci, is only a good guide to the SSCC in 37% of cases and should not be considered as a reliable surgical landmark.

Humans↗
PubMed2002

Radiation-induced cancers of the pharynx and larynx: a study of five clinical cases.

Radiation-induced cancer, a rare clinical entity, is often difficult to diagnose and manage. This study reports a series of five cases of radiocarcinogenesis of the pharynx and/or larynx that developed after external radiotherapy. The primary lesion was diagnosed at a mean age of 50 years (+/-12.9) and the radiation-induced cancer at a mean age of 59 years (+/-13.1), giving a latent period of 9 years (+/-3.7). Analysis of gammagraphic records indicated that four of the patients had developed a secondary tumour in the penumbra of irradiation fields. In these zones, the delivered dose was between 20 and 80% of the prescribed dose, corresponding to an estimated cumulative mean dose of 14.1-56.3 Gy. These results are compared with data in the literature to determine the diagnostic criteria for radiation-induced cancer, possible predisposition (genetic or acquired) and the dose effect.

Adult↗
PubMed2001

[Autografts versus biomaterials for ossiculoplasty with normal stapes; a comparative analysis of functional outcome in 100 cases].

Ossicular graft is usually considered as the reference for surgical substitution in ossiculoplasties. Nevertheless, according to the infectious risks, nothing but autografts or synthetic prosthetic substitutes should be used nowadays. Authors compare hearing results for 100 patients after ossiculoplasty with either ossicular autograft or calcium-phospathe chain reconstruction. Audiometric results were retreived using both Glasgow Benefit Plot study and post-operative air-bone gap thresholds closure. Significant hearing improvement was statistically demonstrated in both conditions, and 60% of the patients had a post-operative hearing gain. Autograft ossicular reconstructions did not show to provide higher results. Biocompatibility and functionnal properties of calcium-phosphate materials retreived in this study, indicate that those ceramic substitutes should be considered as the best alternative to autografts.

Adolescent↗
PubMed2001

[Otomycosis].

Explore the source record for details and available documents.

Adult↗
PubMed1999

Cerebellar encephalomalacia on magnetic resonance imaging after removal of acoustic tumor.

MRI is widely used for postoperative surveillance of patients undergoing surgery for removal of acoustic neuroma. The purpose of this study was to investigate the frequency and pattern of postoperative changes in the cerebellum and brain stem on MRI after removal of acoustic neuroma. A retrospective study was conducted in 30 consecutive patients who underwent postoperative MRI between 1994 and 1995. The timing of the scans after surgery ranged from 12 months to 10 years. T2 -weighted turbo spin-echo images revealed cerebellar encephalomalacia in 17 of 30 cases. Cerebellar encephalomalacia was found more consistently in patients who had large tumors and was more frequent after the suboccipital approach. Encephalomalacia is largely caused by gliotic changes in the adjacent cerebellar tissues after tumor removal.

Adolescent↗
PubMed1999

[The role of areolar tissue on otologic surgery].

Areolar tissue is a loose conjunctive tissue, located between the fascia temporalis superficialis and the temporal aponeurosis. It can be used in several circumstances during otologic surgery. First, in stapes surgery, it can be used as an interposition between the piston and the platinotomy. Its thickness has no equivalent in comparison with other temporal tissues, explaining in part its usefulness in this indication. In perilymphatic fistula surgery, the areolar tissue is especially recommended for round window and oval window grafting because of its spontaneous adhesive capacity. It can be useful in myringoplasty, to reenforce an atrophic tympanic membrane or to close a small perforation. Also areolar tissue can be used as a flap or as a free graft to reconstruction of the external acoustic meatus. It's a good conjunctive support, which can be covered by skin graft. Finally areolar tissue is an interesting and useful material for otologic surgery. Its qualities are complementary to those of the temporal aponeurosis.

Connective Tissue↗
PubMed1998

[The value of beta-2 transferrin analysis and MR cisternography for the diagnosis of cerebrospinal fluid fistulas].

The diagnosis of cerebrospinal fluid (CSF) fistula may require invasive techniques. Detection of CSF and perilymph-specific beta 2 transferrin and MR cisternography which greatly enhances the CSF signal are sensitive and noninvasive techniques which allowed a precise diagnosis in seven patients with suspected CSF fistula. We review the different diagnostic techniques used for CSF fistula, beta 2 transferrin analysis and MR cisternography appear to provide accurate and noninvasive methods for investigating CSF fistulae. They should replace invasive techniques such as CT cisternography.

Adult↗
PubMed1997

[Bacteriological study in acute otitis media].

AIM: A prospective study on bacteriological epidemiology in acute otitis media was conducted in a pediatric hospital emergency service from January 1993 to October 1995. PATIENTS: One hundred and fifty-eight children, aged 6 months to 6 years, with an acute otitis media were included. Culturing and cleansing of the ear canal and tympanocentesis for aspiration and culture of the secretions were performed in 118 children (46 of whom had received antibiotics before for 48 hours). MAIN RESULTS: Middle ear aspirates were sterile in 35% of the children who had not received antibiotics and in 64% of those already treated. Bacteria in middle ear were predominantly Haemophilus influenzae and Streptococcus pneumoniae. Fifty-nine percent of S pneumoniae strains were penicillin-resistant; however, they were responsible for clinical failure in only 8% of cases. No Staphylococcus strains, commensal of the ear canal, could be considered as pathogenic for the middle ear. CONCLUSION: The preciseness with which secretions of middle ear are aspirated reduces the risk of contamination and comparison of ear canal and middle ear cultures allows to identify them. The high ratio of sterile middle ear aspirates after antibiotic treatment raises the question if other factors are responsible for persistent symptoms. The existence of penicillin-resistant S pneumoniae must be known to adjust treatment.

Acute Disease↗
PubMed1997

[Radio-anatomical study of the external auditory canal. Comparison between anatomical pieces and x-ray computed tomography].

Ear canal CT scan is widely used in addition to clinical examination, for diagnosis and evaluation of disease extension. Ear mouldings were performed on 11 cadavers (22 mouldings), 5 measurements were taken on each specimen and compared with CT scan measurement. Moulding measurements varied from side to side in one specimen, and moreover from one specimen on another one. Comparison between mouldings and CT scan showed that medial meatus measurements are identical. On the other hand, there are wide gaps for the lateral measurements. Biometrical disparity of the external auditory canal (EAC) was confirmed by this study. CT scan measurements in the lateral portion of the EAC are not reliable. Quantitative usefulness of CT scan is therefore limited to the study of the bony meatus.

Adult↗
PubMed1996

Perilymph detection by beta 2-transferrin immunoblotting assay. Application to the diagnosis of perilymphatic fistulae.

beta 2-Transferrin, the asialotransferrin, is found in cerebrospinal fluid (CSF) and inner ear perilymph, but is absent from serum and other body fluids or secretions except the aqueous humor. The detection of this asialo-fraction of the transferrin in ear fluid microsamples with an immunoblotting technique is of great interest when a perilymphatic fistula (PLF) is suspected. beta 2-Transferrin was detected on microsamples collected by syringe or on micro-collagen sponges from 30 patients undergoing ear surgery. The problem is reviewed, the technique and sample preparation are explained and the results discussed. beta 2-Transferrin detection in the ear fluid allows the identification of perilymph, except in the CSF oto- or rhinorrheal context, and is proposed as a promising test to confirm perilymphatic fistula.

Blotting, Western↗
PubMed1996

[Restoration of the mandible after trans-mandibular approach of invasive tumors of the oropharynx (43 cases)].

Preservation of the mandible is often possible in surgery of invasive malignant tumors of the oropharynx. From 1983 to 1993, we operated 158 T3 of the oropharynx: 73% with mandibulectomy and 27% with osteotomy (43 cases). Now, the osteotomy of the mandible is performed in more than 90% of the patients. The osteosynthesis needs two titanium plates; the pharyngoplasty is made with a pectoralis major myocutaneous flap. Followup: 36 cases of 43 gave satisfactory results. The osteotomy complication rate was 5 (12%): 5 osteitis (2 after radiotherapy).

Adult↗
PubMed1996

[Electrophysiologic and other objective tests in pediatric cochlear implantation].

Various electrophysiological procedures have been developed and utilized in pediatric cochlear implant patients. During surgery and just before implantation, recording of Electrically-Evoked Auditory Brainstem Responses (EABR) by electrical stimulation via a promontory needle electrode is a useful tool to select the suitable ear for implantation in the absence of other criteria. After implantation, peroperative assessment of the Electrically-Evoked Stapedius Reflex thresholds allows an estimation of the comfort levels not to be exceeded during the first tuning sessions. Recording of Averaged Electrode Voltages (AEV) provides assurance against general device failure, and can localize defectives electrodes which will be disactivated. Finally EABR obtained by electrical stimulation via the implant is the last control showing objective auditory responses. Furthermore there is a strong correlation between EABR thresholds and behavioral thresholds which will be obtained during the first tuning session. When a device malfunction is suspected after implantation, recording of AEV and EABR are performed, and the results are compared with the preoperative data.

Age Factors↗
PubMed1995

Usefulness of the galea flap in treatment of extensive frontal bone defects: a study of 14 patients.

We present a technique for treating extensive frontal bone loss after chronic osteitis and subsequent treatment. Unlike the technique usually performed in such cases (exclusion and filling), the frontal sinuses were conserved by isolating them from the reconstructed frontal vault. Isolation was achieved by means of a temporal galea and periosteum flap with a pedicle arising from the superficial temporal vessels. The study concerned 14 patients operated on from two to seven times for osteitis, which persisted in many patients for more than 10 years.

Adolescent↗
PubMed1994

[Vertigo and middle ear pathology].

The association of vertigo and diseases of the middle ear is not uncommon. It occurs especially during the course of chronic or acute otitis but can also occur as a sequela. Vestibular involvement is due to several pathophysiological mechanisms that influence the choice of treatment. The same is true for expansive processes of the tympanic cavity. When associated to otospongiosis, vertigo occurring during Ménière's disease can transiently contraindicate an operation on the tapes. On the contrary, vertigo resulting from traumatic lesion of the middle ear can suggest surgical intervention. Surgery of the middle ear can itself cause severe vertigo which sometimes requires a new operation. Lastly, the fortuitous association of disease of the middle ear with labyrinth disease, especially retrolabyrinthic such as eighth cranial nerve neurinome, is not uncommon, but can be long overlooked if it is not routinely suggested in the presence of labyrinth type symptoms.

Acute Disease↗