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Biomedical subjects

P Boudard

Publications and source records attributed to P Boudard.

18 recordsLinked to original sources
PubMed1997

Anatomical results with titanium implants in the mastoid region.

We report our experience with titanium implants for extra-aural rehabilitation in the mastoid region with a bone-anchored hearing aid (BAHA) and auricular prosthesis. The purpose of this study was to evaluate the clinical status of the soft tissue adjacent to 63 skin-penetrating devices in 43 patients and to compare our findings with those of other reports. Forty-four fixtures have been implanted in 36 patients for the BAHA and 19 in seven patients for the auricular prostheses. The evaluation concerns osseointegration, pain in the mastoid area, skin reaction around the abutment and removal of the abutment. Three implants extruded; one due to trauma and two with no explanation. Follow-up ranged from 3 to 60 months after surgical implantation. The first outpatient check-up was performed at three months after implantation and then every six months. The soft tissue reaction around the percutaneous unit was classified at each control according to the classification proposed by Holgers et al. There was no irritation (type 0) in 87.5% of the controls for the BAHA group and in 87.2% for the group of auricular prostheses. No adverse skin reactions were noted in 61.36% of the BAHA group and in 66.66% of the auricular prosthesis group. Results of this study confirm the skin's ability to tolerate a skin-penetrating unit made of pure titanium. The importance of reducing the thickness of the skin around the implant and of local hygienic conditions is emphasized.

Adolescent↗
PubMed1997

[Techniques of total reconstruction of the pinna].

Reconstruction of the pinna must be adapted for each individual case. Surgical techniques which use autologous costal cartilage are the most reliable. During the 1970s Burt Brent described a technique in 4 stages which gives very good results. More recently, Satoru Nagata has proposed total reconstruction of the pinna in two stages. For cases where there is insufficient spare skin, a tissue expansion prosthesis may be used in cases with extensive scarring and fibrosis, the superficial temporalis fascia flap is useful. Bone-anchored prostheses are reserved for those cases in which surgery is contra-indicated for general reasons. Based on our experience of 119 reconstructions of the pinna, we discuss the various techniques which may be used.

Ear, External↗
PubMed1997

[Decalcified, lyophilized, sterile heterotopic porcine ossicular xenografts. Experimental evaluation in the guinea pig].

Using the guinea pig middle ear model, we assessed decalcified, lyophylized, sterile heterotopic porcine ossicular xeno-implants based on a histology (optic and electron scan microscope) and immunologic (immunofluorscence) methods. Implants were placed in the middle ear and others in the dorsal subcutaneous area. Allo-implants were compared as controls. Implants were placed in the middle ear in 54 animals and skin implants in 14. Under the influence of BMP, the implant ossified in all cases in the middle ear. Intense immune recruitment was not observed. Inversely, there was a mononuclear infiltration reaction to the skin implants with formation of a fibrous capsule, immunoglobulin and complement influx and consequently sequestration. The allo-implants were partially reossified. These findings confirm the value of decalcification with hydrochloric acid for BMP induction, independent of species and the failure of attempted immune despecification. Implant outcome is not dependent on its antigen load, which is high compared with its weight, but on the site of implantation. The middle ear appears to be a privileged site of implantation.

Animals↗
PubMed1995

[The use of osseointegration of hearing aids].

The principles of osseointegration defined by Branemark are reviewed. The authors describe the otological applications of titanium implants: bone anchored hearing aids (BAHA). The good results obtained depend on the selection of the patients and the observance of a rigorous surgical technique. The present paper summarizes our results with 32 BAHA implanted in 27 patients.

Adolescent↗
PubMed1992

[Leiomyosarcoma of the larynx: presentation of a case].

The authors report a new case of laryngeal leiomyosarcoma. The patient was a 43-year-old-man. The tumor extended to the left vocal cord, the paraglottic space and the deep layers of the left false vocal cord. Histologically, the lesion showed the typical pattern of a grade-3 leiomyosarcoma. Immunochemical studies revealed a strong positive staining with the actin smooth muscle antisera. A partial laryngectomy was performed. There was no evidence of recurrent or metastatic disease 10 months after surgery.

Adult↗
PubMed1991

[Current techniques of pharyngo-velar reconstruction after excision for cancer].

Carcinological surgery of the pharyngo-velar region poses delicate problems of reconstruction in exereses exceeding the midline. To avoid false alimentary pathways through the nose and phonatory problems (open rhinolalia), we propose the use, with or without the combination of a muscular cutaneous flap, of a free antecubital flap or of a latter is apparently fully satisfactory on the functional plane with the additional advantage of not leaving any aesthetic sequellae.

Humans↗
PubMed1989

Anatomical and surgical particularities of cholesteatomas in children.

In children, cholesteatoma is closely related to dysfunction of the eustachian tube and evolves inside a malleable temporal bone. The importance of auditory and speech functions in such patients has caused us to use a very particular clinical philosophy. At the present time we have studied 154 cases of cholesteatomas in children under 15 years old. The following three points have been shown: the pathogenesis of a cholesteatoma can be of the primary type, secondary (due to an unfavorable extension of retraction pocket or to squamous cell migration) or even be iatrogenic; anatomical and clinical findings (with X-ray studies) predicate the treatment used; surgical treatment frequently requires a "second-look" operation.

Adolescent↗
PubMed1989

Aesthetic surgery for microtia.

We describe here a technique for reconstruction of the external ear based upon an autogenous costal cartilage graft which is inserted into a cutaneous pocket dissected in the auricular area. Three subsequent procedures are then performed: rotation of the ear-lobe; reconstruction of the tragus; and elevation of the auricle. The ideal age for reconstruction is about 7 years. This technique was originally described by Brent, who has a very extensive experience with this kind of surgery. Skin deficiencies can be overcome by using either a temporo-parietal fascial flap or a skin expander.

Cartilage↗
PubMed1989

[Mérocel's method in otorhinolaryngology].

Merocel intra-nasal pack are very effective in controlling epistaxis. Different forms of Merocel are very usefull in external otitis and after endonasal and middle ear surgery. They can protect some particular structures during oto-neuro and head and neck surgery.

Bandages↗
PubMed1989

[Use of a temporoparietal fascial flap in difficult reconstructions of the external ear].

Temporo parietal fascial flap is a way of total ear reconstruction when there is not a sufficient quantity of available skin in auricular region. This flap very thin, supplied by superficial temporal vessels is located above the auricle and can cover the framework's convolutions. This technique has been well described by Burt Brent. Our experience is based upon 12 total ear reconstruction with this kind of flap. When there is an extreme skin shortage, but of good quality, we discuss the technique of skin expander.

Ear, External↗
PubMed1989

[Primary malignant melanoma of ORL mucosa. Apropos of 5 cases].

Based on five observations of primary mucosal melanomas recently treated in the department, the authors describe the main features of this very rare condition, and particularly the evolutive aspects in diagnosis and prognosis. Histological diagnosis is sometimes difficult, and must involve specific argentic staining and a search for the presence of the protein S100. Tumor thickness was systematically examined. No prognostic interpretation, however, is possible, given the small number of cases in the series. Evolution is unpredictable; there is very commonly a series of local recurrences which may be well controlled, followed by remote metastases remaining long quiescent, bypassing the cervical ganglion relay. Treatment is surgical whenever possible, with palliative radiotherapy for local recurrences and chemotherapy for metastatic forms. Other therapies have yet to prove their effectiveness.

Aged↗
PubMed1989

[treatment of an epistaxis using a bilateral nasolabial flap in Osler-Rendu disease].

Severe and recurrent epistaxis in cases of Rendu-Osler disease (Hereditary hemorrhagic telangiectasia) are very difficult to treat. For one case the authors propose a bilateral nasolabial flap with inferior pedicle. They describe the technique and after 15 months of follow-up there is no recurrency. This treatment is used for particular cases: old people with short expectation of life, severe anaemia involving the vital prognosis.

Aged↗