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Biomedical subjects

S Collet

Publications and source records attributed to S Collet.

At least 19 recordsLinked to original sources
PubMed2006

The silent sinus syndrome.

Silent sinus syndrome is a rare clinical entity typically characterized by spontaneous and progressive enophthalmos and hypoglobus caused by an alteration of the normal orbital architecture and function from maxillary collapse in the setting of the chronic maxillary sinus hypoventilation. The authors report an unusual case revealed by mild dental pain, present the imaging (before, during and after the development of the disease), discuss the different theories related to pathogenesis and comment the treatment.

Animals↗
PubMed2006

[Actinomycotic lachrymal canaliculitis: a case report].

The authors report a case of unilateral chronic epiphora resistant to prolonged topical antibiotic treatment in a 62-year-old woman. Culture yielded some colonies of Actinomyces species. A dacryocystorhinostomy was found to be ineffective. Canaliculotomy with removal of cast resolved the chronic canaliculitis. Histological examination confirmed the diagnosis of solid cast of Actinomyces.

Actinomycosis↗
PubMed2005

The role of nasal cavity disinfection in the bacteriology of chronic sinusitis.

OBJECTIVES: Several factors may influence the results of bacteriological studies in chronic rhinosinusitis. We investigated the potential role of nasal cavity disinfection in the bacteriology of the bulla ethmoidalis in patients suffering from chronic sinusitis. MATERIAL AND METHODS: Bacteriology of the bulla ethmoidalis was studied in 176 consecutive adult patients presenting a chronic sinusitis refractory to standard medical treatment who underwent functional endoscopic sinus surgery. Two different techniques were used: (A) a technique with nasal vestibule and facial disinfection with chlorhexedin (N = 89 patients and 165 samples) vs. (B) a technique with facial, nasal vestibule and nasal cavity disinfection with a povidone-iodine solution followed by a cleansing of the nasal cavity (N = 87 patients and 166 samples). RESULTS: Culture rate was 89.6% (183 bacterial isolates) for technique (A) vs 76.5% (164 bacterial isolates) for technique (B) (p < 0.001). Major bacteria encountered in the (A) group and in the (B) group were respectively: Coagulase Negative Staphylococcus: 77 vs 40 isolates (p < 0.001); Coagulase positive Staphylococcus: 44 vs 30 isolates (p = 0.061); Streptococcus pneumoniae: 4 vs 5 isolates; Others: Streptococcus sp.: 12 vs 16 isolates; Haemophilus influenzae: 8 vs 6 isolates; Enterobacteriacea: 33 vs 53 isolates (p = 0.013) and others Gram Negative Bacilli: 3 vs 7 isolates. CONCLUSIONS: The standard (A) technique to study the bacteriology of the bulla ethmoidalis in patients with chronic sinusitis yielded a higher percentage of positive culture and of bacterial isolates than a more advanced (B) technique. This is mainly due to the higher percentage of contaminant bacteria such as Coagulase Negative Staphylococcus recovered with the standard technique. Enterobacteriacea and others Gram Negative Bacilli were more often encountered into the bulla ethmoidalis with the technique where disinfection of the nasal cavity was performed.

Adult↗
PubMed2005

Guidelines to the management of epistaxis.

This article is a review of the literature on epistaxis and its treatment. Data were collected from MedLine until mid September 2005, and from others readings and books. Its first goal was to present to the Belgian ENT practitioners an overview, as complete as possible, of the modern concepts in etiologies, medical, conservative, surgical (including embolization), and adjunctive therapies of epistaxis. All these topics are discussed and commented, from a medico-surgical point of view, and also from a cost effectiveness one.

Cost-Benefit Analysis↗
PubMed2005

Smell disorders in ENT clinic.

Olfactory disorders may have several causes. Nasal polyposis or chronic sinusitis can result in nasal obstructions that block the access of odorants to the olfactory epithelium, and this can explain the development of olfactory disorders. On the other hand, when nasal endoscopy has revealed that the nasal cleft is free of inflammatory or tumoural disease, olfactory disorders may be explained by neuroepithelial or central nervous system disturbances. This paper will provide information about current approaches to smell disorders in otorhinolaryngology. Major causes will be reviewed as outcomes after medical or surgical treatment. An algorithm will also be given to standardise clinical investigations, including psychophysical olfactory testing, imaging and electrophysiological examinations.

Central Nervous System Diseases↗
PubMed2004

Extracranial sinonasal tract meningioma: a case report.

Extracranial meningioma is an unusual tumor, mainly found in the head and neck area. Before surgical removal and histopathological examination, this diagnosis is rarely considered. We report a case of an extracranial meningioma located in the frontal sinuses of a 65-year-old-woman. Symptomatology included trouble of vision due to bilateral exophtalmos and mild headaches. Bilateral exophtalmos was secondary to the development of huge frontal mucoceles. These mucoceles grew slowly due to the frontal recesses blockage by the extracranial meningioma. External approach was performed with removal of the mucocele walls and of the extracranial meningioma itself. The frontal recesses were blocked with synthetic cement, and orbital roofs were reconstructed with a polydioxanon-sheet (PDS). Frontal sinuses were excluded and filled with bone bank grafts. A review of the literature on extracranial meningioma and a discussion about the surgical management of this case are proposed in this paper.

Aged↗
PubMed2002

Effect of nasal valve surgery by open-septorhinoplasty and lateral cartilage grafts (spreader grafts) on snoring among a population of single snorers. Preliminary report.

Snoring is traditionally considered more of a social nuisance than disease. The observation that nasal obstruction may modify breathing during sleep and daytime behavior and our clinical observations suggesting that some single snorer patients who had undergone surgery of the nasal valve for nasal obstruction complaints had presented a decrease in their snoring, led us to make a retrospective study on twenty nine patients. Eight of them were simple snorers. They underwent a surgery of the nasal valve under general anesthesia through an open septorhinoplasty during which lateral graft cartilages (modified spreader grafts) were set in place between septolateral cartilage and the anterior and superior edge of the nasal septum. Active anterior rhinomanometry (AAR), posterior active rhinomanometry (PAR) and a self-assessment of the nasal patency by the patient himself on a visual analog scale (VAS) were compared before and one year after surgery. Snoring was assessed by both bed partners according to a four step scale (none, slight, moderate and severe). No significant differences were found between AAR or between PAR. But significant differences were measured with VAS (for the left (p < 0.0001) and the right sides (p < 0.001). All patients but one demonstrated substantially decreased snoring. As there is no clear cut evidence of changes in nasal resistances measured by rhinomanometry, we suggest that the observed decrease in snoring may be induced by changes in the direction of the nasal airflow against the nasal mucosa which may produce by a reflex between mecanoreceptors of the nasal mucosa and muscles of the pharynx, an increased tonus of the muscles of the pharynx.

Adult↗
PubMed2001

Is septal deviation a risk factor for chronic sinusitis? Review of literature.

INTRODUCTION: The purpose of this work is to examine the role of septal deviation in adults in the pathogenesis of chronic sinusitis. This evaluation would allow a better understanding of the contributing factors to this pathology and would improve results in their management. MATERIAL AND METHODS: This review was based on a Medline research over English and French literature published between 1980 and May 2001. Twenty-five papers were scrutinized. RESULTS: Few investigators examined the role of the deviated septum on sinus disease. Methodologies and results are often contradictory. Furthermore, these studies are mainly based on radiological imaging. In most studies, prevalence of septal deviation looks the same when having compared among patients with radiological rhinosinusitis and among general population. An increased incidence and severity of sinus disease correlated to an increasing angle of septal deviation in the ostiomeatal complex area is reported by Calhoun (7), Youssem (4), Matschke (18) et Elahi (20). One study (1) demonstrates a significant association between the shape of the nasal septum and the location of the sinus disease: septal crest is associated with homolateral sinusitis, "watch-glass shaped diformity" with controlateral sinusitis. Stammberger (21, 25) suggests a pathophysiological role of the septum through a mechanical obstruction on the ostiomeatal complex; Danese (1) and Blaugrund (19) by an alteration of the ciliary activity secondary to a modified air flow. Bachert (24) demonstrates a connection between septal deviation and antral ventilation. CONCLUSION: This literature review cannot establish a definite role to the nasal septum neither as the pathogenesis of chronic sinusitis nor as a contributing factor. No relationship between septal surgery combined with sinus surgery, and the postoperative prognosis nor on the subjective comfort of patients can be demonstrated. Subsequently, it appears that performing septoplasty only aims at relieving nasal obstruction complaint or at improving surgical access to the ethmoïd sinus.

Adult↗
PubMed2000

Endoscopic endonasal surgery for paranasal sinus mucoceles.

Paranasal sinus mucoceles are benign, space-occupying, cystic lesions that require a surgical treatment. An endoscopic endonasal marsupialisation is nowadays the surgical approach of choice in most of the cases. The aim of the present study is to validate this option and to determine the clinical characteristics of paranasal sinus mucoceles. A retrospective study based on the clinical experience of several ENT surgeons was performed using a standardised questionnaire. The respondents participate to a report on endoscopic endonasal surgery for non-inflammatory disease in Belgium. One hundred and fourty patients presenting 178 mucoceles were included in this study. Primitive mucoceles were reported in 35% of the patients, posttraumatic mucoceles in 2.1% and postoperative mucoceles in 62.9%. The time interval between first rhinologic procedure and the mucocele diagnosis was respectively 24.4 months after FESS and 108.3 months after an external procedure. Paranasal sinus mucoceles predominantly occur in the fronto-ethmoidal region (64%), followed by the maxillary sinus (18.6%), the sphenoid sinus (8.4%) and the posterior ethmoid sinus (6.7%). Uncommon locations were also reported in 2.3% (Inferior turbinate, middle turbinate, pterygomaxillary space). Endoscopic endonasal marsupialisation (combined with an external procedure for 8 patients) was successful in 97.9% of the patients. Only 3 patients showed recurrence. Endoscopic endonasal marsupialisation of paranasal sinus mucoceles is a reliable therapeutic option with favorable results and is supported by the questioned ENT surgeons in Belgium.

Adolescent↗
PubMed2000

Surgery of inverted papillomas under endoscopic control.

Six centers cooperated in a retrospective study on endoscopic surgical resection of Papillomas of the nose and paranasal sinuses in order to assess both the efficiency and the safety of this kind of surgical approach. From 1991 till march 2000, 87 cases of Papillomas resections under--at least partially--endoscopic control were gathered, among which 85 were Inverted Papillomas (IP), 2 were Exophytic Papilloma (EP) and one was IP coexisting with Collumnar Cell Papilloma (CCP). Malignant transformation was found out in 3 cases of IP. Regarding the 85 patients with IP demographics are as follows: 61 males, 24 females, with a mean age of 58.4 years (STDV: 13.96) in a range from 27 to 92 years. The mean follow-up was of 41.9 months with range of 1-120 months. Fifteen recurrences occurred that were treated by revision surgery either under endoscopic control or by limited external approach. The mean time for recurrences to occur was 8.07 months with range of 1-24 months. The three patients with malignant transformation underwent postoperative radiation therapy. All of the patients are free of recurrence, however for some of them the follow-up is too short to definitely assess their free of disease status. The role of modern diagnostic tools in medical imaging--CAT and MRI--in order to assess clearly the limits of the tumors and to enhance the efficiency and the safety in the choice of a surgical approach is pointed out. The stress is put on the need for radical excision under endoscopic control which can be combined with the Caldwell-Luc transantral approach or with frontal trepanation for the cure of tumors impossible to be reached under endoscopic control only. Irrespective of the tumor extent and of the approaches that was used for excision a close endoscopic follow-up still remain mandatory, by trained surgeons, in the long term management of IP. Biopsies, CAT and/or MRI must be performed in any case with recurrence suspicion.

Adult↗
PubMed2000

Transcanalicular diode laser assisted dacryocystorhinostomy.

AIM OF THE STUDY: To assess the validity of transcanalicular diode laser assisted dacryocystorhinostomy (TLADCR) in the treatment of distal obstruction of the lachrymal pathways. MATERIAL AND METHOD: Between June 1999 and February 2000, 29 TLADCR were performed in the ENT department on 26 patients. Surgical indications included chronic dacryocystitis in 19 cases and dacryostenosis in 10 cases. In all cases but one, the surgery was carried out under a standard general anesthetic. The diode laser was used with a power setting of 10 watts. RESULTS: Seventeen out of 29 TLADCR were regarded as having successful outcomes. 2 out of 29 TLADCR had a little persisting tearing regarded as non debilitating and much less than which was present preoperatively. In 10 out of 29 TLADCR, the procedure was deemed a failure. These failures included 4 out of the 10 primary dacryostenosis and 6 out of the 19 chronic dacryocystitis. Two patients refused further treatment. In the other 8, surgical revision was undertaken via the traditional endonasal approach. In 7 of these cases, the lachrymal system was full of purulent secretions. COMPLICATIONS: Two patients developed a partial stenosis of one canaliculus that was diagnosed during the surgical revision. Another patient had a small fistula between the canalicular system and the skin of the corner of the eye that disappeared after the revision surgery. In one other case, the superior canaliculus was cauterised by the denudated portion of a resculpted laser fibre. Two bicanalicular nasal stent required reinsertion. Three patients developed a granuloma around the stent. Four patients developed an episode of infection whilst the stent was still in situ. CONCLUSION: Transcanalicular diode laser assisted dacryocystorhinostomy (TLADCR) performed with a 600-micron contact fibre is a relatively simple, elegant and effective procedure when used in conjunction with nasal endoscopy, to treat distal obstruction of the lachrymal pathways. But, the cost, the high prevalence of minor complications and the currently higher reported failure rate would favour external or endonasal approaches over this approach.

Adolescent↗
PubMed2000

Transnasal endoscopic orbital decompression and Graves' ophtalmopathy.

AIM OF THE STUDY: To assess the validity and the limits of endoscopic endonasal orbital decompression for Graves' ophtalmopathy resistant to the medical theapy. MATERIAL AND PATIENTS: Between September 1994 and May 1998, 16 patients with Graves' ophtalmopathy resistant to the medical treatment underwent an orbital decompression transnasally. 27 orbits were decompressed. The surgery was bilateral in 11 patients. In the 5 remaining cases, the surgery was unilateral. It was carried out on the left side in 2 cases and on the right side in 3 cases. RESULTS: Preoperatively, the average visual acuity was 8/10. Postoperatively, the visual acuity was 9.5/10. The average preoperative exophtalmometry measurement was 25.04 mm and the average postoperative measurement was 21.83 mm. The average retrodisplacement was 3.17 mm (range: 2-8). Preoperatively, 3 patients had mild diplopia whereas 5 others had moderate to severe extraocular muscle dysfunction. Postoperatively, 6 patients had mild diplopia whereas 10 patients required squint surgery for moderate to severe extraocular muscle dysfunction. CONCLUSION: Endoscopic orbital decompression improve all the symptoms of Graves' ophtalmopathy but one: the extraocular muscle dysfunction. Its cardinal indication is the treatment of compressive optic neuropathy whereas this surgical approach provides an excellent control of the medial wall of the orbit and the orbital apex. But the average reduction of proptosis of 3.17 mm is not high enough to propose this approach alone for the treatment of disfiguring proptosis. In such cases, a 2 or 3 wall orbital decompression should be performed to get marked cosmetic and functional improvement. In all cases, the patient should be informed about the risk of postoperative diplopia.

Adult↗
PubMed2000

Secondary ciliary dyskinesia in upper respiratory tract.

The system of mucociliary clearance has the important task to remove from the airways inhaled substances and locally formed secretions. Inborn disorders of the mucociliary transport are due to ciliary dysfunction (Primary Ciliary Dyskinesia) (PCD) or of increased viscosity of the bronchial secretions (Cystic Fibrosis). To differentiate PCD from the ultrastructural abnormalities found during or after injuries such as respiratory infections, the name of Secondary--or acquired--Ciliary Dyskinesia (SCD) was created. In controls, less than 4% of the cilia may show ultrastructural abnormalities. The most frequent of these are the compound cilia and the peripheral microtubular abnormalities. Compound cilia often appear after infection and therefore are thought to arise secondarily. Secondary ultrastructural abnormalities of cilia include also blebs of the axoneme membrane, ciliary disorientation, and absence of axoneme membrane. No increase in ultrastructural ciliary abnormalities has been found in a variety of respiratory disorders: smoking, asthma and allergic rhinitis, chronic rhinitis and sinusitis, chronic bronchitis, cystic fibrosis, and lung carcinoma. But severe modifications of the respiratory epithelium can be seen. Important for the secondary ciliary disorders is their local and reversible character. To distinct from ultrastructural images between primary and secondary ciliary dyskinesia is often uneasy because some of the findings in secondary ciliary dyskinesia obviously mimic those dedicated to primary ciliary dyskinesia.

Bacterial Infections↗
PubMed1997

Diagnostic techniques in chronic sinusitis: endoscopy, sinusomanometry.

The first endoscope was conceived as early as 1806. Since then successive technical advances led endoscopy of the nose and paranasal sinuses to a routine procedure. From the rediscovery of the rigid telescopes by Hopkins in the fifties, progress has stemmed essentially from the quality of the more powerful cold lights and the improvement in the light output of the fiber optics. Exam procedures of the nose and sinuses are conducted under general as well as local anesthesia, and are commonly combined with concomitant diagnostic procedures: measure of the mucociliary clearance with indicators, biopsies, smear sampling for bacterial and fungal examinations, and sinusomanometry which can help to estimate the patency of the maxillary ostium and of the nasofrontal duct. Sinus endoscopy has been widely used to correlate efficiency of other diagnostic techniques such as plain X-rays, CT scanners, A and B mode ultrasonography. A similar work should be done for MRI. Endoscopic exploration is the key to the management of chronic pathology as it brings precise information on the quality of the naso-sinus mucosa, the presence of secretions and, combined with sinusomanometry, the functional state of the ostia or ducts.

Anesthesia, General↗
PubMed1987

Taurine supplementation of a premature formula improves fat absorption in preterm infants.

The predominance of taurine (Tau) conjugated over glycine conjugated bile acids in infants fed human milk as opposed to those on formulas without added Tau could account for a more complete absorption of fat. Fifteen low birth weight infants were randomized to either Enfamil Premature or to Enfamil Premature added with 40 mumol/dl of Tau and compared to a third group made up of nine low birth weight infants fed their own mother's preterm milk. Formulas and human milk were fed according to tolerance and constituted the sole nutrition for 3 months. A metabolic study was carried out at 3 wk of age and control of growth was done periodically. Urinary Tau excretion (mumol/dl) was very low (p less than 0.001) in the group fed Enfamil Premature (0.3 +/- 0.1) when compared to the values obtained in infants supplemented with Tau (51.6 +/- 12.5) and in those on human milk (36.3 +/- 7.9). Infants supplemented with Tau (92.5 +/- 1.2) had a coefficient of fat absorption which was higher (p less than 0.05) than the unsupplemented group (87.5 +/- 7.9) and comparable to the human milk-fed group (91.6 +/- 1.4). The effect was more pronounced on the saturated fatty acids and varied inversely with their individual water solubility. There was no effect of Tau on nitrogen retention and growth was identical in the three groups. These data show that the addition of Tau to formula had no effect on growth but improved the absorption of fat especially saturated fatty acids which require higher concentrations of bile acids to form mixed micelles.

Absorption↗
PubMed1985

Protein quality and quantity in preterm infants receiving the same energy intake.

Fifteen low-birth-weight appropriate for gestational age infants, weighing 1.3 to 1.6 kg, were assigned to three isocaloric formulas differing in the quantity and form of nitrogen delivered. A balance study was done between 21 and 30 days after birth. Nitrogen retention expressed as milligram per kilogram per 100 kcal of metabolizable energy was greater with the 60:40 whey/casein and with the casein hydrolysate preparations than with the 20:80 whey/casein formula, which provided the same amount of energy (150 kcal/kg/day) but smaller quantities of protein (3.5 g/kg/day) than the two others (4.3 g/kg/day and 4.4 g/kg/day). Weight gain until discharge from the hospital and increment of height and head circumference over a three-month period showed an advantage of the two formulas providing higher intakes of protein. This study suggests that with high-energy intakes, protein quality does not affect nitrogen retention and growth unless the quantity of protein ingested falls below a critical level.

Caseins↗
PubMed1984

The composition of preterm milk in relation to the degree of prematurity.

Fifty-one samples of 24-h milk collections obtained during the 1st month of lactation from mothers who delivered after gestations of 26 to 31 wk (VPT) contained higher concentrations of nitrogen (297 +/- 11 mg/dl), total fatty acids (4.46 +/- 0.17 g/dl), percentage medium chain fatty acids (10.8 +/- 0.7), and energy (78.3 +/- 2.0 kcal/dl) than either or both those from 32 to 36 wk (PT) and term (T) gestations. PT collections did not differ from T milk with regard to nitrogen (250 +/- 13 versus 259 +/- 13), total fatty acids (3.94 +/- 0.20 versus 3.20 +/- 0.30), percentage medium chain fatty acids (9.1 +/- 0.5 versus 8.1 +/- 0.7) and energy (69.0 +/- 2.7 versus 66.6 +/- 2.4). Although postpartum age (5 to 10 versus 11 to 30 days) did not change the nutrient and energy content of VPT, PT, and T collections, it is only in 11 to 30 day VPT milk that nitrogen and energy content became higher (p less than 0.05) than either or both PT and T milk. We conclude that the differences in macronutrient composition of PT milk are limited to VPT milk and the data from repeated milk collections in the same mother (28 wk) suggest that there is considerable variability in its composition.

Amino Acids↗