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Biomedical subjects

V Ducroz

Publications and source records attributed to V Ducroz.

16 recordsLinked to original sources
PubMed1999

Results of partial laryngectomy for benign neural tumors of the larynx in children.

The objective of this study was to assess the long-term results of partial laryngectomy for benign neural tumors of the larynx. We reviewed 8 patients with laryngeal involvement -- 7 with neurofibromatosis and 1 without -- treated between 1980 and 1994. The mean age was 6.5 years. A partial laryngectomy was performed in 7 cases. All the tumors were located in the aryepiglottic folds. Clinical, radiologic, and endoscopic follow-ups were used for evaluating recurrence. A good laryngeal airway, swallowing without aspiration, and voice quality were sought in assessing the functional results. Five patients had good functional results with no recurrences. One patient died of malignant transformation and metastatic dissemination of his disease. To summarize, partial laryngectomy is a relatively safe and effective procedure, even in childhood, for treating this rare localization of neurofibromatosis. A malignant transformation of the tumor is possible and carries a poor prognosis.

Adolescent↗
PubMed1998

Fourth branchial pouch anomalies: a study of six cases and review of the literature.

A retrospective study in the ENT departments of the Timone Children's Hospital in Marseille and the Armand Trousseau Hospital in Paris and a review of the literature was performed in order to update knowledge about fourth branchial pouch anomalies. Over the 12-year period studied, a total of six children were treated: three boys and three girls. The lesions were located on the left side in all cases and infection was the most common manifestation. Clinical presentation ranged from suppurative thyroiditis in most cases to stridor in a few newborns. The most useful diagnostic examinations are CT-scan of the neck and endoscopy of the pyriform sinus. The authors emphasize the need for complete surgical resection including the cyst and fistulous tract down to the pyriform sinus.

Branchial Region↗
PubMed1998

Results of tympanoplasty in children with primary ciliary dyskinesia.

OBJECTIVE: To assess the results of tympanoplasty in children with primary ciliary dyskinesia complicated by tympanic perforation or cholesteatoma with hearing loss and/or recurrent otorrhea. DESIGN: Retrospective study. Postoperative follow-up of 26.3 months in the type 1 tympanoplasty group and 46 months in the child with cholesteatoma. SETTING: Hospitalized care, referral center. PATIENTS: Seven children with primary ciliary dyskinesia, complicated in 6 children by 9 tympanic perforations (3 bilateral perforations) and in 1 child by an attical cholesteatoma. RESULTS: After 9 type 1 tympanoplasties, the grafts were intact in 9 ears, with no recurrence of otorrhea, but serous otitis media was present in 6 of the 9 ears. Auditory improvement was significant, with an average gain of 17-dB hearing level in speech frequencies. After a canal wall-down tympanoplasty with mastoidectomy for attic cholesteatoma in 1 ear, the cavity that was operated on showed no signs of otorrhea or residual cholesteatoma after a follow-up of 46 months. CONCLUSION: In children with primary ciliary dyskinesia, tympanoplasty has a high probability of graft success and auditory improvement, despite the frequent recurrence of serous otitis media.

Adolescent↗
PubMed1998

First branchial cleft anomalies: a study of 39 cases and a review of the literature.

OBJECTIVES: To identify the clinical and anatomical presentations and to discuss the guidelines for surgical management of anomalies of the first branchial cleft. DESIGN: Retrospective study. SETTING: Three tertiary care centers. PATIENTS: Thirty-nine patients with first branchial cleft anomalies operated on between 1980 and 1996. INTERVENTION: All patients were treated surgically. Complete removal of the lesion required superficial parotidectomy with facial nerve dissection in 36 cases. The relationship of the facial nerve and anomalies is discussed. RESULTS: Anatomically, 3 types of first branchial cleft anomalies are identified: fistulas (n=11), sinuses (n=20), and cysts (n=8). Clinically, 3 types of presentation are noted: chronic purulent drainage from the ear (n=12), periauricular swelling in the parotid area (n=18), and abscess or persistent fistula in the neck located above a horizontal plane passing through the hyoid bone (n=21). A membranous attachment between the floor of the external auditory canal and the tympanic membrane was observed in 10% of cases. The facial nerve was located lateral to the anomaly in 39% of cases. CONCLUSIONS: Before definitive surgery, many patients (n=17) underwent incision and drainage for infection owing to the difficulties in diagnosing this anomaly. Wide exposure is necessary in most cases, and a standard parotidectomy incision allows adequate exposure of the anomaly and preservation of the facial nerve. Complete removal without complications depends on a good understanding of regional embryogenesis, a knowledge of the circumstances surrounding discovery, an awareness of the different anatomical presentations, and a readiness to identify and protect the facial nerve during resection.

Adolescent↗
PubMed1998

Posterior laryngeal clefts: preliminary report of a new surgical procedure using tibial periosteum as an interposition graft.

OBJECTIVE: To present the preliminary results of a new surgical procedure for posterior laryngeal cleft repair. DESIGN: Retrospective study in an academic tertiary care center. METHOD: The study included three male patients (age at surgery, 2, 13, and 14 mo). One presented with severe aspiration and cyanotic attacks, the two others with aspiration and recurrent chest infections. The types of laryngeal clefts included complete cleft of the cricoid with varying degrees of tracheal involvement but not further than the first six tracheal rings. Associated malformations included one VATER syndrome, one esophageal atresia, and one tracheoesophageal fistula. Surgery was performed under general anesthesia with nasotracheal intubation. A vertical anterior laryngofissure was performed. The mucosal margins of the clefts were incised and then repaired in two layers with polyglactin sutures. The original feature of this procedure was the interposition of a small piece of tibial periosteum between the two layers. This fascia graft is known to be strong and resistant in cleft palate surgery. MAIN OUTCOME MEASURE: Clinical and endoscopic follow-up was used for evaluation of results. RESULTS: The three patients had successful laryngeal repair at a mean follow-up of 6 months (range, 4-14 mo). CONCLUSION: The anterior laryngofissure provides a good surgical access to the cleft. The interposition of tibial periosteum allows durability of the cleft repair. A longer follow-up is needed to confirm these preliminary results. A computed tomography scan study and a study on the rabbit are planned in order to evaluate the outcome of these periosteal grafts.

Adolescent↗
PubMed1997

Midline cervical cleft.

Midline cervical cleft is a rare congenital anomaly of the ventral neck and its embryological origin has not been clearly established. Less than 100 cases have been reported in the literature. We present a case of midline cervical cleft operated on at the age of 2 months in order to illustrate its clinical presentation and surgical management.

Branchial Region↗
PubMed1997

Nasal dermoid sinus cysts in children.

Thirty-six children with nasal dermoid sinus cysts were treated in the Department Pediatric Otolaryngology, Armand Trousseau's Children's Hospital (Paris, France) between 1974 and 1994. Ten of the patients presented with a midline cyst only, eight had nasal pits only, and 18 had combined cases. In six of the 36 patients, presurgical imagery indicated signs of intracranial extension of the tract, reaching the foramen caecum without intracranial mass. Three surgical techniques were used: an external rhinoplasty approach with medial crura section in 23 cases, a direct median approach in seven cases, and a paracanthal approach in six cases. Only two cases had meningeal adherences. Two superficial recurrences occurred within the 7-year follow-up period. Widening of the scar occurred in four children after verticomedian approach or nasal pit excision. The external rhinoplasty procedure with medial crura section results in a wide surgical approach, low recurrence rate, and good aesthetic results.

Adolescent↗
PubMed1997

[Inferior turbinectomy in asthmatic children].

Nineteen children with asthma underwent bilateral inferior turbinectomy from 1990 to 1995. Mean age was 11.5 years (range 8-17). All had obstructive allergic rhinitis and were resistant to long-term local corticosteroids. All operations were done under general anesthesia and endoscopic control. Mean hospital stay was 3 days. The postoperative period was uneventful and mean follow-up is 21 months (10-44). The patients described outcome as a clear improvement (n = 15), partial improvement (n = 3) and unilateral improvement (n = 1). The effect on asthma was more difficult to ascertain due to the number of cofactors. It can be noted however that asthma was not aggravated and that in 9 cases episodes decreased in frequency. Inferior turbinectomy provides considerable improvement in the comfort of patients with asthma, especially in terms of nasal ventilation.

Adolescent↗
PubMed1996

[Management of breach of the tegmen isolated or associated with cephalocele].

This is a retrospective report of 41 tegmen breaches observed in 2 different populations : 27 patients among a series of 252 cases of operated chronic otitis (6.7%) and 14 patients admitted for management of tegmen breach and dura mater involvement. The most frequent cause was chronic otitis (36 cases, including 6 due to iatrogenic causes); there were also 2 cases of petrus fracture, 2 cases of intracranial hypertension and 1 idiopathic case. Computed tomography revealed a bony breach in 97% of the cases. Encephalo-meningocele was associated in 11 cases (31%). In these cases, MRI confirmed the preoperative diagnosis. Treatment via the mastoid route allowed removal of the infectious process and via the suprapetrous route allowed closure of the breaches in the bone and dura mater as well as treatment of associated cephaloceles, except in case of major infection where the cephalocele was closed in a second operation.

Adult↗
PubMed1996

[Malformations of the nasal fossa and paramedian facial clefts. New perspectives].

Since choanal atresia may be associated with other cranio-facial malformations, including various degrees of nasal fossa malformation, and be a part of paramedian facial clefts, (as described by Tessier), they can be integrated into the larger group of neurocristopathies. We identified four such cases with combined clinical elements corresponding to Tessier's paramedian facial cleft, including eyelid coloboma, mild to severe choanal and nasal fossa anomalies, ethmoidal hypoplasia and anterior skull base malformation, sometimes with proboscis lateralis. These various malformations are due to abnormality of the olfactive placode and the adjacent mesenchyme. These discoveries incited us to elaborate a conception first of all on the pertinent embryology involved, second, to propose a new classification based on anatomical and pathogenic embryological considerations. And finally, since endonasal laser therapy is particularly dangerous in such cases, to propose the use of transpalatal approach to restore choanal permeability. Pediatric ENT surgeons should pay special attention to any small stigmatism of facial cleft when dealing with children affected by choanal atresia.

Abnormalities, Multiple↗
PubMed1995

[Clinical and surgical aspects of cysts and fistulae of the nose in children. Apropos of 37 cases].

Thirty-seven children with nasal midline masses and/or sinus ostia were surgically treated in the pediatric ENT and cervicofacial surgery department of Trousseau children hospital in Paris, from 1974 to 1994. The patients presented with midline cysts (11 cases), sinus ostia (8 cases) or both (18 cases). Various surgical techniques were used ranging from transcolumellar approach (25 cases) to direct midline approach (8 cases) or paracanthal approach. Preoperative imagery and surgery showed in 6 patients an intracranial extension to the base of the foramen cecum, without intracranial mass. Histologic examination demonstrated 33 dermoïds, 1 lipoma, 1 hamartoma, 1 glioma ans 1 hemangioma. 2 recurrences occurred after surgery. In children, the transcolumellar approach provides an enhanced exposure with a few percentage of recurrences and good cosmetic results.

Adolescent↗
PubMed1995

[Fracture of the medial wall of the orbit. Apropos of 4 cases].

Fractures or the medial wall of the orbit are uncommon and clinical signs are often discreet. This report was focused on isolated fractures of the medial wall of the orbit. Blow-out trauma is usually the cause. In these cases the clinical signs ranged from simple ecchymosis to blindness by haematoma of the orbital cone. Computed tomography is a major tool for diagnosis and making therapeutic indications for these fractures. Treatment depends on the oculomotor involvements as measured by forced duction tests.

Blindness↗
PubMed1993

[Correction of nose deviations using latero-septal grafts from irradiated bovine cartilage].

Deviated noses corrective surgery is not without problems. Authors give the result obtained by the use of processed irradiated bovine cartilage (Chondroplast) as spreader graft in eighteen rhinoplasty, associated with a classical septorhinoplasty technique. The maximum background is five years. The future of the grafts can be appreciated on direct signs obtained by palpation, or indirect ones such as stability of the functional or aesthetic result, radiological visualisation of the bovine cartilage graft. Their volumetric stability is satisfactory and their guide role is excellent. This undisputed aid in the aesthetic and functional correction of deviated noses, associated with availability, easy use and a good tolerance, made the authors use spreader grafts in processed irradiated bovine cartilage as a choice technique in this indication, associated with bone and septal surgery, when local cartilage autografts are not available in sufficient quantities.

Animals↗
PubMedDate not supplied

Nasal fossa malformations and paramedian facial cleft: new perspectives.

Choanal atresia may be associated with other cranio-facial malformations, including various degrees of nasal fossa malformation, and may be a part of paramedian facial clefts (as described by Tessier et al. [1977]). We identified five such cases with combined clinical elements corresponding to Tessier's paramedian facial cleft, including eyelid coloboma, mild to severe choanal and nasal fossa anomalies, ethmoidal hypoplasia and anterior skull base malformation, sometimes with proboscis lateralis and half-nose hypoplasia. These observations incited us, first, to elaborate a conception which accounts for the likely embryological mechanisms involved; second, to propose a new classification based on anatomical and pathogenic embryological considerations; and last, to propose the use of transpalatal approach to restore choanal permeability, since endonasal laser therapy is particularly dangerous in such cases.

Child, Preschool↗