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Biomedical subjects

Y Goffart

Publications and source records attributed to Y Goffart.

17 recordsLinked to original sources
PubMed2006

Sinonasal involvement as a rare extraintestinal manifestation of Crohn's disease.

Crohn's disease is a chronic idiopathic slowly developing transmural inflammation of the digestive system. It usually involves the small intestine and/or the area around the anus but can also affect the entire gastrointestinal tract anywhere from the mouth to the anus. Extra intestinal manifestations occur frequently and multiple organ systems may be affected: the skin, joints, spine, eyes, liver and bile ducts. In contrast, nasal manifestations are extremely rare and only a few cases have been reported up to date in the worldwide literature. The authors report two cases with nasal manifestations concomitant to intestinal Crohn's disease and go over the relevant literature on such an association.

Acute Disease↗
PubMed2005

Management of neck masses in adults.

Initial management of a neck mass in adults is a frequently encountered problem in ENT practice. The differential diagnosis with regards to clinical presentation, localization, imaging studies and cytology and/or histology is reviewed. An algorithm is provided to help the practioner.

Adult↗
PubMed2004

Facial pain from visceral origin.

INTRODUCTION: Unilateral facial pain in the trigeminal area is known to be caused by a cancer in the superior lobe of the lung. CASE REPORT: A 65 year old male, heavy smoker, presented a permanent otalgia and a mandibular pain on the left side. These symptoms could not be relieved by common analgesics. All explorations for common etiologies were negative. After an episode of dyspnea, a left lung cancer was discovered. Thanks to radiotherapy and chemotherapy, the patient's pain was improved. CONCLUSION: Referred facial pain is rare and can be explained by the invasion of the tenth nerve by an upper lobe lung tumor. In most cases, the patient presents a right otalgia and pain in the area of V3. The diagnosis can be delayed from 1 month to 4 years after the onset of the pain. Referred facial pain is improved by the treatment of the causal lung cancer.

Aged↗
PubMed2002

Standard ENT clinical evaluation of the sleep-disordered breathing patient; a consensus report.

Sleep disordered breathing (SDB) patients usually undergo an ENT clinical examination before any therapeutic decision. This clinical examination would be predictive about the occurrence of Obstructive Sleep Apnea Syndrome, cost effective, reproducible and would determine the sites of obstruction in the upper airways. To achieve this, ENT specialists from Belgium, representatives of academic hospitals in the country, have tried to establish an updated work-up in the clinical evaluation of the SDB patients. History, risk factors evaluation, excessive daytime sleepiness, static and dynamic evaluation of the upper airways (velopharynx aspect, tonsils grading, Mallampati score, Müller's maneuver, fiberoptic evaluation) have been standardized in a consensus report easily accessible to the vast majority of ENT specialists. This consensus must be understood as a clinical work-up to perform before the monitoring of breathing during sleep.

Belgium↗
PubMed2002

Side effects and complications of velopharyngeal surgery.

Although velopharyngeal surgery is generally safe, complications are not uncommon. This article reviews the major complications occurring in the postoperative period and the severe late complications such as velopharyngeal incompetence and nasopharyngeal stenosis. Most of these complications can be prevented by a careful operative technique and preoperative evaluation. We also emphasise the frequency of minor modifications of voice, swallowing, taste and velopharyngeal function.

Humans↗
PubMed2002

Surgical treatment of the sleep-disordered breathing patient; a consensus report.

Sleep disordered breathing patients may undergo surgical treatment after history, clinical examination and polysomnographic study if they demonstrate upper airway obstruction. This article focus on the surgical treatment designed for these patients. Sino-nasal surgery, rhinopharyngeal procedure, velopharyngeal procedures (Uvulopalato-pharyngoplasty, Laser assisted uvulopalatoplasty, Radiofrequency tissue volume reduction) as well as base of the tongue procedures were discussed among a panel of Belgian ENT specialists offering their experience in this field. Algorithm on corrective surgery as well as guidelines for postoperative management are proposed in the management of sleep disordered breathing patients.

Belgium↗
PubMed2001

Juxtapapillary subretinal pigment epithelial polypoid pseudocysts associated with unilateral tilted optic disc: case report with clinicopathologic correlation.

OBJECTIVE: To describe the unique preoperative appearance, successful postoperative clinical course, and histopathologic features of a cluster of progressively enlarging pseudocysts that arose at the temporal margin of a unilateral tilted optic disc. STUDY DESIGN: Case report. METHODS: Clinical observation, color fundus photography, fluorescein angiography, and optical coherence tomography, as well as routine histologic and immunohistochemical studies of tissue removed by subretinal surgery. RESULTS: Subretinal surgical excision of the lesions resulted in retinal reattachment with improved postoperative visual acuity. Histologic examination disclosed a cluster of fluid-filled polypoid pseudocysts lined by small vessels of choroidal origin lying beneath the basement membrane of the overlying retinal pigment epithelium (RPE). CONCLUSIONS: We postulate that buds of small vessels of choroidal origin grew through or around the edge of Bruch's membrane at the temporal margin of the tilted optic disc and then passed under the juxtapapillary RPE. Ensuing leakage of proteinaceous fluid from these vessels eventuated in formation of a cluster of polypoid pseudocysts and subsequent localized papillomacular retinal separation with visual loss. The lesions were amenable to subretinal surgical removal with restoration of visual acuity.

Adult↗
PubMed2000

Minimally invasive endoscopic management of malignant sinonasal tumours.

A large retrospective study from two belgian institutions of 78 patients who underwent minimally invasive endoscopic management for malignant sinonasal tumors from, 1992-1999 is presented. We attempt to assess the results of this less invasive approach. The spectrum of disease included adenocarcinoma, squamous cell carcinoma, olfactory neuroblastoma and other malignant tumors. All patients were treated primarily for cure. 66 patients were operated on by a purely endoscopic technique, while 9 patients had a simultaneous neurosurgical and endoscopic approach, and 3 a limited orbital approach. 16 patients (20.5%) presented with local recurrence, 6 patients (7.7%) sustained distant metastases and 7 patients (9%) presented simultaneous local recurrence and distant metastases. The 2-years and 5-years survival rates of the whole group were respectively 73.1% and 52.3%, while the adenocarcinoma group exhibits a significantly better prognosis than other histological types with 2-years and 5-years survival rates of 89.8% and 63.8%. Patients who could be treated purely endoscopically had a significantly better survival in comparison to patients treated by an external and endoscopic approach. Morbidity was minimal and the local control rate as well as survival rates were comparable to literature data. Endoscopic resection was adequate, providing clear margins and en bloc removal in most cases. Our results encourage us to use this minimally invasive approach in selected cases as a reliable alternative to the systematic use of an exclusively external approach.

Adolescent↗
PubMed1993

[Physiology of the upper airways].

Patency of the upper airways is maintained by an adjustable balance between the level of tonic and phasic upper airway dilator muscle activity and closing forces generated by inspiratory negative pressure, gravity and surface tension. During sleep, dilator muscle tone is decreased, producing elevated respiratory resistances. During exercise, increased ventilation is normally associated with combined oronasal breathing. Various receptors are implicated to maintain an adequate level of respiratory resistances.

Adaptation, Physiological↗
PubMed1993

[Physiology of deglutition].

Swallowing physiology and sucking reflex together with their significance are reviewed. The intra-oral events in children and adults are described.

Adolescent↗
PubMed1993

[Physiopathology of mouth breathing. Snoring and apnea].

Oral breathing causes changes in pulmonary mechanics as well as in the pressure of arterial blood gases. In response to increased nasal obstruction oro-nasal breathing occurs. The level of oro-nasal partitioning maintains an adequate level of respiratory resistance. Sleep disordered breathing, although not only related to oral breathing, is a common disorder. When upper airway resistance is increased limitation of flow occurs. Snoring indicates a mild degree of reduced airflow. Sleep apnea occurs when upstream pressure falls below a critical pressure (Pcrit). The mechanisms are reviewed.

Adult↗
PubMed1991

[Therapeutic maxillary expansion].

The purpose of this study was to assess the effects of rapid maxillary expansion on nasal airflow studies and mouth breathing habit. 15 children aged from 5 to 12 years underwent rapid palatal expansion for orthodontic abnormalities. Otolaryngologic evaluation, computerized active anterior rhinomanometric measurements and oral myo-functional disorder examination were obtained before treatment, 2 months after expansion and after a retention period of approximately 10/12 months. Based on this multidisciplinary judgment and confirmed by the rhinomanometric values two groups could be distinguished: a group of predominantly mouth breathers where the nasal airway resistance had an average decrease of 34% and a group of predominantly nasal breathers where the nasal airway resistance had an average decrease of less than 5%. From the initial 8 predominantly mouth breathers before treatment only 2 remained clinically unchanged. From these results it was concluded that for the 15 children involved in this study rapid maxillary expansion affected the nasal airway patency in a way tailored to the initial deficiency and had a significative effect on the respiratory mode.

Airway Resistance↗
PubMed1990

Computed tomography of metastatic cervical lymph nodes. A clinical, computed tomographic, pathologic correlative study.

A retrospective comparative study of 63 neck dissections was undertaken to evaluate further the accuracy of high-resolution computed tomography (CT) in the detection of nodal metastases, as previous studies have indicated a trend toward the superiority of CT scanning over palpation. The respective values of neck examination, CT scanning, and histopathologic examination were assessed in 51 patients with head and neck cancer who underwent a total of 63 neck dissections. The overall agreement between clinical examination findings and histopathologic findings was 92% vs 81% for CT scanning. A retrospective analysis of the CT findings failed to reveal greater accuracy. We found nodes measuring 10 mm or more with central low density always to be malignant. Because CT scanning seems to offer little advantage over palpation in the nonirradiated neck, it should not be regarded as an essential tool in the staging of nodal disease. After radiation therapy, as neck dissection is only performed because of clinical or radiologic suspicion, CT scanning is of utmost importance.

False Negative Reactions↗
PubMed1988

[Unusual use of myocutaneous pedicled grafts in cervico-facial cancer].

The principle, the technique and the usual uses of pectoralis major and latissimus dorsi myocutaneous flaps in head and neck oncology are called again. Three examples of unusual use are described: reconstruction of the tongue after total glossectomy with preservation of the larynx, mediastinal tracheostomy, pharyngo-esophageal reconstruction with muscle flap alone after total laryngo-pharyngectomy.

Glossectomy↗
PubMed1988

[Phrenic nerve paralysis complicating cervicofacial surgery].

Radical neck dissection remains the keystone to lymph nodes control in modern Head and Neck Surgery. Like any major operation, it has inherent complications ranging from minor surgical complications such as wound infection to potentially life-threatening complications such as fistula or carotid rupture. We have observed two cases of surgical damage of the phrenic nerve following radical neck dissection. Transient or definitive phrenic nerve palsy after radical neck dissection has been previously reported. The physiopathology according to the age and the clinical implications of that rare complication are discussed.

Adult↗