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Biomedical subjects

Y Manach

Publications and source records attributed to Y Manach.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Surgical treatment of severe laryngeal stenoses in children].

This article constitutes a short review of the experience of the ENT service at the Hôpital Bretonneau, in Paris, with regards to laryngeal stenosis in children. Since 1974, 115 cases of severe stenosis have been operated on. 70 cases presented acquired lesions, primarily related to endotracheal intubation, while congenital malformations accounted for another 45 cases. 41% of the patients had stenosis that reduced the laryngeal lumen by 90%, or more. The different surgical approach (consisting in castellated incision of the anterior wall, or in anterior, or more rarely posterior, cartilage supplementation), as well as the various stenting methods used are briefly described and discussed.

Adolescent↗
PubMed1988

Facial vascular malformations in children. Conventional and digital, diagnostic and therapeutic angiography.

The authors present their experience with conventional and digital angiography of vascular malformations of the head and neck in children. 22 hemangioendotheliomas, 8 venous angiomas, and 3 arteriovenous fistula were studied. 22 patients were embolised. DSA offers many advantages during the diagnostic as well during the therapeutic phase of angiography. Embolization appears to have a major role in treatment of such vascular malformations.

Angiography↗
PubMed1988

[The base of the piriform sinus in the surgical treatment of fistula of the 4th endobranchial pouch. Apropos of 8 cases].

Fistula of the fourth endobrachial pouch, a congenital malformation, can be defined as an abnormal persistence of the canal joining the base of the piriform sinus and the deep surface of the lateral lobe of the thyroid. These fistulae, which have been more clearly understood over the last ten years, still constitute a delicate surgical problem, which is rarely discussed in the literature, based on the detection of their tract at their origin, the piriform sinus. The 8 cases operated at Hôpital Necker since 1981 reveal the variability of their tract, which, according to the authors, warrants an anatomosurgical analysis.

Adolescent↗
PubMed1988

[Titanium osteo-integrated fixtures. Otologic applications].

The osteofixtures developed by P.I. Branemark are pure titanium screws implanted percutaneously and intraosseously in the mastoid region. The mechanical properties and biocompatibility towards bone and soft tissues of these titanium fixtures were studied after 80,000 cases of human application, essentially in the field of dentistry. The authors present their preliminary results in the otological field: firstly, the auditory prosthesis with a mean gain of 20 dB over classical prostheses via air and bone transmission and, secondly, the epiprosthesis of the external ear in cases of aplasia with scarred skin.

Adolescent↗
PubMed1988

[D-penicillamine in the treatment of recurrent laryngeal stenosis in children].

Five children with recurrent tracheal stenosis after use of an endolaryngeal calibrator and/or a laryngoplasty were treated with D-penicillamine and chloroquine. The relevant literature relating to biological processes of normal and pathologic healing is reviewed, particularly with respect to the effect of D-penicillamine on collagen synthesis. Decannulation was possible in 4 of the children reported presently, including three in whom medical treatment was combined with use of an endolaryngeal calibrator.

Child↗
PubMed1987

[Maxillofacial abnormalities of syndromes of the 1st branchial arch].

Hemifacial microsomia and Treacher Collins syndrome are the most frequent among the first and second branchial arch syndromes to include anomalies of the facial skeleton. Hemifacial microsomia is almost always unilateral and is characterised by hypoplasia or agenesis of the mandibular ramus. Treacher Collins syndrome is always bilateral and involves specifically the zygomatic bones. The treatment of skeletal anomalies is seldom started before 10-12 years of age, except in severe form with major aesthetic impairment. Such cases are treated at the beginning of school age, on and after 6-8 years. Several operations, including osteotomies of the jaws and bone grafts, are usually necessary to achieve an acceptable result.

Bone Transplantation↗
PubMed1987

[Management of severe ear aplasias].

Microtia set two problems. A functional one in the case of bilateral microtia. The middle ear surgery has bad result specially in the cases of oto-mandibular or Treacher-Collins syndromes. In the unilateral microtia the results are slightly better, so the functional surgery is effected after a radiographic evaluation. The esthetic problem proper is now corrected with the B. Brent technique.

Abnormalities, Multiple↗
PubMed1987

[ORL localizations of Rosai-Dorfman disease. Apropos of 4 cases].

Four cases of Rosai and Dorfman's disease are presented. This adenomegalic sinusal histiocytosis is usually a benign affection even though the appearance and degree of glandular enlargement can suggest malignant disease. A literature review showed 215 cases reported up to the present.

Adolescent↗
PubMed1987

[Radiological evaluation of major aplasias of the ear].

Results of radiologic, radiotomographic and CT scan imaging of patients with major aplasias of ear are presented. In the absence of an indication for functional surgery these explorations allow evaluation of the risk of an epithelial inclusion within an undetected anlage of external auditory canal. When functional surgery is indicated results of these investigations allow assessment of pneumatization of petrous bone, possibility of construction of a new external auditory canal, and the internal ear. Study of middle ear is still insufficient in the region of the ossicula, particularly the fenestrae and stapes.

Ear↗
PubMed1987

[Plastic surgery of aplasia of the external ear. Apropos of 65 cases].

Principles underlying reconstructive surgery of external ear for major aplasia are described and results presented for 65 patients treated using a cartilaginous framework of a costal autograft as described by B. Brent. Possibilities are discussed of combining this technic with auditory function surgery and the wearing of an auditory prosthesis within the framework of general care of major aplasias.

Cartilage↗
PubMed1987

[Functional surgery of major aplasia of the ear. Apropos of 109 patients].

Based on data from 109 patients operated upon for 125 major aplasias of ear, clinical and operative aspects and results of surgery are analysed. Functional prognosis is related essentially to the nature of the stapes, normal in 66% of cases, and the quality of healing of the newly formed canal. One auditive result out of four in cases of unilateral aplasia and one out of two in bilateral cases constituted the proportion of patients obtaining socially valuable postoperative auditive gain. Functional surgery for aplasia of ear should therefore be reserved mainly for bilateral forms because of the lack of any alternative to apparatus wearing.

Abnormalities, Multiple↗
PubMed1985

[Laryngo-tracheo-esophageal cleft associated with missed atresia].

Laryngo-tracheo-esophageal cleft (LTEC) is a rare malformation. Treatment is always surgical and still has uncertain results. One case of LTEC (type III), associated with a "missed atresia" of the esophagus is reported. The diagnosis of eso-tracheal, H-Type fistula was first suspected at birth before transfer of the baby to the neonatal surgery department where the diagnostic of long LTEC was established. Surgical repair was done through lateral cervicotomy and allowed complete cure of the eso-tracheal communication without tracheotomy. Barium swallowing, controlled on the eleventh post-operative day, showed a perfect result of the reconstruction and an underlying esophageal malformation, previously described as "missed atresia". The treatment of this second malformation was performed two months later by plain resection-anastomosis with excellent outcome at a one year follow up with no recurrent fistula nor GE reflux or laryngeal nerve palsy. To the best of our knowledge, this type of association has not been previously reported.

Abnormalities, Multiple↗
PubMed1984

[Tracheomalacia in esophageal atresia].

On the basis of a series comprising 154 cases of Type III oesophageal atresia and 19 cases of Type I oesophageal atresia the authors have tried to define the place of tracheomalacia in association with oesophageal atresia. We have studied a certain number of technical and anatomical factors as well as the relation of tracheomalacia to the other complications, in order to class more precisely the therapeutic solutions available.

Cartilage Diseases↗
PubMed1983

[Risk of recurrent laryngeal nerve palsy in surgery of esophageal atresia].

From the last 100 cases of esophageal atresia treated since october 1975, the authors emphasised the incidence of left or right recurrent laryngeal nerve palsy. This incidence is about 20%. Most often, an unilateral palsy is asymptomatic, but in a few cases many complications have been reported. Therefore it is necessary to insist on the surgical and anatomic factors which could increase the risk of a nervous injury and the technics to prevent it.

Esophageal Atresia↗
PubMedDate not supplied

Double-blind, placebo-controlled multicentre trial of the efficacy and tolerance of morniflumate suppositories in the treatment of tonsillitis in children.

The efficacy and tolerability of morniflumate suppositories used together with phenoxymethylpenicillin were studied in a placebo-controlled, double-blind trial in 101 children with acute tonsillitis. Patients received a suppository containing 400 mg morniflumate or placebo twice daily for 4 days; all patients also received 1,500,000 IU/day phenoxymethylpenicillin. Response to treatment was assessed by clinical examination before and after 2 and 4 days' treatment. Efficacy was evaluated by resolution of oropharyngeal pain, congestion, fever, size and sensitivity of adenopathies, quality of life and duration of sleep. Body temperature fell rapidly after the start of treatment. There was also resolution of pharyngeal pain, earache, dysphagia and adenopathy. Spontaneous pharyngeal pain was present after 4 days in significantly (P = 0.03) fewer patients receiving morniflumate than receiving placebo. It is suggested that morniflumate combined with antibiotic therapy is an effective and well-tolerated treatment for tonsillitis in children.

Administration, Rectal↗
PubMedDate not supplied

[A biochemical and cytological explanation of cochlear otospongiosis].

Carrying on their study about the enzymatic activity of the otospongiotic micro-foci and the hydrolytic activity of the perilymph, the authors present their work concerning the value of trypsin and alpha-1-anti-trypsin in the perilymph of otospongiotic patients operated on by stapedectomy. They describe the method used and give the obtained results which permit to believe that the values of trypsin, and a contrario of anti-trypsin, appear to constitute an index of the severity of the progression. Moreover, the authors have investigated the eventual toxic action of various trypsin concentrations on the hair cells of the Corti organ in the guinea-pig. This study has been carried through successfully by means of the electron microscopic scanning method which allows to obtain an "electron cochleogramme in situ". They explain the method and come to the conclusion that the intensity and extension of the Corti hair cells alterations in a cochlea receiving a perfusion with trypsin solutions, are tightly related to the trypsin concentration. However, they do not pretend so far that these results reflect exactly the anatomo-pathologic reality during the slow progression of otospongiosis towards cochlear deterioration. These two series of experimentation appear to confirm their enzymatic concept of otospongiosis: the long, slow and extremely capricious progression of the disease is the duplicate of its cytologic progression, the contact between hydroltic enzymes and Corti cells having the same capricious character. These findings perfectly corroborate the previus ones they made in this field, as well as the correlations they have established between hydrolytic activity of the perilymph and audiometric progression. Consequently, they believe that the mechanism of the otospongiotic disease is provoked by the rupture of the balance trypsin/anti-trypsin in the otospongiotic micro-foci and thus in the inner ear fluids.

Animals↗