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Biomedical subjects

Y Raulo

Publications and source records attributed to Y Raulo.

At least 37 records · Page 2Linked to original sources
PubMed1997

Influence of underfilling on breast implant deflation.

The authors report a series of 407 patients with a total of 709 saline breast implants (average follow-up, 7.1 years). In this retrospective series, the overall deflation rate was 6.6 percent (47 of 709). Initial comparison of the deflation rates for smooth (8.8 percent) versus textured (1.8 percent) implants suggested a significant difference between the implant types. However, further analysis of the data revealed that smooth implants had a longer average follow-up period and tended to have lower fill volumes. These data were re-examined using Kaplan-Meier survival analysis plots, which corrected for differences in follow-up times, and log rank tests performed to determine significance. Implant type was found to have a non-significant association with rupture rate. In contrast, the percent fill (implant fill volume per minimum recommended fill volume x 100) was significantly associated with the spontaneous ruptures; a mean difference of 13.9 percent (89.2 percent versus 103.1 percent) was found between the series of deflated implants and the nondeflated implants (p < 0.0001). These data suggest that underfilling is a major cause of deflation.

Adolescent↗
PubMed1995

[Temporal muscle flap in cranio-facial reconstructive surgery. Apropos of 32 cases].

The temporalis muscle flap is used in craniofacial reconstructive surgery to repair defects, to restore facial contours and to cover bone grafts. These possibilities of reconstruction are analysed in the light of 32 cases. After reviewing the anatomy and the surgical technique, this series is presented as a function of the various types of defect: cranio-orbital (9 cases), defects of the malar area (6 cases), maxillary defects (7 cases), mandibular defects (7 cases), malar and parotid soft tissues defects (2 cases), mastoid defects (1 case). This study indicates that the temporalis flap possesses several advantages: great vascular reliability, associated with simplicity of flap raising and an easily available tissue volume. The arc of rotation constitutes the limiting factor. Romberg's syndrome does not constitute an ideal indication of choice, as the muscle may be atrophied. Similarly, when the defect requires thin cover, it would be wiser to use a thinner flap, such as fascia temporalis superficialis. Donor site sequelae are negligible. Limitation of mouth opening (3 cases) and frontal paralysis (2 cases) are usually transient. The field of application of this flap can be extended by continuing the flap as far as the pericranium or calvarium, allowing complex reconstructions.

Adolescent↗
PubMed1995

[Intra-extracranial meningioma in the cranial vault].

Between 1982 and 1993, 11 cases of intra-extracranial vault meningiomas were treated in Créteil, by the same multidisciplinary team. The average age was 53.5 years and the Karnofsky rating was high (> 80 in 7 cases). Ten of the 11 cases had medial tumours with venous sinus thrombosis occurring in 9 of these. The location of the tumour was frontal in 6 and parietal in 4 patients. Of the medial tumours, 5 (half) were bilateral intracranial lesions. The average duration of symptoms was more than 10 years in four cases, between 1 and 3 years in five, and the diagnosis was made immediately in two patients. MRI coronal sections, after venous contrast injection, allowed diagnosis of the lesion and visualisation of the sinus thrombosis. Embolisation was performed pre-operatively in all cases scheduled to have surgery, resulting in safe excision of the tumour. Surgery was performed in 9 patients with complete tumour removal achieved in 8. Of those who did not undergo surgery, one received radiotherapy and the other died before treatment. The bony defect was covered with cadaveric bone, autogenous bone, coral and methyl-methacrylate in one, two, two and two patients respectively. Complications occurred in 2 cases: extradural secondary infection and CSF rhinorrhea treated with a lumbo-peritoneal shunt. The post-operative Karnofsky rating was greater than 90 in seven cases, 70 in one, and 50 in two cases. After an average follow-up of 4 years, 3 patients had tumor recurrence at 4, 7, and 8 years; the first having a locally malignant character, the second showing radiological recurrence in a case of subtotal removal, and the third a marginal recurrence. Two of the 3 patients underwent further surgery. The malignant case, received radiotherapy but unfortunately a new recurrence occurred 14 months later. As radiotherapy was used in only 3 cases, statistically significant conclusions concerning efficacy cannot be drawn.

Adult↗
PubMed1994

[Mammary silicone granuloma. Apropos of 3 cases].

Since the beginning of the sixties, plastic surgeons now use silicone gel prostheses, in aesthetic or reconstruction surgery, for augmentation mammaplasty. Organic complications occurring after the insertion of these implants are reported in the literature, due to the large number of women now treated. Out of the purely local complications, and the general complications related to silicone biocompatibility, some regional complications are described, such as silicone granuloma. Authors describe three cases of sicilone granuloma they have observed and cured. After a short review of the literature, they underline problems raised by silicone granuloma, such as those related to diagnostic and therapeutic approaches.

Breast Implants↗
PubMed1993

[Pathology of autografts of the nipple in mammaplasty. Apropos of 2 original cases].

Autologous nipple graft is a classical technique in nipple reconstruction. The authors present two cases of deferred development of specific lesions in the grafted nipple, including one historical case of Paget's disease. After reviewing the current state of knowledge concerning Paget's disease of the nipple and in the light of these two cases, the authors discuss the histogenesis of this disease and the pathology of the grafted nipple in reconstructive surgery.

Adult↗
PubMed1993

[Basal cell carcinoma of the nose].

UNLABELLED: The purpose of this study of 81 patients with basal cell carcinoma (BCC) of the nose was to present the oncological and cosmetic results of surgical treatment and compare these results with those of other possible treatments. MATERIAL AND METHOD: We report a series of 81 cases of histologically proven BCC of the nose located chiefly on the alae nasi and on the lower end of this organ; 42 p. 100 of the tumors had previously been treated and had recurred. The patients' mean age was 63 years, and the shortest follow-up was 3 years. Excision of the tumor under simple or reinforced local anaesthesia was complete in 88 p. 100 of the cases, incomplete or borderline in 12 p. 100 and systematically repeated. Extemporaneous histological examination was performed in 18 p. 100 of the cases. The operative lesion was repaired with a graft or a flap. There was no postsurgical treatment. RESULTS: The recurrence rate was 4 p. 100 with a minimum follow-up of 3 years. The cosmetic result was good in 78 p. 100 of the patients. DISCUSSION: Numerous treatments have been used against BCC of the nose, the results, advantages and disadvantages of each of these treatments are given below: 1. Cryosurgery. The problem with this method is that it is relatively difficult to perform and requires reliable operators. The cure rate is similar to that of other treatments. 2. Chemotherapy is not frequently used. 3. Electrocoagulation. Contrary to the conventional excision, this method precludes all histological controls, and the common idea of good oncological results is now being revised. 4. Radiotherapy. The recurrence rate varies from 7 to 11.8 p. 100 with fair cosmetic results. It requires numerous sessions, cannot be repeated in case of recurrence and complicates the surgical treatment. In addition, there is a long-term risk of radiodystrophy. 5. Curietherapy by local implantation of 192Iridium has a recurrence rate of 2.5 to 7 p. 100. This treatment requires hospitalization and is costly. It is indicated in cases of complex surgery, difficult conventional radiotherapy and above all, sclerodermatous BCC. 6. Surgery has a recurrence rate which varies from 3.7 to 12.6 p. 100. Recurrences are due to insufficient excision, and this underlines the value of histological control which can be done only at surgery. It is a rapid and ambulatory treatment, usually performed under local anaesthesia. The cosmetic result is good (85 to 90 p. 100) and the patients must be made aware of this preoperatively with some degree of reliability, depending on age, location, size of BCC and on the surgical technique utilized. CONCLUSION: Surgical treatment of nasal BCC is safe, effective and rapid, with good oncological and cosmetic results, and it has many advantages over the other treatments.

Adult↗
PubMed1992

[Effect of inadequate filling of deflation of inflatable breast prostheses. Statistical study of 535 inflatable prostheses].

This study was based on a series of 535 inflatable prostheses used for breast reconstruction or augmentation with a mean follow-up of 5.15 years. The authors specifically analysed the statistical correlation between underinflation and deflation due to late rupture. They demonstrated a statistically significant difference between the initial filling of the prostheses which subsequently deflated and the initial filling of all prostheses of the series. The mean filling of prostheses which subsequently deflated was 89% while the mean filling of all prosthesis in the series was 100%. The various pathologies are analysed according to the cosmetic or reconstructive indications. The two series, cosmetic and reconstructive, were homogeneous in terms of filling volume and deflation; the only difference concerned the age distribution. Patients undergoing breast reconstruction with a prosthesis were older than patients undergoing augmentation surgery for small breasts. The authors discuss the advantages and disadvantages of this type of prosthesis.

Adolescent↗
PubMed1992

[Surgical injury of the temporo-frontal branch of the facial nerve. Anatomical study and clinical consequences].

The frequency of frontal paralysis due to surgical trauma of the temporo-frontal nerve seems to be increasing due to the growing number of operations in the temporo-frontal area and the complexity of surgical techniques. A series of 20 anatomical dissections demonstrates the course of the temporo-frontal nerve. Frontal myomectomy of the healthy side to allow facial equilibration seems to us to be the best technique of reconstructive surgery for definitive frontal paralysis.

Aged↗
PubMed1991

[Indications for bone autografts and allografts in cranioplasties. Apropos of a series of 51 cases, 30 of them with follow-up].

Based on a series of 51 cranioplasties performed between 1978 and 1988 with follow-up of 30 cases, the authors define the respective indications for bone autografts and allografts. The various donor sites of autografts are reviewed, particularly in relation to the history of their use. Similarly, the history of the use of allografts is also reviewed and the various methods of sterilisation are considered. The authors review all of the literature on this subject and compare their results with those of other authors.

Adolescent↗
PubMed1990

[Use of the calvarium for bone grafting in cranio-maxillo-facial surgery].

Bone grafts's traditional donor sites in cranio-maxillo-facial surgery have been for many years and are still in some occasions the ribs, iliac crest and tibia. Bone grafts taken from the calvaria have been used by some surgeons in the past but its wide acceptance was only achieved after Paul Tessier had reported his own experience. The calvaria is composed of inner and outer tables that encloses a layer of cancellous bone called the diploe. A high degree of variability exist with respect to skull thickness. Nevertheless parietal bones is the preferable site for the harvesting of the graft. The embryonic origin of the cranium should be responsible for greater survival of the graft. Membranous bone would maintain its volume to a greater extent than endochondral bone when autografted in the cranio-facial region. However this remains controversial. Two techniques can be used for the harvesting of a calvarial bone grafts. A split thickness calvarial graft involves removal of the outer table while leaving the inner layer in place. Its main disadvantage is the relatively thinness of the bone transferred. A full thickness segment of skull involves the cranium cavity be entered. A half of the graft can be split along the diploe space and returned to fill the donor site. The other half is used for reconstruction. It is a more complicated procedure. Cranial grafts have been used in the following cases. Correction of contour defect of the forehead and zygomatic bones, orbital floor reconstruction, restoration of the nasal bridge, bone grafting of the maxilla and mandibule. The advantages are the following: the donor and recipient sites are in adjacent surgical fields, the donor site scar is hidden in the scalp, morbidity associated with removing the graft is almost inexistent. (ABSTRACT TRUNCATED AT 250 WORDS)

Craniosynostoses↗
PubMed1988

[Basal cell epithelioma of the eyelids].

UNLABELLED: The purpose of this study of 36 patients was to assess the oncological, functional and cosmetic results of surgery in the treatment of basal cell carcinoma of the eyelid and to compare them with those obtained with other possible therapeutic methods. MATERIAL AND METHODS: We report a series of 36 cases of histologically proven basal cell carcinoma principally located on the lower eyelid and the inner canthus. 27 p. 100 of the patients had previously been treated and presented with a recurrent tumour. Mean age was 61 years. Minimum follow-up was 5 years. Reinforced and potentiated local anaesthesia was given in most cases. Tumoral excision was complete in 31 patients, insufficient or borderline in 5 patients. Intraoperative extemporaneous biopsy was performed in 8 p. 100 of the cases. Repair was carried out by direct suture or by grafting, the flap being simple or combined with a mucosal or chondromucosal graft. The lacrymal passages were destroyed in 5 cases and were not reconstructed in 4 of them. There was no postsurgical therapy. RESULTS: As regards the malignancy itself, the recurrence rate was 6 p. 100 and affected patients who had previously been treated. The cure rate was 100 p. 100 in patients for whom surgery was the first treatment, and 94 p. 100 in the totality of patients. Functionally, there was one case of ectropion, and epiphora developed in 7.4 p. 100 of the cases. In this series epiphora was associated with destruction of the lacrymal passages in only one patient. Satisfactory cosmetic results were obtained in 85 p. 100 of the cases, bearing in mind that the assessment was necessarily subjective. DISCUSSION: Treatments of basal cell carcinoma are numerous. We shall analyze their results, advantages and drawbacks compared with those of surgery. Cryotherapy raises technical problems of execution which are responsible for an excessively high recurrence rate. Chemotherapy has recently been enriched with the introduction of Solcoderm, but the follow-up is still too short. Electrocoagulation gives good oncological results, but it can only be used for small lesions. Radiotherapy (contact, penetrating or semi-penetrating X-ray therapy, electron therapy) has a cure rate of 95 p. 100 and gives acceptable cosmetic results. However, it requires numerous sessions, cannot be repeated if it fails and complicates surgical treatment; in the long term, it carries a risk of radiodystrophy. Its functional and ocular complications have been estimated at 9 p. 100. Epiphora is present in 2 to 19 p. 100 of the cases.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1986

[Erdheim-Chester disease. The multiviceral form presenting as exophthalmos].

Erdheim-Chester disease is a rare visceral xantho-granulomatosis, the 17th case of which is reported here. The initial symptom, bilateral exophthalmos, was uncommon. The picture was completed by a retroperitoneal xanthogranuloma and by bilateral and symmetrical osteosclerosis of the long bones. The lack of X-bodies at electron microscopy differentiated the disease from Hand-Schüller-Christian disease. The patient's condition improved with chemotherapy (vinblastine and doxorubicin) combined with corticosteroid therapy. After a 5-month remission period, he died of an intercurrent infection. No autopsy was performed.

Diagnosis, Differential↗