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Biomedical subjects

A Pech

Publications and source records attributed to A Pech.

At least 73 records · Page 4Linked to original sources
PubMed1984

[Translabyrinthine approach in the surgery of acoustic neurinoma. How to shorten the operative time].

A procedure was sought for shortening duration of operation through an enlarged translabyrinthine (ETL) approach in acoustic neurinoma surgery. Two factors appear to be of primary importance. First, the equipment used must be adapted for the purpose and of reliable quality: the 3 M craniotome for the extralabyrinthine phase, the Zimmer AMSCO ototome for the labyrinthine phase, and Yasargil's autostatic retractor to maintain retraction of the temporal lobe and lateral sinuses. Second, a precise operative methodology: wide exposure and retraction of the temporal lobe and lateral sinus in all cases to provide a panoramic view of the labyrinthine region; ablation of the incus and initiation of a posterior tympanotomy to assist dissection to expose the 2nd and 3rd portions of the facial nerve; labyrinthectomy and identification of the internal auditory canal (IAC) in the region of the small fossa of the hemisphere as an aid to continuation of the operation; identification of Limaçon's aqueduct, which is a barrier that must not be crossed when exposing the jugular bulb and mixed nerve regions; isolation of the facial nerve in the base of the IAC by reclining the superior restibular nerve, the facial nerve lying just behind the latter.

Ear, Inner↗
PubMed1984

[Value of thallium scintigraphy in thyroid pathology].

The value of thallium 201 (Tl 201) scintigraphy was investigated in 45 patients with thyroid affections. Scintigrams were performed with both technetium 99 m (Tc 99 m) and Tl 201. Of the 27 patients with 43 thyroid nodules confirmed histologically (16 patients were operated upon and needle puncture cytology conducted in 11 cases), all cold nodules to Tc 99 m and Tl 201 were found to be benign. Of the 28 hot nodules to Tl 201, cancer was demonstrated in 8 cases, equivalent to 72 p. 100 of false positives against the 47 p. 100 of all cases reported in the literature. In benign affections, thyroid topography to Tl 201 can now be obtained in patients with plummer's toxic nodules without the need for Quérido's test and without iodine saturation of the thyroid. Gonadal toxicity of Tl 201 prevents its routine use in patients under 35, who were excluded from this study.

Humans↗
PubMed1984

[Early diagnosis of acoustic neurinoma. Tumors less than 2 centimeters].

Computerized gas meatography ( CGM ) represents the must reliable method for detection of stages I and II of acoustic neurinomas. A critical study of its indications was conducted based of results in a series of 14 tumors of less than 2 cm diameter and of 43 CGM . Although early auditory evoked potentials are currently the most significant selection criteria, procedures for detecting retrocochlear lesions remain unchanged, particularly for the ENT specialist.

Deafness↗
PubMed1983

[Lateral cervical chemodectoma].

Diagnostic and surgical features of lateral cervical chemodectomas are discussed in relation to a personal series of 13 patients with carotid body tumors and 7 with tumors of the intravagal glomus. Clinically, these affections are poor in symptomatology, those of the carotid glomus presenting as an isolated cervical tumor, intravagal glomus tumors as parapharyngeal masses of the retrostyloid type. Arteriographic findings are discussed in detail, as they constitute the only pathognomonic signs, enable differentiation between the two tumor sites, and supply essential pre-operative data: location of the pedicles, possible invasion of arterial walls, and the limits of the tumor. Surgical approach should be wide to enable control of the distal end of the internal carotid artery, if necessary under the base of the cranium, excision of the tumor usually being possible by employing the subadventitial resection technique.

Adult↗
PubMed1982

[Results of rhinoplasties. A computer study of 351 medical records].

The authors studied the cosmetic results of 1380 rhinoplasties carried out over a period of 10 years by two surgeons, Professor A. Pech and Professor M. Cannoni. They used a classical reduction rhinoplasty technique. Different procedures were used for the tip of the nose depending on the individual indications, and the development of ideas over a period of time. Only 351 files, complete with pre- and post-operative photographs have been selected. The photographs have been analyzed on the basis of 70 criteria by an independent, young female ENT specialist, and the results of her analysis were fed to the computer. The study provides three types of answer. Firstly, the results were good in 69% of cases, and the greater the experience of the surgeon, the greater the success. Secondly, the different techniques for correcting the tip of the nose are analysed with good scores for Cinelli's technique (69%). The tip modeling procedures of Converse and of Lipsett have been abandoned owing to the high frequency of round tips. Finally, the different types of anomalies encountered are listed: 42% round tips, 20% asymmetrical tips, 17% residual humps, 11% of wide nasal bones, hooked noses and postoperative deviations. The authors then comment on the results, focusing on following points: the frequency of incomplete files (70%); the general improvement in the results with the gaining of experience, the decline in the proportion of hooked noses, also in line with experience, from 24% in the first 5 years to 7% after 10 years; the development of ideas concerning the techniques to be used in correcting the tip of the nose with an evergrowing place for those sacrificing the dome of the alar cartilages, such as the "Hockey stick" and a personal procedure derived from Pollot; wide nasal bones and failures in the tracing of the naso-frontal angle (64%) for which no solution is suggested; and, finally, postoperative nasal deviations. Since undertaking this study, the authors have successfully avoided this defect by using the external approach.

Computers↗