Search PubMedSearch

Biomedical subjects

C Junien-Lavillauroy

Publications and source records attributed to C Junien-Lavillauroy.

At least 19 recordsLinked to original sources

[Cervical branchiomeric paraganglioma. Report of 21 cases].

Over the last 24 years the authors operated 21 branchiomeric paragangliomas in 18 patients. They emphasize the difficulty of making the diagnosis and the importance of completing a thorough work-up before deciding surgery. Adequate imaging is particularly important (neck sonography, computed tomography, arteriography) to avoid making the diagnosis by exploratory neck dissection and to assess the vascular risk. Biological studies have regained importance, especially in the context of complex neuro-cristopathy. Treatment is essentially surgical and must be considered with prudence in patients with bilateral lesions. The surgical removal of branchiomeric paragangliomas necessitates preparation of a small saphenous vein bypass in case it is not possible to avoid sacrificing the internal carotid artery.

Adult

[Malignant cervical epithelial adenopathy from unknown primary source. Apropos of a series of 54 cases].

Fifty four patients with cervical lymph node metastasis from an unknown primary tumor underwent treatment from 1969 to 1988. Fourty five underwent radical neck dissection. 69% had node capsular effraction and 36% perinodal vascular embolism. Thirty four patients underwent postoperative radiotherapy including rhinopharynx, cervical oesophagus and all the bilateral cervical nodes. The primary tumor appeared after treatment in 7 cases. Total survival rate is 36% 5 years after treatment. Vascular embolism aggravates the prognosis. Radiosurgical association allow effective control of loco-regional cancer but does not improve survival rate. Prognosis is aggravated by metastases arising (18%).

Adult

[Selective laryngeal re-innervations in the dog by nervous microsutures of branches of the recurrent laryngeal nerve].

INTRODUCTION: This work has been carried out to investigate in an animal model, the possibility of surgical selective reinnervation of the larynx following destruction of the laryngeal branch of the vagus nerve. MATERIAL AND METHODS: In ten dogs, on the right side of the neck only, the recurrent laryngeal nerve was identified, cut and section of the nerve removed. Following this the hemi-larynx on the operated side was reinnervated in the following manner. Using a microsurgical suture (described in the text) the motor nerves from extra-laryngeal muscles were anastomosed onto the nerves supplying the intrinsic abductors and adductors of the larynx. The nerve to sterno-thyroid was anastomosed onto the nerve supplying the posterior crico-arytenoid muscle (vocal cord abductor). Similarly the nerve supplying thyrohyoid was anastomosed onto the cut distal end of the adductor division of the recurrent laryngeal nerve. Clinical, electromyographical and histological evaluations have been used to prove the reinnervation. RESULTS: In the nine surviving animals successful re-innervations, as defined by the return of normal function, has been achieved for posterior crico-arytenoid and 7 adductor muscles. CONCLUSION: This study has demonstrated the feasibility of laryngeal reinnervation after surgical section of the recurrent laryngeal nerve, and give some cause for optimism for its ultimate application in man.

Anastomosis, Surgical

[Tracheo-bronchial granular cell tumors. Apropos of 4 cases].

We have seen four cases of granular cell tumor (Abrikossoff's tumour) and it is recalled that these tumours are most often discovered fortuitously by bronchoscopy in the tracheo-bronchial region because they have a non specific clinical presentation. The cytological and histological characteristics enable an accurate diagnosis but there are problems posed as to the histogenesis of these tumours. With a tumour with a slow progression regular surveillance with regular biopsies seems preferable as in certain cases the tumour regresses spontaneously or disappears after ablation with the forceps. A good alternative approach is destruction of the tumours with a laser in certain complicated forms which enables one to avoid surgical excision.

Adolescent

[Cancers of the supraglottic larynx: results and therapeutic indications apropos of 124 cases].

The authors report their experience of the treatment of the supraglottic laryngeal carcinoma in a retrospective study of 124 patients primarily treated in the ENT department of Grenoble University hospital. Fourteen patients received only radiotherapy, the others 110 patients were treated by surgery: partial or reconstructive surgery in 47 cases, total surgery in 63 cases. The carcinological results demonstrate the good prognosis of the intra-laryngeal tumors. Their treatment allows a good loco-regional control (tumoral recurrences: 4%, regional recurrences: 2%). The main prognostic factor is the nodal involvement with capsular rupture which is responsible for the most locoregional and metastatic recurrences.

Adult

[Primary and recovery transmaxillar buccopharyngectomy in buccopharyngeal cancers].

From january 1976 to december 1986, 78 patients were treated surgically for squamous cell carcinoma of the lateral buccopharyngeal junction without chemotherapy at first. 36 patients were treated by primary surgery with post-operative radiotherapy and 31 patients were treated by recovery surgery. Post-operative course was uncomplicated in 41% of cases (39% in primary surgery, 43% in recovery surgery); in 14% of cases serious local complications were observed (11% in primary surgery, 17% in recovery surgery). Carcinological failures appeared in 46% of cases in primary surgery and in 70% of cases in recovery surgery. Three years and five years actuarial survival rate were 45% and 39% respectively in recovery surgery. Prognostic factors are studied: resection quality, histological metastasis in lymph nodes. The authors emphasize on the best control of the big tumors in primary surgery and on the best results with small ulcerated infiltrant carcinoma.

Adult

Anatomical intra-laryngeal anterior branch study of the recurrent (inferior) laryngeal nerve.

The studies are based upon 60 dissections of the recurrent laryngeal n. (inferior laryngeal n.). The authors describe in detail the branches destined for the intrinsic musculature of the larynx. This study is a working approach for interventions of selective laryngeal reinnervation in man. The conclusion is that, it is necessary to resect the inferior cornu of the thyroid cartilage, to reach the abductor and adductor branches of the vocal cord.

Female

Chemotherapy with low doses of radiation followed by definitive radiotherapy for advanced unresectable carcinoma of the head and neck.

Thirty-six patients with advanced unresectable carcinoma of the head and neck were treated with a combination of three courses of chemotherapy and low doses of radiation, followed after 3 weeks by definitive irradiation. Each course was repeated every 3 weeks with the following sequence. Cisplatin (20 mg/m2) was given in a 20-minute infusion, followed by a 2-hour infusion of 5-fluorouracil (400mg/m2), on days 1,2,5, and 6. Low doses of radiation were given on days 3 and 4, followed by a 2-hour infusion of 5-fluorouracil (400 mg/m2) with a dose of 3 Gy on the target volume. For definitive irradiation, a total dose of 60 Gy was delivered in 30 fractions within 6 weeks. The complete response rate reached 30%, and the partial response rate was 30%. With a median follow-up of 11 months, median overall survival was 10 months; median survival was 21 months for patients with complete response, 9 months for patients with partial response, and 6 months for those with no response (P=.02).

Adult

[Retrospective study of the treatment of piriform sinus cancers. Apropos of 97 cases].

Results of a retrospective analysis of case-reports of 97 patients treated for piriform sinus cancer showed a high frequency of large tumors and adenopathies providing an explanation for the very poor prognosis of these cancers. Therapy of choice for T1-T2 tumors is still radiotherapy. However, recently obtained results and data from the literature demonstrate the increased benefits of partial surgery with monoblock curettage followed by radiotherapy in cases with an ulcerous tumor, a mobile larynx and adenopathy of 3 cm or more. For T3-T4 cases the best treatment is by total pharyngolaryngectomy and postoperative radiotherapy.

Adult

[Value of the pectoralis major musculocutaneous flap in the repair of the posterior wall of the pharynx and the lateral wall of the hypopharynx].

Two further indications for the use of a musculocutaneous flap from pectoralis major are reported: mucosal reconstruction after posterior pharyngectomy and vertical hemi-laryngopharyngectomy. This method was used in 7 cases, after previous surgery in 6 of these patients. Caution is necessary when interpreting carcinologic results because of the lack of long-term follow up results, but postoperative course was uncomplicated and tube removal and subnormal feeding was possible within 3 to 6 weeks.

Aged