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Biomedical subjects

C Peytral

Publications and source records attributed to C Peytral.

At least 37 records · Page 2Linked to original sources
PubMed1988

[Postoperative iatrogenic lesions of the external branch of the accessory spinal nerve].

Iatrogenic lesions of the spinal nerve are rare and generally occur during cervicotomy for aetiological assessment of adenopathy. The spinal nerve is essentially damaged at two sites: the supraclavicular fossa (where the nerve is very superficial) and in the antero-lateral triangle of the neck (where the nerve approaches the sterno-cleido-mastoid muscle). The lesion of the spinal nerve essentially presents in the form of paralysis of the trapezius; which should be examined systematically postoperatively and at subsequent consultations, as the clinical signs may only develop after a certain latency period. The spinal nerve lesion requires early surgical repair (graft, suture) which gives the best results when it is associated with long-term, patient physiotherapy. Legally, the practitioner is generally condemned due to failure to obtain informed consent, which emphasises the importance of preoperative consultations during which the patients should be warned of the possibility of a lesion to this nerve.

Accessory Nerve↗
PubMed1988

[Drug ototoxicity. Medicolegal aspects].

Drug ototoxicity is a preoccupying iatrogenic complication. Experimental studies over recent years, in particular a pharmacokinetic study of the elimination of aminoglycosides, have enabled the authors to define rules of prescription for parenteral aminoglycosides designed to reduce to a minimum the risk associated with their use. New aminoglycosides such as Netromycin appear to be associated with reduced toxicity. The medico-legal consequences of this complication are still rare, although more precise rules of prescription tend to make the experts more rigorous. The experimental evidence of cochleovestibular toxicity of aminoglycosides applied locally in the presence of a perforated tympanum leaves no room for doubt. The principal factor seems to be the duration of treatment. The prescription of a local aminoglycoside in the presence of a perforated tympanum would only appear to be justified from a legal point of view when absolutely indicated by antibiotic sensitivity tests.

Aged↗
PubMed1988

[Iatrogenic complications of nasal sinuses surgery].

In order to illustrate the necessity of obtaining informed consent before any form of nasal sinus surgery, the authors present 23 cases of insurance claims filed between 1976 and 1986 in private practice. Ten serious complications (6 cases of blindness, 4 fractures of the anterior cranial (fossa) and eight cases of oculomotor nerve paralysis are reported. The legal proceedings demonstrate the real risks of radical surgery to the sinuses, as well as intranasal ethmoidectomy and rhinoplasties.

Blindness↗
PubMed1988

[Severe iatrogenic complications of surgery of the middle ear and their medicolegal aspects].

The authors analysed 62 cases of severe iatrogenic complications occurring after middle ear surgery (death, cophosis, PFP) between 1976 and 1986. They compared their results to those of a similar study conducted between 1950 and 1975. They observed an increase in the number of legal proceedings, probably due more to the increased demand by patients than to a higher incidence of these complications. Civil proceedings are much more frequent than penal proceedings. The authors stress the importance attributed by judges to the expert report and to the obtaining of informed consent.

Deafness↗
PubMed1988

[Severe complications of tonsillectomy].

The authors report 15 fatal complications after tonsillectomy based on the claims made between 1976 and 1986 to three insurance companies specialised in medical defence. The advantages and disadvantages of tonsillectomy with intubation and with the Sluder apparatus are recalled. Analysis of the legal proceedings of these cases reveals the principal points of jurisprudence: the importance of the preoperative assessment, pre-anaesthetic examination and informed consent. The concept of shared responsibility means that the surgeon must ensure the quality of the technical equipment of the establishment in which the operation is performed and the quality of the postoperative care.

Adolescent↗
PubMed1988

[Medicolegal aspects of esthetic surgery].

The particular features of the contractual agreement binding patient and plastic surgeon are recalled. The obligation of the result appears to be distorted in the course of jurisprudence. The severity of the judgements means that great care must be taken in the management before, during and after the operation (study of the patient's motivations, informed consent, iconographic survey, technical equipment, postoperative care,...). The problem of competence and the technical training of the surgeon are also discussed.

Ear, External↗
PubMed1985

[Effect of alpha-leukocyte interferon on laryngeal papillomatosis in children].

In 16 cases of severe juvenile laryngeal papillomatosis, alpha-leucocyte interferon was injected intramuscularly in doses of 150 000 units/kg three times a week for 6 months. Follow-up endoscopy was performed monthly to evaluate the course of the disease and to destroy all accessible papillomas by electrocoagulation, laser or forceps. Plasma interferon levels were measured monthly by the biological method in 9 of the 16 children. Recurrence of the papillomas was prevented in 11/16 cases during treatment with interferon. The effectiveness of this treatment seemed to be associated with high plasma interferon levels. The drug was perfectly tolerated in 15/16 patients. These results suggest that children with laryngeal papillomatosis would benefit from a further trial with modified and reinforced dosage.

Adolescent↗
PubMed1984

[Evaluation of 6 years of CO2 laser microsurgery in laryngology].

Laryngeal microsurgery has been performed using a CO2 laser since 1978. It is essential to conduct a strict phoniatric pre-operative examination and to ensure correct anesthesia. Results after 735 operations underline the advantages of this technique for the treatment of benign laryngeal lesions (diffuse papillomatosis, sessile polyps, granuloma), in phonosurgery (nodules, bundle edema, corditis) and in the repermeabilization of the laryngeal network (paralysis, stenosis, laryngeal edema).

Carbon Dioxide↗
PubMed1984

[Repermeabilization of the laryngeal pathway using the laser].

Based on results in 48 cases, the principal indications and the place of laser in the repermeabilization of the glottic tract are discussed. Results on the cord adhesions were fair, whereas they were more constant with respect to regain of function in stenosis, paralysis and laryngeal edema. Laser can be used as single therapy by the endoscopic route for ankylosis or diplegia of the larynx, but should also act as a complement to a surgical or radiotherapeutic action.

Humans↗
PubMed1983

[Multiple myeloma manifested by plasmocytic laryngeal localization].

Multiple myelomas are very rarely accompanied by extramedullary collections of plasma cells. The authors report the exceptional case of a multiple myeloma which was revealed by a sub-glottal localization of plasma cells. This case illustrates the difficulties of interpretation of histological examinations and the value of tissue immuno-fluorescence for confirmation of the diagnosis.

Female↗